WorldWideScience

Sample records for birth plan intervention

  1. 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....

  2. Planned place of birth

    DEFF Research Database (Denmark)

    Overgaard, Charlotte; Coxon, Kirstie; Stewart, Mary

    in Denmark Coxon K et al: Planned place of birth in England: perceptions of accessing obstetric units, midwife led units and home birth amongst women and their partners. How these papers interrelate These papers draw upon recent research in maternity care, undertaken in Denmark and in England. In both......Title Planned place of birth: issues of choice, access and equity. Outline In Northern European countries, giving birth is generally safe for healthy women with uncomplicated pregnancies, and their babies. However, place of birth can affect women’s outcomes and experiences of birth. Whilst tertiary...... centres provide appropriate medical supervision to women with complex pregnancies, the likelihood of receiving interventions including surgical birth is increased for low risk women in these settings. In this symposium, we consider issues of choice, access and equitable care for women in the context...

  3. Birth Plans

    Science.gov (United States)

    ... licensed to handle low-risk births and whose philosophy emphasizes educating expectant parents about the natural aspects ... Partner Message About Us Contact Us Partners Editorial Policy Permissions Guidelines Privacy Policy & Terms of Use Notice ...

  4. Evolution of the Birth Plan

    OpenAIRE

    Kaufman, Tamara

    2007-01-01

    Many birth professionals are discarding the birth plan as an outdated and ineffectual document. This column discusses the past limitations and present uses of the birth plan in an effort to enhance current teaching on how expectant parents can write and use this important document. Encouraging expectant parents to prepare two separate, but corresponding, birth plans—the “Discussion Birth Plan” and the “Hospital Birth Plan”—is proposed. Teaching suggestions and possible implications are explor...

  5. High ANC coverage and low skilled attendance in a rural Tanzanian district: a case for implementing a birth plan intervention.

    Science.gov (United States)

    Magoma, Moke; Requejo, Jennifer; Campbell, Oona M R; Cousens, Simon; Filippi, Veronique

    2010-03-19

    In Tanzania, more than 90% of all pregnant women attend antenatal care at least once and approximately 62% four times or more, yet less than five in ten receive skilled delivery care at available health units. We conducted a qualitative study in Ngorongoro district, Northern Tanzania, in order to gain an understanding of the health systems and socio-cultural factors underlying this divergent pattern of high use of antenatal services and low use of skilled delivery care. Specifically, the study examined beliefs and behaviors related to antenatal, labor, delivery and postnatal care among the Maasai and Watemi ethnic groups. The perspectives of health care providers and traditional birth attendants on childbirth and the factors determining where women deliver were also investigated. Twelve key informant interviews and fifteen focus group discussions were held with Maasai and Watemi women, traditional birth attendants, health care providers, and community members. Principles of the grounded theory approach were used to elicit and assess the various perspectives of each group of participants interviewed. The Maasai and Watemi women's preferences for a home birth and lack of planning for delivery are reinforced by the failure of health care providers to consistently communicate the importance of skilled delivery and immediate post-partum care for all women during routine antenatal visits. Husbands typically serve as gatekeepers of women's reproductive health in the two groups - including decisions about where they will deliver- yet they are rarely encouraged to attend antenatal sessions. While husbands are encouraged to participate in programs to prevent maternal-to-child transmission of HIV, messages about the importance of skilled delivery care for all women are not given emphasis. Increasing coverage of skilled delivery care and achieving the full implementation of Tanzania's Focused Antenatal Care Package in Ngorongoro depends upon improved training and monitoring of

  6. High ANC coverage and low skilled attendance in a rural Tanzanian district: a case for implementing a birth plan intervention

    Directory of Open Access Journals (Sweden)

    Cousens Simon

    2010-03-01

    Full Text Available Abstract Background In Tanzania, more than 90% of all pregnant women attend antenatal care at least once and approximately 62% four times or more, yet less than five in ten receive skilled delivery care at available health units. We conducted a qualitative study in Ngorongoro district, Northern Tanzania, in order to gain an understanding of the health systems and socio-cultural factors underlying this divergent pattern of high use of antenatal services and low use of skilled delivery care. Specifically, the study examined beliefs and behaviors related to antenatal, labor, delivery and postnatal care among the Maasai and Watemi ethnic groups. The perspectives of health care providers and traditional birth attendants on childbirth and the factors determining where women deliver were also investigated. Methods Twelve key informant interviews and fifteen focus group discussions were held with Maasai and Watemi women, traditional birth attendants, health care providers, and community members. Principles of the grounded theory approach were used to elicit and assess the various perspectives of each group of participants interviewed. Results The Maasai and Watemi women's preferences for a home birth and lack of planning for delivery are reinforced by the failure of health care providers to consistently communicate the importance of skilled delivery and immediate post-partum care for all women during routine antenatal visits. Husbands typically serve as gatekeepers of women's reproductive health in the two groups - including decisions about where they will deliver- yet they are rarely encouraged to attend antenatal sessions. While husbands are encouraged to participate in programs to prevent maternal-to-child transmission of HIV, messages about the importance of skilled delivery care for all women are not given emphasis. Conclusions Increasing coverage of skilled delivery care and achieving the full implementation of Tanzania's Focused Antenatal Care

  7. Planned Out-of-Hospital Birth and Birth Outcomes

    Science.gov (United States)

    Snowden, Jonathan M.; Tilden, Ellen L.; Snyder, Janice; Quigley, Brian; Caughey, Aaron B.; Cheng, Yvonne W.

    2016-01-01

    Background The frequency of planned out-of-hospital birth in the United States has increased in recent years. The value of studies assessing the perinatal risks of planned out-of-hospital birth versus hospital birth has been limited by cases in which transfer to a hospital is required and a birth that was initially planned as an out-of-hospital birth is misclassified as a hospital birth. Methods We performed a population-based, retrospective cohort study of all births that occurred in Oregon during 2012 and 2013 using data from newly revised Oregon birth certificates that allowed for the disaggregation of hospital births into the categories of planned in-hospital births and planned out-of-hospital births that took place in the hospital after a woman’s intrapartum transfer to the hospital. We assessed perinatal morbidity and mortality, maternal morbidity, and obstetrical procedures according to the planned birth setting (out of hospital vs. hospital). Results Planned out-of-hospital birth was associated with a higher rate of perinatal death than was planned in-hospital birth (3.9 vs. 1.8 deaths per 1000 deliveries, P = 0.003; odds ratio after adjustment for maternal characteristics and medical conditions, 2.43; 95% confidence interval [CI], 1.37 to 4.30; adjusted risk difference, 1.52 deaths per 1000 births; 95% CI, 0.51 to 2.54). The odds for neonatal seizure were higher and the odds for admission to a neonatal intensive care unit lower with planned out-of-hospital births than with planned in-hospital birth. Planned out-of-hospital birth was also strongly associated with unassisted vaginal delivery (93.8%, vs. 71.9% with planned in-hospital births; P<0.001) and with decreased odds for obstetrical procedures. Conclusions Perinatal mortality was higher with planned out-of-hospital birth than with planned in-hospital birth, but the absolute risk of death was low in both settings. (Funded by the Eunice Kennedy Shriver National Institute of Child Health and Human

  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 delivery [37-40 and ≥41 weeks]). The overall risk of neonatal death was significantly higher in planned 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

  9. Birth and Emergency Planning: A Cross Sectional Survey of ...

    African Journals Online (AJOL)

    Accompaniment by a birth companion and saving money were considered the most useful planning steps. Knowledge of danger signs was associated with birth and emergency planning, and birth and emergency planning was associated with reported birth outcome. Birth and emergency planning as a critical component of ...

  10. What to include in your birth plan

    Science.gov (United States)

    ... also find sample birth plans and templates in books and websites for pregnant moms. Even if you ... Hawkins JL, Bucklin BA. Obstetrical anesthesia. In: Gabbe SG, Niebyl ... Pregnancies. 6th ed. Philadelphia, PA: Elsevier Saunders; ...

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

    NARCIS (Netherlands)

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

    2017-01-01

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

  12. 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

  13. 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

  14. Transfer to hospital in planned home births

    DEFF Research Database (Denmark)

    Blix, Ellen; Kumle, Merethe; Kjærgaard, Hanne

    2014-01-01

    BACKGROUND: There is concern about the safety of homebirths, especially in women transferred to hospital during or after labour. The scope of transfer in planned home births has not been assessed in a systematic review. This review aimed to describe the proportions and indications for transfer from...... home to hospital during or after labour in planned home births. METHODS: The databases Pubmed, Embase, Cinahl, Svemed+, and the Cochrane Library were searched using the MeSH term "home childbirth". Inclusion criteria were as follows: the study population was women who chose planned home birth...... at the onset of labour; the studies were from Western countries; the birth attendant was an authorised midwife or medical doctor; the studies were published in 1985 or later, with data not older than from 1980; and data on transfer from home to hospital were described. Of the 3366 titles identified, 83 full...

  15. 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

  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.; 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

  17. Age, relationship status, and the planning status of births

    Directory of Open Access Journals (Sweden)

    Sarah Hayford

    2010-08-01

    Full Text Available In the United States historically, births to older mothers have been more likely to be planned than births to younger mothers, and births to unmarried women have been less likely to be planned than births to married women. As the average age of mothers has increased and more births have occurred outside of marriage in the United States, the intersection of these trends may have weakened the traditional linkage between age and birth planning status. In this article, we examine differences by maternal age in planning status of births using The 2002 National Survey of Family Growth. We find that age is strongly associated with planning status, but the association is reduced in magnitude when controlling for relationship status and is stronger for first and second births than for higher-parity births. Further, the association between union status and the planning status of births varies by race-ethnicity.

  18. Family planning and birth control counseling.

    Science.gov (United States)

    Dawrant, A G

    1977-06-18

    The following item appeared recently in our local newspaper: "The Federal Government plans to press the provinces to establish special abortion clinics that would also provide family planning services, Health Minister Marc Lalonde announced. The proposed clinics would combine abortion services with family planning and birth control counseling, cancer screening and other services related to the health of mothers, he said." It seems that the federal government is attempting to cover the bitter pill of a therapeutic abortion clinic with the sugar coating of family planning and contraceptive counseling. Family planning and contraceptive counseling is an important part of the day-to-day work of the great majority of family physicians and gynecologists, and I urge all physicians who are opposed to Mr. Lalonde's proposal to contact their Members of Parliament and their representatives in the provincial legislatures. Let us urge the Canadian Medical Association to make it clear that the appropriate setting for contraceptive counseling and related services should be the office of the family physician or gynecologist. The time has come for the association to take a more aggressive approach in the field of family planning and birth control counseling and, at the same time, actively discourage government involvement in this important area of preventive medicine. Further, let us make it clear that the whole question of therapeutic abortions and abortion clinics is to be regarded as distinct from family planning and contraceptive counseling.

  19. Confronting Rhetorical Disability: A Critical Analysis of Women's Birth Plans

    Science.gov (United States)

    Owens, Kim Hensley

    2009-01-01

    Through its analysis of birth plans, documents some women create to guide their birth attendants' actions during hospital births, this article reveals the rhetorical complexity of childbirth and analyzes women's attempts to harness birth plans as tools of resistance and self-education. Asserting that technologies can both silence and give voice,…

  20. 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.

  1. Maternal factors and the probability of a planned home birth

    NARCIS (Netherlands)

    Anthony, S.; Buitendijk, S.E.; Offerhaus, P.M.; Dommelen, P. van; Pal-de Bruin, K.M. van der

    2005-01-01

    Objectives: In the Netherlands, approximately one-third of births are planned home births, mostly supervised by a midwife. The relationship between maternal demographic factors and home births supervised by midwives was examined. Design: Cross-sectional study. Setting: Dutch national perinatal

  2. The interventional radiology business plan.

    Science.gov (United States)

    Beheshti, Michael V; Meek, Mary E; Kaufman, John A

    2012-09-01

    Strategic planning and business planning are processes commonly employed by organizations that exist in competitive environments. Although it is difficult to prove a causal relationship between formal strategic/business planning and positive organizational performance, there is broad agreement that formal strategic and business plans are components of successful organizations. The various elements of strategic plans and business plans are not common in the vernacular of practicing physicians. As health care becomes more competitive, familiarity with these tools may grow in importance. Herein we provide an overview of formal strategic and business planning, and offer a roadmap for an interventional radiology-specific plan that may be useful for organizations confronting competitive and financial threats. Copyright © 2012 SIR. Published by Elsevier Inc. All rights reserved.

  3. Differences in optimality index between planned place of birth in a birth centre and alternative planned places of birth, a nationwide prospective cohort study in The Netherlands: results of the Dutch Birth Centre Study

    NARCIS (Netherlands)

    Hermus, M.A.A.; Hitzert, M.; Boesveld, I.I.; Akker-van Marle, E.M. van den; Dommelen, P. van; Franx, A.; Graaf, J.P. de; Lith, J.M.M. van; Steegers, E.E.; Wiegers, T.A.; Pal-de Bruin, K.K. van der

    2017-01-01

    Objectives To compare the Optimality Index of planned birth in a birth centre with planned birth in a hospital and planned home birth for low-risk term pregnant women who start labour under the responsibility of a community midwife. Design Prospective cohort study. Setting Low-risk pregnant women

  4. Ethics and professional responsibility: Essential dimensions of planned home birth.

    Science.gov (United States)

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

    2016-06-01

    Planned home birth is a paradigmatic case study of the importance of ethics and professionalism in contemporary perinatology. In this article we provide a summary of recent analyses of the Centers for Disease Control database on attendants and birth outcomes in the United States. This summary documents the increased risks of neonatal mortality and morbidity of planned home birth as well as bias in Apgar scoring. We then describe the professional responsibility model of obstetric ethics, which is based on the professional medical ethics of two major figures in the history of medical ethics, Drs. John Gregory of Scotland and Thomas Percival of England. This model emphasizes the identification and careful balancing of the perinatologist's ethical obligations to pregnant, fetal, and neonatal patients. This model stands in sharp contrast to one-dimensional maternal-rights-based reductionist model of obstetric ethics, which is based solely on the pregnant woman's rights. We then identify the implications of the professional responsibility model for the perinatologist's role in directive counseling of women who express an interest in or ask about planned home birth. Perinatologists should explain the evidence of the increased, preventable perinatal risks of planned home birth, recommend against it, and recommend planned hospital birth. Perinatologists have the professional responsibility to create and sustain a strong culture of safety committed to a home-birth-like experience in the hospital. By routinely fulfilling these professional responsibilities perinatologists can help to prevent the documented, increased risks planned home birth. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. [Outcomes of Planned Out-of-Hospital and Low-Risk Hospital Births in Lower Saxony].

    Science.gov (United States)

    Petersen, Antje; Köhler, Lea-Marie; Schwarz, Christiane; Vaske, Bernhard; Gross, Mechthild M

    2017-08-01

    Introduction Internationally, there is debate on the safety of different birth settings inside and outside of hospitals. Low-risk women in Germany can choose where they give birth, and out-of-hospital births are especially necessary in regions lacking infrastructure. To date, national studies are required. Materials and Methods We investigated planned out-of-hospital (OH) and hospital births in Lower Saxony, Germany, in 2005. Women with a singleton fetus in the vertex position were included once they reached 34+0 gestational weeks. 1 273 out of 4 424 births were included via risk assessment. Outcomes were compared using Pearson's chi-squared test, the Mann-Whitney test, and logistic regression. Results 152 (36.6%) nulliparae (NP) and 263 (63.4%) multiparae (MP) gave birth out of hospital, 439 (51.2%) nulliparae and 419 (48.8%) multiparae in a hospital. 10.1% of women whose care started outside of the hospital needed a transfer to the hospital. Women who planned OH were older and had a higher level of education. Women without a migration background displayed an increased rate of out-of-hospital birth. A higher proportion received their antenatal care from midwives rather than medical doctors. Induction of labor was less likely for women with planned out-of-hospital births, as were other intrapartum interventions. In hospital births, fetal monitoring was more likely performed via cardiotocograph instead of intermittent auscultation. Duration of labor was significantly longer in OH births (median: NP: 9.01 h vs. 7.38 h; MP: 4.53 h vs. 4.25 h). Nulliparae had more spontaneous births out-of-hospital (94.7%) than in hospital (73.6%). There was no difference in adverse fetal outcomes, blood loss, and severe perineal lacerations. The perineum was less frequently intact in hospital births. Retained placenta was more often documented in out-of-hospital births. Conclusions In an out-of-hospital setting, fewer interventions were performed, spontaneous births

  6. 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.

  7. Prelinguistic Communication Intervention: Birth-to-2.

    Science.gov (United States)

    Stremel-Campbell, Kathleen; Rowland, Charity

    1987-01-01

    Suggestions for narrowing the discrepancy between the knowledge base of early communication development and the implementation of effective communication interventions for severely handicapped infants and young children are offered including strategies for facilitating emerging language development, increasing positive interactions with infants,…

  8. Women's attitudes towards the medicalization of childbirth and their associations with planned and actual modes of birth.

    Science.gov (United States)

    Benyamini, Yael; Molcho, Maya Lila; Dan, Uzi; Gozlan, Miri; Preis, Heidi

    2017-10-01

    Rates of medical interventions in childbirth have greatly increased in the Western world. Women's attitudes affect their birth choices. To assess women's attitudes towards the medicalization of childbirth and their associations with women's background as well as their fear of birth and planned and unplanned modes of birth. This longitudinal observational study included 836 parous woman recruited at women's health centres and natural birth communities in Israel. All women filled in questionnaires about attitudes towards the medicalization of childbirth, fear of birth, and planned birth choices. Women at birth. Attitudes towards medicalization were more positive among younger and less educated women, those who emigrated from the former Soviet Union, and those with a more complicated obstetric background. Baseline attitudes did not differ by parity yet became less positive throughout pregnancy only for primiparae. More positive attitudes were related to greater fear of birth. The attitudes were significantly associated with planned birth choices and predicted emergency caesareans and instrumental births. Women form attitudes towards the medicalization of childbirth which may still be open to change during the first pregnancy. More favourable attitudes are related to more medical modes of birth, planned and unplanned. Understanding women's views of childbirth medicalization may be key to understanding their choices and how they affect labour and birth. Copyright © 2017 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  9. Impact of Birth Preparedness and Complication Readiness Interventions on Birth with a Skilled Attendant : A Systematic Review

    NARCIS (Netherlands)

    Miltenburg, Andrea Solnes; Roggeveen, Yadira; Shields, Laura; van Elteren, Marianne; van Roosmalen, Jos; Stekelenburg, Jelle; Portela, Anayda

    2015-01-01

    Background Increased preparedness for birth and complications is an essential part of antenatal care and has the potential to increase birth with a skilled attendant. We conducted a systematic review of studies to assess the effect of birth preparedness and complication readiness interventions on

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

    Science.gov (United States)

    Shi, Lihong

    2017-12-01

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

  11. ALARA and planning of interventions

    Energy Technology Data Exchange (ETDEWEB)

    Rocaboy, A. [Electricite de France, Avoine (France)

    1995-03-01

    The implementation of ALARA programs implies integration of radiation protection criterion at all stages of outage management. Within the framework of its ALARA policy, Electricide de France (EDF) has given an incentive to all of its nuclear power plants to develop {open_quotes}good practices{close_quotes} in this domain, and to exchange their experience by the way of a national feed back file. Among the developments in the field of outage organization, some plants have focused on the planning stage of activities because of its influence on the radiological conditions of interventions and on the good succession of tasks within the radiological controlled areas. This paper presents the experience of Chinon nuclear power plant. At Chinon, we are pursuing this goal through careful outage planning. We want the ALARA program during outages to be part of the overall maintenance task planning. This planning includes the provision of the availability of every safety-related component, and of the variations of water levels in hthereactor and steam generators to take advantage of the shield created by the water. We have developed a computerized data base with the exact position of all the components in the reactor building in order to avoid unnecessary interactions between different tasks performed in the same room. A common language between Operation and Maintenance had been established over the past years, using {open_quotes}Milestones and Corridors{close_quotes}. A real time dose rate counting system enables the Radiation Protection (RP) Department to do an accurate and efficient follow up during the outage for all the {open_quotes}ALARA{close_quotes} maintenance tasks.

  12. Maternal goals for childbirth associated with planned vaginal and planned cesarean birth.

    Science.gov (United States)

    Quiroz, Lieschen H; Blomquist, Joan L; Macmillan, Deborah; McCullough, Alexis; Handa, Victoria L

    2011-10-01

    We describe maternal childbirth goals among women planning either cesarean or vaginal birth. Women in the third trimester planning cesarean or vaginal birth were asked to report up to five childbirth goals. Goal achievement was assessed postpartum. Based on free-text responses, discrete goal categories were identified. Goals and goal achievement were compared between the two groups. Satisfaction was rated on a visual analogue scale and was compared with goal achievement. The sample included 163 women planning vaginal birth and 69 women planning cesarean. Twelve goal categories were identified. Only women planning vaginal birth reported a desire to achieve fulfillment related to childbirth. Women planning cesarean were less likely to express a desire to maintain control over their own responses during childbirth and more likely to report a desire to avoid complications. The 72 women who achieved all stated goals reported significantly higher mean satisfaction scores than the 94 women reporting that at least one goal was not achieved (P  =  0.001). Goal achievement was higher among women planning cesarean than among those planning vaginal birth (52.2% versus 23.1%, P  <  0.001). This research furthers our understanding of women's attitudes regarding cesarean childbirth and definitions of a successful birth experience. © Thieme Medical Publishers.

  13. Outcome of planned home and hospital births among low-risk women in Iceland in 2005-2009: a retrospective cohort study.

    Science.gov (United States)

    Halfdansdottir, Berglind; Smarason, Alexander Kr; Olafsdottir, Olof A; Hildingsson, Ingegerd; Sveinsdottir, Herdis

    2015-03-01

    At 2.2 percent in 2012, the home birth rate in Iceland is the highest in the Nordic countries and has been rising rapidly in the new millennium. The objective of this study was to compare the outcomes of planned home births and planned hospital births in comparable low-risk groups in Iceland. The study is a retrospective cohort study comparing the total population of 307 planned home births in Iceland in 2005-2009 to a matched 1:3 sample of 921 planned hospital births. Regression analysis, adjusted for confounding variables, was performed for the primary outcome variables. The rate of oxytocin augmentation, epidural analgesia, and postpartum hemorrhage was significantly lower when labor started as a planned home birth. Differences in the rates of other primary outcome variables were not significant. The home birth group had lower rates of operative birth and obstetric anal sphincter injury. The rate of 5-minute Apgar score < 7 was the same in the home and hospital birth groups, but the home birth group had a higher rate of neonatal intensive care unit admission. Intervention and adverse outcome rates in both study groups, including transfer rates, were higher among primiparas than multiparas. Oxytocin augmentation, epidural analgesia, and postpartum hemorrhage rates were significantly interrelated. This study adds to the growing body of evidence that suggests that planned home birth for low-risk women is as safe as planned hospital birth. © 2015 Wiley Periodicals, Inc.

  14. The Canadian birth place study: examining maternity care provider attitudes and interprofessional conflict around planned home birth

    OpenAIRE

    Vedam, Saraswathi; Stoll, Kathrin; Schummers, Laura; Fairbrother, Nichole; Klein, Michael C; Thordarson, Dana; Kornelsen, Jude; Dharamsi, Shafik; Rogers, Judy; Liston, Robert; Kaczorowski, Janusz

    2014-01-01

    Background: Available birth settings have diversified in Canada since the integration of regulated midwifery. Midwives are required to offer eligible women choice of birth place; and 25-30% of midwifery clients plan home births. Canadian provincial health ministries have instituted reimbursement schema and regulatory guidelines to ensure access to midwives in all settings. Evidence from well-designed Canadian cohort studies demonstrate the safety and efficacy of midwife-attended home birth. H...

  15. Interventions for women who have a caesarean birth to increase uptake and duration of breastfeeding: A systematic review.

    Science.gov (United States)

    Beake, Sarah; Bick, Debra; Narracott, Cath; Chang, Yan-Shing

    2017-10-01

    Rates of breastfeeding uptake are lower after a caesarean birth than vaginal birth, despite caesarean rates increasing globally over the past 30 years, and many high-income countries reporting overall caesarean rates of above 25%. A number of factors are likely to be associated with women's infant feeding decisions following a caesarean birth such as limited postoperative mobility, postoperative pain, and ongoing management of medical complications that may have triggered the need for a caesarean birth. The aim of this systematic review was to evaluate evidence of interventions on the initiation and duration of any and exclusive breastfeeding among women who had a planned or unplanned caesarean birth. Seven studies, presenting quantitative and qualitative evidence, published in the English language from January 1994 to February 2016 were included. A limited number of interventions were identified relevant to women who had had a caesarean birth. These included immediate or early skin-to-skin contact, parent education, the provision of sidecar bassinets when rooming-in, and use of breast pumps. Only one study, an intervention that included parent education and targeted breastfeeding support, increased initiation and continuation of breastfeeding, but due to methodological limitations, findings should be considered with caution. There is a need to better understand the impact of caesarean birth on maternal physiological, psychological, and physical recovery, the physiology of lactation and breastfeeding and infant feeding behaviors if effective interventions are to be implemented. © 2016 John Wiley & Sons Ltd.

  16. Scenario Planning as Organizational Intervention

    DEFF Research Database (Denmark)

    Balarezo, Jose; Nielsen, Bo Bernhard

    2017-01-01

    Purpose: This paper identifies four areas in need of future research to enhance our theoretical understanding of scenario planning, and sets the basis for future empirical examination of its effects on individual and organizational level outcomes. Design/methodology/approach: This paper organizes...... existing contributions on scenario planning within a new consolidating framework that includes antecedents, processes, and outcomes. The proposed framework allows for integration of the extant literature on scenario planning from a wide variety of fields, including strategic management, finance, human...

  17. Historical and social context for birth planning in Iceland.

    Science.gov (United States)

    Swanson, J M

    1988-01-01

    Iceland is a rugged subarctic island 600 miles from Norway and 500 miles from Scotland. From the mid-14th to the end of the 18th century the island was virtually isolated. Isolation and sociocultural factors interacted to delay the fertility transition in Iceland until late in the 20th century. In 1983 Iceland had the highest crude birth rate of any developed country -- 18.4/1000. Between 1890-1982, the population almost tripled, to 235,501 inhabitants. The total fertility rate is 2.2, down from 4.17 in 1960. Combined with a high birth rate was a low mortality rate of 7.0/1000 of the population and a life expectancy of 79.5 years for women and 73.9 years for men -- the highest in the world. Infant mortality is only 6.2/1000 live births. This combination of high fertility, low mortality, and low emigration caused the high population growth. By the end of the 18th century, Iceland had achieved near universal literacy, and education through university is free, but not until 1960 did a woman receive a doctorate from the University of Iceland. By 198, 2/3 of women in Iceland participated in the labor force, but their earnings were only 2/3 those of men. In 1983 a Women's Party was formed, and women now hold 15% of the seats in the Althing (Parliament). Marriage rates have declined to 5.22/1000 of the population. The unique marital pattern of Iceland contributes to the high (41%) illegitimacy rate. Icelandic couples cohabit and have a child or 2 before they marry. They therefore tend to marry late (25.5 for men, 23.3 for women). Health care, including family planning services, is free in Iceland; and there is a medical school, a school of pharmacy, and 2 nursing schools. 35% of Icelandic women 20-40 years of age use either the pill or the IUD. Over-the-counter contraceptives are also available, and an average of 358 women are sterilized each year. The abortion rate is only 10.6/1000 females 15-49 years of age. The Birth Control Act of 1975 calls for the provision of sex

  18. [Planned non-hospital births in industrialized countries: bureaucratic dream vs. professional responsibility].

    Science.gov (United States)

    Arabin, B; Chervenak, F A; McCullough, L B

    2013-02-01

    This article addresses in how far planned non-hospital births should be an alternative to planned hospital births. Advocates of planned non-hospital deliveries have emphasised patient safety, patient satisfaction, cost effectiveness, and respect for women's rights. We provide a critical evaluation of each of these claims and have doubts that the information available for the pregnant women and the public is in accord with professional responsibility. We understand that the increasing rates of interventions and operative deliveries in hospital births demand an answer, but we doubt that planned home birth is the appropriate professional solution. Complications during non-hospital births inevitably demand a transport of mother and child to a perinatal centre. The time delay by itself is an unnecessary risk for both and this cannot be abolished by bureaucratic quality criteria as introduced for non-hospital births in Germany. Evidence-based studies have shown that modern knowledge of the course of delivery including ultrasound as well as intensive care during the delivery all reduce the rate of operative deliveries. Unfortunately, this is not well-known and only rarely considered during any delivery. All these facts, however, are the best arguments to find a cooperative model within perinatal centres to combine the art of midwifery with modern science, reduction of pain and perinatal care of the pregnant women before, during and after birth. We therefore call on obstetricians, midwifes and health-care providers as well as health politicians to carefully analyse the studies from Western countries showing increasing risks if the model of intention-to-treat is considered and accoordingly not to support planned non-hospital births nor to include these models into prospective trials. Alternatively, we recommend the introduction of a home-like climate within hospitals and perinatal centres, to avoid unnecessary invasive measures and to really care for the pregnant mother

  19. The Canadian birth place study: examining maternity care provider attitudes and interprofessional conflict around planned home birth.

    Science.gov (United States)

    Vedam, Saraswathi; Stoll, Kathrin; Schummers, Laura; Fairbrother, Nichole; Klein, Michael C; Thordarson, Dana; Kornelsen, Jude; Dharamsi, Shafik; Rogers, Judy; Liston, Robert; Kaczorowski, Janusz

    2014-10-28

    Available birth settings have diversified in Canada since the integration of regulated midwifery. Midwives are required to offer eligible women choice of birth place; and 25-30% of midwifery clients plan home births. Canadian provincial health ministries have instituted reimbursement schema and regulatory guidelines to ensure access to midwives in all settings. Evidence from well-designed Canadian cohort studies demonstrate the safety and efficacy of midwife-attended home birth. However, national rates of planned home birth remain low, and many maternity providers do not support choice of birth place. In this national, mixed-methods study, our team administered a cross-sectional survey, and developed a 17 item Provider Attitudes to Planned Home Birth Scale (PAPHB-m) to assess attitudes towards home birth among maternity providers. We entered care provider type into a linear regression model, with the PAPHB-m score as the outcome variable. Using Students' t tests and ANOVA for categorical variables and correlational analysis (Pearson's r) for continuous variables, we conducted provider-specific bivariate analyses of all socio-demographic, education, and practice variables (n=90) that were in both the midwife and physician surveys. Median favourability scores on the PAPHB-m scale were very low among obstetricians (33.0), moderately low for family physicians (38.0) and very high for midwives (80.0), and 84% of the variance in attitudes could be accounted for by care provider type. Amount of exposure to planned home birth during midwifery or medical education and practice was significantly associated with favourability scores. Concerns about perinatal loss and lawsuits, discomfort with inter-professional consultations, and preference for the familiarity of the hospital correlated with less favourable attitudes to home birth. Among all providers, favourability scores were linked to beliefs about the evidence on safety of home birth, and confidence in their own ability

  20. Postpartum family planning: current evidence on successful interventions

    Directory of Open Access Journals (Sweden)

    Blazer C

    2016-04-01

    Full Text Available Cassandra Blazer, Ndola Prata Bixby Center for Population, Health, and Sustainability, School of Public Health, University of California, Berkeley, CA, USA Abstract: We reviewed existing evidence of the efficacy of postpartum family planning interventions targeting women in the 12 months postpartum period in low- and middle-income countries. We searched for studies from January 1, 2004 to September 19, 2015, using the US Preventive Services Task Force recommendations to assess evidence quality. Our search resulted in 26 studies: 11 based in sub-Saharan Africa, six in the Middle East and North Africa, and nine in Asia. Twenty of the included studies assessed health facility-based interventions. Three were focused on community interventions, two had community and facility components, and one was a workplace program. Overall quality of the evidence was moderate, including evidence for counseling interventions. Male partner involvement, integration with other service delivery platforms, such as prevention of mother-to-child transmission of HIV and immunization, and innovative product delivery programs may increase knowledge and use during the postpartum period. Community-based and workplace strategies need a much stronger base of evidence to prompt recommendations. Keywords: postpartum period, family planning, birth spacing, interventions, systematic review, contraception, less developed countries

  1. Patient Communication, Satisfaction, and Trust Before and After Use of a Standardized Birth Plan.

    Science.gov (United States)

    Anderson, Clare-Marie; Monardo, Rosie; Soon, Reni; Lum, Jennifer; Tschann, Mary; Kaneshiro, Bliss

    2017-11-01

    The birth plan was developed as a way for pregnant women to communicate their desires and expectations for labor and delivery. Standardized birth plans have been used by some birth facilities as a communication tool. In this quality improvement project, we sought to describe communication, trust, and satisfaction scores after delivery in a group of patients who used a standardized birth plan. All pregnant women at 24 or more weeks of gestation were asked to complete a short, standardized birth plan. Communication, trust, and satisfaction were assessed before and after delivery. Descriptive analyses showed that communication, trust, and satisfaction scores were high following delivery. Scores for all three factors increased significantly following delivery though increases were modest. Most patients (84%) indicated they would use a birth plan with a subsequent delivery.

  2. Massage Interventions and Developmental Skills in Infants Born with Low Birth Weight

    Science.gov (United States)

    Kelmanson, I. A.; Adulas, E. I.

    2009-01-01

    This study aimed at evaluating possible effects of massage interventions on developmental progress in the infants born with low birth weight (LBW). Forty infants (17 boys, 23 girls) who were born in St. Petersburg in 2000 through 2002 and met a conventional definition of LBW (less than 2500 g at birth) entered the study. Of these, 36 (17 boys, 19…

  3. Trends in birth asphyxia, obstetric interventions and perinatal mortality among term singletons: a nationwide cohort study

    NARCIS (Netherlands)

    Ensing, Sabine; Abu-Hanna, Ameen; Schaaf, Jelle M.; Mol, Ben Willem J.; Ravelli, Anita C. J.

    2015-01-01

    The objective of the present study is to investigate trends in birth asphyxia and perinatal mortality in the Netherlands over the last decade. A nationwide cohort study among women with a term singleton pregnancy. We assessed trends in birth asphyxia in relation to obstetric interventions for fetal

  4. Use of a birth plan within woman-held maternity records: a qualitative study with women and staff in northeast Scotland.

    Science.gov (United States)

    Whitford, Heather M; Entwistle, Vikki A; van Teijlingen, Edwin; Aitchison, Patricia E; Davidson, Tracey; Humphrey, Tracy; Tucker, Janet S

    2014-09-01

    Birth plans are written preferences for labor and birth which women prepare in advance. Most studies have examined them as a novel intervention or "outside" formal care provision. This study considered use of a standard birth plan section within a national, woman-held maternity record. Exploratory qualitative interviews were conducted with women (42) and maternity service staff (24) in northeast Scotland. Data were analyzed thematically. Staff and women were generally positive about the provision of the birth plan section within the record. Perceived benefits included the opportunity to highlight preferences, enhance communication, stimulate discussions, and address anxieties. However, not all women experienced these benefits or understood the birth plan's purpose. Some were unaware of the opportunity to complete it or could not access the support they needed from staff to discuss or be confident about their options. Some were reluctant to plan too much. Staff recognized the need to support women with birth plan completion but noted practical challenges to this. A supportive antenatal opportunity to allow discussion of options may be needed to realize the potential benefits of routine inclusion of birth plans in maternity notes. © 2014 Wiley Periodicals, Inc.

  5. Domestic violence, marital control, and family planning, maternal, and birth outcomes in Timor-Leste.

    Science.gov (United States)

    Meiksin, Rebecca; Meekers, Dominique; Thompson, Susan; Hagopian, Amy; Mercer, Mary Anne

    2015-06-01

    Patriarchal traditions and a history of armed conflict in Timor-Leste provide a context that facilitates violence against women. More than a third of ever-married Timorese women report physical and/or sexual domestic violence (DV) perpetrated by their most recent partner. DV violates women's rights and may threaten their reproductive health. Marital control may also limit women's reproductive control and healthcare access. Our study investigated relationships between DV and marital control and subsequent family planning, maternal healthcare, and birth outcomes in Timor-Leste. Using logistic regression, we examined 2009-2010 Demographic and Health Survey data from a nationally representative sample of 2,951 women in Timor-Leste. We controlled for age, education, and wealth. We limited our analyses of pregnancy- and birth-related outcomes to those from the 6 months preceding the survey. Rural women with controlling husbands were less likely than other rural women to have an unmet need for family planning (Adj. OR 0.6; 95 % CI 0.4-0.9). Rural women who experienced DV were more likely than other rural women to have an unplanned pregnancy (Adj. OR 2.6; 95 % CI 1.4-4.8), fewer than four antenatal visits (Adj. OR 2.3; 95 % CI 1.1-4.9), or a baby born smaller than average (Adj. OR 3.1; 95 % CI 1.4-6.7). DV and marital control were not associated with the tested outcomes among urban women. Given high rates of DV internationally, our findings have important implications. Preventing DV may benefit both women and future generations. Furthermore, rural women who experience DV may benefit from targeted interventions that mediate associated risks of negative family planning, maternal healthcare, and birth outcomes.

  6. Comparing the odds of postpartum haemorrhage in planned home birth against planned hospital birth: results of an observational study of over 500,000 maternities in the UK

    Directory of Open Access Journals (Sweden)

    Nove Andrea

    2012-11-01

    Full Text Available Abstract Background The aim of this study is to compare the odds of postpartum haemorrhage among women who opt for home birth against the odds of postpartum haemorrhage for those who plan a hospital birth. It is an observational study involving secondary analysis of maternity records, using binary logistic regression modelling. The data relate to pregnancies that received maternity care from one of fifteen hospitals in the former North West Thames Regional Health Authority Area in England, and which resulted in a live or stillbirth in the years 1988–2000 inclusive, excluding ‘high-risk’ pregnancies, unplanned home births, pre-term births, elective Caesareans and medical inductions. Results Even after adjustment for known confounders such as parity, the odds of postpartum haemorrhage (≥1000ml of blood lost are significantly higher if a hospital birth is intended than if a home birth is intended (odds ratio 2.5, 95% confidence interval 1.7 to 3.8. The ‘home birth’ group included women who were transferred to hospital during labour or shortly after birth. Conclusions Women and their partners should be advised that the risk of PPH is higher among births planned to take place in hospital compared to births planned to take place at home, but that further research is needed to understand (a whether the same pattern applies to the more life-threatening categories of PPH, and (b why hospital birth is associated with increased odds of PPH. If it is due to the way in which labour is managed in hospital, changes should be made to practices which compromise the safety of labouring women.

  7. Birth intervention and non-maternal infant-handling during parturition in a nonhuman primate.

    Science.gov (United States)

    Pan, Wenshi; Gu, Tieliu; Pan, Yue; Feng, Chunguang; Long, Yu; Zhao, Yi; Meng, Hao; Liang, Zuhong; Yao, Meng

    2014-10-01

    Direct intervention in infant delivery by non-parturient individuals is a rare phenomenon in nonhuman primates. In contrast, birth assistance by other individuals, or the practice of midwifery, is universal among human societies and generally believed to be a behavior unique to our species. It has been proposed that the enlarged head of the human fetus and the relatively narrow birth canal constrained by bipedalism has made human parturition more difficult than in nonhuman primates, and these anatomic challenges have led to the rotation of the fetus in the birth canal and an occiput anterior (i.e., backward-facing) orientation of emergence. These characteristics have hindered the mother's ability to self-assist the delivery of the infant, therefore necessitating assistance by other individuals or midwives for successful birth. Here we report the first high-definition video recordings of birth intervention behavior in a wild nonhuman primate, the white-headed langur (Trachypithecus leucocephalus). We observed that while a primiparous female gave birth to an infant in an occiput posterior (i.e., forward-facing) orientation, a multiparous female intervened in the delivery by manually pulling the infant out of the birth canal and cared for it in the following hours. Our finding shows extensive social interactions throughout parturition, and presents an unequivocal case of non-maternal intervention with infant birth in a nonhuman primate.

  8. [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

  9. Transfers to hospital in planned home birth in four Nordic countries

    DEFF Research Database (Denmark)

    Blix, Ellen; Kumle, Merethe H; Ingversen, Karen

    2016-01-01

    INTRODUCTION: Women planning a home birth are transferred to hospital in case of complications or elevated risk for adverse outcomes. The aim of the present study was to describe the indications for transfer to hospital in planned home births, and the proportion of cases in which this occurs....... MATERIAL AND METHODS: Women in Norway, Sweden, Denmark and Iceland who had opted for, and were accepted for, home birth at the onset of labor, were included in the study. Data from 3068 women, 572 nulliparas and 2446 multiparas, were analyzed for proportion of transfers during labor and within 72 h after...... birth, indications for transfer, how long before or after birth the transfer started, time from birth to start of transfer, duration and mode of transfer, and whether the transfer was classified as potentially urgent. Analyses were stratified for nulliparity and multiparity. RESULTS: One-third (186...

  10. Perinatal and maternal outcomes in planned home and obstetric unit births in women at 'higher risk' of complications: secondary analysis of the Birthplace national prospective cohort study.

    Science.gov (United States)

    Li, Y; Townend, J; Rowe, R; Brocklehurst, P; Knight, M; Linsell, L; Macfarlane, A; McCourt, C; Newburn, M; Marlow, N; Pasupathy, D; Redshaw, M; Sandall, J; Silverton, L; Hollowell, J

    2015-04-01

    To explore and compare perinatal and maternal outcomes in women at 'higher risk' of complications planning home versus obstetric unit (OU) birth. Prospective cohort study. OUs and planned home births in England. 8180 'higher risk' women in the Birthplace cohort. We used Poisson regression to calculate relative risks adjusted for maternal characteristics. Sensitivity analyses explored possible effects of differences in risk between groups and alternative outcome measures. Composite perinatal outcome measure encompassing 'intrapartum related mortality and morbidity' (intrapartum stillbirth, early neonatal death, neonatal encephalopathy, meconium aspiration syndrome, brachial plexus injury, fractured humerus or clavicle) and neonatal admission within 48 hours for more than 48 hours. Two composite maternal outcome measures capturing intrapartum interventions/adverse maternal outcomes and straightforward birth. The risk of 'intrapartum related mortality and morbidity' or neonatal admission for more than 48 hours was lower in planned home births than planned OU births [adjusted relative risks (RR) 0.50, 95% CI 0.31-0.81]. Adjustment for clinical risk factors did not materially affect this finding. The direction of effect was reversed for the more restricted outcome measure 'intrapartum related mortality and morbidity' (RR adjusted for parity 1.92, 95% CI 0.97-3.80). Maternal interventions were lower in planned home births. The babies of 'higher risk' women who plan birth in an OU appear more likely to be admitted to neonatal care than those whose mothers plan birth at home, but it is unclear if this reflects a real difference in morbidity. Rates of intrapartum related morbidity and mortality did not differ statistically significantly between settings at the 5% level but a larger study would be required to rule out a clinically important difference between the groups. © 2015 The Authors. BJOG An International Journal of Obstetrics and Gynaecology published by John

  11. Effect of Implementing a Birth Plan on Womens' Childbirth Experiences and Maternal & Neonatal Outcomes

    Science.gov (United States)

    Farahat, Amal Hussain; Mohamed, Hanan El Sayed; Elkader, Shadia Abd; El-Nemer, Amina

    2015-01-01

    Childbirth satisfaction represents a sense of feeling good about one's birth. It is thought to result from having a sense of control, having expectations met, feeling empowered, confident and supported. The aim of this study was to implement a birth plan and evaluate its effect on women's childbirth experiences and maternal, neonatal outcomes. A…

  12. Does planning of births affect childhood undernutrition? Evidence from demographic and health surveys of selected South Asian countries.

    Science.gov (United States)

    Rana, Md Juel; Goli, Srinivas

    2018-03-01

    The prevalence of child undernutrition in South Asia is high, as is also the unmet need for family planning. In previous literature, the biodemographic relationship of family planning, particularly birth order and birth spacing, and nutritional status of children have been assessed separately. The aim of this study was to work on the hypothesis that the planning of births comprising timing, spacing, and number of births improves child undernutrition, especially in the areas with high prevalence of stunting and underweight. We used recent Demographic and Health Survey data from four selected South Asian countries. Binary logistic regression models were applied to estimate the adjusted percentage of stunting and underweight by identified independent factors. Findings suggested that after controlling for other socioeconomic factors, children in the first birth order with >24 mo of interval between marriage and first birth have a lower risk for stunting (20%; p planning of births. The probability of child undernutrition is lower among children born with >24 mo of birth spacing than its counterpart in all birth orders, but the significance of birth spacing reduces with increasing birth orders. Appropriate planning of births using family planning methods in countries with high birth rates has the potential to reduce childhood undernutrition. Thus, the planning of births emerges as an important biodemographic approach to eradicate childhood undernutrition especially in developing regions like South Asia and thereby to achieve sustainable development goals by 2030. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. 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.

  14. Broadcasting Birth Control: mass media and family planning

    NARCIS (Netherlands)

    Parry, M.

    2013-01-01

    This book explores the use of media by American birth control movement since the early twentieth century, as they built support for fertility control and the availability of contraception. Though these public efforts in advertising and education were undertaken initially by leading advocates,

  15. Global report on preterm birth and stillbirth (3 of 7: evidence for effectiveness of interventions

    Directory of Open Access Journals (Sweden)

    Rubens Craig E

    2010-02-01

    Full Text Available Abstract Introduction Interventions directed toward mothers before and during pregnancy and childbirth may help reduce preterm births and stillbirths. Survival of preterm newborns may also be improved with interventions given during these times or soon after birth. This comprehensive review assesses existing interventions for low- and middle-income countries (LMICs. Methods Approximately 2,000 intervention studies were systematically evaluated through December 31, 2008. They addressed preterm birth or low birth weight; stillbirth or perinatal mortality; and management of preterm newborns. Out of 82 identified interventions, 49 were relevant to LMICs and had reasonable amounts of evidence, and therefore selected for in-depth reviews. Each was classified and assessed by the quality of available evidence and its potential to treat or prevent preterm birth and stillbirth. Impacts on other maternal, fetal, newborn or child health outcomes were also considered. Assessments were based on an adaptation of the Grades of Recommendation Assessment, Development and Evaluation criteria. Results Most interventions require additional research to improve the quality of evidence. Others had little evidence of benefit and should be discontinued. The following are supported by moderate- to high-quality evidence and strongly recommended for LMICs: • Two interventions prevent preterm births—smoking cessation and progesterone • Eight interventions prevent stillbirths—balanced protein energy supplementation, screening and treatment of syphilis, intermittant presumptive treatment for malaria during pregnancy, insecticide-treated mosquito nets, birth preparedness, emergency obstetric care, cesarean section for breech presentation, and elective induction for post-term delivery • Eleven interventions improve survival of preterm newborns—prophylactic steroids in preterm labor, antibiotics for PROM, vitamin K supplementation at delivery, case management of

  16. What Interventions Are Being Used to Prevent Preterm Birth and When?

    Science.gov (United States)

    Feng, Yu Yang; Jarde, Alexander; Seo, Ye Rin; Powell, Anne; Nwebube, Nwachukwu; McDonald, Sarah D

    2018-01-04

    This study sought to determine the proportions of women at risk of preterm birth who received progesterone, elective and rescue cerclage, or pessary to prevent preterm birth, by using medical records. The authors also sought to determine whether these proportions differed among primary-, secondary-, and tertiary-level centres. The authors conducted a retrospective cohort study and extracted data from consecutive medical charts of women with an estimated date of confinement over 3 months in primary-, secondary-, and tertiary-level centres in Southern Ontario. The study identified women with a previous spontaneous preterm birth or a short cervix and determined whether they were offered and whether they received a preventive intervention for preterm birth. Descriptive statistics and Fisher exact tests were calculated. The authors reviewed 1024 consecutive charts at primary, secondary, and tertiary centres and identified 31 women with a previous spontaneous preterm birth or a short cervix. Of these women, less than one half (42%) received progesterone or cerclage for prevention of preterm birth, and none received pessary. One in four women (26%) were not referred to an obstetrician or maternal-fetal medicine specialist in time for an intervention, and among those referred before 24 weeks of gestation, an intervention was offered to 57% of the women. Less than half of women at risk of spontaneous preterm birth received progesterone, cerclage, or pessary, attesting to the importance of improving knowledge translation methods to encourage timely referral and use of progesterone for the prevention of preterm birth. Copyright © 2017 Society of Obstetricians and Gynaecologists of Canada. Published by Elsevier Inc. All rights reserved.

  17. Interactive intervention planning in particle accelerator environments with ionizing radiation

    Energy Technology Data Exchange (ETDEWEB)

    Fabry, Thomas, E-mail: thomas.fabry@cern.ch [European Organization for Nuclear Research, CERN, CH-1211 Genève 23 (Switzerland); Vanherpe, Liesbeth [European Organization for Nuclear Research, CERN, CH-1211 Genève 23 (Switzerland); Baudin, Mathieu [European Organization for Nuclear Research, CERN, CH-1211 Genève 23 (Switzerland); LCPI, ENSAM ParisTech, 151 Boulevard de l' Hôpital, 75013 Paris (France); Theis, Chris [European Organization for Nuclear Research, CERN, CH-1211 Genève 23 (Switzerland); Braesch, Christian [SYMME, Université de Savoie, Polytech Annecy-Chambry, 5 chemin de Bellevue, 74944 Annecy le Vieux (France); Feral, Bruno [European Organization for Nuclear Research, CERN, CH-1211 Genève 23 (Switzerland)

    2013-04-21

    A core issue during the planning of a maintenance intervention in a facility with ionizing radiation is the minimization of the integrated equivalent dose contracted by the maintenance workers during the intervention. In this work, we lay down the concepts for intervention planning in an irradiated environment and present a new software program for intervention planning, which provides interactive visualization of facilities and radiation levels, as well as tools for interactive trajectory planning. The software includes automatic calculation of the expected integrated equivalent radiation dose contracted during an intervention.

  18. Interactive intervention planning in particle accelerator environments with ionizing radiation

    CERN Document Server

    Fabry, Thomas; Baudin, Mathieu; Theis, Chris; Braesch, Christian; Feral, Bruno

    2013-01-01

    A core issue during the planning of a maintenance intervention in a facility with ionizing radiation is the minimization of the integrated equivalent dose contracted by the maintenance workers during the intervention. In this work, we lay down the concepts for intervention planning in an irradiated environment and present a new software program for intervention planning, which provides interactive visualization of facilities and radiation levels, as well as tools for interactive trajectory planning. The software includes automatic calculation of the expected integrated equivalent radiation dose contracted during an intervention.

  19. Perinatal and maternal outcomes by planned place of birth for healthy women with low risk pregnancies: the Birthplace in England national prospective cohort study.

    NARCIS (Netherlands)

    Brocklehurst, P.; Kwee, A.; Birthplace in England Collaborative Group

    2011-01-01

    Objective: To compare perinatal outcomes, maternal outcomes, and interventions in labour by planned place of birth at the start of care in labour for women with low risk pregnancies. Design: Prospective cohort study. Setting: England: all NHS trusts providing intrapartum care at home,

  20. Long-term childhood outcomes after interventions for prevention and management of preterm birth.

    Science.gov (United States)

    Murray, Sarah R; Stock, Sarah J; Norman, Jane E

    2017-12-01

    Globally, preterm birth rates are rising and have a significant impact on neonatal morbidity and mortality. Preterm birth remains difficult to prevent and a number of strategies for preterm birth prevention (progesterone, cervical pessaries, cervical cerclage, tocolytics, and antibiotics) have been identified. While some of these show more promise, there is a paucity of evidence regarding the long-term effects of these strategies on childhood outcomes. Strategies used to improve the health of babies if born preterm, such as antenatal magnesium sulfate for fetal neuroprotection and antenatal corticosteroids for fetal lung maturation, show evidence of short-term benefit but lack large-scale follow-up data of long-term childhood outcomes. Future research on preterm birth interventions should include long-term follow-up of the children, ideally with similar outcome measures to allow for future meta-analyses. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Birth after caesarean study – planned vaginal birth or planned elective repeat caesarean for women at term with a single previous caesarean birth: protocol for a patient preference study and randomised trial

    Directory of Open Access Journals (Sweden)

    Haslam Ross R

    2007-08-01

    Full Text Available Abstract Background For women who have a caesarean section in their preceding pregnancy, two care policies for birth are considered standard: planned vaginal birth and planned elective repeat caesarean. Currently available information about the benefits and harms of both forms of care are derived from retrospective and prospective cohort studies. There have been no randomised trials, and recognising the deficiencies in the literature, there have been calls for methodologically rigorous studies to assess maternal and infant health outcomes associated with both care policies. The aims of our study are to assess in women with a previous caesarean birth, who are eligible in the subsequent pregnancy for a vaginal birth, whether a policy of planned vaginal birth after caesarean compared with a policy of planned repeat caesarean affects the risk of serious complications for the woman and her infant. Methods/Design Design: Multicentred patient preference study and a randomised clinical trial. Inclusion Criteria: Women with a single prior caesarean presenting in their next pregnancy with a single, live fetus in cephalic presentation, who have reached 37 weeks gestation, and who do not have a contraindication to a planned VBAC. Trial Entry & Randomisation: Eligible women will be given an information sheet during pregnancy, and will be recruited to the study from 37 weeks gestation after an obstetrician has confirmed eligibility for a planned vaginal birth. Written informed consent will be obtained. Women who consent to the patient preference study will be allocated their preference for either planned VBAC or planned, elective repeat caesarean. Women who consent to the randomised trial will be randomly allocated to either the planned vaginal birth after caesarean or planned elective repeat caesarean group. Treatment Groups: Women in the planned vaginal birth group will await spontaneous onset of labour whilst appropriate. Women in the elective repeat

  2. Birth-Related Posttraumatic Stress Disorder: Implications for Early Intervention Services

    Science.gov (United States)

    Pizur-Barnekow, Kris; Doering, Jennifer J.; Willett, Marjorie; Ruminski, Christine; Spring, Molly

    2014-01-01

    The positive impact of healthy relationships on child development is widely accepted. A healthy relationship between mother and child is at risk when a mother experiences symptoms of birth-related posttraumatic stress disorder (PTSD). Mothers of children with special needs are at high risk for this disorder and early intervention (EI)…

  3. Maternal attachment representations after very preterm birth and the effect of early intervention

    NARCIS (Netherlands)

    Meijssen, Dominique; Wolf, Marie-Jeanne; van Bakel, Hedwig; Koldewijn, Karen; Kok, Joke; van Baar, Anneloes

    2011-01-01

    Objective: For very preterm infants the mother-infant relationship may be compromised. Maternal attachment representations 18 (corrected) months after very preterm birth and the effect of the post-discharge Infant Behavioral Assessment and Intervention Program (IBAIP) were studied. The IBAIP is

  4. Interventions during labor and birth in the United States: a qualitative analysis of women's experiences.

    Science.gov (United States)

    Bibeau, Alana M

    2014-12-01

    To explore and describe hospital-birthing women's understandings of and experiences with interventions during labor and birth. Qualitative data was collected as part of a larger ethnographic study of childbirth in the United States. The grounded theory method was employed to analyze interviews with 59 women from three states who had recently given birth in hospitals with physicians or certified nurse-midwives in attendance. Four themes emerged from the data. The themes safety/risk and provider match, described women's expectations regarding intervention and their interactions with providers. A third theme addressed how women experienced interventions and their perceptions of control over decision-making. A final theme characterized women's satisfaction with maternity care. Women who received interventions expressed varying levels of comfort or apprehension associated with both expectations of maternity care and provider match. Women whose expectations matched those of the provider reported more positive experiences. Regardless of provider match, women expressed ambivalence about the use of interventions and confusion over their appropriate place. Women's ability to make sense of interventions was related to how well they navigated a complicated and bureaucratic maternity system. Increasing attention needs to be paid to the impact of these factors on women's perceptions of care during pregnancy and childbirth. Copyright © 2014 Elsevier B.V. All rights reserved.

  5. Interactive Visual Intervention Planning: Interactive Visualization for Intervention Planning in Particle Accelerator Environments with Ionizing Radiation

    CERN Document Server

    Fabry, Thomas; Feral, Bruno

    2013-01-01

    Intervention planning is crucial for maintenance operations in particle accelerator environments with ionizing radiation, during which the radiation dose contracted by maintenance workers should be reduced to a minimum. In this context, we discuss the visualization aspects of a new software tool, which integrates interactive exploration of a scene depicting an accelerator facility augmented with residual radiation level simulations, with the visualization of intervention data such as the followed trajectory and maintenance tasks. The visualization of each of these aspects has its effect on the final predicted contracted radiation dose. In this context, we explore the possible benefits of a user study, with the goal of enhancing the visual conditions in which the intervention planner using the software tool is minimizing the radiation dose.

  6. Birth plan compliance and its relation to maternal and neonatal outcomes

    Directory of Open Access Journals (Sweden)

    Pedro Hidalgo-Lopezosa

    2017-12-01

    Full Text Available ABSTRACT Objective: to know the degree of fulfillment of the requests that women reflect in their birth plans and to determine their influence on the main obstetric and neonatal outcomes. Method: retrospective, descriptive and analytical study with 178 women with birth plans in third-level hospital. Inclusion criteria: low risk gestation, cephalic presentation, single childbirth, delivered at term. Scheduled and urgent cesareans without labor were excluded. A descriptive and inferential analysis of the variables was performed. Results: the birth plan was mostly fulfilled in only 37% of the women. The group of women whose compliance was low (less than or equal to 50% had a cesarean section rate of 18.8% and their children had worse outcomes in the Apgar test and umbilical cord pH; while in women with high compliance (75% or more, the percentage of cesareans fell to 6.1% and their children had better outcomes. Conclusion: birth plans have a low degree of compliance. The higher the compliance, the better is the maternal and neonatal outcomes. The birth plan can be an effective tool to achieve better outcomes for the mother and her child. Measures are needed to improve its compliance.

  7. Born in Bradford’s Better Start: an experimental birth cohort study to evaluate the impact of early life interventions

    Directory of Open Access Journals (Sweden)

    Josie Dickerson

    2016-08-01

    Full Text Available Abstract Background Early interventions are recognised as key to improving life chances for children and reducing inequalities in health and well-being, however there is a paucity of high quality research into the effectiveness of interventions to address childhood health and development outcomes. Planning and implementing standalone RCTs for multiple, individual interventions would be slow, cumbersome and expensive. This paper describes the protocol for an innovative experimental birth cohort: Born in Bradford’s Better Start (BiBBS that will simultaneously evaluate the impact of multiple early life interventions using efficient study designs. Better Start Bradford (BSB has been allocated £49 million from the Big Lottery Fund to implement 22 interventions to improve outcomes for children aged 0–3 in three key areas: social and emotional development; communication and language development; and nutrition and obesity. The interventions will be implemented in three deprived and ethnically diverse inner city areas of Bradford. Method The BiBBS study aims to recruit 5000 babies, their mothers and their mothers’ partners over 5 years from January 2016-December 2020. Demographic and socioeconomic information, physical and mental health, lifestyle factors and biological samples will be collected during pregnancy. Parents and children will be linked to their routine health and local authority (including education data throughout the children’s lives. Their participation in BSB interventions will also be tracked. BiBBS will test interventions using the Trials within Cohorts (TwiCs approach and other quasi-experimental designs where TwiCs are neither feasible nor ethical, to evaluate these early life interventions. The effects of single interventions, and the cumulative effects of stacked (multiple interventions on health and social outcomes during the critical early years will be measured. Discussion The focus of the BiBBS cohort is on

  8. Do couples make fertility plans one birth at a time?

    Science.gov (United States)

    Udry, J R

    1983-05-01

    Criteria are specified for distinguishing one-decision from sequential-decision models of fertility. Sequential decisions are not demonstrated by parity-specific differences in fertility determinants. Sequential models must demonstrate the importance of unanticipated intervening events in changing fertility plans or fertility experience. They must demonstrate that the intervening events are not caused by the fertility. Two empirical tests are designed to determine which model best fits the data. One test predicts fertility plans, the other fertility events. Both tests provide some support for sequential models.

  9. Maternal and newborn outcomes after a prior cesarean birth by planned mode of delivery and history of prior vaginal birth in British Columbia: a retrospective cohort study.

    Science.gov (United States)

    Bickford, Celeste D; Janssen, Patricia A

    2015-01-01

    As rates for cesarean births continue to rise, more women are faced with the choice to plan a vaginal or a repeat cesarean birth after a previous cesarean. The objective of this population-based retrospective cohort study was to compare the safety of planned vaginal birth with cesarean birth after 1-2 previous cesarean sections. We identified singleton term births in British Columbia from 2000 to 2008 using data from the British Columbia Perinatal Data Registry. Women carrying a singleton fetus in cephalic presentation at term (37-41 weeks of gestation completed) with 1-2 prior cesarean births were included. Those with gestational hypertension, pre-existing diabetes and cardiac disease were excluded. Maternal and neonatal outcomes were classified as either life-threatening or non-life threatening. We compared outcomes among women with none versus at least 1 previous vaginal birth, by planned method of delivery. We estimated relative risks (RR) and 95% confidence intervals (CI) for composite outcomes using Poisson regression. Of the 33 812 women in the sample, 5406 had a history of vaginal delivery and 28 406 did not. The composite risk for life-threatening maternal outcomes was elevated among women planning vaginal compared with cesarean birth both with and without a prior vaginal birth (RR 2.06, 95% CI 1.20-3.52) and (2.52, 95% CI 2.04-3.11). Absolute differences (attributable risk [AR]) were 1.01% and 1.31% respectively. Non-life threatening maternal outcomes were decreased among women planning a vaginal birth if they had had at least 1 prior vaginal delivery (RR 0.51, 95% CI 0.33-0.77; AR 1.17%). The composite risk of intrapartum stillbirth, neonatal death or life-threatening neonatal outcomes did not differ among women planning vaginal or cesarean birth with a prior vaginal delivery and non-life threatening neonatal outcomes were decreased, (RR 0.67, 95% CI 0.52-0.86); AR 1.92%). After 1 or 2 previous cesarean births, risks for adverse outcomes between planned

  10. Paramedics׳ involvement in planned home birth: A one-year case study.

    Science.gov (United States)

    McLelland, Gayle; McKenna, Lisa; Morgans, Amee; Smith, Karen

    2016-07-01

    to report findings from a study performed prior to the introduction of publicly funded home birth programmes in Victoria, Australia, that investigated the incidence of planned home births attended by paramedics and explored the clinical support they provided as well as the implications for education and practice. retrospective data previously collected via an in-field electronic patient care record (VACIS(®)) was provided by a state-wide ambulance service. Cases were identified via a comprehensive filter, manually screened and analysed using SPSS version 19. over a 12-month period paramedics attended 26 intended home births. Eight women were transported in labour, most for failure to progress. Three called the ambulance service and their pre-organised midwife simultaneously. Paramedics were required for a range of complications including post partum haemorrhage, perineal tears and neonatal resuscitation. Procedures performed for mothers included IV therapy and administering pain relief. For infants, paramedics performed intermittent positive pressure ventilation, endotracheal intubation and external cardiac compression. Of the 23 women transferred to hospital, 22 were transported to hospital within 32minutes. findings highlight that paramedics can provide clinical support, as well as efficient transportation, during perinatal emergencies at planned home births. Cooperative collaboration between ambulance services, privately practising midwives and maternity services to develop guidelines for emergency clinical support and transportation service may minimise risk associated with planned home births. This could also lead to opportunities for interprofessional education between midwives and paramedics. Copyright © 2016 Elsevier Ltd. All rights reserved.

  11. Using GIS Mapping to Target Public Health Interventions: Examining Birth Outcomes Across GIS Techniques.

    Science.gov (United States)

    MacQuillan, E L; Curtis, A B; Baker, K M; Paul, R; Back, Y O

    2017-08-01

    With advances in spatial analysis techniques, there has been a trend in recent public health research to assess the contribution of area-level factors to health disparity for a number of outcomes, including births. Although it is widely accepted that health disparity is best addressed by targeted, evidence-based and data-driven community efforts, and despite national and local focus in the U.S. to reduce infant mortality and improve maternal-child health, there is little work exploring how choice of scale and specific GIS visualization technique may alter the perception of analyses focused on health disparity in birth outcomes. Retrospective cohort study. Spatial analysis of individual-level vital records data for low birthweight and preterm births born to black women from 2007 to 2012 in one mid-sized Midwest city using different geographic information systems (GIS) visualization techniques [geocoded address records were aggregated at two levels of scale and additionally mapped using kernel density estimation (KDE)]. GIS analyses in this study support our hypothesis that choice of geographic scale (neighborhood or census tract) for aggregated birth data can alter programmatic decision-making. Results indicate that the relative merits of aggregated visualization or the use of KDE technique depend on the scale of intervention. The KDE map proved useful in targeting specific areas for interventions in cities with smaller populations and larger census tracts, where they allow for greater specificity in identifying intervention areas. When public health programmers seek to inform intervention placement in highly populated areas, however, aggregated data at the census tract level may be preferred, since it requires lower investments in terms of time and cartographic skill and, unlike neighborhood, census tracts are standardized in that they become smaller as the population density of an area increases.

  12. Planned early birth versus expectant management (waiting) for prelabour rupture of membranes at term (37 weeks or more).

    Science.gov (United States)

    Middleton, Philippa; Shepherd, Emily; Flenady, Vicki; McBain, Rosemary D; Crowther, Caroline A

    2017-01-04

    Prelabour rupture of membranes (PROM) at term is managed expectantly or by planned early birth. It is not clear if waiting for birth to occur spontaneously is better than intervening, e.g. by inducing labour. The objective of this review is to assess the effects of planned early birth (immediate intervention or intervention within 24 hours) when compared with expectant management (no planned intervention within 24 hours) for women with term PROM on maternal, fetal and neonatal outcomes. We searched Cochrane Pregnancy and Childbirth's Trials Register (9 September 2016) and reference lists of retrieved studies. Randomised or quasi-randomised controlled trials of planned early birth compared with expectant management (either in hospital or at home) in women with PROM at 37 weeks' gestation or later. Two review authors independently assessed trials for inclusion, extracted the data, and assessed risk of bias of the included studies. Data were checked for accuracy. Twenty-three trials involving 8615 women and their babies were included in the update of this review. Ten trials assessed intravenous oxytocin; 12 trials assessed prostaglandins (six trials in the form of vaginal prostaglandin E2 and six as oral, sublingual or vaginal misoprostol); and one trial each assessed Caulophyllum and acupuncture. Overall, three trials were judged to be at low risk of bias, while the other 20 were at unclear or high risk of bias.Primary outcomes: women who had planned early birth were at a reduced risk of maternal infectious morbidity (chorioamnionitis and/or endometritis) than women who had expectant management following term prelabour rupture of membranes (average risk ratio (RR) 0.49; 95% confidence interval (CI) 0.33 to 0.72; eight trials, 6864 women; Tau² = 0.19; I² = 72%; low-quality evidence), and their neonates were less likely to have definite or probable early-onset neonatal sepsis (RR 0.73; 95% CI 0.58 to 0.92; 16 trials, 7314 infants;low-quality evidence). No clear

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

    DEFF Research Database (Denmark)

    Steingrimsdottir, Herdis

    plans of both men and women, and by separating the effect by level of academic ability, race and family income. The results show that unrestricted access to the pill caused high ability women to move towards occupations with higher wages, higher occupational prestige scores and higher male ratios......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...... access to the pill is found to be on non-white students, both among men and women. The paper uses Census Data to compare the changes in career plans to actual changes in labor market outcomes. When looking at the actual career outcomes, early access to the pill affects both men and women - shifting...

  14. "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...

  15. The Effect of Educational Intervention on Family Planning ...

    African Journals Online (AJOL)

    Army barracks in Nigeria have low contraceptive prevalence rates (CPRs) and many children per family. The aim of this interventional study, involving 963 married women, is to determine the impact of health education on family planning knowledge, attitudes, and practices among married barrack women. The intervention ...

  16. 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.

  17. Maternal attachment representations after very preterm birth and the effect of early intervention.

    Science.gov (United States)

    Meijssen, Dominique; Wolf, Marie-Jeanne; van Bakel, Hedwig; Koldewijn, Karen; Kok, Joke; van Baar, Anneloes

    2011-02-01

    For very preterm infants the mother-infant relationship may be compromised. Maternal attachment representations 18 (corrected) months after very preterm birth and the effect of the post-discharge Infant Behavioral Assessment and Intervention Program (IBAIP) were studied. The IBAIP is designed to assist parents to support and enhance their infant's regulatory competence and development. The intervention consisted of 6-8 home visits during the first 8 months after birth. Seventy-eight mothers of very preterm infants (attachment representations were assessed with the Working Model of the Child Interview (WMCI). The interviews resulted in a classification of the attachment representations into balanced or non-balanced. 30% of the mothers had non-balanced attachment representations. Qualitative content analysis of the answers showed that negative feelings when first seeing their baby and negative or ambivalent feelings in the first weeks at home with their baby are related to non-balanced attachment representations. The WMCI revealed no differences between the intervention and control group. Early support for mothers of very preterm born infants to develop a healthy mother-infant relationship is recommended especially for mothers who report negative first experiences. Copyright © 2010 Elsevier Inc. All rights reserved.

  18. 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...... access to the pill is found to be on non-white students, both among men and women. The paper uses Census Data to compare the changes in career plans to actual changes in labor market outcomes. When looking at the actual career outcomes, early access to the pill affects both men and women - shifting...... their careers towards traditionally male dominated occupations associated with higher wages. Early access to the pill is also associated with significantly higher actual income for men....

  19. 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…

  20. Comparing two motor assessment tools to evaluate neurobehavioral intervention effects in infants with very low birth weight at 1 year

    NARCIS (Netherlands)

    van Hus, Janeline W. P.; Jeukens-Visser, Martine; Koldewijn, Karen; van Sonderen, Loekie; Kok, Joke H.; Nollet, Frans; van Wassenaer-Leemhuis, Aleid G.

    2013-01-01

    Infants with very low birth weight (VLBW) are at increased risk for motor deficits, which may be reduced by early intervention programs. For detection of motor deficits and to monitor intervention, different assessment tools are available. It is important to choose tools that are sensitive to

  1. Particular intervention plan of Cherbourg's military harbour

    International Nuclear Information System (INIS)

    2014-01-01

    The Particular intervention plan (PPI in French) is an emergency plan which foresees the measures and means to be implemented to address the potential risks of the presence and operation of a nuclear facility. This plan is implemented and developed by the Prefect in case of nuclear accident (or incident leading to a potential accident), the impact of which extending beyond the facility perimeter. It represents a special section of the organisation plan for civil protection response (ORSEC plan). The PPI foresees the necessary measures and means for crisis management during the first hours following the accident and is triggered by the Department Prefect according to the information provided by the facility operator. Its aim is to protect the populations leaving within 10 km of the facility against a potential radiological hazard. The PPI describes: the facility, the intervention area, the protection measures for the population, the conditions of emergency plan triggering, the crisis organisation, the action forms of the different services, and the post-accident stage. This document is the public version of the Particular intervention plan of the military harbour of Cherbourg (Manche, France) which hosts several nuclear facilities devoted to the construction and dismantling of nuclear submarines (without weapons)

  2. Particular intervention plan of the Flamanville Nuclear Power Plant

    International Nuclear Information System (INIS)

    2008-01-01

    The Particular intervention plan (PPI in French) is an emergency plan which foresees the measures and means to be implemented to address the potential risks of the presence and operation of a nuclear facility. This plan is implemented and developed by the Prefect in case of nuclear accident (or incident leading to a potential accident), the impact of which extending beyond the facility perimeter. It represents a special section of the organisation plan for civil protection response (ORSEC plan). The PPI foresees the necessary measures and means for crisis management during the first hours following the accident and is triggered by the Department Prefect according to the information provided by the facility operator. Its aim is to protect the populations leaving within 10 km of the facility against a potential radiological hazard. The PPI describes: the facility, the intervention area, the protection measures for the population, the conditions of emergency plan triggering, the crisis organisation, the action forms of the different services, and the post-accident stage. This document is the public version of the Particular intervention plan of the Flamanville NPP (Manche, France)

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

    Science.gov (United States)

    Ryder, R E

    1993-09-18

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

  4. "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

  5. Improving the quality and content of midwives' discussions with low-risk women about their options for place of birth: Co-production and evaluation of an intervention package.

    Science.gov (United States)

    Henshall, Catherine; Taylor, Beck; Goodwin, Laura; Farre, Albert; Jones, Miss Eleanor; Kenyon, Sara

    2018-04-01

    Women's planned place of birth is gaining increasing importance in the UK, however evidence suggests that there is variation in the content of community midwives' discussions with low risk women about their place of birth options. The objective of this study was to develop an intervention to improve the quality and content of place of birth discussions between midwives and low-risk women and to evaluate this intervention in practice. The study design comprised of three stages: (1) The first stage included focus groups with midwives to explore the barriers to carrying out place of birth discussions with women. (2) In the second stage, COM-B theory provided a structure for co-produced intervention development with midwives and women representatives; priority areas for change were agreed and the components of an intervention package to standardise the quality of these discussions were decided. (3) The third stage of the study adopted a mixed methods approach including questionnaires, focus groups and interviews with midwives to evaluate the implementation of the co-produced package in practice. A maternity NHS Trust in the West Midlands, UK. A total of 38 midwives took part in the first stage of the study. Intervention design (stage 2) included 58 midwives, and the evaluation (stage 3) involved 66 midwives. Four women were involved in the intervention design stage of the study in a Patient and Public Involvement role (not formally consented as participants). In the first study stage participants agreed that pragmatic, standardised information on the safety, intervention and transfer rates for each birth setting (obstetric unit, midwifery-led unit, home) was required. In the second stage of the study, co-production between researchers, women and midwives resulted in an intervention package designed to support the implementation of these changes and included an update session for midwives, a script, a leaflet, and ongoing support through a named lead midwife and regular

  6. Effects of a midwife psycho-education intervention to reduce childbirth fear on women's birth outcomes and postpartum psychological wellbeing.

    Science.gov (United States)

    Fenwick, Jennifer; Toohill, Jocelyn; Gamble, Jenny; Creedy, Debra K; Buist, Anne; Turkstra, Erika; Sneddon, Anne; Scuffham, Paul A; Ryding, Elsa L

    2015-10-30

    High levels of childbirth fear impact birth preparation, obstetric outcomes and emotional wellbeing for around one in five women living in developed countries. Higher rates of obstetric intervention and caesarean section (CS) are experienced in fearful women. The efficacy of interventions to reduce childbirth fear is unclear, with no previous randomised controlled trials reporting birth outcomes or postnatal psychological wellbeing following a midwife led intervention. Between May 2012 and June 2013 women in their second trimester of pregnancy were recruited. Women with a fear score ≥ 66 on the Wijma Delivery Expectancy / Experience Questionnaire (W-DEQ) were randomised to receive telephone psycho-education by a midwife, or usual maternity care. A two armed non-blinded parallel (1:1) multi-site randomised controlled trial with participants allocated in blocks of ten and stratified by hospital site and parity using an electronic centralised computer service. The outcomes of the RCT on obstetric outcomes, maternal psychological well-being, parenting confidence, birth satisfaction, and future birth preference were analysed by intention to treat and reported here. 1410 women were screened for high childbirth fear (W-DEQ ≥66). Three hundred and thirty-nine (n = 339) women were randomised (intervention n = 170; controls n = 169). One hundred and eighty-four women (54 %) returned data for final analysis at 6 weeks postpartum (intervention n = 91; controls n = 93). Compared to controls the intervention group had a clinically meaningful but not statistically significant reduction in overall caesarean section (34 % vs 42 %, p = 0.27) and emergency CS rates (18 % vs 25 %, p = 0.23). Fewer women in the intervention group preferred caesarean section for a future pregnancy (18 % vs 30 %, p = 0.04). All other obstetric variables remained similar. There were no differences in postnatal depression symptoms scores, parenting confidence, or

  7. The effectiveness of birth plans in increasing use of skilled care at delivery and postnatal care in rural Tanzania: a cluster randomised trial.

    Science.gov (United States)

    Magoma, Moke; Requejo, Jennifer; Campbell, Oona; Cousens, Simon; Merialdi, Mario; Filippi, Veronique

    2013-04-01

    To determine the effectiveness of birth plans in increasing use of skilled care at delivery and in the postnatal period among antenatal care (ANC) attendees in a rural district with low occupancy of health units for delivery but high antenatal care uptake in northern Tanzania. Cluster randomised trial in Ngorongoro district, Arusha region, involving 16 health units (8 per arm). Nine hundred and five pregnant women at 24 weeks of gestation and above (404 in the intervention arm) were recruited and followed up to at least 1 month postpartum. Skilled delivery care uptake was 16.8% higher in the intervention units than in the control [95% CI 2.6-31.0; P = 0.02]. Postnatal care utilisation in the first month of delivery was higher (difference in proportions: 30.0% [95% CI 1.3-47.7; P < 0.01]) and also initiated earlier (mean duration 6.6 ± 1.7 days vs. 20.9 ± 4.4 days, P < 0.01) in the intervention than in the control arm. Women's and providers' reports of care satisfaction (received or provided) did not differ greatly between the two arms of the study (difference in proportion: 12.1% [95% CI -6.3-30.5] P = 0.17 and 6.9% [95% CI -3.2-17.1] P = 0.15, respectively). Implementation of birth plans during ANC can increase the uptake of skilled delivery and post delivery care in the study district without negatively affecting women's and providers' satisfaction with available ANC services. Birth plans should be considered along with the range of other recommended interventions as a strategy to improve the uptake of maternal health services. © 2013 Blackwell Publishing Ltd.

  8. Planning Intervention Using Dynamic Assessments: A Case Study

    Science.gov (United States)

    Hasson, Natalie; Dodd, Barbara

    2014-01-01

    Dynamic assessments (DA) of language have been shown to be a useful addition to the battery of tests used to diagnose language impairments in children, and to evaluate their skills. The current article explores the value of the information gained from a DA in planning intervention for a child with language impairment. A single case study was used…

  9. Clinician-centred interventions to increase vaginal birth after caesarean section (VBAC): a systematic review.

    Science.gov (United States)

    Lundgren, Ingela; Smith, Valerie; Nilsson, Christina; Vehvilainen-Julkunen, Katri; Nicoletti, Jane; Devane, Declan; Bernloehr, Annette; van Limbeek, Evelien; Lalor, Joan; Begley, Cecily

    2015-02-05

    The number of caesarean sections (CS) is increasing globally, and repeat CS after a previous CS is a significant contributor to the overall CS rate. Vaginal birth after caesarean (VBAC) can be seen as a real and viable option for most women with previous CS. To achieve success, however, women need the support of their clinicians (obstetricians and midwives). The aim of this study was to evaluate clinician-centred interventions designed to increase the rate of VBAC. The bibliographic databases of The Cochrane Library, PubMed, PsychINFO and CINAHL were searched for randomised controlled trials, including cluster randomised trials that evaluated the effectiveness of any intervention targeted directly at clinicians aimed at increasing VBAC rates. Included studies were appraised independently by two reviewers. Data were extracted independently by three reviewers. The quality of the included studies was assessed using the quality assessment tool, 'Effective Public Health Practice Project'. The primary outcome measure was VBAC rates. 238 citations were screened, 255 were excluded by title and abstract. 11 full-text papers were reviewed; eight were excluded, resulting in three included papers. One study evaluated the effectiveness of antepartum x-ray pelvimetry (XRP) in 306 women with one previous CS. One study evaluated the effects of external peer review on CS birth in 45 hospitals, and the third evaluated opinion leader education and audit and feedback in 16 hospitals. The use of external peer review, audit and feedback had no significant effect on VBAC rates. An educational strategy delivered by an opinion leader significantly increased VBAC rates. The use of XRP significantly increased CS rates. This systematic review indicates that few studies have evaluated the effects of clinician-centred interventions on VBAC rates, and interventions are of varying types which limited the ability to meta-analyse data. A further limitation is that the included studies were

  10. Clinician-centred interventions to increase vaginal birth after caesarean section (VBAC): a systematic review.

    LENUS (Irish Health Repository)

    Lundgren, Ingela

    2015-02-05

    BackgroundThe number of caesarean sections (CS) is increasing globally, and repeat CS after a previous CS is a significant contributor to the overall CS rate. Vaginal birth after caesarean (VBAC) can be seen as a real and viable option for most women with previous CS. To achieve success, however, women need the support of their clinicians (obstetricians and midwives). The aim of this study was to evaluate clinician-centred interventions designed to increase the rate of VBAC.MethodsThe bibliographic databases of The Cochrane Library, PubMed, PsychINFO and CINAHL were searched for randomised controlled trials, including cluster randomised trials that evaluated the effectiveness of any intervention targeted directly at clinicians aimed at increasing VBAC rates. Included studies were appraised independently by two reviewers. Data were extracted independently by three reviewers. The quality of the included studies was assessed using the quality assessment tool, `Effective Public Health Practice Project¿. The primary outcome measure was VBAC rates.Results238 citations were screened, 255 were excluded by title and abstract. 11 full-text papers were reviewed; eight were excluded, resulting in three included papers. One study evaluated the effectiveness of antepartum x-ray pelvimetry (XRP) in 306 women with one previous CS. One study evaluated the effects of external peer review on CS birth in 45 hospitals, and the third evaluated opinion leader education and audit and feedback in 16 hospitals. The use of external peer review, audit and feedback had no significant effect on VBAC rates. An educational strategy delivered by an opinion leader significantly increased VBAC rates. The use of XRP significantly increased CS rates.ConclusionsThis systematic review indicates that few studies have evaluated the effects of clinician-centred interventions on VBAC rates, and interventions are of varying types which limited the ability to meta-analyse data. A further limitation is that

  11. [Family intervention according to Roy. Planning, execution and evaluation].

    Science.gov (United States)

    de Montigny, F

    1992-10-01

    Last month, the author presented the first two steps necessary in the development of a nursing care plan. This care plan utilized Sister Callista Roy's conceptual model and was designed to evaluate the family system. The readers became familiar with the Joly family, whose family system was evaluated (this included Diane and Jessie). Analysis of the collected data identified two nursing diagnoses and the author explained the way that nursing diagnosis is derived. The first identified nursing diagnosis revealed a threat to the beneficiary, the second diagnosis revealed a threat to the family system. This second article is devoted to the three other steps involved in the development of a nursing care plan that will assist the nurse in developing a systematic strategy in caring for this type of family. The planning step consists of the identification of objectives for care. These objectives must be specific, measurable and realistic as well as able to answer the question: "What changes are intended for this family?" Suggestions are offered for objective development. Once the objectives are finalized, the nurse chooses pertinent and realistic interventions that permit her/him, as well as Diane, to attain the identified objectives. The nurse's interventions are centred around stimuli that are increased, decreased or maintained by the goal of modifying or reinforcing observed behaviors. In the care plan example developed for the Joly family, the identified interventions are not all inclusive and serve as suggestions. During the course of the interventions the nurse must constantly readjust and adapt the interventions to fit with changing needs.(ABSTRACT TRUNCATED AT 250 WORDS)

  12. [Journalism and family planning in Guinea-Bissau. Putting the accent on birth spacing].

    Science.gov (United States)

    Vaz, C

    1989-05-01

    A conference on awareness in the mass media of the problems of family planning was held in March 1989 at Bissau by the Guinean Association for Education and Promotion of Family Health (AGEPSF). Representatives of radio, a daily newspaper, and the national press agency discussed the objectives of AGEPSF and the benefits of family planning with specialists in different sectors of national life. The secretary general of AGEPSF affirmed the interest of the government in creating a health organization to coordinate national policy in family planning and to diffuse information on family planning. The family planning objective of the AGEPSF is not limitation of births but rather spacing to promote maternal and child health. AGEPSF is a member of the International Planned Parenthood Federation and maintains relations with similar organizations throughout the world. According to the director of the national maternity hospital, family planning is a sensitive topic but it has become accepted in numerous countries as marriage in rural areas and abortions in urban areas are widespread practices in Africa with potentially grave consequences. The general director of the National Institute for Studies and Research placed the theme of family planning in the context of Guinea-Bissau by citing the low level of education, the almost insignificant number of literate women, and the lack of health services in rural areas as the principal causes of increasing infant mortality in the country. African countries should create favorable conditions, elevate the level of living of their populations, and develop concrete health actions to reduce infant and maternal mortality.

  13. Outcomes of planned home births attended by certified nurse-midwives in southeastern Pennsylvania, 1983-2008.

    Science.gov (United States)

    Cox, Kim J; Schlegel, Ruth; Payne, Pat; Teaf, Dusty; Albers, Leah

    2013-01-01

    In this study, we examined the perinatal outcomes of planned home births over a 25-year period (1983-2008) in a group of primarily Amish women (98%) attended by certified nurse-midwives (CNMs) in southeastern Pennsylvania. This was a retrospective, descriptive analysis of data (N = 1836 births) from several CNM practices. Data were abstracted for 25 items, including demographics, labor, and birth. Initially, 2 investigators abstracted 15 records to compare assessments and standardize definitions. Charts were then divided and abstracted individually by one investigator. Several relationships were examined in 2 by 2 tables using the chi-square procedure for the difference in proportions. Maternal and newborn transfers to the hospital were included in the analysis. Of the women who planned home birth for 1836 pregnancies, 1733 of the births occurred at home. Although more than one-third of the women were of high parity (gravida 5-13), rates of postpartum hemorrhage were low (n = 96, 5.5%). There were no maternal deaths. Nearly half of the maternal transfers to the hospital (n = 103, 5.6%) were for ruptured membranes without labor (n = 25, 1.4%) and/or failure to progress (n = 23, 1.3%). The neonatal hospital admission rate also was low (n = 13, 0.75%). Of the 7 (0.4%) early neonatal deaths, all were attributed to lethal congenital anomalies that are common to this population. This study is the first to describe the outcomes of planned home births in a primarily Amish population cared for by CNMs. It also adds to the literature on planned home births in the United States and supports the findings from previous studies that women who have home births attended by CNMs have safety profiles equal to or better than profiles of women who had hospital births in similar populations. © 2013 by the American College of Nurse-Midwives.

  14. Perinatal mortality and morbidity in a nationwide cohort of 529,688 low-risk planned home and hospital births

    NARCIS (Netherlands)

    de jonge, A.; van der Goes, B. Y.; Ravelli, A. C. J.; Amelink-Verburg, M. P.; Mol, B. W.; Nijhuis, J. G.; Bennebroek Gravenhorst, J.; Buitendijk, S. E.

    2009-01-01

    OBJECTIVE: To compare perinatal mortality and severe perinatal morbidity between planned home and planned hospital births, among low-risk women who started their labour in primary care. DESIGN: A nationwide cohort study. SETTING: The entire Netherlands. POPULATION: A total of 529,688 low-risk women

  15. Factors influencing the enrollment of eligible extremely-low-birth-weight children in the part C early intervention program.

    Science.gov (United States)

    Wang, C Jason; Elliott, Marc N; Rogowski, Jeannette; Lim, Nelson; Ratner, Jessica A; Schuster, Mark A

    2009-01-01

    To determine whether eligible extremely-low-birth-weight children ( or =24 weeks, and survival for the first 120 days of life. We created a linked data set with data from Early Intervention (1996-2001), Vital Records (1996-1998), death certificates, and Medicaid. Each child was followed from birth to 3 years old, the program eligibility period. A total of 54% of ELBW children were enrolled in EI at any time from birth to 36 months. Even among children ever enrolled in Medicaid (83% of all ELBW children), only 63% were enrolled in EI. Being born in a multiple gestational birth, having heavier birth weight (750 to 999 g), and having ever enrolled in Medicaid were positively associated with EI enrollment. Among Medicaid patients for whom perinatal data were available, additional risk adjustment showed that EI enrollment was more likely with birth in level 3 hospitals, birth weight 750 to 999 g, Neonatal Medical Index severity level V (most severe), and longer initial length of hospital stay. Only about half of eligible ELBW children in South Carolina were enrolled-much lower than reported elsewhere. Efforts are needed to understand why eligible infants are not being enrolled and to develop strategies to remedy the situation.

  16. Planned vaginal birth or elective repeat caesarean: patient preference restricted cohort with nested randomised trial.

    Directory of Open Access Journals (Sweden)

    Caroline A Crowther

    Full Text Available BACKGROUND: Uncertainty exists about benefits and harms of a planned vaginal birth after caesarean (VBAC compared with elective repeat caesarean (ERC. We conducted a prospective restricted cohort study consisting of a patient preference cohort study, and a small nested randomised trial to compare benefits and risks of a planned ERC with planned VBAC. METHODS AND FINDINGS: 2,345 women with one prior caesarean, eligible for VBAC at term, were recruited from 14 Australian maternity hospitals. Women were assigned by patient preference (n = 2,323 or randomisation (n = 22 to planned VBAC (1,225 patient preference, 12 randomised or planned ERC (1,098 patient preference, ten randomised. The primary outcome was risk of fetal death or death of liveborn infant before discharge or serious infant outcome. Data were analysed for the 2,345 women (100% and infants enrolled. The risk of fetal death or liveborn infant death prior to discharge or serious infant outcome was significantly lower for infants born in the planned ERC group compared with infants in the planned VBAC group (0.9% versus 2.4%; relative risk [RR] 0.39; 95% CI 0.19-0.80; number needed to treat to benefit 66; 95% CI 40-200. Fewer women in the planned ERC group compared with women in the planned VBAC had a major haemorrhage (blood loss ≥ 1,500 ml and/or blood transfusion, (0.8% [9/1,108] versus 2.3% [29/1,237]; RR 0.37; 95% CI 0.17-0.80. CONCLUSIONS: Among women with one prior caesarean, planned ERC compared with planned VBAC was associated with a lower risk of fetal and infant death or serious infant outcome. The risk of major maternal haemorrhage was reduced with no increase in maternal or perinatal complications to time of hospital discharge. Women, clinicians, and policy makers can use this information to develop health advice and make decisions about care for women who have had a previous caesarean. TRIAL REGISTRATION: Current Controlled Trials ISRCTN53974531

  17. Planned vaginal birth or elective repeat caesarean: patient preference restricted cohort with nested randomised trial.

    Science.gov (United States)

    Crowther, Caroline A; Dodd, Jodie M; Hiller, Janet E; Haslam, Ross R; Robinson, Jeffrey S

    2012-01-01

    Uncertainty exists about benefits and harms of a planned vaginal birth after caesarean (VBAC) compared with elective repeat caesarean (ERC). We conducted a prospective restricted cohort study consisting of a patient preference cohort study, and a small nested randomised trial to compare benefits and risks of a planned ERC with planned VBAC. 2,345 women with one prior caesarean, eligible for VBAC at term, were recruited from 14 Australian maternity hospitals. Women were assigned by patient preference (n = 2,323) or randomisation (n = 22) to planned VBAC (1,225 patient preference, 12 randomised) or planned ERC (1,098 patient preference, ten randomised). The primary outcome was risk of fetal death or death of liveborn infant before discharge or serious infant outcome. Data were analysed for the 2,345 women (100%) and infants enrolled. The risk of fetal death or liveborn infant death prior to discharge or serious infant outcome was significantly lower for infants born in the planned ERC group compared with infants in the planned VBAC group (0.9% versus 2.4%; relative risk [RR] 0.39; 95% CI 0.19-0.80; number needed to treat to benefit 66; 95% CI 40-200). Fewer women in the planned ERC group compared with women in the planned VBAC had a major haemorrhage (blood loss ≥ 1,500 ml and/or blood transfusion), (0.8% [9/1,108] versus 2.3% [29/1,237]; RR 0.37; 95% CI 0.17-0.80). Among women with one prior caesarean, planned ERC compared with planned VBAC was associated with a lower risk of fetal and infant death or serious infant outcome. The risk of major maternal haemorrhage was reduced with no increase in maternal or perinatal complications to time of hospital discharge. Women, clinicians, and policy makers can use this information to develop health advice and make decisions about care for women who have had a previous caesarean. Current Controlled Trials ISRCTN53974531

  18. Infant behavioral assessment and intervention program in very low birth weight infants improves independency in mobility at preschool age

    NARCIS (Netherlands)

    Verkerk, Gijs; Jeukens-Visser, Martine; Koldewijn, Karen; van Wassenaer, Aleid; Houtzager, Bregje; Kok, Joke; Nollet, Frans

    2011-01-01

    To evaluate the effects of the Infant Behavioral Assessment and Intervention Program(©) (IBAIP) in very low birth weight infants on sensory processing and daily activities at preschool age. Follow-up of children included in a randomized controlled trial. Eighty-six infants were enrolled in

  19. Personal beliefs and alternative childbirth choices: a survey of 552 women who planned to give birth at home.

    Science.gov (United States)

    Bastian, H

    1993-12-01

    In Australia, planning to give birth at home was unusual in the middle to late 1980s, a choice made by only about 0.5 percent of women. This study investigated the personal beliefs and circumstances of 552 women who planned to give birth at home. Results showed that these women came from diverse backgrounds and beliefs, although in general they were of higher than average educational and occupational status, and less likely to hold Christian beliefs relative to the Australian community in general. Their lives and experiences reflected both unconventional and more traditional choices, and the view that women who give birth at home characteristically belong to the counterculture could not be justified. The findings of this study suggest that stereotypes of women who give birth at home do not apply to the circumstances of substantial numbers of women.

  20. Trends in the distribution of gestational age and contribution of planned births in New South Wales, Australia.

    Directory of Open Access Journals (Sweden)

    Natasha Nassar

    Full Text Available BACKGROUND: There is concern that the rate of planned births (by pre-labour caesarean section or induction of labour is increasing and that the gestation at which they are being conducted is decreasing. The aim of this study was to describe trends in the distribution of gestational age, and assess the contribution of planned birth to any such changes. METHODS: We utilised the New South Wales (NSW Perinatal Data Collection to undertake a population-based study of all births in NSW, Australia 1994-2009. Trends in gestational age were determined by year, labour onset and plurality of birth. RESULTS: From 1994-2009, there was a gradual and steady left-shift in overall distribution of gestational age at birth, with a decline in the modal gestational age from 40 to 39 weeks. For singletons, there was a steady but significant reduction in the proportion of spontaneous births. Labour inductions increased in the proportion performed, with a gradual and changing shift in the distribution from a majority at 40 weeks to an increase at both 37-39 weeks and 41 weeks gestation. The proportion of pre-labour caesareans also increased steadily at each gestational age and doubled since 1994, with most performed at 39 weeks in 2009 compared with 38 weeks up to 2001. CONCLUSIONS: Findings suggest a changing pattern towards births at earlier gestations, fewer births commencing spontaneously and increasing planned births. Factors associated with changing clinical practice and long-term implications on the health and well-being of mothers and babies should be assessed.

  1. Planned birth at or near term for improving health outcomes for pregnant women with gestational diabetes and their infants.

    Science.gov (United States)

    Biesty, Linda M; Egan, Aoife M; Dunne, Fidelma; Dempsey, Eugene; Meskell, Pauline; Smith, Valerie; Ni Bhuinneain, G Meabh; Devane, Declan

    2018-01-05

    no clear differences between women randomised to induction of labour and women randomised to expectant management for postpartum haemorrhage (RR 1.17, 95% CI 0.53 to 2.54, one trial, 425 women); admission to intensive care unit (RR 1.48, 95% CI 0.25 to 8.76, one trial, 425 women); and intact perineum (RR 1.02, 95% CI 0.73 to 1.43, one trial, 425 women). No infant experienced a birth trauma, therefore, we could not draw conclusions about the effect of the intervention on the outcomes of brachial plexus injury and bone fracture at birth. Infants of women in the induction-of-labour group had higher incidences of neonatal hyperbilirubinaemia (jaundice) when compared to infants of women in the expectant-management group (RR 2.46, 95% CI 1.11 to 5.46, one trial, 425 women).We found no data on the following prespecified outcomes of this review: postnatal depression, maternal satisfaction, length of postnatal stay (mother), acidaemia, intracranial haemorrhage, hypoxia ischaemic encephalopathy, small-for-gestational age, length of postnatal stay (baby) and cost.The authors of this trial acknowledge that it is underpowered for their primary outcome of caesarean section. The authors of the trial and of this review note that the CIs demonstrate a wide range, therefore making it inappropriate to draw definite conclusions. There is limited evidence to inform implications for practice. The available data are not of high quality and lack power to detect possible important differences in either benefit or harm. There is an urgent need for high-quality trials evaluating the effectiveness of planned birth at or near term gestation for women with gestational diabetes compared with an expectant approach.

  2. Perinatal mortality and morbidity up to 28 days after birth among 743 070 low-risk planned home and hospital births: a cohort study based on three merged national perinatal databases

    NARCIS (Netherlands)

    de Jonge, A.; Geerts, C.C.; van der Goes, B.Y.; Mol, B.W.; Buitendijk, S.E.; Nijhuis, J.G.

    2015-01-01

    Objective To compare rates of adverse perinatal outcomes between planned home births versus planned hospital births. Design A nationwide cohort study. Setting The Netherlands. Population Low-risk women in midwife-led care at the onset of labour. Methods Analysis of national registration data. Main

  3. Demographic Characteristics, Health Behaviors before and during Pregnancy, and Pregnancy and Birth Outcomes in Mothers with different Pregnancy Planning Status

    Science.gov (United States)

    Cheung, Yin Bun; Godfrey, Keith M.; Gluckman, Peter D.; Kwek, Kenneth; Saw, Seang Mei; Chong, Yap-Seng; Lee, Yung Seng; Yap, Fabian; Yen Chan, Jerry Kok; Lek, Ngee

    2016-01-01

    Studies on pregnancy intentions and their consequences have yielded mixed results. Here, we comprehensively analyzed the maternal characteristics, health behaviors before and during pregnancy, as well as pregnancy and birth outcomes, across three different pregnancy planning status in 861 women participating in an ongoing Asian mother-offspring cohort study. At 26-28 weeks’ gestation, the women’s intention and enthusiasm towards their pregnancy were used to classify their pregnancy into planned or unplanned, and unplanned pregnancy was further subdivided into mistimed or unintended. Data on maternal characteristics, health behaviors, and pregnancy outcomes up to that stage, were recorded. After delivery, birth outcomes of the offspring were recorded. Linear and logistic regression analyses were performed. Overall, 56% had a planned pregnancy, 39% mistimed, and 5% unintended. Compared to women who planned their pregnancy, women with mistimed pregnancy had higher body mass index, and were more likely to have cigarette smoke exposure and less likely to have folic acid supplementation. At 26-28 weeks’ gestation, unintended pregnancy was associated with increased anxiety. Neonates of mistimed pregnancy had shorter birth length compared to those of planned pregnancy, even after adjustment for maternal baseline demographics. These findings suggest that mothers who did not plan their pregnancy had less desirable characteristics or health behaviors before and during pregnancy, and poorer pregnancy and birth outcomes. Shorter birth length in mistimed pregnancy may be attributed to maternal behaviors before or in the early stages of pregnancy, therefore highlighting the importance of preconception health promotion and screening for women of child-bearing age. PMID:27577198

  4. 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

  5. Contraception and Birth Control

    Science.gov (United States)

    ... Facebook Twitter Pinterest Email Print About Contraception and Birth Control Contraception is the prevention of pregnancy. Contraception, or birth control, also allows couples to plan the timing ...

  6. Male Involvement in Maternal Health Planning Key to Utilization of Skilled Birth Services in Malindi Subcounty, Kenya

    Directory of Open Access Journals (Sweden)

    Lilian Nyamusi Nyandieka

    2016-01-01

    Full Text Available Background. In Malindi, rural populations face challenges in accessing skilled birth services. Consequently, the majority of women deliver at home and only seek help when they have complications. This paper reports part findings from a study conducted to assess health priority setting process and its implication on availability, access, and use of emergency obstetric care services in Malindi. Methods. The study utilized qualitative methods to collect data from health personnel and maternal health stakeholders including community members. Source and method triangulation was used to strengthen the credibility of study findings. Data was categorized manually into themes around issues relating to utilization of skilled birth services discussed in this paper. Findings. Various barriers to utilization of skilled birth services were cited. However, most were linked to mwenye (the husband who decides on the place of birth for the wife. Conclusion. Husbands are very influential in regard to decisions on skilled birth service utilization in this community. Their lack of involvement in maternal health planning may contribute as a barrier to utilization of skilled care by pregnant women. There is need to address the mwenye factor in an attempt to mitigate some of the barriers cited for nonutilization of skilled birth services.

  7. Healthcare system intervention for prevention of birth injuries – process evaluation of self-assessment, peer review, feedback and agreement for change

    Science.gov (United States)

    2012-01-01

    Background Patient safety is fundamental in high quality healthcare systems but despite an excellent record of perinatal care in Sweden some children still suffer from substandard care and unnecessary birth injuries. Sustainable patient safety improvements assume changes in key actors’ mental models, norms and culture as well as in the tools, design and organisation of work. Interventions positively affecting team mental models on safety issues are a first step to enhancing change. Our purpose was to study a national intervention programme for the prevention of birth injuries with the aim to elucidate how the main interventions of self-assessment, peer review, feedback and written agreement for change affected the teams and their mental model of patient safety, and thereby their readiness for change. Knowledge of relevant considerations before implementing this type of patient safety intervention series could thereby be increased. Methods Eighty participants in twenty-seven maternity units were interviewed after the first intervention sequence of the programme. A content analysis using a priori coding was performed in order to relate results to the anticipated outcomes of three basic interventions: self-assessment, peer review and written feedback, and agreement for change. Results The self-assessment procedure was valuable and served as a useful tool for elucidating strengths and weaknesses and identifying areas for improvement for a safer delivery in maternity units. The peer-review intervention was appreciated, despite it being of less value when considering the contribution to explicit outcome effects (i.e. new input to team mental models and new suggestions for actions). The feedback report and the mutual agreement on measures for improvements reached when signing the contract seemed exert positive pressures for change. Conclusions Our findings are in line with several studies stressing the importance of self-evaluation by encouraging a thorough review of

  8. Healthcare system intervention for prevention of birth injuries – process evaluation of self-assessment, peer review, feedback and agreement for change

    Directory of Open Access Journals (Sweden)

    Nyström Monica E

    2012-08-01

    Full Text Available Abstract Background Patient safety is fundamental in high quality healthcare systems but despite an excellent record of perinatal care in Sweden some children still suffer from substandard care and unnecessary birth injuries. Sustainable patient safety improvements assume changes in key actors’ mental models, norms and culture as well as in the tools, design and organisation of work. Interventions positively affecting team mental models on safety issues are a first step to enhancing change. Our purpose was to study a national intervention programme for the prevention of birth injuries with the aim to elucidate how the main interventions of self-assessment, peer review, feedback and written agreement for change affected the teams and their mental model of patient safety, and thereby their readiness for change. Knowledge of relevant considerations before implementing this type of patient safety intervention series could thereby be increased. Methods Eighty participants in twenty-seven maternity units were interviewed after the first intervention sequence of the programme. A content analysis using a priori coding was performed in order to relate results to the anticipated outcomes of three basic interventions: self-assessment, peer review and written feedback, and agreement for change. Results The self-assessment procedure was valuable and served as a useful tool for elucidating strengths and weaknesses and identifying areas for improvement for a safer delivery in maternity units. The peer-review intervention was appreciated, despite it being of less value when considering the contribution to explicit outcome effects (i.e. new input to team mental models and new suggestions for actions. The feedback report and the mutual agreement on measures for improvements reached when signing the contract seemed exert positive pressures for change. Conclusions Our findings are in line with several studies stressing the importance of self-evaluation by

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

    Science.gov (United States)

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

    2018-04-12

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

  10. Comparing two motor assessment tools to evaluate neurobehavioral intervention effects in infants with very low birth weight at 1 year.

    Science.gov (United States)

    Van Hus, Janeline W P; Jeukens-Visser, Martine; Koldewijn, Karen; Van Sonderen, Loekie; Kok, Joke H; Nollet, Frans; Van Wassenaer-Leemhuis, Aleid G

    2013-11-01

    Infants with very low birth weight (VLBW) are at increased risk for motor deficits, which may be reduced by early intervention programs. For detection of motor deficits and to monitor intervention, different assessment tools are available. It is important to choose tools that are sensitive to evaluate the efficacy of intervention on motor outcome. The purpose of this study was to compare the Alberta Infant Motor Scale (AIMS) and the Psychomotor Developmental Index (PDI) of the Bayley Scales of Infant Development-Dutch Second Edition (BSID-II-NL) in their ability to evaluate effects of an early intervention, provided by pediatric physical therapists, on motor development in infants with VLBW at 12 months corrected age (CA). This was a secondary study in which data collected from a randomized controlled trial (RCT) were used. At 12 months CA, 116 of 176 infants with VLBW participating in an RCT on the effect of the Infant Behavioral Assessment and Intervention Program were assessed with both the AIMS and the PDI. Intervention effects on the AIMS and PDI were compared. Corrected for baseline differences, significant intervention effects were found for AIMS and PDI scores. The highest effect size was for the AIMS subscale sit. A significant reduction of abnormal motor development in the intervention group was found only with the AIMS. No Dutch norms are available for the AIMS. The responsiveness of the AIMS to detect intervention effects was better than that of the PDI. Therefore, caution is recommended in monitoring infants with VLBW only with the PDI, and the use of both the AIMS and the Bayley Scales of Infant Development is advised when evaluating intervention effects on motor development at 12 months CA.

  11. A facility birth can be the time to start family planning: postpartum intrauterine device experiences from six countries.

    Science.gov (United States)

    Pfitzer, Anne; Mackenzie, Devon; Blanchard, Holly; Hyjazi, Yolande; Kumar, Somesh; Lisanework Kassa, Serawit; Marinduque, Bernabe; Mateo, Marie Grace; Mukarugwiro, Beata; Ngabo, Fidele; Zaeem, Shabana; Zafar, Zonobia; Smith, Jeffrey Michael

    2015-06-01

    Initiation of family planning at the time of birth is opportune, since few women in low-resource settings who give birth in a facility return for further care. Postpartum family planning (PPFP) and postpartum intrauterine device (PPIUD) services were integrated into maternal care in six low- and middle-income countries, applying an insertion technique developed in Paraguay. Facilities with high delivery volume were selected to integrate PPFP/PPIUD services into routine care. Effective PPFP/PPIUD integration requires training and mentoring those providers assisting women at the time of birth. Ongoing monitoring generated data for advocacy. The percentages of PPIUD acceptors ranged from 2.3% of women counseled in Pakistan to 5.8% in the Philippines. Rates of complications among women returning for follow-up were low. Expulsion rates were 3.7% in Pakistan, 3.6% in Ethiopia, and 1.7% in Guinea and the Philippines. Infection rates did not exceed 1.3%, and three countries recorded no cases. Offering PPFP/PPIUD at birth improves access to contraception. Copyright © 2015. Published by Elsevier Ireland Ltd.

  12. Planning for Desperate Climate Intervention: can it Make Sense?

    Science.gov (United States)

    Duncan, Robert

    2014-07-01

    The three National Academies of the United States, working together, authored a comprehensive report in 1992 titled: Policy Implications of Greenhouse Warming: Mitigation, Adaptation, and the Science Base. The authors discussed various possible methods of geoengineering to mitigate the adverse climate effects of the slow, steady buildup of greenhouse gasses in the Earth's atmosphere. Subsequently far less expensive, clever designs were developed by inventors such as Bill Gates and his collaborators, and these have been patented. Many of the techniques in this geoengineering proposition were commonly considered as methods of selectively polluting the upper atmosphere to block the solar luminosity, and hence they met with staunch resistance from the international scientific community. At the time, these geoengineering approaches were proposed as a method of countering the slow steady increase of the earth's temperature that was assumed to be a consequence of the increase in concentration of atmospheric molecules that contain carbon, such as CO2 and CH4. Such intentional intervention in a system as complex as the earth's atmosphere was considered by most scientists, including the authors, as reckless. Within this paper, we propose that the less expensive of these geoengineering plans be reconsidered, but that such a system never be deployed or tested at scale unless a genuine climate runaway condition arises in the future. The more economically compelling approaches should be further tested at the `lab bench' level, and in small laboratory-scale tests, and simulations. A comprehensive plan should be developed to manufacture the required materials at scale and to finalize the design of the necessary system, but no such deployment should be entered into at this time. The many risks of an intense, sudden release of greenhouse gasses, mainly methane and carbon dioxide from geologic sources, are reviewed briefly herein. We consider it only prudent to develop an economical

  13. The Best Laid Plans: Examining the Conditions under Which a Planning Intervention Improves Learning and Reduces Attrition

    Science.gov (United States)

    Sitzmann, Traci; Johnson, Stefanie K.

    2012-01-01

    Planning plays an instrumental role in prominent self-regulation theories (e.g., action regulation, control, goal setting), yet as a scientific community we know little about how people carry out their learning plans. Using an experimental field study, we implemented a repeated-measures intervention requiring trainees to create a plan for when,…

  14. Maternal attitudes towards home birth and their effect on birth outcomes in Iceland: A prospective cohort study.

    Science.gov (United States)

    Halfdansdottir, Berglind; Olafsdottir, Olof A; Hildingsson, Ingegerd; Smarason, Alexander Kr; Sveinsdottir, Herdis

    2016-03-01

    to examine the relationship between attitudes towards home birth and birth outcomes, and whether women's attitudes towards birth and intervention affected this relationship. a prospective cohort study. the study was set in Iceland, a sparsely populated island with harsh terrain, 325,000 inhabitants, high fertility and home birth rates, and less than 5000 births a year. a convenience sample of women who attended antenatal care in Icelandic health care centres, participated in the Childbirth and Health Study in 2009-2011, and expressed consistent attitudes towards home birth (n=809). of the participants, 164 (20.3%) expressed positive attitudes towards choosing home birth and 645 (79.7%) expressed negative attitudes. Women who had a positive attitude towards home birth had significantly more positive attitudes towards birth and more negative attitudes towards intervention than did women who had a negative attitude towards home birth. Of the 340 self-reported low-risk women that answered questionnaires on birth outcomes, 78 (22.9%) had a positive attitude towards home birth and 262 (77.1%) had a negative attitude. Oxytocin augmentation (19.2% (n=15) versus 39.1% (n=100)), epidural analgesia (19.2% (n=15) versus 33.6% (n=88)), and neonatal intensive care unit admission rates (0.0% (n=0) versus 5.0% (n=13)) were significantly lower among women who had a positive attitude towards home birth. Women's attitudes towards birth and intervention affected the relationship between attitudes towards home birth and oxytocin augmentation or epidural analgesia. the beneficial effect of planned home birth on maternal outcome in Iceland may depend to some extent on women's attitudes towards birth and intervention. Efforts to de-stigmatise out-of-hospital birth and de-medicalize women's attitudes towards birth might increase women׳s use of health-appropriate birth services. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. A combined planning and self-efficacy intervention to promote physical activity: a multiple mediation analysis.

    Science.gov (United States)

    Koring, Milena; Richert, Jana; Parschau, Linda; Ernsting, Anna; Lippke, Sonia; Schwarzer, Ralf

    2012-01-01

    Many individuals are motivated to improve their physical activity levels, but often fail to act upon their intention. Interventions fostering volitional strategies, such as action planning, coping planning, and self-efficacy beliefs, can help to translate intentions into behavior. This study examines the effectiveness and the mechanisms of a combined planning and self-efficacy intervention to promote physical activity among motivated individuals. Participants (N = 883) were randomly assigned to the intervention or to a waiting-list control condition. Multivariate analysis of variance revealed that the intervention resulted in significantly more physical activity, higher levels of action planning, coping planning, and volitional self-efficacy beliefs (p self-efficacy mediate between the intervention and physical activity. The study shows that the intervention successfully fostered physical activity and unfolds the underlying self-regulatory mechanisms of the intervention's effectiveness.

  16. The differences between pregnant women who request elective caesarean and those who plan for vaginal birth based on Health Belief Model.

    Science.gov (United States)

    Darsareh, Fatemeh; Aghamolaei, Teamur; Rajaei, Minoo; Madani, Abdoulhossain; Zare, Shahram

    2016-12-01

    Although vaginal birth is the safest type of childbirth, sometimes caesarean is necessary for the safety of the mother or the infant. The problem is that low-risk, healthy women are choosing caesarean as a birth option despite the fact that it is fraught with possible complications. To determine the differences and identify the predictors for the way women plan their childbirth based on Health Belief Model. A cross-sectional study was conducted in Bandar abbas city, Iran, from May to October 2015. The study recruited eligible women who self identified themselves as requesting a caesarean or vaginal birth in their response to a questionnaire. Of 470 recruited women, 183 (38.9%) planned to have a caesarean without medical indication. Maternal characteristics (age, level of education, occupational status, involvement in a medical profession, and household income) and obstetric variables (health provider type, place of prenatal care, and the number of children planned for the future) influenced the decisions made by the women. There was a significant difference between women planning a caesarean and those planning vaginal birth in terms of childbirth knowledge. Significant differences were observed regarding maternal self-efficacy, with women planning a caesarean reporting significantly lower self-efficacy than women planning a vaginal birth. Women planning a caesarean birth were also significantly less likely to perceive themselves as being at risk for caesarean-related side effects than women planning a vaginal birth. Comprehensive childbirth knowledge can lead to positive maternal attitude towards vaginal birth and may improve birth confidence. Copyright © 2016 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  17. Risk of maternal and neonatal complications in subsequent pregnancy after planned caesarean section in a first birth, compared with emergency caesarean section: a nationwide comparative cohort study

    NARCIS (Netherlands)

    Kok, N.; Ruiter, L.; Hof, M.; Ravelli, A.; Mol, B. W.; Pajkrt, E.; Kazemier, B.

    2014-01-01

    To compare the difference in risks of neonatal and maternal complications, including uterine rupture, in a second birth following a planned caesarean section versus emergency caesarean section in the first birth. Prospective cohort study. Population-based cohort in the Netherlands. Linked data set

  18. [Occupational health protection in business economics--business plan for health intervention].

    Science.gov (United States)

    Rydlewska-Liszkowska, Izabela

    2011-01-01

    One of the company's actions for strengthening human capital is the protection of health and safety of its employees. Its implementation needs financial resources, therefore, employers expect tangible effectiveness in terms of health and economics. Business plan as an element of company planning can be a helpful tool for new health interventions management. The aim of this work was to elaborate a business plan framework for occupational health interventions at the company level, combining occupational health practices with company management and economics. The business plan of occupational health interventions was based on the literature review, the author's own research projects and meta-analysis of research reports on economic relations between occupational health status and company productivity. The study resulted in the development of the business plan for occupational health interventions at the company level. It consists of summary and several sections that address such issues as the key elements of the intervention discussed against a background of the company economics and management, occupational health and safety status of the staff, employees' health care organization, organizational plan of providing the employees with health protection, marketing plan, including specificity of health interventions in the company marketing plan and financial plan, reflecting the economic effects of health care interventions on the overall financial management of the company. Business plan defines occupational health and safety interventions as a part of the company activities as a whole. Planning health care interventions without relating them to the statutory goals of the company may have the adverse impact on the financial balance and profitability of the company. Therefore, business plan by providing the opportunity of comparing different options of occupational health interventions to be implemented by employers is a key element of the management of employees

  19. The practical use of an interactive visualization and planning tool for intervention planning in particle accelerator environments with ionizing radiation

    Energy Technology Data Exchange (ETDEWEB)

    Fabry, Thomas, E-mail: thomas.fabry@cern.ch [European Organization for Nuclear Research, CERN, CH-1211 Genève 23 (Switzerland); Blaha, Jan; Vanherpe, Liesbeth [European Organization for Nuclear Research, CERN, CH-1211 Genève 23 (Switzerland); Braesch, Christian; Tabourot, Laurent [SYMME, Université de Savoie, Polytech Annecy-Chambéry, 5 Chemin de Bellevue, 74944 Annecy le Vieux (France); Feral, Bruno [European Organization for Nuclear Research, CERN, CH-1211 Genève 23 (Switzerland)

    2014-04-11

    A core issue during the planning of a maintenance intervention in a facility with ionizing radiation is the minimization of the integrated equivalent dose contracted by the maintenance workers during the intervention. In this work, we explore the use of a technical-scientific software program facilitating the intervention planning in irradiated environments using sound mathematical concepts. We show how the software can be used in planning future operations using a case studies: the decommissioning of a beam dump for a linear 160 MeV H{sup −} accelerator. Interactive visualization of the facilities and radiation levels, as well as tools for interactive trajectory planning are explored, as well as automatic calculation of the expected integrated individual dose contracted during an intervention.

  20. The practical use of an interactive visualization and planning tool for intervention planning in particle accelerator environments with ionizing radiation

    CERN Document Server

    Fabry, Thomas; Vanherpe, Liesbeth; Braesch, Christian; Tabourot, Laurent; Feral, Bruno

    2014-01-01

    A core issue during the planning of a maintenance intervention in a facility with ionizing radiation is the minimization of the integrated equivalent dose contracted by the maintenance workers during the intervention. In this work, we explore the use of a technical-scientific software program facilitating the intervention planning in irradiated environments using sound mathematical concepts. We show how the software can be used in planning future operations using a case studies: the decommissioning of a beam dump for a linear 160 MeV H− accelerator. Interactive visualization of the facilities and radiation levels, as well as tools for interactive trajectory planning are explored, as well as automatic calculation of the expected integrated individual dose contracted during an intervention.

  1. Serious adverse neonatal outcomes such as 5-minute Apgar score of zero and seizures or severe neurologic dysfunction are increased in planned home births after cesarean delivery

    OpenAIRE

    Gr?nebaum, Amos; McCullough, Laurence B.; Arabin, Birgit; Chervenak, Frank A.

    2017-01-01

    The United States is with 37,451 home births in 2014 the country with the largest absolute number of home births among all developed countries. The purpose of this study was to examine the occurrence and risks of a 5-minute Apgar score of zero and neonatal seizures or serious neurologic dysfunction in women with a history of prior cesarean delivery for planned home vaginal birth after cesarean (VBAC), compared to hospital VBAC and hospital birth cesarean deliveries for term normal weight infa...

  2. Family-Centered Early Intervention Visual Impairment Services through Matrix Session Planning

    Science.gov (United States)

    Ely, Mindy S.; Gullifor, Kateri; Hollinshead, Tara

    2017-01-01

    Early intervention visual impairment services are built on a model that values family. Matrix session planning pulls together parent priorities, family routines, and identified strategies in a way that helps families and early intervention professionals outline a plan that can both highlight long-term goals and focus on what can be done today.…

  3. What is the impact of interventions that prevent fetal mortality on the increase of preterm live births in the State of Sao Paulo, Brazil?

    Science.gov (United States)

    Alencar, Gizelton Pereira; da Silva, Zilda Pereira; Santos, Patrícia Carla; Raspantini, Priscila Ribeiro; Moura, Barbara Laisa Alves; de Almeida, Marcia Furquim; do Nascimento, Felipe Parra; Rodrigues, Laura C

    2015-07-23

    There is a global growing trend of preterm births and a decline trend of fetal deaths. Is there an impact of the decline of fetal mortality on the increase of preterm live births in State of Sao Paulo, Brazil? The time trends were evaluated by gestational age through exponential regression analysis. Data analyzed included the fetal mortality ratio, proportion of preterm live births, fertility rate of women 35 years and over, prenatal care, mother's education, multiple births and cesarean section deliveries. A survival analysis was carried out for 2000 and 2010. Preterm births showed the highest annual increase (3.2%) in the less than 28 weeks of gestation group and fetal mortality ratio decreased (7.4%) in the same gestational age group. There was an increase of cesarean section births and it was higher in the increased trend in multiple births and fertility rates of women of 35 years and over. The variables were highly correlated to which other over time. In 2000, 8.2% of all pregnancies resulted in preterm births (0.9% in fetal deaths and 7.3% in live births). In 2010, the preterm birth increased to 9.4% (0.8% were preterm fetal deaths and 8.6% preterm live births). The results suggest that 45.2% could be the maximum contribution of successful interventions to prevent a fetal death on the increase in preterm live births. This increasing trend is also related to changes of the women reproductive profile with the change of the women reproductive profile and access to prenatal care.

  4. Assessment of Individual Doses and Intervention Planning at CERN

    International Nuclear Information System (INIS)

    Brugger, M.; Forkel-Wirth, D.; Gaborit, J.C.; Menzel, H.; Roesler, S.; Vincke, H.

    2006-01-01

    Founded in 1954, CERN is the European Organization for Nuclear Research, one of the world's largest international particle physics centres. It sits astride the Franco-Swiss border near Geneva. The Large Hadron Collider (Lhc) is currently being installed in a 27-kilometer ring tunnel, buried deep below the countryside on the outskirts of Geneva, Switzerland and the Pays de Gex, France. When its operation begins in 2007, the Lhc will be the world's most powerful particle accelerator. The start-up and the operation of the Lhc will mark a new era for CERN's operational radiation protection. The total surface of CERN's radiation areas will enlarge significantly and a large number of work places have to be regularly monitored by CERN's radiation protection group. The maintenance personnel will comprise CERN staff, outside contractors and a large number of physicists from all over the world. CERN meets this challenge by applying optimisation processes already in the design of accelerator and detector components and by an appropriate intervention and dose planning during operation. Detailed Monte Carlo calculations were performed during the design phase of the Lhc and were used to identify the potential radiation hazards during future maintenance in areas with elevated beam losses (accelerator ejection and injection, beam dumps, target areas or beam cleaning insertions) and thus elevated dose rates. In an iterative way, the design of the accelerator components and the layout of these regions were optimised. The impact of the proposed modifications on the dose to personnel was evaluated by Monte Carlo simulations. Calculated individual and collective doses were then compared to design constraints. (authors)

  5. On-site emergency intervention plan for nuclear accident situation at SCN-Pitesti TRIGA Reactor

    International Nuclear Information System (INIS)

    Margeanu, S.; Oprea, I.

    2008-01-01

    A 14 MW TRIGA research reactor is operated on the Institute for Nuclear Research site. In the event of a nuclear accident or radiological emergency that may affect the public the effectiveness of protective actions depends on the adequacy of intervention plans prepared in advance. Considerable planning is necessary to reduce to manageable levels the types of decisions leading to effective responses to protect the public in such an event. The essential structures of our on-site, off-site and county emergency intervention plan and the correlation between emergency intervention plans are presented. (authors)

  6. Planning for the Future: A Model for Using the Principles of Transition to Guide the Development of Behavior Intervention Plans

    Science.gov (United States)

    Mueller, Tracy Gershwin; Bassett, Diane S.; Brewer, Robin D.

    2012-01-01

    The Individuals with Disabilities Education Act (IDEA) mandates the implementation of a behavior intervention plan based on a functional behavioral assessment when a student's behavior necessitates disciplinary actions. However, IDEA does not provide any clear guidelines as to what the plans should contain nor how they can address behaviors that…

  7. Family Involvement in Early Intervention Service Planning: Links to Parental Satisfaction and Self-Efficacy

    Science.gov (United States)

    Popp, Tierney K.; You, Hyun-Kyung

    2016-01-01

    The mediating role of parental satisfaction in the relation between family involvement in early intervention service planning and parental self-efficacy was explored. Participants included families of children with disability or delay involved in early intervention (n = 2586). Data were examined upon entry into early intervention (T1) and at…

  8. Translating the Social-Ecological Perspective into Multilevel Interventions for Family Planning: How Far Are We?

    Science.gov (United States)

    Schölmerich, Vera L. N.; Kawachi, Ichiro

    2016-01-01

    Scholars and practitioners frequently make recommendations to develop family planning interventions that are "multilevel." Such interventions take explicit account of the role of environments by incorporating multilevel or social-ecological frameworks into their design and implementation. However, research on how interventions have…

  9. U.A.R.: influential factors in the acceptance of birth control and the consequential approaches to family planning.

    Science.gov (United States)

    Rzepnicki, T; Diller, C

    1973-01-01

    A number of factors have retarded the acceptance of birth control methods among peasant communities in Egypt: 1) the religious world-view of the peasant discourages him from interfering with the natural process of procreation; 2) the large family is important socially and economically in peasant society for strength and security and for the distribution of labor; 3) the status of a married woman depends to a great extent on the number of children, particularly the number of sons, she bears; and 4) in the Egyptian village, the midwife discourages the use of contraception. Acceptance and utilization of birth control methods in Egypt are directly proportionate to the level of education of the individual. The better the economic status of the family, the smaller the family is likely to be. Demographically, the closer a family lives to Cairo, the more likely it is that birth control techniques are being used. Egyptian family planning programs which take into consideration the difficulties of spreading the acceptance and use of contraceptives in traditional societies are discussed.

  10. Intervention planning for a digital intervention for self-management of hypertension: a theory-, evidence- and person-based approach.

    Science.gov (United States)

    Band, Rebecca; Bradbury, Katherine; Morton, Katherine; May, Carl; Michie, Susan; Mair, Frances S; Murray, Elizabeth; McManus, Richard J; Little, Paul; Yardley, Lucy

    2017-02-23

    This paper describes the intervention planning process for the Home and Online Management and Evaluation of Blood Pressure (HOME BP), a digital intervention to promote hypertension self-management. It illustrates how a Person-Based Approach can be integrated with theory- and evidence-based approaches. The Person-Based Approach to intervention development emphasises the use of qualitative research to ensure that the intervention is acceptable, persuasive, engaging and easy to implement. Our intervention planning process comprised two parallel, integrated work streams, which combined theory-, evidence- and person-based elements. The first work stream involved collating evidence from a mixed methods feasibility study, a systematic review and a synthesis of qualitative research. This evidence was analysed to identify likely barriers and facilitators to uptake and implementation as well as design features that should be incorporated in the HOME BP intervention. The second work stream used three complementary approaches to theoretical modelling: developing brief guiding principles for intervention design, causal modelling to map behaviour change techniques in the intervention onto the Behaviour Change Wheel and Normalisation Process Theory frameworks, and developing a logic model. The different elements of our integrated approach to intervention planning yielded important, complementary insights into how to design the intervention to maximise acceptability and ease of implementation by both patients and health professionals. From the primary and secondary evidence, we identified key barriers to overcome (such as patient and health professional concerns about side effects of escalating medication) and effective intervention ingredients (such as providing in-person support for making healthy behaviour changes). Our guiding principles highlighted unique design features that could address these issues (such as online reassurance and procedures for managing concerns). Causal

  11. Evaluation of Progesterone Utilization and Birth Outcomes in a State Medicaid Plan.

    Science.gov (United States)

    Hydery, Tasmina; Price, Mylissa K; Greenwood, Bonnie C; Takeshita, Mito; Kunte, Parag S; Mauro, Rose P; Lenz, Kimberly; Jeffrey, Paul L

    2017-10-01

    Progesterone (hydroxyprogesterone caproate injection and vaginal progesterone) has been shown to reduce preterm birth (PTB) rates by a third among pregnant women at high risk. The purpose of this analysis is to report birth outcomes and medication adherence among Massachusetts Medicaid (MassHealth) members receiving progesterone, evaluate the association between member characteristics and birth outcomes and medication adherence, and compare cost of care with a prior preterm pregnancy. This retrospective cohort study used medical claims, pharmacy claims, and prior authorization (PA) request data for MassHealth members who had a PA submitted for progesterone between January 1, 2011, and March 31, 2015. Members were excluded due to breaks in coverage, progesterone was not indicated for prevention of PTB, and if current gestational week or date of delivery was unavailable. A total of 418 members were screened for inclusion of whom 190 met criteria and 169 filled progesterone. Mean age was 29.2 years (SD = 5.23), and clinical comorbidities were identified in 90.5% of members. Consistent with clinical trials on progesterone effectiveness, 62.1% of members had a term delivery (37 wks of gestation). Among members with prior gestational age at delivery available, the average difference in gestational age between pregnancies was 8.25 weeks (SD = 6.11). In addition, 66.3% of members were adherent to progesterone based on proportion of days covered (PDC) of 0.8 or higher. The overall mean PDC was 0.79 (SD = 0.26). Despite similar birth outcomes in clinical trials and national trends, medication adherence is low in this state Medicaid program. Therefore, members may benefit from adherence support. © 2017 Pharmacotherapy Publications, Inc.

  12. Project of Particular intervention plan of the Belleville-sur-Loire NPP. Special provisions of the ORSEC plan

    International Nuclear Information System (INIS)

    2015-01-01

    The Particular intervention plan (PPI in French) is an emergency plan which foresees the measures and means to be implemented to address the potential risks of the presence and operation of a nuclear facility. This plan is implemented and developed by the Prefect in case of nuclear accident (or incident leading to a potential accident), the impact of which extending beyond the facility perimeter. It represents a special section of the organisation plan for civil protection response (ORSEC plan). The PPI foresees the necessary measures and means for crisis management during the first hours following the accident and is triggered by the Department Prefect according to the information provided by the facility operator. Its aim is to protect the populations leaving within 10 km of the facility against a potential radiological hazard. The PPI describes: the facility, the intervention area, the protection measures for the population, the conditions of emergency plan triggering, the crisis organisation, the action forms of the different services, and the post-accident stage. This document is the project of Particular intervention plan for the Belleville-sur-Loire Nuclear Power Plant (Cher, France)

  13. A Community-Based Intervention to Prevent Obesity Beginning at Birth among American Indian Children: Study Design and Rationale for the PTOTS Study

    Science.gov (United States)

    Karanja, Njeri; Aickin, Mikel; Lutz, Tam; Mist, Scott; Jobe, Jared B.; Maupome, Gerardo; Ritenbaugh, Cheryl

    2012-01-01

    Eating and physical activity behaviors associated with adult obesity have early antecedents, yet few studies have focused on obesity prevention interventions targeting very young children. Efforts to prevent obesity beginning at birth seem particularly important in populations at risk for early-onset obesity. National estimates indicate that…

  14. Sustained developmental effects of the infant behavioral assessment and intervention program in very low birth weight infants at 5.5 years corrected age

    NARCIS (Netherlands)

    van Hus, Janeline W. P.; Jeukens-Visser, Martine; Koldewijn, Karen; Geldof, Christiaan J. A.; Kok, Joke H.; Nollet, Frans; van Wassenaer-Leemhuis, Aleid G.

    2013-01-01

    To evaluate the effect of the Infant Behavioral Assessment and Intervention Program (IBAIP) in very low birth weight (VLBW) infants on cognitive, neuromotor, and behavioral development at 5.5 years corrected age (CA). In a randomized controlled trial, 86 VLBW infants received post discharge IBAIP

  15. Rates of obstetric intervention during birth and selected maternal and perinatal outcomes for low risk women born in Australia compared to those born overseas.

    Science.gov (United States)

    Dahlen, Hannah G; Schmied, Virginia; Dennis, Cindy-Lee; Thornton, Charlene

    2013-05-01

    There are mixed reports in the literature about obstetric intervention and maternal and neonatal outcomes for migrant women born in resource rich countries. The aim of this study was to compare the risk profile, rates of obstetric intervention and selected maternal and perinatal outcomes for low risk women born in Australia compared to those born overseas. A population-based descriptive study was undertaken in NSW of all singleton births recorded in the NSW Midwives Data Collection between 2000-2008 (n=691,738). Risk profile, obstetric intervention rates and selected maternal and perinatal outcomes were examined. Women born in Australia were slightly younger (30 vs 31 years), less likely to be primiparous (41% vs 43%), three times more likely to smoke (18% vs 6%) and more likely to give birth in a private hospital (26% vs 18%) compared to women not born in Australia. Among the seven most common migrant groups to Australia, women born in Lebanon were the youngest, least likely to be primiparous and least likely to give birth in a private hospital. Hypertension was lowest amongst Vietnamese women (3%) and gestational diabetes highest amongst women born in China (14%). The highest caesarean section (31%), instrumental birth rates (16%) and episiotomy rates (32%) were seen in Indian women, along with the highest rates of babies obstetric intervention rates and maternal and neonatal outcomes between Australian-born and women born overseas and these differences are seen overall and in low risk populations. The finding that Indian women (the leading migrant group to Australia) have the lowest normal birth rate and high rates of low birth weight babies is concerning, and attention needs to be focused on why there are disparities in outcomes and on effective models of care that might improve outcomes for this population.

  16. Health Promotion Interventions for Low-Income Californians Through Medi-Cal Managed Care Plans, 2012.

    Science.gov (United States)

    Backman, Desiree R; Kohatsu, Neal D; Paciotti, Brian M; Byrne, Jennifer V; Kizer, Kenneth W

    2015-11-12

    Prevention is the most cost-effective approach to promote population health, yet little is known about the delivery of health promotion interventions in the nation's largest Medicaid program, Medi-Cal. The purpose of this study was to inventory health promotion interventions delivered through Medi-Cal Managed Care Plans; identify attributes of the interventions that plans judged to have the greatest impact on their members; and determine the extent to which the plans refer members to community assistance programs and sponsor health-promoting community activities. The lead health educator from each managed care plan was asked to complete a 190-item online survey in January 2013; 20 of 21 managed care plans responded. Survey data on the health promotion interventions with the greatest impact were grouped according to intervention attributes and measures of effectiveness; quantitative data were analyzed using descriptive statistics. Health promotion interventions judged to have the greatest impact on Medi-Cal members were delivered in various ways; educational materials, one-on-one education, and group classes were delivered most frequently. Behavior change, knowledge gain, and improved disease management were cited most often as measures of effectiveness. Across all interventions, median educational hours were limited (2.4 h), and median Medi-Cal member participation was low (265 members per intervention). Most interventions with greatest impact (120 of 137 [88%]) focused on tertiary prevention. There were mixed results in referring members to community assistance programs and investing in community activities. Managed care plans have many opportunities to more effectively deliver health promotion interventions. Establishing measurable, evidence-based, consensus standards for such programs could facilitate improved delivery of these services.

  17. Self-Efficacy, Planning and Action Control in an Oral Self-Care Intervention

    Science.gov (United States)

    Zhou, Guangyu; Sun, Caiyun; Knoll, Nina; Hamilton, Kyra; Schwarzer, Ralf

    2015-01-01

    To evaluate a theory-guided intervention on oral self-care and examine the possible mechanisms among self-regulatory factors, two brief intervention arms were compared, an information-based education treatment and a self-regulation treatment focusing on planning and action control. Young adults (N = 284; aged 18-29 years) were assessed at baseline…

  18. [Differential fertility by intelligence. The role of birth planning (Author's transl)].

    Science.gov (United States)

    Udry, J R

    1979-10-01

    A survey was conducted in 1974 among white residents of 16 U.S. cities to investigate the relationship between intelligence and fertility. The IQ was measured with the Peabody Picture Vocabulary Test, and fertility was measured on the number of born children. Age, duration of marriage, profession, and influence of social milieu were also taken into consideration. An inverse relationship was found between fertility and IQ, caused by the fact that low IQ women had more unwanted births than high IQ women. It was also shown that low IQ women had an elevated failure rate with any contraceptive method, and that the best way to control their fertility was to utilize exclusively permanent contraceptive methods administered by a physician.

  19. Decision Driven Scenario Planning for Process-Level Interventions

    Science.gov (United States)

    Chemarck, Thomas J.; Payne, Tiffani D.

    2005-01-01

    This article builds on previous work that classified types of scenario planning as effective or relevant for particular situations, by adding consideration for levels within the organization. In addition, the argument is built for using a particular form of scenarios to anticipate or explore process level problems and outcomes. The problem of…

  20. Automatic image processing solutions for MRI-guided minimally invasive intervention planning

    NARCIS (Netherlands)

    Noorda, YH

    2016-01-01

    In this thesis, automatic image processing methods are discussed for the purpose of improving treatment planning of MRI-guided minimally invasive interventions. Specifically, the following topics are addressed: rib detection in MRI, liver motion modeling in MRI and MR-CT registration of planning

  1. Economic Evaluation of Family Planning Interventions in Low and Middle Income Countries : A Systematic Review

    NARCIS (Netherlands)

    Zakiyah, Neily; van Asselt, Antoinette D. I.; Roijmans, Frank; Postma, Maarten J.

    2016-01-01

    Background A significant number of women in low and middle income countries (L-MICs) who need any family planning, experience a lack in access to modern effective methods. This study was conducted to review potential cost effectiveness of scaling up family planning interventions in these regions

  2. Challenges of Planning a Birth-to-Three Evaluation: A Universal Early Childhood System Evaluation

    Science.gov (United States)

    Leow, Christine; Hilado, Aimee; Limlingan, Maria Cristina; Howard, Eboni

    2014-01-01

    In an effort to bring rigorous research into the education and social sciences field, the past decade had seen an increase in the advocacy of randomized controlled trials. The argument in favor of using randomized controlled trial is that one can evaluate the impact of an intervention in comparison to a control group with confidence during a…

  3. Youth Unemployment, Deprivation and Educational Planning Intervention in Nigeria

    OpenAIRE

    Sambo, Maria Anpe; Bawa, John

    2017-01-01

    Youth unemployment poses grave economic and social problems for Nigeria and requires urgent attention. Youth are the engine room that propels any society to greater heights. This paper looks at the youths’ unemployment situation, deprivation and policy interventions. These youths have become a “generation at risk” because of the lack of sufficient or sustainable decent work making them extremely vulnerable. The paper also examines the theoretical theory to underpin it as well as consequences ...

  4. Economic Evaluation of Family Planning Interventions in Low and Middle Income Countries; A Systematic Review.

    Science.gov (United States)

    Zakiyah, Neily; van Asselt, Antoinette D I; Roijmans, Frank; Postma, Maarten J

    2016-01-01

    A significant number of women in low and middle income countries (L-MICs) who need any family planning, experience a lack in access to modern effective methods. This study was conducted to review potential cost effectiveness of scaling up family planning interventions in these regions from the published literatures and assess their implication for policy and future research. A systematic review was performed in several electronic databases i.e Medline (Pubmed), Embase, Popline, The National Bureau of Economic Research (NBER), EBSCOHost, and The Cochrane Library. Articles reporting full economic evaluations of strategies to improve family planning interventions in one or more L-MICs, published between 1995 until 2015 were eligible for inclusion. Data was synthesized and analyzed using a narrative approach and the reporting quality of the included studies was assessed using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement. From 920 references screened, 9 studies were eligible for inclusion. Six references assessed cost effectiveness of improving family planning interventions in one or more L-MICs, while the rest assessed costs and consequences of integrating family planning and HIV services, concerning sub-Saharan Africa. Assembled evidence suggested that improving family planning interventions is cost effective in a variety of L-MICs as measured against accepted international cost effectiveness benchmarks. In areas with high HIV prevalence, integrating family planning and HIV services can be efficient and cost effective; however the evidence is only supported by a very limited number of studies. The major drivers of cost effectiveness were cost of increasing coverage, effectiveness of the interventions and country-specific factors. Improving family planning interventions in low and middle income countries appears to be cost-effective. Additional economic evaluation studies with improved reporting quality are necessary to generate

  5. Economic Evaluation of Family Planning Interventions in Low and Middle Income Countries; A Systematic Review.

    Directory of Open Access Journals (Sweden)

    Neily Zakiyah

    Full Text Available A significant number of women in low and middle income countries (L-MICs who need any family planning, experience a lack in access to modern effective methods. This study was conducted to review potential cost effectiveness of scaling up family planning interventions in these regions from the published literatures and assess their implication for policy and future research.A systematic review was performed in several electronic databases i.e Medline (Pubmed, Embase, Popline, The National Bureau of Economic Research (NBER, EBSCOHost, and The Cochrane Library. Articles reporting full economic evaluations of strategies to improve family planning interventions in one or more L-MICs, published between 1995 until 2015 were eligible for inclusion. Data was synthesized and analyzed using a narrative approach and the reporting quality of the included studies was assessed using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS statement.From 920 references screened, 9 studies were eligible for inclusion. Six references assessed cost effectiveness of improving family planning interventions in one or more L-MICs, while the rest assessed costs and consequences of integrating family planning and HIV services, concerning sub-Saharan Africa. Assembled evidence suggested that improving family planning interventions is cost effective in a variety of L-MICs as measured against accepted international cost effectiveness benchmarks. In areas with high HIV prevalence, integrating family planning and HIV services can be efficient and cost effective; however the evidence is only supported by a very limited number of studies. The major drivers of cost effectiveness were cost of increasing coverage, effectiveness of the interventions and country-specific factors.Improving family planning interventions in low and middle income countries appears to be cost-effective. Additional economic evaluation studies with improved reporting quality are necessary

  6. Use of geographic information systems for planning HIV prevention interventions for high-risk youths.

    Science.gov (United States)

    Geanuracos, Catherine G; Cunningham, Shayna D; Weiss, George; Forte, Draco; Reid, Lisa M Henry; Ellen, Jonathan M

    2007-11-01

    Geographic information system (GIS) analysis is an emerging tool for public health intervention planning. Connect to Protect, a researcher-community collaboration working in 15 cities to reduce HIV infection among youths, developed GIS databases of local health, crime, and demographic data to evaluate the geographic epidemiology of sexually transmitted infections and HIV risk among adolescents. We describe the process and problems of data acquisition, analysis, and mapping in the development of structural interventions, demonstrating how program planners can use this technology to inform and improve planning decisions. The Connect to Protect project's experience suggests strategies for incorporating public data and GIS technology into the next generation of public health interventions.

  7. Serious adverse neonatal outcomes such as 5-minute Apgar score of zero and seizures or severe neurologic dysfunction are increased in planned home births after cesarean delivery.

    Directory of Open Access Journals (Sweden)

    Amos Grünebaum

    Full Text Available The United States is with 37,451 home births in 2014 the country with the largest absolute number of home births among all developed countries. The purpose of this study was to examine the occurrence and risks of a 5-minute Apgar score of zero and neonatal seizures or serious neurologic dysfunction in women with a history of prior cesarean delivery for planned home vaginal birth after cesarean (VBAC, compared to hospital VBAC and hospital birth cesarean deliveries for term normal weight infants in the United States from 2007-2014. We report in this study outcomes of women who had one or more prior cesarean deliveries and included women who had a successful vaginal birth after a trial of labor after cesarean (TOLAC at home and in the hospital, and a repeat cesarean delivery in the hospital. We excluded preterm births (<37 weeks and infants weighing under 2500 g. Hospital VBACS were the reference. Women with a planned home birth VBAC had an approximately 10-fold and higher increase in adverse neonatal outcomes when compared to hospital VBACS and hospital repeat cesarean deliveries, a significantly higher incidence and risk of a 5-minute Apgar score of 0 of 1 in 890 (11.24/10,000, relative risk 9.04, 95% confidence interval 4-20.39, p<.0001 and an incidence of neonatal seizures or severe neurologic dysfunction of 1 in 814 (Incidence: 12.27/10,000, relative risk 11.19, 95% confidence interval 5.13-24.29, p<.0001. Because of the significantly increased neonatal risks, obstetric providers should therefore not offer or perform planned home TOLACs and for those desiring a VBAC should strongly recommend a planned TOLAC in the appropriate hospital setting. We emphasize that this stance should be accompanied by effective efforts to make TOLAC available in the appropriate hospital setting.

  8. Experiences and lessons learned for planning and supply of micronutrient powders interventions

    Science.gov (United States)

    Schauer, Claudia; Sunley, Nigel; Nyhus Dhillon, Christina; Roca, Claudia; Tapia, Gustavo; Mathema, Pragya; Walton, Shelley; Situma, Ruth; Zlotkin, Stanley; DW Klemm, Rolf

    2017-01-01

    Abstract Realistic planning for a nutrition intervention is a critical component of implementation, yet effective approaches have been poorly documented. Under the auspices of “The Micronutrient Powders Consultation: Lessons Learned for Operational Guidance,” 3 working groups were formed to summarize experiences and lessons across countries regarding micronutrient powders (MNP) interventions for young children. This paper focuses on programmatic experiences in the planning stages of an MNP intervention, encompassing assessment, enabling environment and adaptation, as well as considerations for supply. Methods included a review of published and grey literature, key informant interviews, and deliberations throughout the consultation process. We found that assessments helped justify adopting an MNP intervention, but these assessments were often limited by their narrow scope and inadequate data. Establishing coordinating bodies and integrating MNP into existing policies and programmes have helped foster an enabling environment and support programme stability. Formative research and pilots have been used to adapt MNP interventions to specific contexts, but they have been insufficient to inform scale‐up. In terms of supply, most countries have opted to procure MNP through international suppliers, but this still requires understanding and navigating the local regulatory environment at the earliest stages of an intervention. Overall, these findings indicate that although some key planning and supply activities are generally undertaken, improvements are needed to plan for effective scale‐up. Much still needs to be learned on MNP planning, and we propose a set of research questions that require further investigation. PMID:28960875

  9. A Business Case Framework for Planning Clinical Nurse Specialist-Led Interventions.

    Science.gov (United States)

    Bartlett Ellis, Rebecca J; Embree, Jennifer L; Ellis, Kurt G

    2015-01-01

    The purpose of this article is to describe a business case framework that can guide clinical nurse specialists (CNS) in clinical intervention development. Increased emphasis on cost-effective interventions in healthcare requires skills in analyzing the need to make the business case, especially for resource-intensive interventions. This framework assists the CNS to anticipate resource use and then consider if the intervention makes good business sense. We describe a business case framework that can assist the CNS to fully explore the problem and determine if developing an intervention is a good investment. We describe several analyses that facilitate making the business case to include the following: problem identification and alignment with strategic priorities, needs assessment, stakeholder analysis, market analysis, intervention implementation planning, financial analysis, and outcome evaluation. The findings from these analyses can be used to develop a formal proposal to present to hospital leaders in a position to make decisions. By aligning intervention planning with organizational priorities and engaging patients in the process, interventions will be more likely to be implemented in practice and produce robust outcomes. The business case framework can be used to justify to organization decision makers the need to invest resources in new interventions that will make a difference for quality outcomes as well as the financial bottom line. This framework can be used to plan interventions that align with organizational strategic priorities, plan for associated costs and benefits, and outcome evaluation. Clinical nurse specialists are well positioned to lead clinical intervention projects that will improve the quality of patient care and be cost-effective. To do so requires skill development in making the business case.

  10. Simulation based planning of surgical interventions in pediatric cardiology

    Science.gov (United States)

    Marsden, Alison L.

    2013-10-01

    Hemodynamics plays an essential role in the progression and treatment of cardiovascular disease. However, while medical imaging provides increasingly detailed anatomical information, clinicians often have limited access to hemodynamic data that may be crucial to patient risk assessment and treatment planning. Computational simulations can now provide detailed hemodynamic data to augment clinical knowledge in both adult and pediatric applications. There is a particular need for simulation tools in pediatric cardiology, due to the wide variation in anatomy and physiology in congenital heart disease patients, necessitating individualized treatment plans. Despite great strides in medical imaging, enabling extraction of flow information from magnetic resonance and ultrasound imaging, simulations offer predictive capabilities that imaging alone cannot provide. Patient specific simulations can be used for in silico testing of new surgical designs, treatment planning, device testing, and patient risk stratification. Furthermore, simulations can be performed at no direct risk to the patient. In this paper, we outline the current state of the art in methods for cardiovascular blood flow simulation and virtual surgery. We then step through pressing challenges in the field, including multiscale modeling, boundary condition selection, optimization, and uncertainty quantification. Finally, we summarize simulation results of two representative examples from pediatric cardiology: single ventricle physiology, and coronary aneurysms caused by Kawasaki disease. These examples illustrate the potential impact of computational modeling tools in the clinical setting.

  11. Evaluation of the effects of a birth plan on Taiwanese women's childbirth experiences, control and expectations fulfilment: a randomised controlled trial.

    Science.gov (United States)

    Kuo, Su-Chen; Lin, Kuan-Chia; Hsu, Chi-Ho; Yang, Cherng-Chia; Chang, Min-Yu; Tsao, Chien-Ming; Lin, Lie-Chu

    2010-07-01

    In many western countries, pregnant women often prepare birth plans, outlining how they would like their childbirth experiences to proceed. However there have been no experimental studies to evaluate the effect of birth plans. The objective of this research was to evaluate the effects of birth plans on women's fulfilment of their childbirth expectations, their control over the birth process, and overall experiences. A randomised, single-blind controlled trial study design was used. This study involved seven hospitals and 10 obstetricians in Taiwan. Participants included primiparous women, each under the care of one of seven Taiwanese medical facilities, and who had been pregnant for at least 32 weeks. They were also at least 18 years old, and had no pregnancy complications. An exclusion criterion was elective caesarean as a mode of delivery. A total of 296 women in hospital clinics who met the study criteria were allocated by block randomisation to experimental (n=155) or control (n=141) groups. The women completed their basic personal information and a childbirth expectations questionnaire when they were recruited. One day after delivery, all the participants completed a questionnaire about the childbirth experience, control and fulfilment of their childbirth expectations. The experimental group had a statistically higher degree of positive childbirth experiences than that of the control group (t=2.48, p=0.01). The experimental group also showed a higher degree of childbirth control (t=9.60, pcontrol groups in prenatal birth expectations, but a significant difference (t=2.63, p=0.01) in the degree of fulfilment of their childbirth expectations after delivery. On a subscale measuring the fulfilment of childbirth expectations, there was a statistically higher degree of mastery and participation (t=3.74, pcontrol group. The results justify the clinical implementation of birth plans. Providing birth plans in medical facilities is an effective means of fulfilling

  12. Effect of family planning interventions on couple years of protection in Malawi.

    Science.gov (United States)

    Lemani, Clara; Kamtuwanje, Nenani; Phiri, Billy; Speizer, Ilene S; Singh, Kavita; Mtema, Olive; Chisanu, Ndidza; Tang, Jennifer H

    2018-04-01

    The primary objective was to assess the effect of family planning interventions at two health facilities in Malawi on couple years of protection (CYP). A prospective quasi-experimental design was used to compare CYP and uptake of long-acting reversible contraception (LARC) between two intervention facilities (Area 25 Health Center and Kasungu District Hospital) and two nonintervention facilities (Mkanda Health Center and Dowa District Hospital). The interventions included community mobilization and demand generation for family planning, and training and mentoring of providers in LARC insertion. Monthly data were collected from 1 year prior to intervention implementation until 2 years thereafter. From the pre-intervention year to the second post-intervention year, CYP increased by 175.1% at Area 25, whereas it decreased by 33.8% at Mkanda. At Kasungu and Dowa, CYP increased by 90.7% and 64.4%, respectively. Uptake of LARC increased by 12.2% at Area 25 r, 6.2% at Kasungu, and 2.9% at Dowa, but decreased by 3.8% at Mkanda. The interventions led to an increase in CYP and LARC uptake. Future family planning programs should sensitize communities about family planning and train providers to provide all contraceptives so that women can make informed decisions and use the contraceptive of their choice. © 2018 The Authors. International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics.

  13. MAP-IT: A Practical Tool for Planning Complex Behavior Modification Interventions.

    Science.gov (United States)

    Hansen, Sylvia; Kanning, Martina; Lauer, Romy; Steinacker, Jürgen M; Schlicht, Wolfgang

    2017-09-01

    Health research often aims to prevent noncommunicable diseases and to improve individual and public health by discovering intervention strategies that are effective in changing behavior and/or environments that are detrimental to one's health. Ideally, findings from original research support practitioners in planning and implementing effective interventions. Unfortunately, interventions often fail to overcome the translational block between science and practice. They often ignore theoretical knowledge, overlook empirical evidence, and underrate the impact of the environment. Accordingly, sustainable changes in individual behavior and/or the environment are difficult to achieve. Developing theory-driven and evidence-based interventions in the real world is a complex task. Existing implementation frameworks and theories often do not meet the needs of health practitioners. The purpose of this article is to synthesize existing frameworks and to provide a tool, the Matrix Assisting Practitioner's Intervention Planning Tool (MAP-IT), that links research to practice and helps practitioners to design multicomponent interventions. In this article, we use physical activity of older adults as an example to explain the rationale of MAP-IT. In MAP-IT, individual as well as environmental mechanisms are listed and behavior change techniques are linked to these mechanisms and to intervention components. MAP-IT is theory-driven and evidence-based. It is time-saving and helpful for practitioners when planning complex interventions.

  14. Evaluating the comparative effectiveness of different demand side interventions to increase maternal health service utilization and practice of birth spacing in South Kivu, Democratic Republic of Congo: an innovative, mixed methods approach.

    Science.gov (United States)

    Dumbaugh, Mari; Bapolisi, Wyvine; van de Weerd, Jennie; Zabiti, Michel; Mommers, Paula; Balaluka, Ghislain Bisimwa; Merten, Sonja

    2017-07-03

    In this protocol we describe a mixed methods study in the province of South Kivu, Democratic Republic of Congo evaluating the effectiveness of different demand side strategies to increase maternal health service utilization and the practice of birth spacing. Conditional service subsidization, conditional cash transfers and non-monetary incentives aim to encourage women to use maternal health services and practice birth spacing in two different health districts. Our methodology will comparatively evaluate the effectiveness of different approaches against each other and no intervention. This study comprises four main research activities: 1) Formative qualitative research to determine feasibility of planned activities and inform development of the quantitative survey; 2) A community-based, longitudinal survey; 3) A retrospective review of health facility records; 4) Qualitative exploration of intervention acceptability and emergent themes through in-depth interviews with program participants, non-participants, their partners and health providers. Female community health workers are engaged as core members of the research team, working in tandem with female survey teams to identify women in the community who meet eligibility criteria. Female community health workers also act as key informants and community entry points during methods design and qualitative exploration. Main study outcomes are completion of antenatal care, institutional delivery, practice of birth spacing, family planning uptake and intervention acceptability in the communities. Qualitative methods also explore decision making around maternal health service use, fertility preference and perceptions of family planning. The innovative mixed methods design allows quantitative data to inform the relationships and phenomena to be explored in qualitative collection. In turn, qualitative findings will be triangulated with quantitative findings. Inspired by the principles of grounded theory, qualitative

  15. Developing team leadership to facilitate guideline utilization: planning and evaluating a 3-month intervention strategy.

    Science.gov (United States)

    Gifford, Wendy; Davies, Barbara; Tourangeau, Ann; Lefebre, Nancy

    2011-01-01

    Research describes leadership as important to guideline use. Yet interventions to develop current and future leaders for this purpose are not well understood. To describe the planning and evaluation of a leadership intervention to facilitate nurses' use of guideline recommendations for diabetic foot ulcers in home health care. Planning the intervention involved a synthesis of theory and research (qualitative interviews and chart audits). One workshop and three follow-up teleconferences were delivered at two sites to nurse managers and clinical leaders (n=15) responsible for 180 staff nurses. Evaluation involved workshop surveys and interviews. Highest rated intervention components (four-point scale) were: identification of target indicators (mean 3.7), and development of a team leadership action plan (mean 3.5). Pre-workshop barriers assessment rated lowest (mean 2.9). Three months later participants indicated their leadership performance had changed as a result of the intervention, being more engaged with staff and clear about implementation goals. Creating a team leadership action plan to operationalize leadership behaviours can help in delivery of evidence-informed care. Access to clinical data and understanding team leadership knowledge and skills prior to formal training will assist nursing management in tailoring intervention strategies to identify needs and gaps. © 2010 The Authors. Journal compilation © 2010 Blackwell Publishing Ltd.

  16. Improving Collaborative Behaviour Planning in Adult Auditory Rehabilitation: Development of the I-PLAN Intervention Using the Behaviour Change Wheel.

    Science.gov (United States)

    Barker, Fiona; de Lusignan, Simon; Cooke, Deborah

    2016-09-28

    The consequences of poorly managed hearing loss can be ameliorated with hearing aid use but rates of use are sub-optimal. The impact of audiologist behaviour on subsequent use, particularly over the long term, is unknown. This study aimed to describe the role of the behaviour change wheel in developing an intervention to introduce and embed particular clinical behaviours into adult hearing aid fitting consultations, within the framework of the Medical Research Council guidance on complex interventions. Following the steps of the behaviour change wheel, audiologist behaviours that might influence hearing aid use were identified based on a systematic review and qualitative work with audiologists. An analysis, using the COM-B model, identified potential drivers of the target behaviours. This was used to select intervention functions and behaviour change techniques likely to influence behaviour in this context. The target behaviours were as follows: giving information about the benefits of hearing aid use and the negative consequences of non-use, providing prompts for use and engaging in collaborative behavioural planning for use. The behavioural analysis suggested that psychological capability, opportunity and motivation were potential drivers of these behaviours. The intervention functions of education, coercion, training, environmental restructuring, modelling and enablement were selected and combined to develop a single complex intervention that seeks to address the target behaviours. This is the first study to use the behaviour change wheel to develop a complex intervention in the context of audiology. The theory-based development of the intervention will facilitate evaluation of its feasibility and effectiveness.

  17. Observing the Birth of Supermassive Black Holes with the Planned ICECUBE Neutrino Detector

    International Nuclear Information System (INIS)

    Shi, X.; Fuller, G.M.; Halzen, F.

    1998-01-01

    It has been suggested that the supermassive black holes, at the centers of galaxies and quasars, may initially form in single collapses of relativistic star clusters or supermassive stars built up during the evolution of dense star clusters. We show that it may be possible for ICECUBE (a planned 1km 3 neutrino detector in Antarctica) to detect the neutrino bursts associated with those collapses at redshift z approx-lt 0.2 with a rate of ∼ 0.1 - 1 burst per year. Such detections could give new insights into the formation of structure in the Universe, especially when correlated with gravitational wave signatures or even gamma-ray bursts. copyright 1998 The American Physical Society

  18. Particular intervention plan of the Areva La Hague facility - 2012 edition

    International Nuclear Information System (INIS)

    2012-01-01

    The Particular intervention plan (PPI in French) is an emergency plan which foresees the measures and means to be implemented to address the potential risks of the presence and operation of a nuclear facility. This plan is implemented and developed by the Prefect in case of nuclear accident (or incident leading to a potential accident), the impact of which extending beyond the facility perimeter. It represents a special section of the organisation plan for civil protection response (ORSEC plan). The PPI foresees the necessary measures and means for crisis management during the first hours following the accident and is triggered by the Department Prefect according to the information provided by the facility operator. Its aim is to protect the populations leaving within 10 km of the facility against a potential radiological hazard. The PPI describes: the facility, the intervention area, the protection measures for the population, the conditions of emergency plan triggering, the crisis organisation, the action forms of the different services, and the post-accident stage. This document is the public version of the Particular intervention plan of the Areva NC La Hague fuel reprocessing plant (located on the territories of Beaumont-Hague, Digulleville, Herqueville, Jobourg and Omonville-la-Petite towns, Manche, France) which comprises the totally decommissioned UP2 400 unit, and the UP2 800 production unit still in operation

  19. Particular intervention plan of the Cruas-Meysse Nuclear Power Plant

    International Nuclear Information System (INIS)

    2013-01-01

    The Particular intervention plan (PPI in French) is an emergency plan which foresees the measures and means to be implemented to address the potential risks of the presence and operation of a nuclear facility. This plan is implemented and developed by the Prefect in case of nuclear accident (or incident leading to a potential accident), the impact of which extending beyond the facility perimeter. It represents a special section of the organisation plan for civil protection response (ORSEC plan). The PPI foresees the necessary measures and means for crisis management during the first hours following the accident and is triggered by the Department Prefect according to the information provided by the facility operator. Its aim is to protect the populations leaving within 10 km of the facility against a potential radiological hazard. The PPI describes: the facility, the intervention area, the protection measures for the population, the conditions of emergency plan triggering, the crisis organisation, the action forms of the different services, and the post-accident stage. This document is the public version of the Particular intervention plan of the Cruas-Meysse NPP (Ardeche, France)

  20. Can a community health worker and a trained traditional birth attendant work as a team to deliver child health interventions in rural Zambia?

    Science.gov (United States)

    Yeboah-Antwi, Kojo; Hamer, Davidson H; Semrau, Katherine; Waltensperger, Karen Z; Snetro-Plewman, Gail; Kambikambi, Chilobe; Sakala, Amon; Filumba, Stephen; Sichamba, Bias; Marsh, David R

    2014-10-27

    Teaming is an accepted approach in health care settings but rarely practiced at the community level in developing countries. Save the Children trained and deployed teams of volunteer community health workers (CHWs) and trained traditional birth attendants (TBAs) to provide essential newborn and curative care for children aged 0-59 months in rural Zambia. This paper assessed whether CHWs and trained TBAs can work as teams to deliver interventions and ensure a continuum of care for all children under-five, including newborns. We trained CHW-TBA teams in teaming concepts and assessed their level of teaming prospectively every six months for two years. The overall score was a function of both teamwork and taskwork. We also assessed personal, community and service factors likely to influence the level of teaming. We created forty-seven teams of predominantly younger, male CHWs and older, female trained TBAs. After two years of deployment, twenty-one teams scored "high", twelve scored "low," and fourteen were inactive. Teamwork was high for mutual trust, team cohesion, comprehension of team goals and objectives, and communication, but not for decision making/planning. Taskwork was high for joint behavior change communication and outreach services with local health workers, but not for intra-team referral. Teams with members residing within one hour's walking distance were more likely to score high. It is feasible for a CHW and a trained TBA to work as a team. This may be an approach to provide a continuum of care for children under-five including newborns.

  1. Inadequate birth spacing is perceived as riskier than all family planning methods, except sterilization and abortion, in a qualitative study among urban Nigerians.

    Science.gov (United States)

    Schwandt, Hilary M; Skinner, Joanna; Hebert, Luciana Estelle; Cobb, Lisa; Saad, Abdulmumin; Odeku, Mojisola

    2017-09-11

    Fertility is high in Nigeria and contraceptive use is low. Little is known about how urban Nigerians perceive the risk of contraceptive use in relation to pregnancy and birth. This study examines and compares the risk perception of family planning methods and pregnancy related scenarios among urban Nigerians. A total of 26 focus group discussions with 243 participants were conducted in September and October 2010 in Ibadan and Kaduna. The groups were stratified by sex, age, family planning use, and city. Study participants were asked to identify the risk associated with six different family planning methods and four pregnancy related risks. The data were coded in ATLAS.ti 6 and analyzed using the thematic content analysis approach. The ten family planning and pregnancy related items ranked as follows from most to least risky: sterilization, abortion, getting pregnant soon after having a baby (no birth spacing), pill, IUD, injectable, having a birth under 18 years of age (teenage motherhood), condom use, having six children, and fertility awareness methods. Risk of family planning methods was often categorized in terms of side effects and complications. Positive perceptions of teenage motherhood and having many children influenced the low ranking of these items. Inadequate birth spacing was rated as more risky than all contraceptive methods and pregnancy related events except for sterilization and abortion. Some of the participants' risk perceptions of contraceptives and pregnancy related scenarios does not correspond to actual risk of methods and practices. Instead, the items' perceived riskiness largely correspond with prevailing social norms. However, there was a high level of understanding of the risks of inadequate birth spacing. This study is not a randomized control trial so the study has not been registered as such.

  2. Effectiveness of Anabolic Steroid Preventative Intervention among Gym Users: Applying Theory of Planned Behavior

    OpenAIRE

    Jalilian, Farzad; Allahverdipour, Hamid; Moeini, Babak; Moghimbeigi, Abbas

    2011-01-01

    Background: Use of anabolic androgenic steroids (AAS) has been associated with adversephysical and psychiatric effects and it is known as rising problem among youth people. Thisstudy was conducted to evaluate anabolic steroids preventative intervention efficiency amonggym users in Iran and theory of planned behaviour was applied as theoretical framework.Methods: Overall, 120 male gym users participated in this study as intervention and controlgroup. This was a longitudinal randomized pretest ...

  3. Serious adverse neonatal outcomes such as 5-minute Apgar score of zero and seizures or severe neurologic dysfunction are increased in planned home births after cesarean delivery.

    Science.gov (United States)

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

    2017-01-01

    The United States is with 37,451 home births in 2014 the country with the largest absolute number of home births among all developed countries. The purpose of this study was to examine the occurrence and risks of a 5-minute Apgar score of zero and neonatal seizures or serious neurologic dysfunction in women with a history of prior cesarean delivery for planned home vaginal birth after cesarean (VBAC), compared to hospital VBAC and hospital birth cesarean deliveries for term normal weight infants in the United States from 2007-2014. We report in this study outcomes of women who had one or more prior cesarean deliveries and included women who had a successful vaginal birth after a trial of labor after cesarean (TOLAC) at home and in the hospital, and a repeat cesarean delivery in the hospital. We excluded preterm births (cesarean deliveries, a significantly higher incidence and risk of a 5-minute Apgar score of 0 of 1 in 890 (11.24/10,000, relative risk 9.04, 95% confidence interval 4-20.39, p<.0001) and an incidence of neonatal seizures or severe neurologic dysfunction of 1 in 814 (Incidence: 12.27/10,000, relative risk 11.19, 95% confidence interval 5.13-24.29, p<.0001). Because of the significantly increased neonatal risks, obstetric providers should therefore not offer or perform planned home TOLACs and for those desiring a VBAC should strongly recommend a planned TOLAC in the appropriate hospital setting. We emphasize that this stance should be accompanied by effective efforts to make TOLAC available in the appropriate hospital setting.

  4. The influence of preferred place of birth on the course of pregnancy and labor among healthy nulliparous women : a prospective cohort study

    NARCIS (Netherlands)

    Luc J.Smits; dr. Marianne Nieuwenhuijze; Jan G. Nijhuis; Johan L. Severens; Raymond G. de Vries; Tamar M. van Haaren-ten Haken; Marijke Hendrix

    2015-01-01

    Background: Most studies on birth settings investigate the association between planned place of birth at the start of labor and birth outcomes and intervention rates. To optimize maternity care it also is important to pay attention to the entire process of pregnancy and childbirth. This study

  5. A prospective study of effects of psychological factors and sleep on obstetric interventions, mode of birth, and neonatal outcomes among low-risk British Columbian women

    Directory of Open Access Journals (Sweden)

    Hall Wendy A

    2012-08-01

    Full Text Available Abstract Background Obstetrical interventions, including caesarean sections, are increasing in Canada. Canadian women’s psychological states, fatigue, and sleep have not been examined prospectively for contributions to obstetric interventions and adverse neonatal outcomes. Context and purpose of the study: The prospective study was conducted in British Columbia (BC, Canada with 650 low-risk pregnant women. Of those women, 624 were included in this study. Women were recruited through providers’ offices, media, posters, and pregnancy fairs. We examined associations between pregnant women’s fatigue, sleep deprivation, and psychological states (anxiety and childbirth fear and women’s exposure to obstetrical interventions and adverse neonatal outcomes (preterm, admission to NICU, low APGARS, and low birth weight. Methods Data from our cross-sectional survey were linked, using women’s personal health numbers, to birth outcomes from the Perinatal Services BC database. After stratifying for parity, we used Pearson’s Chi-square to examine associations between psychological states, fatigue, sleep deprivation and maternal characteristics. We used hierarchical logistic regression modeling to test 9 hypotheses comparing women with high and low childbirth fear and anxiety on likelihood of having epidural anaesthetic, a caesarean section (stratified for parity, assisted vaginal delivery, and adverse neonatal outcomes and women with and without sleep deprivation and high levels of fatigue on likelihood of giving birth by caesarean section, while controlling for maternal, obstetrical (e.g., infant macrosomia, and psychological variables. Results Significantly higher proportions of multiparas, reporting difficult and upsetting labours and births, expectations of childbirth interventions, and health stressors, reported high levels of childbirth fear. Women who reported antenatal relationship, housing, financial, and health stressors and multiparas

  6. A prospective study of effects of psychological factors and sleep on obstetric interventions, mode of birth, and neonatal outcomes among low-risk British Columbian women.

    Science.gov (United States)

    Hall, Wendy A; Stoll, Kathrin; Hutton, Eileen K; Brown, Helen

    2012-08-03

    Obstetrical interventions, including caesarean sections, are increasing in Canada. Canadian women's psychological states, fatigue, and sleep have not been examined prospectively for contributions to obstetric interventions and adverse neonatal outcomes.Context and purpose of the study: The prospective study was conducted in British Columbia (BC), Canada with 650 low-risk pregnant women. Of those women, 624 were included in this study. Women were recruited through providers' offices, media, posters, and pregnancy fairs. We examined associations between pregnant women's fatigue, sleep deprivation, and psychological states (anxiety and childbirth fear) and women's exposure to obstetrical interventions and adverse neonatal outcomes (preterm, admission to NICU, low APGARS, and low birth weight). Data from our cross-sectional survey were linked, using women's personal health numbers, to birth outcomes from the Perinatal Services BC database. After stratifying for parity, we used Pearson's Chi-square to examine associations between psychological states, fatigue, sleep deprivation and maternal characteristics. We used hierarchical logistic regression modeling to test 9 hypotheses comparing women with high and low childbirth fear and anxiety on likelihood of having epidural anaesthetic, a caesarean section (stratified for parity), assisted vaginal delivery, and adverse neonatal outcomes and women with and without sleep deprivation and high levels of fatigue on likelihood of giving birth by caesarean section, while controlling for maternal, obstetrical (e.g., infant macrosomia), and psychological variables. Significantly higher proportions of multiparas, reporting difficult and upsetting labours and births, expectations of childbirth interventions, and health stressors, reported high levels of childbirth fear. Women who reported antenatal relationship, housing, financial, and health stressors and multiparas reporting low family incomes were significantly more likely to

  7. Planned birth at or near term for improving health outcomes for pregnant women with pre-existing diabetes and their infants.

    Science.gov (United States)

    Biesty, Linda M; Egan, Aoife M; Dunne, Fidelma; Smith, Valerie; Meskell, Pauline; Dempsey, Eugene; Ni Bhuinneain, G Meabh; Devane, Declan

    2018-02-09

    Pregnant women with pre-existing diabetes (Type 1 or Type 2) have increased rates of adverse maternal and neonatal outcomes. Current clinical guidelines support elective birth, at or near term, because of increased perinatal mortality during the third trimester of pregnancy.This review replaces a review previously published in 2001 that included "diabetic pregnant women", which has now been split into two reviews. This current review focuses on pregnant women with pre-existing diabetes (Type 1 or Type 2) and a sister review focuses on women with gestational diabetes. To assess the effect of planned birth (either by induction of labour or caesarean birth) at or near term gestation (37 to 40 weeks' gestation) compared with an expectant approach, for improving health outcomes for pregnant women with pre-existing diabetes and their infants. The primary outcomes relate to maternal and perinatal mortality and morbidity. We searched Cochrane Pregnancy and Childbirth's Trials Register, ClinicalTrials.gov, the WHO International Clinical Trials Registry Platform (ICTRP) (15 August 2017), and reference lists of retrieved studies. We planned to include randomised trials (including those using a cluster-randomised design) and non-randomised trials (e.g. quasi-randomised trials using alternate allocation) which compared planned birth, at or near term, with an expectant approach for pregnant women with pre-existing diabetes. Two of the review authors independently assessed study eligibility. In future updates of this review, at least two of the review authors will extract data and assess the risk of bias in included studies. We will also assess the quality of the evidence using the GRADE approach. We identified no eligible published trials for inclusion in this review.We did identify one randomised trial which examined whether expectant management reduced the incidence of caesarean birth in uncomplicated pregnancies of women with gestational diabetes (requiring insulin) and with

  8. Promoting Later Planned Retirement : The Differential Impact of Construal Level Interventions for Younger and Older Individuals

    NARCIS (Netherlands)

    R.J.G. van Schie (Ron); B.G.C. Dellaert (Benedict); A.C.D. Donkers (Bas)

    2013-01-01

    textabstractIndividuals’ planned retirement age is affected by a trade-off between financial costs (a feasibility oriented consideration) and the number of years in retirement (a desirability oriented consideration). Previous research shows that construal level interventions (i.e., activating a

  9. Using Field Experiments to Evaluate the Impact of Financial Planning and Counseling Interventions

    Science.gov (United States)

    Collins, J. Michael

    2017-01-01

    Field experiments, which are a powerful research technique, are common in some fields, but they have not been widely used in studying the effect of financial and counseling planning interventions. Financial services can benefit from the expanded use of field experiments to explore potential causal mechanisms for the effects of financial planning…

  10. Staff Concerns in Schools Planning for and Implementing School-Wide Positive Behavior Interventions and Supports

    Science.gov (United States)

    Tyre, Ashli D.; Feuerborn, Laura L.; Woods, Leslie

    2018-01-01

    Understanding staff concerns about a systemic change effort allows leadership teams to better anticipate and address staff needs for professional development and support. In this study, staff concerns in nine schools planning for or implementing School-Wide Positive Behavior Interventions and Supports (SWPBIS) were explored using the…

  11. Effect of a participatory intervention with women's groups on birth outcomes and maternal depression in Jharkhand and Orissa, India: a cluster-randomised controlled trial.

    Science.gov (United States)

    Tripathy, Prasanta; Nair, Nirmala; Barnett, Sarah; Mahapatra, Rajendra; Borghi, Josephine; Rath, Shibanand; Rath, Suchitra; Gope, Rajkumar; Mahto, Dipnath; Sinha, Rajesh; Lakshminarayana, Rashmi; Patel, Vikram; Pagel, Christina; Prost, Audrey; Costello, Anthony

    2010-04-03

    Community mobilisation through participatory women's groups might improve birth outcomes in poor rural communities. We therefore assessed this approach in a largely tribal and rural population in three districts in eastern India. From 36 clusters in Jharkhand and Orissa, with an estimated population of 228 186, we assigned 18 clusters to intervention or control using stratified randomisation. Women were eligible to participate if they were aged 15-49 years, residing in the project area, and had given birth during the study. In intervention clusters, a facilitator convened 13 groups every month to support participatory action and learning for women, and facilitated the development and implementation of strategies to address maternal and newborn health problems. The primary outcomes were reductions in neonatal mortality rate (NMR) and maternal depression scores. Analysis was by intention to treat. This trial is registered as an International Standard Randomised Controlled Trial, number ISRCTN21817853. After baseline surveillance of 4692 births, we monitored outcomes for 19 030 births during 3 years (2005-08). NMRs per 1000 were 55.6, 37.1, and 36.3 during the first, second, and third years, respectively, in intervention clusters, and 53.4, 59.6, and 64.3, respectively, in control clusters. NMR was 32% lower in intervention clusters adjusted for clustering, stratification, and baseline differences (odds ratio 0.68, 95% CI 0.59-0.78) during the 3 years, and 45% lower in years 2 and 3 (0.55, 0.46-0.66). Although we did not note a significant effect on maternal depression overall, reduction in moderate depression was 57% in year 3 (0.43, 0.23-0.80). This intervention could be used with or as a potential alternative to health-worker-led interventions, and presents new opportunities for policy makers to improve maternal and newborn health outcomes in poor populations. Health Foundation, UK Department for International Development, Wellcome Trust, and the Big Lottery Fund

  12. From Project to Program: Tupange's Experience with Scaling Up Family Planning Interventions in Urban Kenya.

    Science.gov (United States)

    Keyonzo, Nelson; Nyachae, Paul; Kagwe, Peter; Kilonzo, Margaret; Mumba, Feddis; Owino, Kenneth; Kichamu, George; Kigen, Bartilol; Fajans, Peter; Ghiron, Laura; Simmons, Ruth

    2015-05-01

    This paper describes how the Urban Reproductive Health Initiative in Kenya, the Tupange Project (2010-2015), successfully applied the ExpandNet approach to sustainably scale up family planning interventions, first in Machakos and Kakamega, and subsequently also in its three core cities, Nairobi, Kisumu and Mombasa. This new focus meant shifting from a "project" to a "program" approach, which required paying attention to government leadership and ownership, limiting external inputs, institutionalizing interventions in existing structures and emphasizing sustainability. The paper also highlights the project's efforts to prepare for the future scale up of Tupange's interventions in other counties to support continuing and improved access to family planning services in the new context of devolution (decentralization) in Kenya. Copyright © 2015. Published by Elsevier Ltd.

  13. Development of a Program Logic Model and Evaluation Plan for a Participatory Ergonomics Intervention in Construction

    Science.gov (United States)

    Jaegers, Lisa; Dale, Ann Marie; Weaver, Nancy; Buchholz, Bryan; Welch, Laura; Evanoff, Bradley

    2013-01-01

    Background Intervention studies in participatory ergonomics (PE) are often difficult to interpret due to limited descriptions of program planning and evaluation. Methods In an ongoing PE program with floor layers, we developed a logic model to describe our program plan, and process and summative evaluations designed to describe the efficacy of the program. Results The logic model was a useful tool for describing the program elements and subsequent modifications. The process evaluation measured how well the program was delivered as intended, and revealed the need for program modifications. The summative evaluation provided early measures of the efficacy of the program as delivered. Conclusions Inadequate information on program delivery may lead to erroneous conclusions about intervention efficacy due to Type III error. A logic model guided the delivery and evaluation of our intervention and provides useful information to aid interpretation of results. PMID:24006097

  14. Use of Geographic Information Systems for Planning HIV Prevention Interventions for High-Risk Youths

    Science.gov (United States)

    Geanuracos, Catherine G.; Cunningham, Shayna D.; Weiss, George; Forte, Draco; Henry Reid, Lisa M.; Ellen, Jonathan M.

    2007-01-01

    Geographic information system (GIS) analysis is an emerging tool for public health intervention planning. Connect to Protect, a researcher–community collaboration working in 15 cities to reduce HIV infection among youths, developed GIS databases of local health, crime, and demographic data to evaluate the geographic epidemiology of sexually transmitted infections and HIV risk among adolescents. We describe the process and problems of data acquisition, analysis, and mapping in the development of structural interventions, demonstrating how program planners can use this technology to inform and improve planning decisions. The Connect to Protect project’s experience suggests strategies for incorporating public data and GIS technology into the next generation of public health interventions. PMID:17901452

  15. Evaluating the impact of the community-based health planning and services initiative on uptake of skilled birth care in Ghana.

    Directory of Open Access Journals (Sweden)

    Fiifi Amoako Johnson

    Full Text Available The Community-based Health Planning and Services (CHPS initiative is a major government policy to improve maternal and child health and accelerate progress in the reduction of maternal mortality in Ghana. However, strategic intelligence on the impact of the initiative is lacking, given the persistant problems of patchy geographical access to care for rural women. This study investigates the impact of proximity to CHPS on facilitating uptake of skilled birth care in rural areas.Data from the 2003 and 2008 Demographic and Health Survey, on 4,349 births from 463 rural communities were linked to georeferenced data on health facilities, CHPS and topographic data on national road-networks. Distance to nearest health facility and CHPS was computed using the closest facility functionality in ArcGIS 10.1. Multilevel logistic regression was used to examine the effect of proximity to health facilities and CHPS on use of skilled care at birth, adjusting for relevant predictors and clustering within communities. The results show that a substantial proportion of births continue to occur in communities more than 8 km from both health facilities and CHPS. Increases in uptake of skilled birth care are more pronounced where both health facilities and CHPS compounds are within 8 km, but not in communities within 8 km of CHPS but lack access to health facilities. Where both health facilities and CHPS are within 8 km, the odds of skilled birth care is 16% higher than where there is only a health facility within 8km.Where CHPS compounds are set up near health facilities, there is improved access to care, demonstrating the facilitatory role of CHPS in stimulating access to better care at birth, in areas where health facilities are accessible.

  16. Sarah's birth. How the medicalisation of childbirth may be shaped in different settings: Vignette from a study of routine intervention in Jeddah, Saudi Arabia.

    Science.gov (United States)

    Scamell, Mandie; Altaweli, Roa; McCourt, Christine

    2017-02-01

    The expansion of the medicalisation of childbirth has been described in the literature as being a global phenomenon. The vignette described in this paper, selected from an ethnographic study of routine intervention in Saudi Arabian hospitals illustrates how the worldwide spread of the bio-medical model does not take place within a cultural vacuum. To illuminate the ways in which the medicalisation of birth may be understood and practised in different cultural settings, through a vignette of a specific birth, drawn as a typical case from an ethnographic study that investigated clinical decision-making in the second stage of labour in Saudi Arabia. Ethnographic data collection methods, including participant observation and interviews. The data presented in this paper are drawn from ethnographic field notes collected during field work in Saudi Arabia, and informed by analysis of a wider set of field notes and interviews with professionals working in this context. While the medicalisation of care is a universal phenomenon, the ways in which the care of women is managed using routine medical intervention are framed by the local cultural context in which these practices take place. The ethnographic data presented in this paper shows the medicalisation of birth thesis to be incomplete. The evidence presented in this paper illustrates how local belief systems are not so much subsumed by the expansion of the bio-medical model of childbirth, rather they may actively facilitate a process of localised reinterpretation of such universalised and standardised practices. In this case, aspects of the social and cultural context of Jeddah operates to intensify the biomedical model at the expense of respectful maternity care. In this article, field note data on the birth of one Saudi Arabian woman is used as an illustration of how the medicalisation of childbirth has been appropriated and reinterpreted in Jeddah, Saudi Arabia. Copyright © 2016 Australian College of Midwives

  17. Evaluation of the Dawson College Shooting Psychological Intervention: Moving Toward a Multimodal Extensive Plan

    Science.gov (United States)

    Séguin, Monique; Chawky, Nadia; Lesage, Alain; Boyer, Richard; Guay, Stéphane; Bleau, Pierre; Miquelon, Paule; Szkrumelak, Nadia; Steiner, Warren; Roy, Denise

    2013-01-01

    In 2006, following the shooting at Dawson College, the authorities implemented an intervention plan. This provided an opportunity to analyze the responses to services offered, and afforded a learning opportunity, which led to the proposal of an extensive multimodal short- and long-term psychological plan for future needs. Both quantitative and qualitative data were gathered 18 months after the event, involving the participation of 948 students and staff. Mental health problems and the perception of services offered after the shooting were investigated, using standardized measures. Second, focus groups and individual interviews were conducted among a subgroup of participants (support team members; teachers and employees; students and parents) and permitted to gather data on services received and services required. Individual report of events, the extent of psychological impact and services offered and received were analyzed in terms of the following dimensions: intervention philosophy, training, ongoing offer of services and finally, detection and outreach. A significant incidence of disorders and a high rate of exacerbation of preexisting mental disorders were observed within the 18 months following the shooting. Postimmediate and short-term intervention appeared adequate, but the long-term collective vision toward community support and availability of mental health services were lacking. Lessons learned from this evaluation and other school shootings suggest that preparedness and long-term community responses are often overlooked. A multimodal extensive plan is proposed based on a theoretical model from which interventions strategies could be drawn. PMID:24795790

  18. Evaluation of the Dawson College Shooting Psychological Intervention: Moving Toward a Multimodal Extensive Plan.

    Science.gov (United States)

    Séguin, Monique; Chawky, Nadia; Lesage, Alain; Boyer, Richard; Guay, Stéphane; Bleau, Pierre; Miquelon, Paule; Szkrumelak, Nadia; Steiner, Warren; Roy, Denise

    2013-05-01

    In 2006, following the shooting at Dawson College, the authorities implemented an intervention plan. This provided an opportunity to analyze the responses to services offered, and afforded a learning opportunity, which led to the proposal of an extensive multimodal short- and long-term psychological plan for future needs. Both quantitative and qualitative data were gathered 18 months after the event, involving the participation of 948 students and staff. Mental health problems and the perception of services offered after the shooting were investigated, using standardized measures. Second, focus groups and individual interviews were conducted among a subgroup of participants (support team members; teachers and employees; students and parents) and permitted to gather data on services received and services required. Individual report of events, the extent of psychological impact and services offered and received were analyzed in terms of the following dimensions: intervention philosophy, training, ongoing offer of services and finally, detection and outreach. A significant incidence of disorders and a high rate of exacerbation of preexisting mental disorders were observed within the 18 months following the shooting. Postimmediate and short-term intervention appeared adequate, but the long-term collective vision toward community support and availability of mental health services were lacking. Lessons learned from this evaluation and other school shootings suggest that preparedness and long-term community responses are often overlooked. A multimodal extensive plan is proposed based on a theoretical model from which interventions strategies could be drawn.

  19. How countries link REDD+ interventions to drivers in their readiness plans: implications for monitoring systems

    International Nuclear Information System (INIS)

    Salvini, G; Herold, M; De Sy, V; Kissinger, G; Brockhaus, M; Skutsch, M

    2014-01-01

    Countries participating in the REDD+ scheme are in the readiness phase, designing policy interventions to address drivers of deforestation and forest degradation (DD). In order for REDD+ interventions to be effective, it is essential that they take into account the specific drivers that they aim to address. Moreover it is crucial to design systems that monitor the effectiveness of the planned interventions. In this article we provide a comprehensive and comparative assessment of interventions proposed by 43 REDD+ countries in 98 readiness documents. We summarize the types of interventions and assess if they are formulated referring to the drivers of DD that they are aiming to address. Based on this assessment we consider the implications for systems for monitoring effectiveness of proposed interventions. Most countries reviewed link proposed interventions to specific drivers of DD. The majority of the countries making this link have better driver data quality, in particularly those that present their data in ratio or ordinal terms. Proposed interventions focus not only on activities to reduce deforestation, but also on other forest related REDD+ activities such as sustainable forest management, which reduce forest degradation and enhance forest stocks. Moreover, driver-specific interventions often relate to drivers not only inside but also outside the forest sector. Hence we suggest that monitoring systems need to assess not only deforestation rates through remote sensing, but also degradation and other carbon stock changes within the forest, using more detailed ground level surveys and measurements. In addition, the performance of interventions outside the forest need to be monitored, even if the impacts of these cannot be linked to specific changes in forest carbon stock in specific locations. (paper)

  20. Preterm Birth

    Science.gov (United States)

    ... After hours (404) 639-2888 Contact Media Preterm Birth Recommend on Facebook Tweet Share Compartir Preterm birth ... Can anything be done to prevent a preterm birth? Preventing preterm birth remains a challenge because there ...

  1. 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 ...

  2. Newborns health in the Danube Region: Environment, biomonitoring, interventions and economic benefits in a large prospective birth cohort study

    Czech Academy of Sciences Publication Activity Database

    Andersen, Z.J.; Šrám, Radim; Ščasný, M.; Gurzau, E.S.; Fucic, A.; Gribaldo, L.; Rössner ml., Pavel; Rössnerová, Andrea; Kohlová, M.B.; Máca, V.; Zvěřinová, I.; Gajdošová, D.; Moshammer, H.; Rudnai, P.; Knudsen, L. E.

    2016-01-01

    Roč. 88, mar. (2016), s. 112-122 ISSN 0160-4120 Institutional support: RVO:68378041 Keywords : birth cohort * environment * biomonitoring * air pollution * danube region * childhood health Subject RIV: EB - Genetics ; Molecular Biology Impact factor: 7.088, year: 2016

  3. Bereavement care interventions and outcome criteria planned by community nurses in the Canary Islands.

    Science.gov (United States)

    Rodríguez-Álvaro, Martín; García-Hernández, Alfonso Miguel; Brito-Brito, Pedro Ruymán; Aguirre-Jaime, Armando; Fernández-Gutiérrez, Domingo Ángel

    2018-02-19

    Nursing care in bereavement is complex. Primary health care is the ideal setting to support the bereaved, but we do not know much about the care plans designed by primary health care nurses in the treatment of grief. To identify the outcomes criteria and interventions planned by nurses for mourners with and without complications in the Canary Islands. Retrospective longitudinal study, using the electronic health records of the Canary Islands health service of people with a diagnosis of grieving, risk of complicated grieving and complicated grieving, in the period 2009-2014. NOC outcomes criteria were recorded in 67% of the mourners, and up to 24 different outcomes were identified. The main outcomes measures were Grief resolution; Psychosocial adjustment, Life change; Coping; Family coping; Family social climate and Caregiver emotional health. The remaining outcomes were present in less than 1% of the mourners. Although the outcomes criteria proposed by nurses in the mourners with and without complications were quite homogeneous, differences in interventions were found. In 67% of the cases, NIC interventions were reported. Ninety-nine different interventions were identified in the mourners; the most frequent were Emotional support; Grief work facilitation; Active listening; Coping enhancement and counselling. The remaining identified interventions were present in less than 5% of patients. The main interventions in the mourners with complications were Grief work facilitation; Coping enhancement; Active listening; Counselling and Family integrity promotion. Nurses state that there are more interventions and outcomes in mourners with complications. Given the few methodologically reliable studies that prove their effectiveness, continued research in this area is recommended. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  4. Theory of planned behavior interventions for reducing heterosexual risk behaviors: A meta-analysis.

    Science.gov (United States)

    Tyson, Mandy; Covey, Judith; Rosenthal, Harriet E S

    2014-12-01

    The meta-analysis reported here examined interventions informed by the theory of planned behavior (TPB) or theory of reasoned action (TRA) aimed at reducing heterosexual risk behaviors (prevention of STDs and unwanted pregnancy). Studies were eligible for inclusion if they were either randomized control trials or quasi-experimental studies that compared the TPB-based intervention against a control group. Search strategy consisted of articles identified in previous reviews, keyword search through search engines, examination of key journals, and contacting key experts. Forty-seven intervention studies were included in the meta-analysis. Random effects models revealed that pooled effect sizes for TPB-based interventions had small but significant effects on behavior and other secondary outcomes (i.e., knowledge, attitudes, normative beliefs, perceived behavioral control, and intentions). Significant heterogeneity found between effect sizes was explored using metaregression. Larger effects were found for interventions that provided opportunities for social comparison. The TPB provides a valuable framework for designing interventions to change heterosexual risk behaviors. However, effect sizes varied quite substantially between studies, and further research is needed to explore the reasons why.

  5. Influence of planning and civil initiative, as a form of public intervention, on gentrification

    Directory of Open Access Journals (Sweden)

    Lukić Ivana

    2011-01-01

    Full Text Available The main purpose of this paper is to establish the connection between gentrification and planning, as a form of state and civil intervention, along with citing instances of local community reactions to negative effects of gentrification. The work examines how these two forms of public intervention, by means of implementing measures/actions, influence positive and negative effects of gentrification and contribute to maintaining balance between them. Furthermore, it explains how they act in service of public interest. The main criterion for the selection of research examples has been the form of intervention implemented (measures/actions, that is, their diversity. Most examples have been drawn from the USA where, on account of its liberal economic system, the power of planning is weaker, negative effects of gentrification are more dominant and gentrification itself is considered a negative phenomenon. The main objective of the analysis is to determine how to minimize the negative effects. A small number of examples presented have been taken from developed European countries, since those states exert stronger influence on planning and the state/community is more responsible for housing problems and existence of different groups of individuals in the community. Those instances illustrate the maximization of positive effects. In addition, some examples have been drawn from transitional, post-socialist Balkan countries where anti-planning attitude is dominant and negative effects of gentrification are more present. Given their effects on gentrification, the most successful measures/actions, applied in the form of public intervention, ordered by category, are as follows: affordable housing, jobs, local regulations, partnership and direct actions.

  6. Population-based health promotion perspective for older driver safety: Conceptual framework to intervention plan

    Directory of Open Access Journals (Sweden)

    Sherrilene Classen

    2008-01-01

    Full Text Available Sherrilene Classen1,2, Ellen DS Lopez3, Sandra Winter2, Kezia D Awadzi4, Nita Ferree5, Cynthia W Garvan61Department of Occupational Therapy, College of Public Health and Health Professions (CPHHP, University of Florida (UF, Gainesville, FL, USA; 2PhD Program in Rehabilitation Science, CPHHP, UF Gainesville, FL, USA; 3Department of Behavioral Science and Community Health, CPHHP, UF, Gainesville, FL, USA; 4Department of Health Services Research, Management, and Policy, CPHHP, UF, Gainesville, FL, USA; 5Health Science Center Libraries, UF, Gainesville, FL, USA; 6Division of Biostatistics, College of Medicine, UF, Gainesville, FL, USAAbstract: The topic of motor vehicle crashes among the elderly is dynamic and multi-faceted requiring a comprehensive and synergistic approach to intervention planning. This approach must be based on the values of a given population as well as health statistics and asserted through community, organizational and policy strategies. An integrated summary of the predictors (quantitative research, and views (qualitative research of the older drivers and their stakeholders, does not currently exist. This study provided an explicit socio-ecological view explaining the interrelation of possible causative factors, an integrated summary of these causative factors, and empirical guidelines for developing public health interventions to promote older driver safety. Using a mixed methods approach, we were able to compare and integrate main findings from a national crash dataset with perspectives of stakeholders. We identified: 11 multi-causal factors for safe elderly driving; the importance of the environmental factors - previously underrated in the literature- interacting with behavioral and health factors; and the interrelatedness among many socio-ecological factors. For the first time, to our knowledge, we conceptualized the fundamental elements of a multi-causal health promotion plan, with measurable intermediate and long

  7. Feasibility of an online safety planning intervention for rural and urban pregnant abused women.

    Science.gov (United States)

    Bloom, Tina L; Glass, Nancy E; Case, James; Wright, Courtney; Nolte, Kimberly; Parsons, Lindsay

    2014-01-01

    Intimate partner violence (IPV) in pregnancy is common and harmful to maternal-child health. Safety planning is the gold standard for intervention, but most abused women never access safety planning. Pregnant women may face increased barriers to safety planning and risk of severe IPV, particularly if they are also rural residents. Internet-based safety planning interventions may be useful, but no such interventions specific to the needs of pregnant women have been developed. The aim was to evaluate feasibility (usability, safety, and acceptability) of Internet-based safety planning for rural and urban abused pregnant women and practicality of recruitment procedures for future trials. An existing Internet-based safety decision aid for pregnant and postpartum women was adapted; initial content validity was established with survivors of IPV, advocates, and national IPV experts; and a convenience sample of community-dwelling abused pregnant women was recruited and randomized into two groups to test the decision aid. Fifty-nine participants were enrolled; 46 completed the baseline session, 41% of whom (n = 19) resided in nonmetropolitan counties. Participants' average gestational age was 20.2 weeks, and 28.3% resided with the abusive partner. Participants reported severe IPV at baseline (mean Danger Assessment score of 16.1), but all were able to identify a safe computer, and 73.9% completed the baseline session in less than 1 week, with no adverse events reported. These findings provide preliminary evidence for the feasibility, acceptability, and safety of an Internet-based safety decision aid for urban and rural abused pregnant women.

  8. Simulating behaviour change interventions based on the theory of planned behaviour: Impacts on intention and action.

    Science.gov (United States)

    Fife-Schaw, Chris; Sheeran, Paschal; Norman, Paul

    2007-03-01

    The theory of planned behaviour (TPB; Ajzen, 1991) has been used extensively to predict social and health behaviours. However, a critical test of the TPB is whether interventions that increased scores on the theory's predictors would engender behaviour change. The present research deployed a novel technique in order to provide this test. Statistical simulations were conducted on data for 30 behaviours (N=211) that estimated the impact of interventions that generated maximum positive changes in attitudes, subjective norms and perceived behavioural control (PBC) on subsequent intentions and behaviour. Findings indicated that interventions that maximized TPB variables had a substantial impact on behavioural intentions. Although TPB maximization increased the proportion of the sample that performed respective behaviours by 28% compared with baseline, the behaviour of a substantial minority of the sample (26%) did not change. The research also identified several interactions among TPB variables in predicting simulated intention and behaviour scores and investigated the mediating role of intentions in predicting behaviour.

  9. Effectiveness of Anabolic Steroid Preventative Intervention among Gym Users: Applying Theory of Planned Behavior.

    Science.gov (United States)

    Jalilian, Farzad; Allahverdipour, Hamid; Moeini, Babak; Moghimbeigi, Abbas

    2011-01-01

    Use of anabolic androgenic steroids (AAS) has been associated with adverse physical and psychiatric effects and it is known as rising problem among youth people. This study was conducted to evaluate anabolic steroids preventative intervention efficiency among gym users in Iran and theory of planned behaviour was applied as theoretical framework. Overall, 120 male gym users participated in this study as intervention and control group. This was a longitudinal randomized pretest - posttest series control group design panel study to implement a behaviour modification based intervention to prevent AAS use. Cross -tabulation and t-test by using SPSS statistical package, version 13 was used for the statistical analysis. It was found significant improvements in average response for knowledge about side effects of AAS (Pgym users and ado-lescences would be effective to improve adolescents' healthy behaviors and intend them not to use AAS.

  10. Early initiation of basic resuscitation interventions including face mask ventilation may reduce birth asphyxia related mortality in low-income countries: a prospective descriptive observational study.

    Science.gov (United States)

    Ersdal, Hege Langli; Mduma, Estomih; Svensen, Erling; Perlman, Jeffrey M

    2012-07-01

    Early initiation of basic resuscitation interventions within 60 s in apneic newborn infants is thought to be essential in preventing progression to circulatory collapse based on experimental cardio-respiratory responses to asphyxia. The objectives were to describe normal transitional respiratory adaption at birth and to assess the importance of initiating basic resuscitation within the first minutes after birth as it relates to neonatal outcome. This is an observational study of neonatal respiratory adaptation at birth in a rural hospital in Tanzania. Research assistants (n=14) monitored every newborn infant delivery and the response of birth attendants to a depressed baby. Time to initiation of spontaneous respirations or time to onset of breathing following stimulation/suctioning, or face mask ventilation (FMV) in apneic infants, and duration of FMV were recorded. 5845 infants were born; 5689 were liveborn, among these 4769(84%) initiated spontaneous respirations; 93% in ≤30 s and 99% in ≤60 s. Basic resuscitation (stimulation, suction, and/or FMV) was attempted in 920/5689(16.0%); of these 459(49.9%) received FMV. Outcomes included normal n=5613(96.0%), neonatal deaths n=56(1.0%), admitted neonatal area n=20(0.3%), and stillbirths n=156(2.7%). The risk for death or prolonged admission increases 16% for every 30 s delay in initiating FMV up to six minutes (p=0.045) and 6% for every minute of applied FMV (p=0.001). The majority of lifeless babies were in primary apnea and responded to stimulation/suctioning and/or FMV. Infants who required FMV were more likely to die particularly when ventilation was delayed or prolonged. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  11. Temporal Trends in Late Preterm and Early Term Birth Rates in 6 High-Income Countries in North America and Europe and Association With Clinician-Initiated Obstetric Interventions

    DEFF Research Database (Denmark)

    Richards, Jennifer L.; Kramer, Michael S.; Deb-Rinker, Paromita

    2016-01-01

    : Use of clinician-initiated obstetric intervention (either labor induction or prelabor cesarean delivery) during delivery. Main Outcomes and Measures: Annual country-specific late preterm (34-36 weeks) and early term (37-38 weeks) birth rates. Results: The study population included 2 415 432 Canadian......Importance: Clinicians have been urged to delay the use of obstetric interventions (eg, labor induction, cesarean delivery) until 39 weeks or later in the absence of maternal or fetal indications for intervention. Objective: To describe recent trends in late preterm and early term birth rates in 6...... high-income countries and assess association with use of clinician-initiated obstetric interventions. Design: Retrospective analysis of singleton live births from 2006 to the latest available year (ranging from 2010 to 2015) in Canada, Denmark, Finland, Norway, Sweden, and the United States. Exposures...

  12. 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.

  13. Review of interventional procedures in the very low birth-weight infant (<1.5 kg): complications, lessons learned and current practice

    Energy Technology Data Exchange (ETDEWEB)

    Laffan, Eoghan E. [Children' s Hospital of Eastern Ontario, Department of Diagnostic Imaging, Ottawa, ON (Canada); McNamara, Patrick J.; Whyte, Hilary; L' Herault, Johanne [The Hospital for Sick Children, Division of Neonatology, Toronto, ON (Canada); Amaral, Joao; Temple, Michael; John, Philip; Connolly, Bairbre L. [The Hospital for Sick Children, The Image-Guided Therapy Unit, Toronto, ON (Canada)

    2009-08-15

    Interventional radiology (IR) procedures in very low birth-weight (VLBW) infants (<1.5 kg) are challenging due to size, immaturity, comorbidities and lack of devices of suitable size. Infants are moved from the neonatal intensive care unit to the IR suite, further exposing them to risk. Our purpose was to review our experience of interventional procedures in VLBW infants, specifically complications and potential risks. VLBW infants referred for image-guided therapy between 1998 and 2005 were identified and medical records reviewed. ''Complications'' were divided into: major or minor, periprocedural or postprocedural, and intervention-/device-related, patient-related or equipment-related. Transport risk index of physiological stability (TRIPS) scores were calculated. A total of 116 infants (68 male, 48 female) underwent 176 procedures (159 vascular access-related and 17 nonvascular). Of 158 complications identified, 116 were major and 42 were minor. Major complications included hypothermia (n=33), line manipulations/removals (n=25), bleeding (n=12), thrombosis (n=4), cardiac arrest (n=3), tamponade (n=2), and multiorgan failure (n=1). Of the complications, 119 were categorized as intervention-/device-related, 32 patient-related and 7 equipment-related. There were no significant differences between pre- and postprocedural TRIPS scores. Successful completion of IR procedures in the VLBW infant is possible, but complications still occur in these fragile infants. (orig.)

  14. Duration and urgency of transfer in births planned at home and in freestanding midwifery units in England: secondary analysis of the Birthplace national prospective cohort study

    Science.gov (United States)

    2013-01-01

    Background In England, there is a policy of offering healthy women with straightforward pregnancies a choice of birth setting. Options may include home or a freestanding midwifery unit (FMU). Transfer rates from these settings are around 20%, and higher for nulliparous women. The duration of transfer is of interest because of the potential for delay in access to specialist care and is also of concern to women. We aimed to estimate the duration of transfer in births planned at home and in FMUs and explore the effects of distance and urgency on duration. Methods This was a secondary analysis of data collected in a national prospective cohort study including 27,842 ‘low risk’ women with singleton, term, ‘booked’ pregnancies, planning birth in FMUs or at home in England from April 2008 to April 2010. We described transfer duration using the median and interquartile range, for all transfers and those for reasons defined as potentially urgent or non-urgent, and used cumulative distribution curves to compare transfer duration by urgency. We explored the effect of distance for transfers from FMUs and described outcomes in women giving birth within 60 minutes of transfer. Results The median overall transfer time, from decision to transfer to first OU assessment, was shorter in transfers from home compared with transfers from FMUs (49 vs 60 minutes; p < 0.001). The median duration of transfers before birth for potentially urgent reasons (home 42 minutes, FMU 50 minutes) was 8–10 minutes shorter compared with transfers for non-urgent reasons. In transfers for potentially urgent reasons, the median overall transfer time from FMUs within 20 km of an OU was 47 minutes, increasing to 55 minutes from FMUs 20-40 km away and 61 minutes in more remote FMUs. In women who gave birth within 60 minutes after transfer, adverse neonatal outcomes occurred in 1-2% of transfers. Conclusions Transfers from home or FMU commonly take up to 60 minutes from decision to

  15. Implementation intention and action planning interventions in health contexts: state of the research and proposals for the way forward.

    Science.gov (United States)

    Hagger, Martin S; Luszczynska, Aleksandra

    2014-03-01

    The purpose of this paper is to provide an overview of the literature on two planning intervention techniques in health behaviour research, implementation intentions and action planning, and to develop evidence-based recommendations for effective future interventions and highlight priority areas for future research. We focused our review on four key areas: (1) definition and conceptualisation; (2) format and measurement; (3) mechanisms and processes; and (4) design issues. Overall, evidence supports the effectiveness of planning interventions in health behaviour with advantages including low cost and response burden. There is, however, considerable heterogeneity in the effects across studies and relatively few registered randomised trials that include objective behavioural measures. Optimally effective planning interventions should adopt "if-then" plans, account for salient and relevant cues, include examples of cues, be guided rather than user-defined, and include boosters. Future studies should adopt randomised controlled designs, report study protocols, include fidelity checks and relevant comparison groups, and adopt long-term behavioural follow-up measures. Priority areas for future research include the identification of the moderators and mediators of planning intervention effects. Future research also needs to adopt "best practice" components of planning interventions more consistently to elucidate the mechanisms and processes involved. © 2013 The International Association of Applied Psychology.

  16. Taking stock: protocol for evaluating a family planning supply chain intervention in Senegal.

    Science.gov (United States)

    Cavallaro, Francesca L; Duclos, Diane; Baggaley, Rebecca F; Penn-Kekana, Loveday; Goodman, Catherine; Vahanian, Alice; Santos, Andreia C; Bradley, John; Paintain, Lucy; Gallien, Jérémie; Gasparrini, Antonio; Hasselback, Leah; Lynch, Caroline A

    2016-04-21

    In Senegal, only 12% of women of reproductive age in union (WRAU) were using contraceptives and another 29% had an unmet need for contraceptives in 2010-11. One potential barrier to accessing contraceptives is the lack of stock availability in health facilities where women seek them. Multiple supply chain interventions have been piloted in low- and middle-income countries with the aim of improving contraceptive availability in health facilities. However, there is limited evidence on the effect of these interventions on contraceptive availability in facilities, and in turn on family planning use in the population. This evaluation protocol pertains to a supply chain intervention using performance-based contracting for contraceptive distribution that was introduced throughout Senegal between 2012 and 2015. This multi-disciplinary research project will include quantitative, qualitative and economic evaluations. Trained researchers in the different disciplines will implement the studies separately but alongside each other, sharing findings throughout the project to inform each other's data collection. A non-randomised study with stepped-wedge design will be used to estimate the effect of the intervention on contraceptive stock availability in health facilities, and on the modern contraceptive prevalence rate among women in Senegal, compared to the current pull-based distribution model used for other commodities. Secondary data from annual Service Provision Assessments and Demographic and Health Surveys will be used for this study. Data on stock availability and monthly family planning consultations over a 4-year period will be collected from 200 health facilities in five regions to perform time series analyses. A process evaluation will be conducted to understand the extent to which the intervention was implemented as originally designed, the acceptability of third-party logisticians within the health system and potential unintended consequences. These will be assessed

  17. Effects of lifestyle intervention in pregnancy and anthropometrics at birth on offspring metabolic profile at 2.8 years - results from the Lifestyle in Pregnancy and Offspring (LiPO) study

    DEFF Research Database (Denmark)

    Tanvig, Mette; Vinter, Christina A; Jørgensen, Jan S

    2014-01-01

    Context: Maternal obesity and gestational weight gain are linked to offspring adverse metabolic profile, and lifestyle intervention during pregnancy in obese women may have long-term positive effect on their children. Furthermore, although the association between birth weight and later metabolic...... outcomes is well established, little is known about the predictive value of abdominal circumference at birth. Objectives: To study: i) effects of lifestyle intervention during pregnancy in obese women on offspring metabolic risk factors and ii) predictive values of birth weight (BW) and birth abdominal...... circumference (BAC). Design: Follow-up of a randomized controlled trial; the Lifestyle in Pregnancy (LiP) study Setting: Odense and Aarhus University Hospitals, Denmark Participants: Offspring of LiP study participants (n=157) and offspring of normal weight mothers (external reference group, ER, n=97...

  18. Effects of a short behavioural intervention for dental flossing: randomized-controlled trial on planning when, where and how.

    Science.gov (United States)

    Schüz, Benjamin; Wiedemann, Amelie U; Mallach, Natalie; Scholz, Urte

    2009-06-01

    Regular dental flossing has been widely recommended to prevent periodontal diseases. Nevertheless, compliance is below a desirable level. This study evaluates the effects of a brief behavioural intervention on dental flossing and determines whether the effects of such an intervention are stronger in a specific subgroup of individuals (those intending to floss regularly=implemental mindset). Behavioural intervention (planning when, where and how to floss) trial was conducting with 194 participants assigned to an intervention or a control group by a random time schedule; the primary outcome was validated self-report of flossing behaviour. Follow-up data were collected 2 and 8 weeks post-intervention. Individuals receiving the planning intervention significantly outperformed those in the control condition at both the 2- and the 8-week follow-up (4.24 times flossing/week versus 3.9 at 2 weeks; 4.02 versus 2.98 at 8 weeks). Intervention effects were stronger in individuals in the implemental mindset. Dropout rates were higher for participants who received the planning intervention but were not in the implemental mindset. Planning interventions are an economic and effective way to change oral self-care behaviour, and are more effective in individuals in an implemental mindset.

  19. The role of public health authorities, scientific societies and the pharmaceutical industry in planning and conducting intervention trials

    NARCIS (Netherlands)

    van Zwieten, P. A.

    1996-01-01

    BODIES INVOLVED IN CLINICAL TRIALS: Government institutions, academia and associated scientific societies and the pharmaceutical industry are the main entities involved in planning and conducting intervention trials. Funding can only be expected from government institutions and industry, but

  20. A family planning clinic-based intervention to address reproductive coercion: a cluster randomized controlled trial.

    Science.gov (United States)

    Miller, Elizabeth; Tancredi, Daniel J; Decker, Michele R; McCauley, Heather L; Jones, Kelley A; Anderson, Heather; James, Lisa; Silverman, Jay G

    2016-07-01

    We assessed the effectiveness of a provider-delivered intervention targeting reproductive coercion, an important factor in unintended pregnancy. We randomized 25 family planning clinics (17 clusters) to deliver an education/counseling intervention or usual care. Reproductive coercion and partner violence victimization at 1 year follow-up were primary outcomes. Unintended pregnancy, recognition of sexual and reproductive coercion, self-efficacy to use and use of harm reduction behaviors to reduce victimization and contraception nonuse, and knowledge and use of partner violence resources were secondary outcomes. Analyses included all available data using an intention-to-treat approach. Among 4009 females ages 16 to 29 years seeking care, 3687 completed a baseline survey prior to clinic visit from October 2011 to November 2012; 3017 provided data at 12-20weeks post-baseline (T2) and 2926 at 12months post-baseline (T3) (79% retention). Intervention effects were not significant for reproductive coercion [adjusted risk ratio (ARR) 1.50 (95% confidence interval 0.95-2.35)] or partner violence [ARR 1.07 (0.84-1.38)]. Intervention participants reported improved knowledge of partner violence resources [ARR 4.25 (3.29-5.50)] and self-efficacy to enact harm reduction behaviors [adjusted mean difference 0.06 (0.02-0.10)]. In time point-specific models which included moderating effects of exposure to reproductive coercion at baseline, a higher reproductive coercion score at baseline was associated with a decrease in reproductive coercion 1 year later (T3). Use and sharing of the domestic violence hotline number also increased. This brief clinic intervention did not reduce partner violence victimization. The intervention enhanced two outcomes that may increase safety for women, specifically awareness of partner violence resources and self-efficacy to enact harm reduction behaviors. It also appeared to reduce reproductive coercion among women experiencing multiple forms of such

  1. Effectiveness of Anabolic Steroid Preventative Intervention among Gym Users: Applying Theory of Planned Behavior

    Directory of Open Access Journals (Sweden)

    Abbas Moghimbeigi

    2011-07-01

    Full Text Available Background: Use of anabolic androgenic steroids (AAS has been associated with adversephysical and psychiatric effects and it is known as rising problem among youth people. Thisstudy was conducted to evaluate anabolic steroids preventative intervention efficiency amonggym users in Iran and theory of planned behaviour was applied as theoretical framework.Methods: Overall, 120 male gym users participated in this study as intervention and controlgroup. This was a longitudinal randomized pretest - posttest series control group design panelstudy to implement a behaviour modification based intervention to prevent AAS use. Cross -tabulation and t-test by using SPSS statistical package, version 13 was used for the statisticalanalysis.Results: It was found significant improvements in average response for knowledge about sideeffects of AAS (P<0.001, attitude toward, and intention not to use AAS. Additionally afterintervention, the rate of AAS and supplements use was decreased among intervention group.Conclusion: Comprehensive implementation against AAS abuse among gym users and adolescenceswould be effective to improve adolescents’ healthy behaviors and intend them notto use AAS.

  2. Using Geographic Information Systems to Visualize Relationships Between Perinatal Outcomes and Neighborhood Characteristics When Planning Community Interventions.

    Science.gov (United States)

    Suplee, Patricia D; Bloch, Joan Rosen; Hillier, Amy; Herbert, Tasha

    2018-03-01

    To describe maternal morbidity, birth outcomes, and neighborhood characteristics of urban women from a racially segregated city with the use of a geographic information system (GIS). Exploratory neighborhood-level study. Existing birth certificate data were linked and aggregated to neighborhood-level data for spatial analyses. Southern city in New Jersey. Women and their 7,858 live births that occurred between 2009 and 2013. Secondary analyses of extant sources were conducted. Maternal health and newborn birth outcomes were geocoded and then aggregated to the neighborhood level for further exploratory spatial analyses through our GIS database. An iterative process was used to generate meaningful visual representations of the data through maps of maternal and infant health in 19 neighborhoods. The racial and ethnic residential segregation and neighborhood patterns of associations of adverse birth outcomes with poverty and crime were illustrated in GIS maps. In 43% of the births, women had a documented medical risk. Significantly more preterm births occurred for Black women (p < .01) and women older than 35 years of age (p = .01). The rate of diabetes was greater in Hispanic women, and the rate of pregnancy-related hypertensive disorders was greater in Black women. Data-driven maps can provide clear evidence of maternal and infant health and health needs based on the neighborhoods where mothers live. This research is important so that maternity care providers can understand contextual factors that affect mothers in their communities and guide the design of interventions. Copyright © 2018 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses. Published by Elsevier Inc. All rights reserved.

  3. The Role of Need for Contraception in the Evaluation of Interventions to Improve Access to Family-Planning Methods

    Science.gov (United States)

    Leon, Federico R.; Lundgren, Rebecka; Sinai, Irit; Jennings, Victoria

    2011-01-01

    A nonrandomized experiment carried out in Jharkhand, India, shows how the effects of interventions designed to improve access to family-planning methods can be erroneously regarded as trivial when contraceptive use is utilized as dependent variable, ignoring women's need for contraception. Significant effects of the intervention were observed on…

  4. The global epidemic of abuse and disrespect during childbirth: History, evidence, interventions, and FIGO's mother-baby friendly birthing facilities initiative.

    Science.gov (United States)

    Miller, Suellen; Lalonde, Andre

    2015-10-01

    Recent evidence indicates that disrespectful/abusive/coercive service delivery by skilled providers in facilities, which results in actual or perceived poor quality of care, is directly and indirectly associated with adverse maternal and newborn outcomes. The present article reviews the evidence for disrespectful/abusive care during childbirth in facilities (DACF), describes examples of DACF, discusses organizations active in a rights-based respectful maternity care movement, and enumerates some strategies and interventions that have been identified to decrease DACF. It concludes with a discussion of one strategy, which has been recently implemented by FIGO with global partners-the International Pediatrics Association, International Confederation of Midwives, the White Ribbon Alliance, and WHO. This strategy, the Mother and Baby Friendly Birth Facility (MBFBF) Initiative, is a criterion-based audit process based on human rights' doctrines, and modeled on WHO/UNICEF's Baby Friendly Facility Initiative. Copyright © 2015. Published by Elsevier Ireland Ltd.

  5. A qualitative study exploring newborn care behaviours after home births in rural Ethiopia: implications for adoption of essential interventions for saving newborn lives.

    Science.gov (United States)

    Salasibew, Mihretab Melesse; Filteau, Suzanne; Marchant, Tanya

    2014-12-12

    Ethiopia is among seven high-mortality countries which have achieved the fourth millennium development goal with over two-thirds reduction in under-five mortality rate. However, the proportion of neonatal deaths continues to rise and recent studies reported low coverage of the essential interventions saving newborn lives. In the context of low uptake of health facility delivery, it is relevant to explore routine practices during home deliveries and, in this study, we explored the sequence of immediate newborn care practices and associated beliefs following home deliveries in rural communities in Ethiopia. Between April-May 2013, we conducted 26 semi-structured interviews and 2 focus group discussions with eligible mothers, as well as a key informant interview with a local expert in traditional newborn care practices in rural Basona woreda (district) near the urban town of Debrebirhan, 120 km from Addis Ababa, Ethiopia. The most frequently cited sequence of newborn care practices reported by mothers with home deliveries in the rural Basona woreda was to tie the cord, immediately bath then dry the newborn, practice 'Lanka mansat' (local traditional practice on newborns), give pre-lacteal feeding and then initiate breastfeeding. For 'Lanka mansat', the traditional birth attendant applies mild pressure inside the baby's mouth on the soft palate using her index finger. This is performed believing that the baby will have 'better voice' and 'speak clearly' later in life. Coverage figures fail to tell the whole story as to why some essential interventions are not practiced and, in this study, we identified established norms or routines within the rural communities that determine the sequence of newborn care practices following home births. This might explain why some mothers delay initiation of breastfeeding and implementation of other recommended essential interventions saving newborn lives. An in-depth understanding of established routines is necessary, and community

  6. The interplay of ultrasound and computed tomography in the planning and execution of interventional procedures

    International Nuclear Information System (INIS)

    Stafford, S.; Mueller, P.R.

    1987-01-01

    Even in large academic and private settings, where subspecialists abound and diagnostic and interventional radiologists are divided, both physically and philosophically, the interventionalist has emerged from the fluoroscopic suite to participate in the imaging workup of patients referred for precutaneous procedures. This expanded imaging role for the interventionalist is a natural outgrowth of several developments in radiology training. Computed tomography and ultrasound no longer are obscure techniques, understood only by an elite group of academic radiologists in large centers with access to equipment. All residents receive extensive education in these modalities, as imaging is a major part of general radiology. In addition, fellowship programs have been expanded to emphasize organ system training as opposed to ''modality'' training alone. Armed with imaging skills, the interventionalist is able to evaluate the cross-sectional diagnostic images better and to address specific findings and issues with respect to the planned procedure. These specific issues, elucidated by cross-sectional imaging, impact on the planning of interventional procedures addressed in this chapter

  7. Impact of the roll out of comprehensive emergency obstetric care on institutional birth rate in rural Nepal.

    Science.gov (United States)

    Maru, Sheela; Bangura, Alex Harsha; Mehta, Pooja; Bista, Deepak; Borgatta, Lynn; Pande, Sami; Citrin, David; Khanal, Sumesh; Banstola, Amrit; Maru, Duncan

    2017-03-04

    Increasing institutional births rates and improving access to comprehensive emergency obstetric care are central strategies for reducing maternal and neonatal deaths globally. While some studies show women consider service availability when determining where to deliver, the dynamics of how and why institutional birth rates change as comprehensive emergency obstetric care availability increases are unclear. In this pre-post intervention study, we surveyed two exhaustive samples of postpartum women before and after comprehensive emergency obstetric care implementation at a hospital in rural Nepal. We developed a logistic regression model of institutional birth factors through manual backward selection of all significant covariates within and across periods. Qualitatively, we analyzed birth stories through immersion crystallization. Institutional birth rates increased after comprehensive emergency obstetric care implementation (from 30 to 77%, OR 7.7) at both hospital (OR 2.5) and low-level facilities (OR 4.6, p birth location (OR 44.8), safety prioritization in decision-making (OR 7.7), and higher income (OR 1.1) predict institutional birth (p ≤ 0.01 for all). Qualitative analysis revealed comprehensive emergency obstetric care awareness, increased social expectation for institutional birth, and birth planning as important factors. Comprehensive emergency obstetric care expansion appears to have generated significant demand for institutional births through increased safety perceptions and birth planning. Increasing comprehensive emergency obstetric care availability increases birth safety, but it may also be a mechanism for increasing the institutional birth rate in areas of under-utilization.

  8. Birth Defects

    Science.gov (United States)

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

  9. Particular intervention plan of the Civaux Nuclear Power Plant. Public version. Special provision of the organisation plan for civil protection response

    International Nuclear Information System (INIS)

    2016-04-01

    The Particular intervention plan (PPI in French) is an emergency plan which foresees the measures and means to be implemented to address the potential risks of the presence and operation of a nuclear facility. This plan is implemented and developed by the Prefect in case of nuclear accident (or incident leading to a potential accident), the impact of which extending beyond the facility perimeter. It represents a special section of the organisation plan for civil protection response (ORSEC plan). The PPI foresees the necessary measures and means for crisis management during the first hours following the accident and is triggered by the Department Prefect according to the information provided by the facility operator. Its aim is to protect the populations leaving within 10 km of the facility against a potential radiological hazard. The PPI describes: the facility, the intervention area, the protection measures for the population, the conditions of emergency plan triggering, the crisis organisation, the action forms of the different services, and the post-accident stage. This document is the public version of the Particular intervention plan of the Civaux nuclear power plant (Vienne, France)

  10. Effects of an outdoor bicycle-based intervention in healthy rural Indian men with normal and low birth weight

    DEFF Research Database (Denmark)

    Madsen, C; Mogensen, P; Thomas, N

    2015-01-01

    . Fasting blood samples, intravenous glucose tolerance tests and bioimpedance body composition assessment were carried out. Physical activity was measured using combined accelerometry and heart rate monitoring during the first and the last week of the intervention. Following the exercise intervention...... of an outdoor exercise intervention on body composition, insulin secretion and action in young men born with LBW and NBW in rural India. A total of 61 LBW and 56 NBW healthy young men were recruited into the study. The individuals were instructed to perform outdoor bicycle exercise training for 45 min every day......, the LBW group displayed an increase in physical fitness [55.0 ml (O2)/kg min (52.0-58.0)-57.5 ml (O2)/kg min (54.4-60.5)] level and total fat-free mass [10.9% (8.0-13.4)-11.4% (8.0-14.6)], as well as a corresponding decline in the ratio of total fat mass/fat-free mass. In contrast, an increase in total...

  11. The infant behavioral assessment and intervention program in very low birth weight infants; outcome on executive functioning, behaviour and cognition at preschool age.

    Science.gov (United States)

    Verkerk, Gijs; Jeukens-Visser, Martine; Houtzager, Bregje; Koldewijn, Karen; van Wassenaer, Aleid; Nollet, Frans; Kok, Joke

    2012-08-01

    The Infant Behavioral Assessment and Intervention Program (IBAIP©) improved motor function at 24 months, and mental and behavioural development in high risk subgroups of very low birth weight (VLBW) infants. To determine IBAIP's effects on executive functioning, behaviour and cognition at preschool age. Follow-up of a randomised controlled trial (RCT). At 44 months corrected age, all 176 VLBW infants were invited for follow-up. Forty-one term born children were assessed for comparison. Visual Attention Task (VAT), Gift delay, Peabody Picture Vocabulary Test III-NL (PPVT), Visual motor integration tests and Miller assessment for preschoolers. Parents completed Behavior Rating Inventory of Executive Function-Preschool (BRIEF-P) and Child Behavior Checklist (CBCL). At preschool age, 76 (88%) children of the intervention group and 75 (83%) children of the control group participated. There were no significant differences between the intervention and the control group. However, positive interaction effects between intervention and infants with bronchopulmonary dysplasia, infants born at gestational agechildren. The 151 VLBW children performed significantly worse than the term born children on the VAT, BRIEF-P and CBCL. IBAIP effects in VLBW children did not sustain until preschool age on executive functioning, behaviour and cognition. However, the most vulnerable children had a clinical relevant profit from IBAIP. VLBW children performed worse than the term born children. This study is a follow-up at preschool age of the multi-centre RCT of IBAIP versus usual care in VLBW infants. The RCT was performed in Amsterdam, The Netherlands (IBAIP). Copyright © 2012 Elsevier Ltd. All rights reserved.

  12. The Intervention Design and Analysis Scorecard: a planning tool for participatory design of integrated health and safety interventions in the workplace.

    Science.gov (United States)

    Robertson, Michelle; Henning, Robert; Warren, Nicholas; Nobrega, Suzanne; Dove-Steinkamp, Megan; Tibirica, Lize; Bizarro, Andrea

    2013-12-01

    As part of a Research-to-Practice Toolkit development effort by the Center for the Promotion of Health in the New England Workplace, to develop and test a structured participatory approach for engaging front-line employees in the design of integrated health protection and promotion interventions. On the basis of a participatory ergonomics framework, the Intervention Design and Analysis Scorecard (IDEAS) provides a stepwise approach for developing intervention proposals, including root cause analysis and setting evaluation criteria such as scope, obstacles, and cost/benefit trade-offs. The IDEAS was tested at four diverse worksites with trained facilitators. Employees were able to develop and gain management support for integrated interventions at each worksite. The IDEAS can be used effectively by front-line employees to plan integrated interventions in a program dedicated to continuous improvement of employee health protection/promotion and Total Worker Health.

  13. Interactive visual intervention planning in particle accelerator environments with ionizing radiation

    International Nuclear Information System (INIS)

    Fabry, Thomas

    2014-01-01

    radiation. Several industrial and scientific procedures give rise to facilities with ionizing radiation. Most technical and scientific facilities also need maintenance operations. In the spirit of ALARA, these interventions need to be optimized in terms of the exposure of the maintenance workers to ionizing radiation. This optimization cannot be automated since the feasibility of the intervention tasks requires human assessment. The intervention planning could however be facilitated by technical-scientific means, e.g. software tools. In the context sketched above, this thesis provides technical-scientific considerations and the development of technical-scientific methodologies and software tools for the implementation of radiation protection.In particular, this thesis addresses the need for an interactive visual intervention planning tool in the context of high energy particle accelerator facilities. (author)

  14. Implementation of a Family Planning Clinic-Based Partner Violence and Reproductive Coercion Intervention: Provider and Patient Perspectives.

    Science.gov (United States)

    Miller, Elizabeth; McCauley, Heather L; Decker, Michele R; Levenson, Rebecca; Zelazny, Sarah; Jones, Kelley A; Anderson, Heather; Silverman, Jay G

    2017-06-01

    Despite multiple calls for clinic-based services to identify and support women victimized by partner violence, screening remains uncommon in family planning clinics. Furthermore, traditional screening, based on disclosure of violence, may miss women who fear reporting their experiences. Strategies that are sensitive to the signs, symptoms and impact of trauma require exploration. In 2011, as part of a cluster randomized controlled trial, staff at 11 Pennsylvania family planning clinics were trained to offer a trauma-informed intervention addressing intimate partner violence and reproductive coercion to all women seeking care, regardless of exposure to violence. The intervention sought to educate women about available resources and harm reduction strategies. In 2013, at the conclusion of the trial, 18 providers, five administrators and 49 patients completed semistructured interviews exploring acceptability of the intervention and barriers to implementation. Consensus and open coding strategies were used to analyze the data. Providers reported that the intervention increased their confidence in discussing intimate partner violence and reproductive coercion. They noted that asking patients to share the educational information with other women facilitated the conversation. Barriers to implementation included lack of time and not having routine reminders to offer the intervention. Patients described how receiving the intervention gave them important information, made them feel supported and less isolated, and empowered them to help others. A universal intervention may be acceptable to providers and patients. However, successful implementation in family planning settings may require attention to system-level factors that providers view as barriers. Copyright © 2017 by the Guttmacher Institute.

  15. Classification of calcium in intravascular OCT images for the purpose of intervention planning

    Science.gov (United States)

    Shalev, Ronny; Bezerra, Hiram G.; Ray, Soumya; Prabhu, David; Wilson, David L.

    2016-03-01

    The presence of extensive calcification is a primary concern when planning and implementing a vascular percutaneous intervention such as stenting. If the balloon does not expand, the interventionalist must blindly apply high balloon pressure, use an atherectomy device, or abort the procedure. As part of a project to determine the ability of Intravascular Optical Coherence Tomography (IVOCT) to aid intervention planning, we developed a method for automatic classification of calcium in coronary IVOCT images. We developed an approach where plaque texture is modeled by the joint probability distribution of a bank of filter responses where the filter bank was chosen to reflect the qualitative characteristics of the calcium. This distribution is represented by the frequency histogram of filter response cluster centers. The trained algorithm was evaluated on independent ex-vivo image data accurately labeled using registered 3D microscopic cryo-image data which was used as ground truth. In this study, regions for extraction of sub-images (SI's) were selected by experts to include calcium, fibrous, or lipid tissues. We manually optimized algorithm parameters such as choice of filter bank, size of the dictionary, etc. Splitting samples into training and testing data, we achieved 5-fold cross validation calcium classification with F1 score of 93.7+/-2.7% with recall of >=89% and a precision of >=97% in this scenario with admittedly selective data. The automated algorithm performed in close-to-real-time (2.6 seconds per frame) suggesting possible on-line use. This promising preliminary study indicates that computational IVOCT might automatically identify calcium in IVOCT coronary artery images.

  16. Particular intervention plan of the Saint Alban-Saint Maurice l'Exil Nuclear Power Plant

    International Nuclear Information System (INIS)

    2010-01-01

    The Particular intervention plan (PPI in French) is an emergency plan which foresees the measures and means to be implemented to address the potential risks of the presence and operation of a nuclear facility. This plan is implemented and developed by the Prefect in case of nuclear accident (or incident leading to a potential accident), the impact of which extending beyond the facility perimeter. It represents a special section of the organisation plan for civil protection response (ORSEC plan). The PPI foresees the necessary measures and means for crisis management during the first hours following the accident and is triggered by the Department Prefect according to the information provided by the facility operator. Its aim is to protect the populations leaving within 10 km of the facility against a potential radiological hazard. The PPI describes: the facility, the intervention area, the protection measures for the population, the conditions of emergency plan triggering, the crisis organisation, the action forms of the different services, and the post-accident stage. This document is the public version of the Particular intervention plan of the Saint Alban-Saint Maurice NPP (Isere, France)

  17. 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 ...

  18. On-site emergency intervention plan for nuclear accident situation at INR-Pitesti TRIGA reactor

    International Nuclear Information System (INIS)

    Oprea, I.; Margenu, S.; Preda, M.

    2001-01-01

    evaluate alternative countermeasure strategies in the various stage of an accident. In this way, we have developed at INC Pitesti a computer code namely DOZIM which is presented. The structure of the emergency intervention plan, as objectives, general features and procedures is given. Each year there is organized at INR Pitesti an emergency intervention exercise for a nuclear accident situation at the TRIGA reactor. The main objective of such an exercise is to test the response capability in a nuclear accident situation for all the institutions and organizations from all levels as well as to test the implementation of specific procedures

  19. Progestin-Only Birth Control Pills

    Science.gov (United States)

    ... Rehabilitation Emotional Well-Being Mental Health Sex and Birth Control Sex and Sexuality Birth Control Family Health Infants and Toddlers Kids and ... ExpectDepo-Provera: An Injectable ContraceptiveTubal Sterilization (Tubal Ligation)Birth Control OptionsNatural Family PlanningBirth Control: How to Use ...

  20. Palliative assessment and advance care planning in severe dementia: an exploratory randomized controlled trial of a complex intervention.

    Science.gov (United States)

    Sampson, Elizabeth L; Jones, Louise; Thuné-Boyle, Ingela C V; Kukkastenvehmas, Riitta; King, Michael; Leurent, Baptiste; Tookman, Adrian; Blanchard, Martin R

    2011-04-01

    Patients with advanced dementia often receive poor end-of-life care. We aimed to design and pilot a palliative care and advance care plan (ACP) intervention. Patients had undergone emergency hospital admission and had severe dementia. The intervention consisted of a palliative care patient assessment which informed an ACP discussion with the carer, who was offered the opportunity to write an ACP for the person with dementia. Carer-patient dyads were randomized to 'usual care' or the intervention. Carer-related outcome measures included the Kessler Distress Scale, Decision Satisfaction Inventory, Client Satisfaction Questionnaire and the Euroqol-5D, measured at baseline, six weeks, six months and three months after bereavement. The Satisfaction with End of Life Care in Dementia Scale was completed if the patient died. The 32 patient participants were physically frail and in the advanced stages of dementia: 62% had pressure damage to the skin, all needed feeding assistance and 95% were in pain. Nearly 50% died during the six-month follow-up period. Carers were difficult to recruit during acute admission; 33 patients and carers entered the study (22 intervention arm; 11 control arm). Only seven carers made ACPs. The care planning discussion was well received, but few carers wrote an ACP, despite intensive support from an experienced nurse specialist. Advance care planning is, in theory, a necessary intervention for people with severe dementia; the reluctance of carers to write plans needs to be explored further.

  1. Interventions to Increase Male Attendance and Testing for Sexually Transmitted Infections at Publicly-Funded Family Planning Clinics.

    Science.gov (United States)

    Fine, David; Warner, Lee; Salomon, Sarah; Johnson, David M

    2017-07-01

    We assessed the impact of staff, clinic, and community interventions on male and female family planning client visit volume and sexually transmitted infection testing at a multisite community-based health care agency. Staff training, clinic environmental changes, in-reach/outreach, and efficiency assessments were implemented in two Family Health Center (San Diego, CA) family planning clinics during 2010-2012; five Family Health Center family planning programs were identified as comparison clinics. Client visit records were compared between preintervention (2007-2009) and postintervention (2010-2012) for both sets of clinics. Of 7,826 male client visits during the time before intervention, most were for clients who were aged family planning clinics succeeded without affecting female client volume or services. Copyright © 2017 Society for Adolescent Health and Medicine. All rights reserved.

  2. Nursing Students' Attitudes and Intention to Work with Mentally Ill Patients Before and After a Planned Intervention.

    Science.gov (United States)

    Itzhaki, Michal; Meridan, Orit; Sagiv-Schifter, Tammy; Barnoy, Sivia

    2017-06-01

    The authors examined changes in attitudes and intention to work with mentally ill patients (treat, specialize, or work in the field) among nursing students after a planned intervention consisting of a mental health course. Data were collected before and after a planned intervention. The nature of the intervention was educational, for third year undergraduate nursing students. The core intervention included lectures on mental illness, encounters with people coping with mental illness, simulations, and a film on coping with mental illness. Behavioral intention to work with mentally ill patients and three dimensions of nursing students' attitudes (perceived functional characteristics, perceived danger, and value diminution of mentally ill patients) were measured before and after the intervention. The post-intervention impact of the intervention on participants' attitudes and behavioral intention was measured. One hundred and one undergraduate third year nursing students studying at four nursing schools in Israel participated in the study. The planned intervention improved the students' attitudes towards mentally ill patients but did not improve their intention of working with them. Post-intervention, older and less religious students had more intention to work with mentally ill patients. Moreover, older and Jewish students held better attitudes towards the functional characteristics of mentally ill patients. Being older was also correlated with the perception of mentally ill patients as less dangerous and male students ascribed to them more value diminution. Students' attitudes towards mentally ill patients and their behavioral intention to work in the psychiatry field should be addressed during the initial training and in continuing education. Teaching methods should include theoretical learning on multicultural mental health practice concurrently with clinical placements.

  3. The Dutch ‘Focus on Strength’ intervention study protocol: programme design and production, implementation and evaluation plan

    Directory of Open Access Journals (Sweden)

    G. A. Ten Hoor

    2016-06-01

    Full Text Available Abstract Background Overweight youngsters are better in absolute strength exercises than their normal-weight counterparts; a physiological phenomenon with promising psychological impact. In this paper we describe the study protocol of the Dutch, school-based program ‘Focus on Strength’ that aims to improve body composition of 11–13 year old students, and with that to ultimately improve their quality of life. Methods The development of this intervention is based on the Intervention Mapping (IM protocol, which starts from a needs assessment, uses theory and empirical research to develop a detailed intervention plan, and anticipates program implementation and evaluation. This novel intervention targets first year students in preparatory secondary vocational education (11–13 years of age. Teachers are the program implementers. One part of the intervention involves a 30 % increase of strength exercises in the physical education lessons. The other part is based on Motivational Interviewing, promoting autonomous motivation of students to become more physically active outside school. Performance and change objectives are described for both teachers and students. The effectiveness of the intervention will be tested in a Randomized Controlled Trial in 9 Dutch high schools. Discussion Intervention Mapping is a useful framework for program planning a school-based program to improve body composition and motivation to exercise in 11–13 year old adolescents by a “Focus on Strength”. Trial registration NTR5676 , registered 8 February 2016 (retrospectively registered.

  4. What are the working mechanisms of a web-based workplace sitting intervention targeting psychosocial factors and action planning?

    Science.gov (United States)

    De Cocker, Katrien; De Bourdeaudhuij, Ilse; Cardon, Greet; Vandelanotte, Corneel

    2017-05-03

    Office workers demonstrate high levels of sitting on workdays. As sitting is positively associated with adverse health risks in adults, a theory-driven web-based computer-tailored intervention to influence workplace sitting, named 'Start to Stand,' was developed. The intervention was found to be effective in reducing self-reported workplace sitting among Flemish employees. The aim of this study was to investigate through which mechanisms the web-based computer-tailored intervention influenced self-reported workplace sitting. Employees (n = 155) participated in a clustered randomised controlled trial and reported socio-demographics (age, gender, education), work-related (hours at work, employment duration), health-related (weight and height, workplace sitting and physical activity) and psychosocial (knowledge, attitudes, self-efficacy, social support, intention regarding (changing) sitting behaviours) variables at baseline and 1-month follow-up. The product-of-coefficients test of MacKinnon based on multiple linear regression analyses was conducted to examine the mediating role of five psychosocial factors (knowledge, attitudes, self-efficacy, social support, intention). The influence of one self-regulation skill (action planning) in the association between the intervention and self-reported workplace sitting time was investigated via moderation analyses. The intervention had a positive influence on knowledge (p = 0.040), but none of the psychosocial variables did mediate the intervention effect on self-reported workplace sitting. Action planning was found to be a significant moderator (p sitting only occurred in the group completing an action plan. Future interventions aimed at reducing employees' workplace sitting are suggested to focus on self-regulatory skills and promote action planning when using web-based computer-tailored advice. Clinicaltrials.gov NCT02672215 ; (Archived by WebCite at https://clinicaltrials.gov/ct2/show/NCT02672215 ).

  5. Reducing barriers to healthy weight: Planned and responsive adaptations to a lifestyle intervention to serve people with impaired mobility.

    Science.gov (United States)

    Betts, Andrea C; Froehlich-Grobe, Katherine; Driver, Simon; Carlton, Danielle; Kramer, M Kaye

    2018-04-01

    People with impaired mobility (IM) disabilities have a higher prevalence of obesity and obesity-related chronic conditions; however, lifestyle interventions that address the unique needs of people with IM are lacking. This paper describes an adapted evidence-based lifestyle intervention developed through community-based participatory research (CBPR). Individuals with IM, health professionals, disability group representatives, and researchers formed an advisory board to guide the process of thoroughly adapting the Diabetes Prevention Program Group Lifestyle Balance (DPP GLB) intervention after a successful pilot in people with IM. The process involved two phases: 1) planned adaptations to DPP GLB content and delivery, and 2) responsive adaptations to address issues that emerged during intervention delivery. Planned adaptations included combining in-person sessions with conference calls, providing arm-based activity trackers, and adding content on adaptive cooking, adaptive physical activity, injury prevention, unique health considerations, self-advocacy, and caregiver support. During the intervention, participants encountered numerous barriers, including health and mental health issues, transportation, caregivers, employment, adjusting to disability, and functional limitations. We addressed barriers with responsive adaptations, such as supporting electronic self-monitoring, offering make up sessions, and adding content and activities on goal setting, problem solving, planning, peer support, reflection, and motivation. Given the lack of evidence on lifestyle change in people with disabilities, it is critical to involve the community in intervention planning and respond to real-time barriers as participants engage in change. A randomized controlled trial (RCT) is underway to examine the usability, feasibility, and preliminary effectiveness of the adapted intervention. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Community-based game intervention to improve South Asian Indian Americans' engagement with advanced care planning.

    Science.gov (United States)

    Radhakrishnan, Kavita; Van Scoy, Lauren Jodi; Jillapalli, Regina; Saxena, Shubhada; Kim, Miyong T

    2017-07-27

    Advance care planning (ACP) allows individuals to express their preferences for medical treatment in the event that they become incapable of making their own decisions. This study assessed the efficacy of a conversation game intervention for increasing South Asian Indian Americans' (SAIAs') engagement in ACP behaviors as well as the game's acceptability and cultural appropriateness among SAIAs. Eligible community-dwelling SAIAs were recruited at SAIA cultural events held in central Texas during the summer of 2016. Pregame questionnaires included demographics and the 55-item ACP Engagement Survey. Played in groups of 3-5, the game consists of 17 open-ended questions that prompt discussions of end-of-life issues. After each game session, focus groups and questionnaires were used to examine the game's cultural appropriateness and self-rated conversation quality. Postintervention responses on the ACP Engagement Survey and rates of participation in ACP behaviors were collected after 3 months through phone interviews or online surveys. Data were analyzed using descriptive statistics, frequencies, and paired t-tests comparing pre/post averages at a .05 significance level. Of the 47 participants, 64% were female, 62% had graduate degrees, 92% had lived in the U.S. for >10 years, 87% were first-generation immigrants, and 74% had no advance directive prior to the game. At the 3-month follow-up, 58% of participants had completed at least one ACP behavior, 42% had discussed end-of-life issues with loved ones, 15% did so with their healthcare providers, and 18% had created an advanced directive. ACP Engagement Survey scores increased significantly on all four of the process subscales by 3 months postgame. SAIA individuals who played a conversation game had a relatively high rate of performing ACP behaviors 3 months after the intervention. These findings suggest that conversation games may be useful tools for motivating people from minority communities to engage in ACP behaviors.

  7. Android Application Model of “Suami Siaga Plus” as an Innovation in Birth Preparedness and Complication Readiness (BP/CR Intervention

    Directory of Open Access Journals (Sweden)

    Hanna Yuanita Dana Santoso

    2017-08-01

    Full Text Available Objective: WHO recommends Mobile health, a practice of medicine and public health supported by mobile devices, to improve community health status and change people's behavior for the health purposes. The present study sought to examine the effectiveness of the android application program of Suami Siaga Plus in increasing husband’s scores in birth preparedness and complication readiness (BP/CR intervention.Materials and methods: It was a randomized controlled trial with pretest-posttest design. A total of 38 couples of husbands and pregnant women from three health centers at three sub districts in Semarang was selected by proportional systematic random sampling technique and equally distributed into control and intervention group. A questionnaire related to BP/CR published by JHPIEGO was employed in data collection. Statistical analysis was performed to obtain the frequency distribution and percentage of the variables, and also to assess the mean difference of BP/CR score of husbands.Results: Husbands’ knowledge of key danger signs and five standard elements in BP/CR practices in both intervention and control group increased after counseling. Moreover, the proportion of husbands who understand the key danger signs during pregnancy was higher among those who were exposed by Suami Siaga Plus application delivered via mobile phone. Counseling only increased husbands’ score from 61.5 to 62.6 (2%, whilst the combination of counseling and the application boosted 20% of husbands’ score from 60.4 to 72.9 (p-value 0.000.Conclusion: A combination of counseling and Suami Siaga Plus application significantly improves husbands and wives’ score on BP/CR compared to those who received counseling only. The data suggests the application would be able to suppress the three delays, which in turn can reduce the maternal mortality rate. The study results could be important information for the Department of Health and health professionals to use android

  8. The Effects of Self-Monitoring and Performance Feedback on the Treatment Integrity of Behavior Intervention Plan Implementation and Generalization

    Science.gov (United States)

    Mouzakitis, Angela; Codding, Robin S.; Tryon, Georgiana

    2015-01-01

    Accurate implementation of individualized behavior intervention plans (BIPs) is a critical aspect of evidence-based practice. Research demonstrates that neither training nor consultation is sufficient to improve and maintain high rates of treatment integrity (TI). Therefore, evaluation of ongoing support strategies is needed. The purpose of this…

  9. Acceptability, feasibility and effectiveness of an eHealth behaviour intervention using self-regulation: 'MyPlan'.

    Science.gov (United States)

    Plaete, Jolien; De Bourdeaudhuij, Ilse; Verloigne, Maïté; Crombez, Geert

    2015-07-26

    The study aims to evaluate the acceptability, feasibility and effectiveness of the eHealth intervention 'MyPlan', which targets health behaviour in adults. Flemish adults were randomly allocated to a control (n=155), or one of the three intervention groups: a physical activity (PA) (n=158), a fruit intake (n=161) or a vegetable intake group (n=48). PA, fruit or vegetable intake were measured at the start and after one month. Adults with low education, and over 40 years evaluated the personal advice and action plans as more motivating, but also the personal advice as too long than adults with high education and younger adults. Overall, 48% completed the follow-up module after one week, and only 24% after one month. At one-month follow-up, the fruit intake intervention resulted in more fruit intake (F=9.5, p=0.003) and the PA intervention in a higher total physically activity level (F=5.6, p=0.020) than the control group. There was no effect for vegetable intake. 'MyPlan' was feasible and acceptable, and has the potential to increase PA levels, and fruit and vegetable intake. Adaptations to the content of the intervention are further needed, and more attention is needed to motivate participants to complete the different follow-up parts. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  10. Increase urban resilience by planning the public spaces uses for humanitarian interventions.

    Science.gov (United States)

    Delaitre, Maxime; Barroca, Bruno; Vargas, Jorge; Cornejo, Christian; Sierra, Alexis

    2017-04-01

    Challenges in post-disaster crisis of natural origin seem to have a strong relation with territory characteristics (location, habitat, propagation, etc.). Moreover, they determine those requirements needed for humanitarian interventions. Decision-making at response and recuperation stages are supported or limited depending on the availability of public spaces to be used for victims' accommodation, field hospitals and rubble deposits. In the case of Lima and Callao (Peru), the presence and superposition of multiple governmental levels - national, regional (1), provincial (2) and district (50) - result in a highly-complex local Disaster Risk Management system for response coordination. The diversity of actors, their responsibilities and individual initiative suggest competition for the resources available in an emergency situation. Resource location determines if humanitarian operations can be run in an effective and efficient way. In this context, public space is a fundamental resource; if it is well-selected, it will provide access to accumulated resources such as water, electricity and telecommunications for the affected population. To increase urban resilience, it requires previous planning and coordination for emergency response, where institutional and territorial configurations are decisive factors for the recuperation and rehabilitation processes performance. This communication will present the institutional and territorial dimensions of the Peruvian capital which condition emergency management performances to consider the crisis management opportunities, offered by territorial analysis and estimations of actors' needs. It would be a starting point for decision-making on emergence activities locations and for establishing coordination frameworks concerning territorial issues and challenges.

  11. State of the art in computer-assisted planning, intervention, and assessment of liver-tumor ablation.

    Science.gov (United States)

    Schumann, Christian; Rieder, Christian; Bieberstein, Jennifer; Weihusen, Andreas; Zidowitz, Stephan; Moltz, Jan Hendrik; Preusser, Tobias

    2010-01-01

    Percutaneous, image-guided thermal tumor ablation procedures are used increasingly for minimally invasive, local treatment of tumors in the liver. The planning of these procedures; the support of targeting, monitoring, and controlling during the intervention itself; and the assessment of the treatment response can all benefit significantly from computer assistance. The outcome can be optimized by supporting the physician in the process of determining an intervention strategy that enables complete destruction of the targeted tumor while reducing the danger of complications. During the intervention, computer-assisted methods can be used to guide the physician in the implementation of the intended strategy by providing planning information. Assessment of the intervention result is carried out by comparison of the achieved coagulation with the target tumor volume. Supporting this comparison facilitates the early detection of potential recurrences. This report provides an overview of state-of-the-art computer-assisted methods for the support of thermal tumor ablations in the liver. Proper approaches for image segmentation, access-path determination, simulation, visualization, interventional guidance, and post-interventional assessment, as well as integrated work flow-oriented solutions, are reviewed with respect to technical aspects and applicability in the clinical setting.

  12. An Open Trial of the Anxiety Action Plan (AxAP): A Brief Pediatrician-Delivered Intervention for Anxious Youth

    Science.gov (United States)

    Ginsburg, Golda S.; Drake, Kelly; Winegrad, Heather; Fothergill, Kate; Wissow, Larry

    2016-01-01

    Background Anxiety disorders in youth are among the most common psychiatric disorders, yet the majority of affected youth do not receive treatment. One approach to improving access to care is identification and intervention within the primary care setting. Objective This manuscript presents data from a single group pre-post open trial of the Anxiety Action Plan (AxAP), a brief pediatrician-delivered intervention to reduce anxiety in youth who present in the primary care setting. Methods Eleven pediatricians conducted the intervention with 25 youth (mean age 11.16 years; range 6-18 years) with elevated levels of anxiety in their primary care practice setting. Results Pediatricians’ ratings of the AxAP training were positive (mean overall satisfaction was 4.82 on 5 point scale). Pediatricians and parents also reported high levels of intervention satisfaction and acceptability. Parents (but not children) who completed the intervention reported significant reductions from pre- to post-intervention on measures of child anxiety severity, impairment, and caregiver burden (Cohen's d 1.06, .75, .60, respectively). Conclusions Findings suggest that a brief, pediatrician-delivered intervention in primary care settings appears feasible and beneficial to patients. Additional controlled evaluation of the intervention's efficacy is needed. PMID:27403041

  13. Country planning for health interventions under development: lessons from the malaria vaccine decision-making framework and implications for other new interventions

    Science.gov (United States)

    Brooks, Alan; Ba-Nguz, Antoinette

    2012-01-01

    Traditionally it has taken years or decades for new public health interventions targeting diseases found in developing countries to be accessible to those most in need. One reason for the delay has been insufficient anticipation of the eventual processes and evidence required for decision making by countries. This paper describes research into the anticipated processes and data needed to inform decision making on malaria vaccines, the most advanced of which is still in phase 3 trials. From 2006 to 2008, a series of country consultations in Africa led to the development of a guide to assist countries in preparing their malaria vaccine decision-making frameworks. The guide builds upon the World Health Organization’s Vaccine Introduction Guidelines. It identifies the processes and data for decisions, when they would be needed relative to the development timelines of the intervention, and where they will come from. Policy development will be supported by data (e.g. malaria disease burden; roles of other malaria interventions; malaria vaccine impact; economic and financial issues; malaria vaccine efficacy, quality and safety) as will implementation decisions (e.g. programmatic issues and socio-cultural environment). This generic guide can now be applied to any future malaria vaccine. The paper discusses the opportunities and challenges to early planning for country decision-making—from the potential for timely, evidence-informed decisions to the risks of over-promising around an intervention still under development. Careful and well-structured planning by countries is an important way to ensure that new interventions do not remain unused for years or decades after they become available. PMID:22513733

  14. Do intervention plans meet criteria for effective practice to reduce recidivism? How probation officers forget about social capital and basic needs

    NARCIS (Netherlands)

    Bosker, J.; Witteman, C.; Hermanns, J.

    2013-01-01

    The increased use of instruments for assessing risks and needs in probation should lead to intervention plans that meet the criteria for effective practice. An analysis of 300 intervention plans from the Dutch probation service showed that the match between the assessed criminogenic needs and the

  15. Advance care planning, palliative care, and end-of-life care interventions for homeless people: A systematic review.

    Science.gov (United States)

    Sumalinog, Rafael; Harrington, Katy; Dosani, Naheed; Hwang, Stephen W

    2017-02-01

    Homeless individuals have a high prevalence of multiple chronic comorbidities and early mortality compared to the general population. They also experience significant barriers to access and stigmatization in the healthcare system. Providing advance care planning, palliative care, and end-of-life care for this underserved population is an important health issue. To summarize and evaluate the evidence surrounding advance care planning, palliative care, and end-of-life care interventions for homeless persons. A systematic review based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Articles from MEDLINE, EMBASE, CINAHL, PsycINFO, Social Work Abstracts, Cochrane Library, Web of Science, and PubMed databases were searched through 13 June 2015. Peer-reviewed studies that implemented advance care planning, palliative care, and end-of-life care interventions for homeless populations were included. Data from studies were independently extracted by two investigators using pre-specified criteria, and quality was assessed using modified Cochrane and Critical Appraisal Skills Programme tools. Six articles met inclusion criteria. Two studies were randomized controlled trials involving advance directive completion. Two cohort studies investigated the costs of a shelter-based palliative care intervention and predictors for completing advance directives. These studies were rated low to fair quality. Two qualitative studies explored the interface between harm-reduction services and end-of-life care and the conditions for providing palliative care for homeless persons in a support home. The effectiveness of advance care planning, palliative care, and end-of-life care interventions for homeless individuals is uncertain. High-quality studies of interventions that reflect the unique and complex circumstances of homeless populations and investigate patient-related outcomes, caregiver burden, and cost-effectiveness are needed.

  16. Community involvement, planning and coping skills: pilot outcomes of a recreational-therapy intervention for adults with schizophrenia.

    Science.gov (United States)

    Snethen, Gretchen; McCormick, Bryan P; Van Puymbroeck, Marieke

    2012-01-01

    The Independence through Community Access and Navigation (I-CAN) intervention was developed to increase community participation in adults with schizophrenia spectrum disorders (SSD) through identification of interest-based recreation activities and supported participation. Ten individuals consented to participate in a 10-week pilot intervention. Eight individuals participated in the intervention, during which time they worked with a recreational therapist to identify interest-based recreation activities, develop participation goals and coparticipate with the recreational therapist. At the end of the intervention, seven participants were involved in a semistructured interview to understand their perceptions of the intervention, including its outcomes and effectiveness. Therapists' notes and transcripts from the semistructured interviews were used to understand clients' perception of the intervention. Thematic analyses of seven exit interviews suggested the primary perceived outcomes of the intervention included: increased community involvement; development of planning skills; and the development of coping skills. These were facilitated by the therapeutic relationship between the client and therapist. This project provides preliminary support for the I-CAN as a participant-centered method for individuals with SSD to develop skills in the community. Implications for practice and future research are presented.

  17. Birthing Classes

    Science.gov (United States)

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

  18. Birth defects surveillance in China.

    Science.gov (United States)

    Dai, Li; Zhu, Jun; Liang, Juan; Wang, Yan-Ping; Wang, He; Mao, Meng

    2011-11-01

    Birth defects are a global public health problem because of their large contribution to infant mortalities and disabilities. It is estimated that 4%-6% of Chinese newborns are affected by birth defects every year. Surveillance is a basic approach to understanding the occurrence and associated factors of birth defects. The Ministry of Health of China initiated a national hospital-based birth defects monitoring system 20 years ago. Nearly every province in this country has established its own surveillance system in the past. The authors reviewed the result of the monitoring system at different administrative levels in China. Available publications on the surveillance of birth defects and data from national and provincial birth defects surveillance systems were reviewed to evaluate the effectiveness of the surveillance systems. According to the 2009 data, the national hospital-based birth defects surveillance system monitored over 1.3 million births, which accounted for more than 8% of births in China. In addition, 30 provincial hospital-based surveillance programs covered a birth population of more than 3.6 million (22% of births in China). Great achievements have been made in terms of case ascertainment, data quality control, and online reporting. But the surveillance systems in China still have some limitations. A short ascertainment period may miss some internal anomalies, inherited metabolic diseases, and malformed fetus aborted before the 28th gestational week. Discrepancies in antenatal or postnatal diagnosis of birth defects between surveillance institutes may affect the detection rate and introduce biases. Absence of baseline data and lack of integrated database systems limit the application of surveillance data to etiological studies and affect the process of decision-making. The surveillance system for birth defects is prerequisite to propose, conduct and assess any interventions for the disease. To meet the need of study and prevention of birth defects

  19. An Intervention for HPV Risk Reduction Based on the Theory of Planned Behavior: An Exploratory Study with College-Aged Women

    Science.gov (United States)

    Sweeney, Jocelyn Brineman; McAnulty, Richard D.; Reeve, Charlie; Cann, Arnie

    2015-01-01

    The goal of the study was to examine the effectiveness of a group intervention in reducing risks of contracting human papillomavirus (HPV) among college-aged women. Using a randomized design, the study examined the effectiveness of an HPV educational group intervention guided by the Theory of Planned Behavior. The intervention was provided in a…

  20. Self-management interventions including action plans for exacerbations versus usual care in patients with chronic obstructive pulmonary disease.

    Science.gov (United States)

    Lenferink, Anke; Brusse-Keizer, Marjolein; van der Valk, Paul Dlpm; Frith, Peter A; Zwerink, Marlies; Monninkhof, Evelyn M; van der Palen, Job; Effing, Tanja W

    2017-08-04

    Chronic Obstructive Pulmonary Disease (COPD) self-management interventions should be structured but personalised and often multi-component, with goals of motivating, engaging and supporting the patients to positively adapt their behaviour(s) and develop skills to better manage disease. Exacerbation action plans are considered to be a key component of COPD self-management interventions. Studies assessing these interventions show contradictory results. In this Cochrane Review, we compared the effectiveness of COPD self-management interventions that include action plans for acute exacerbations of COPD (AECOPD) with usual care. To evaluate the efficacy of COPD-specific self-management interventions that include an action plan for exacerbations of COPD compared with usual care in terms of health-related quality of life, respiratory-related hospital admissions and other health outcomes. We searched the Cochrane Airways Group Specialised Register of trials, trials registries, and the reference lists of included studies to May 2016. We included randomised controlled trials evaluating a self-management intervention for people with COPD published since 1995. To be eligible for inclusion, the self-management intervention included a written action plan for AECOPD and an iterative process between participant and healthcare provider(s) in which feedback was provided. We excluded disease management programmes classified as pulmonary rehabilitation or exercise classes offered in a hospital, at a rehabilitation centre, or in a community-based setting to avoid overlap with pulmonary rehabilitation as much as possible. Two review authors independently assessed trial quality and extracted data. We resolved disagreements by reaching consensus or by involving a third review author. Study authors were contacted to obtain additional information and missing outcome data where possible. When appropriate, study results were pooled using a random-effects modelling meta-analysis. The primary

  1. What are the working mechanisms of a web-based workplace sitting intervention targeting psychosocial factors and action planning?

    Directory of Open Access Journals (Sweden)

    Katrien De Cocker

    2017-05-01

    Full Text Available Abstract Background Office workers demonstrate high levels of sitting on workdays. As sitting is positively associated with adverse health risks in adults, a theory-driven web-based computer-tailored intervention to influence workplace sitting, named ‘Start to Stand,’ was developed. The intervention was found to be effective in reducing self-reported workplace sitting among Flemish employees. The aim of this study was to investigate through which mechanisms the web-based computer-tailored intervention influenced self-reported workplace sitting. Methods Employees (n = 155 participated in a clustered randomised controlled trial and reported socio-demographics (age, gender, education, work-related (hours at work, employment duration, health-related (weight and height, workplace sitting and physical activity and psychosocial (knowledge, attitudes, self-efficacy, social support, intention regarding (changing sitting behaviours variables at baseline and 1-month follow-up. The product-of-coefficients test of MacKinnon based on multiple linear regression analyses was conducted to examine the mediating role of five psychosocial factors (knowledge, attitudes, self-efficacy, social support, intention. The influence of one self-regulation skill (action planning in the association between the intervention and self-reported workplace sitting time was investigated via moderation analyses. Results The intervention had a positive influence on knowledge (p = 0.040, but none of the psychosocial variables did mediate the intervention effect on self-reported workplace sitting. Action planning was found to be a significant moderator (p < 0.001 as the decrease in self-reported workplace sitting only occurred in the group completing an action plan. Conclusions Future interventions aimed at reducing employees’ workplace sitting are suggested to focus on self-regulatory skills and promote action planning when using web-based computer-tailored advice. Trial

  2. Community-based educational intervention on necklace method as a natural family planning amongst reproductive age group women in India

    OpenAIRE

    Jyothi Ramesh; Ramesh Chandrababu

    2018-01-01

    Objective: To assess the effectiveness of a community-based educational intervention on necklace method as a natural family planning amongst reproductive age group women. This approach helps women decide on their reproductive health choices and avoid ill health, impact and long-term consequences of unwanted pregnancy that lead to unsafe abortion. Methods: A total of 120 women were selected using non-probability purposive sampling technique. The knowledge and practice of participants were a...

  3. Effectiveness of nursing discharge planning interventions on health-related outcomes in discharged elderly inpatients: a systematic review.

    Science.gov (United States)

    Mabire, Cedric; Dwyer, Andrew; Garnier, Antoine; Pellet, Joanie

    2016-09-01

    Inadequate discharge planning for the growing elderly population poses significant challenges for health services. Effective discharge planning interventions have been examined in several studies, but little information is available on nursing's role or the specific components of these interventions. Despite the research published on the importance of discharge planning, the impact on patient's health outcomes still needs to be proven in practice. To determine the best available evidence on the effectiveness of discharge planning interventions involving at least one nurse on health-related outcomes for elderly inpatients discharged home and to assess the relative impact of individual components of discharge planning interventions. Elderly inpatients aged 65 years or older, discharged from acute care and post-acute care rehabilitation hospitals to home. The review focused on the six keys components of Naylor's Transitional Care Model: early geriatric assessment, discharge preparation, patient or caregiver's participation, continuity of care, day of discharge assessment and post-discharge follow-up. This review considered randomized and non-randomized controlled trials, quasi-experimental studies, before and after studies, prospective and retrospective cohort studies, case-control studies and analytical cross-sectional studies. The outcomes for this review were functional ability, symptoms management, adverse outcomes, unmet needs after discharge, coping with disease, health-related quality of life (QoL), satisfaction with care, readmission rate and healthcare utilization. A systematic search was undertaken across 13 databases to retrieve published and unpublished studies in English between 2000 and 2015. Critical appraisal was undertaken by two independent reviewers using standardized critical appraisal instruments from the Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI). Quantitative data were extracted from

  4. Birth Weight

    Science.gov (United States)

    ... may become sick in the first days of life or develop infections. Others may suffer from longer-term problems such as delayed motor and social development or learning disabilities. High birth weight babies are often big because ...

  5. Towards systematic planning of small-scale hydrological intervention-based research (discussion paper)

    NARCIS (Netherlands)

    Pramana, K.E.R.; Ertsen, M.W.; Van de Giesen, N.C.

    2015-01-01

    Many small-scale water development initiatives are accompanied by hydrological research to study either the shape of the intervention or its impacts. Humans influence both, and thus one needs to take human agency into account. This paper focuses on the effects of human actions in the intervention

  6. [Birth hypoxia].

    Science.gov (United States)

    Větr, M

    2015-03-01

    Evaluation of the commonly used laboratory and clinical parameters of the newborn shortly after birth. Check thresholds acidemia, and in relation to the method of termination of pregnancy. Retrospective epidemiological study. Department of Obstetrics and Gynecology, University Hospital, Olomouc. Of the 26,869 children born in the years 2000 to 2013 Inclusion criteria (complete clinical and laboratory findings after birth) fulfill 23,471 (87.4%) neonates. Methods for evaluation of newborns included Apgar score calculation and arterial umbilical cord blood pH and lactate analysis. A total of 0.7% (157) of the neonates had severe acidosis pH below 7.00 arterial umbilical cord blood, its prevalence varies annually between 0.1 to 1.1%. Cutoff lactate in relation to pH reserves. Operating cesarean births in particular accounts for more than half of those with worse clinical findings Apgar and pH <7.00, but only 30% supratreshold lactate values. Also worse clinical evaluation after caesarean section is not in accordance with the laboratory findings. Vaginal surgery, especially forceps have a significant share of severe acidosis than cesarean, regardless of their frequency. Risk factor of forceps to pH less 7.00,OR = 9.28 (5.39 -15.77), P = 0.0000000, while caesarean to pH less 7,00 had OR = 1.52 (1.08 to 2.14), P = 0.01408156. The results obtained confirm that acidosis after birth is quite common, although they may not have response on the clinical condition of the newborn after birth. Evaluation of Apgar is little objective for the detection of hypoxia during birth and is influenced by the immaturity of newborn and method of delivery. Lactate levels may contribute to an objective assessment of hypoxia during birth. Values above 6.3 mmol/l can be considered an important indicator of newborn acidosis and birth hypoxia.

  7. Sleep Disorder Diagnosis During Pregnancy and Risk of Preterm Birth.

    Science.gov (United States)

    Felder, Jennifer N; Baer, Rebecca J; Rand, Larry; Jelliffe-Pawlowski, Laura L; Prather, Aric A

    2017-09-01

    To test the hypothesis that sleep disorder diagnosis would be associated with increased risk of preterm birth and to examine risk by gestational age, preterm birth type, and specific sleep disorder (insomnia, sleep apnea, movement disorder, and other). In this observational study, participants were from a cohort of nearly 3 million women in California between 2007 and 2012. Inclusion criteria were women with singleton neonates liveborn between 20 and 44 weeks of gestation without chromosomal abnormalities or major structural birth defects linked to a hospital discharge database maintained by the California Office of Statewide Health Planning and Development and without mental illness during pregnancy. Sleep disorder was defined based on International Classification of Diseases, 9th Revision, Clinical Modification diagnostic code (n=2,265). Propensity score matching was used to select a referent population at a one-to-one ratio. Odds of preterm birth were examined by gestational age (less than 34 weeks, 34-36 weeks, and less than 37 weeks of gestation) and type (spontaneous, indicated). Prevalence of preterm birth (before 37 weeks of gestation) was 10.9% in the referent group compared with 14.6% among women with a recorded sleep disorder diagnosis. Compared with the referent group, odds (95% CI, P value, percentage) of preterm birth were 1.3 (1.0-1.7, P=.023, 14.1%) for insomnia and 1.5 (1.2-1.8, P<.001, 15.5%) for sleep apnea. Risk varied by gestational age and preterm birth type. Odds of preterm birth were not significantly increased for sleep-related movement disorders or other sleep disorders. Insomnia and sleep apnea were associated with significantly increased risk of preterm birth. Considering the high prevalence of sleep disorders during pregnancy and availability of evidence-based nonpharmacologic interventions, current findings suggest that screening for severe presentations would be prudent.

  8. Can a Gender Equity and Family Planning Intervention for Men Change Their Gender Ideology? Results from the CHARM Intervention in Rural India.

    Science.gov (United States)

    Fleming, Paul J; Silverman, Jay; Ghule, Mohan; Ritter, Julie; Battala, Madhusudana; Velhal, Gajanan; Nair, Saritha; Dasgupta, Anindita; Donta, Balaiah; Saggurti, Niranjan; Raj, Anita

    2018-03-01

    We assess the effect of CHARM, a gender equity and family planning counseling intervention for husbands in rural India, on men's gender ideology. We used a two-armed cluster randomized control trial design and collected survey data from husbands (n=1081) at baseline, 9 months, and 18 months. We used a continuous measure of support for gender equity and a dichotomous measure of equitable attitudes toward women's role in household decision-making. To assess differences on these outcomes, we used generalized linear mixed models. After controlling for socio-demographic factors, men who received the CHARM intervention were significantly more likely than men in the control group to have equitable attitudes toward household decision-making at 9-months follow-up; there was a non-significant difference between the groups for the measure of support for gender equity. For household decision-making, differences were not sustained at 18-months follow-up. Given the role of husbands' gender ideology in women's contraceptive use, the CHARM intervention represents a promising approach for challenging root causes of women's unmet need for contraception. © 2018 The Population Council, Inc.

  9. BCG vaccination at birth and early childhood hospitalization

    DEFF Research Database (Denmark)

    Stensballe, Lone Graff; Sørup, Signe; Aaby, Peter

    2017-01-01

    BACKGROUND: The BCG vaccine is administered to protect against tuberculosis, but studies suggest there may also be non-specific beneficial effects upon the infant immune system, reducing early non-targeted infections and atopic diseases. The present randomised trial tested the hypothesis that BCG...... vaccination at birth would reduce early childhood hospitalisation in Denmark, a high-income setting. METHODS: Pregnant women planning to give birth at three Danish hospitals were invited to participate. After parental consent, newborn children were allocated to BCG or no intervention within 7 days of age.......94). The effect was also similar in the two sexes and across study sites. The results were essentially identical in the per-protocol analysis and after adjustment for baseline characteristics. CONCLUSIONS: BCG vaccination at birth did not reduce the risk of hospitalisation for somatic acquired disease until 15...

  10. Birth control and family planning

    Science.gov (United States)

    ... the World Health Organization selected practice recommendations for contraceptive use, 2nd edition. MMWR Recomm Rep. 2013;62(RR-05):1-60. PMID: 23784109 www.ncbi.nlm.nih.gov/pubmed/23784109 . Committee On Adolescence. Emergency contraception. Pediatrics. 2012;130(6):1174-1182. PMID: ...

  11. Ethics and "normal birth".

    Science.gov (United States)

    Lyerly, Anne Drapkin

    2012-12-01

    The concept of "normal birth" has been promoted as ideal by several international organizations, although debate about its meaning is ongoing. In this article, I examine the concept of normalcy to explore its ethical implications and raise a trio of concerns. First, in its emphasis on nonuse of technology as a goal, the concept of normalcy may marginalize women for whom medical intervention is necessary or beneficial. Second, in its emphasis on birth as a socially meaningful event, the mantra of normalcy may unintentionally avert attention to meaning in medically complicated births. Third, the emphasis on birth as a normal and healthy event may be a contributor to the long-standing tolerance for the dearth of evidence guiding the treatment of illness during pregnancy and the failure to responsibly and productively engage pregnant women in health research. Given these concerns, it is worth debating not just what "normal birth" means, but whether the term as an ideal earns its keep. © 2012, Copyright the Authors Journal compilation © 2012, Wiley Periodicals, Inc.

  12. Is a motivational interviewing based lifestyle intervention for obese pregnant women across Europe implemented as planned?

    DEFF Research Database (Denmark)

    Jelsma, Judith G M; Simmons, David; Gobat, Nina

    2017-01-01

    BACKGROUND: Process evaluation is an essential part of designing and assessing complex interventions. The vitamin D and lifestyle intervention study (DALI) study is testing different strategies to prevent development of gestational diabetes mellitus among European obese pregnant women with a body....... Fidelity of eight (out of twelve) lifestyle coach practitioners was assessed by analysing audio recorded counselling sessions using the MI treatment integrity scale. Furthermore, associations between process elements and GWG were assessed with linear regression analyses. RESULTS: A total of 20...

  13. Quality assessment of home births in Denmark

    DEFF Research Database (Denmark)

    Jensen, Sabrina; Colmorn, Lotte B.; Schroll, Anne-Mette

    2017-01-01

    INTRODUCTION: The safety of home births has been widely debated. Observational studies examining maternal and neonatal outcomes of home births have become more frequent, and the quality of these studies has improved. The aim of the present study was to describe neonatal outcomes of home births...... compared with hospital births and to discuss which data are needed to evaluate the safety of home births. METHODS: This was a register-based cohort study. Data on all births in Denmark (2003-2013) were collected from the Danish Medical Birth Registry (DMBR). The cohort included healthy women...... with uncomplicated pregnancies and no medical interventions during delivery. A total of 6,395 home births and 266,604 hospital births were eligible for analysis. Comparative analyses were performed separately in nulliparous and multiparous women. The outcome measures were neonatal mortality and morbidity. RESULTS...

  14. Self-Efficacy, Planning, or a Combination of Both? A Longitudinal Experimental Study Comparing Effects of Three Interventions on Adolescents’ Body Fat

    Science.gov (United States)

    Luszczynska, Aleksandra; Hagger, Martin S.; Banik, Anna; Horodyska, Karolina; Knoll, Nina; Scholz, Urte

    2016-01-01

    Background The superiority of an intervention combining two sets of theory-based behavior change techniques targeting planning and self-efficacy over an intervention targeting planning only or self-efficacy only has rarely been investigated. Purpose We compared the influence of self-efficacy, planning, and self-efficacy+planning interventions with an education-based control condition on adolescents’ body fat, assuming mediating effects of respective social cognitive variables and moderate-to-vigorous physical activity (MVPA). The moderating role of the built environment was examined. Methods Participants (N = 1217, aged 14–18 years) were randomly assigned to four conditions: planning (n = 270), self-efficacy (n = 311), self-efficacy+planning (n = 351), and control (n = 285). The measurement was conducted at baseline (T1), two-month follow-up (T2), and fourteen-month follow-up (T3). Interventions/control group procedures were delivered at T1 and T2. Percent of body fat tissue (measured at T1 and T3) was the main outcome. Social cognitive mediators (self-efficacy and planning) were assessed at T1 and T2. The behavioral mediator (MVPA) and the presence of built MVPA facilities (the moderator) were evaluated at T1 and T3. Results Similar small increases of body fat were found across the three intervention groups, but the increment of body fat was significantly larger in the control group. On average, differences between control and intervention groups translated to approximately 1% of body fat. Effects of the interventions on body fat were mediated by relevant social cognitive variables and MVPA. A lower increase of body fat was found among intervention group participants who had access to newly-built MVPA facilities. Conclusions We found no superiority of an intervention targeting two social cognitive variables over the intervention targeting one cognition only. PMID:27410961

  15. A quality improvement plan for hypertension control: the INCOTECA Project (INterventions for COntrol of hyperTEnsion in CAtalonia).

    Science.gov (United States)

    Vallès-Fernandez, Roser; Rosell-Murphy, Magdalena; Correcher-Aventin, Olga; Mengual-Martínez, Lucas; Aznar-Martínez, Núria; Prieto-De Lamo, Gemma; Franzi-Sisó, Alícia; Puig-Manresa, Jordi; Ma Bonet-Simó, Josep

    2009-03-25

    Different studies have shown insufficient blood pressure (BP) control in hypertensive patients. Multiple factors influence hypertension management, and the quality of primary care is one of them. We decided therefore to evaluate the effectiveness of a quality improvement plan directed at professionals of Primary Health Care Teams (PHCT) with the aim to achieve a better control of hypertension. The hypothesis of the study is that the implementation of a quality improvement plan will improve the control of hypertension. The primary aim of this study will be to evaluate the effectiveness of this plan. multicentric study quasi-experimental before - after with control group. The non-randomised allocation of the intervention will be done at PHCT level. 18 PHCT in the Barcelona province (Spain). all patients with a diagnosis of hypertension (population based study). patients with a diagnosis of hypertension made later than 01/01/2006 and patients younger than 18 years. a quality improvement plan, which targets primary health care professionals and includes educational sessions, feedback to health professionals, audit and implementation of recommended clinical practice guidelines for the management of hypertensive patients. age, sex, associated co-morbidity (diabetes mellitus type I and II, heart failure and renal failure). The following variables will be recorded: BP measurement, cardiovascular risk and antihypertensive drugs used. Results will be measured before the start of the intervention and twelve months after the start of the study. Dependent variable: prevalence of hypertensive patients with poor BP control. Chi-square test and Student's t-test will be used to measure the association between independent qualitative and quantitative variables, respectively. Non-parametric tests will be used for the analysis of non-normally distributed variables. Significance level (alpha) will be set at improvement plan might benefit the coordination of different professionals of

  16. Preconception care: promoting reproductive planning.

    Science.gov (United States)

    Dean, Sohni V; Lassi, Zohra S; Imam, Ayesha M; Bhutta, Zulfiqar A

    2014-09-26

    Preconception care recognizes that many adolescent girls and young women will be thrust into motherhood without the knowledge, skills or support they need. Sixty million adolescents give birth each year worldwide, even though pregnancy in adolescence has mortality rates at least twice as high as pregnancy in women aged 20-29 years. Reproductive planning and contraceptive use can prevent unintended pregnancies, unsafe abortions and sexually-transmitted infections in adolescent girls and women. Smaller families also mean better nutrition and development opportunities, yet 222 million couples continue to lack access to modern contraception. A systematic review and meta-analysis of the evidence was conducted to ascertain the possible impact of preconception care for adolescents, women and couples of reproductive age on MNCH outcomes. A comprehensive strategy was used to search electronic reference libraries, and both observational and clinical controlled trials were included. Cross-referencing and a separate search strategy for each preconception risk and intervention ensured wider study capture. Comprehensive interventions can prevent first pregnancy in adolescence by 15% and repeat adolescent pregnancy by 37%. Such interventions should address underlying social and community factors, include sexual and reproductive health services, contraceptive provision; personal development programs and emphasizes completion of education. Appropriate birth spacing (18-24 months from birth to next pregnancy compared to short intervals <6 months) can significantly lower maternal mortality, preterm births, stillbirths, low birth weight and early neonatal deaths. Improving adolescent health and preventing adolescent pregnancy; and promotion of birth spacing through increasing correct and consistent use of effective contraception are fundamental to preconception care. Promoting reproductive planning on a wider scale is closely interlinked with the reliable provision of effective

  17. Identification of relevant ICF categories for indication, intervention planning and evaluation of health resort programs: a Delphi exercise

    Science.gov (United States)

    Morita, E.; Weigl, M.; Schuh, A.; Stucki, G.

    2006-01-01

    Health resort programs have a long tradition, mainly in European countries and Japan. They rely on local resources and the physical environment, physical medicine interventions and traditional medicine to optimise functioning and health. Arguably because of the long tradition, there is only a limited number of high-quality studies that examine the effectiveness of health resort programs. Specific challenges to the evaluation of health resort programs are to randomise the holistic approach with a varying number of specific interventions but also the reliance on the effect of the physical environment. Reference standards for the planning and reporting of health resort studies would be highly beneficial. With the International Classification of Functioning Disability and Health (ICF), we now have such a standard that allows us to describe body functions and structures, activities and participation and interaction with environmental factors. A major challenge when applying the ICF in practice is its length. Therefore, the objective of this project was to identify the ICF categories most relevant for health resort programs. We conducted a consensus-building, three-round, e-mail survey using the Delphi technique. Based on the consensus of the experts, it was possible to come up with an ICF Core Set that can serve as reference standards for the indication, intervention planning and evaluation of health resort programs. This preliminary ICF Core Set should be tested in different regions and in subsets of health resort visitors with varying conditions.

  18. Collaborative planning approach to inform the implementation of a healthcare manager intervention for hispanics with serious mental illness: a study protocol

    Directory of Open Access Journals (Sweden)

    Cabassa Leopoldo J

    2011-07-01

    Full Text Available Abstract Background This study describes a collaborative planning approach that blends principles of community-based participatory research (CBPR and intervention mapping to modify a healthcare manager intervention to a new patient population and provider group and to assess the feasibility and acceptability of this modified intervention to improve the physical health of Hispanics with serious mental illness (SMI and at risk for cardiovascular disease (CVD. Methods The proposed study uses a multiphase approach that applies CBPR principles and intervention-mapping steps--an intervention-planning approach--to move from intervention planning to pilot testing. In phase I, a community advisory board composed of researchers and stakeholders will be assembled to learn and review the intervention and make initial modifications. Phase II uses a combination of qualitative methods--patient focus groups and stakeholder interviews--to ensure that the modifications are acceptable to all stakeholders. Phase III uses results from phase II to further modify the intervention, develop an implementation plan, and train two care managers on the modified intervention. Phase IV consists of a 12-month open pilot study (N = 30 to assess the feasibility and acceptability of the modified intervention and explore its initial effects. Lastly, phase V consists of analysis of pilot study data and preparation for future funding to develop a more rigorous evaluation of the modified intervention. Discussion The proposed study is one of the few projects to date to focus on improving the physical health of Hispanics with SMI and at risk for CVD by using a collaborative planning approach to enhance the transportability and use of a promising healthcare manager intervention. This study illustrates how blending health-disparities research and implementation science can help reduce the disproportionate burden of medical illness in a vulnerable population.

  19. Is a motivational interviewing based lifestyle intervention for obese pregnant women across Europe implemented as planned?

    DEFF Research Database (Denmark)

    Jelsma, Judith G M; Simmons, David; Gobat, Nina

    2017-01-01

    mass index ≥29 kg/m(2). The intervention includes guidance on physical activity and/or healthy eating by a lifestyle coach trained in motivational interviewing (MI). The aim of this study was to assess the process elements: reach, dose delivered, fidelity and satisfaction and to investigate whether......BACKGROUND: Process evaluation is an essential part of designing and assessing complex interventions. The vitamin D and lifestyle intervention study (DALI) study is testing different strategies to prevent development of gestational diabetes mellitus among European obese pregnant women with a body....... Fidelity of eight (out of twelve) lifestyle coach practitioners was assessed by analysing audio recorded counselling sessions using the MI treatment integrity scale. Furthermore, associations between process elements and GWG were assessed with linear regression analyses. RESULTS: A total of 20...

  20. Application of Theory of Planned Behavior to Improve Obesity-Preventive Lifestyle among Students: A School-based Interventional Study

    Directory of Open Access Journals (Sweden)

    Alireza Didarloo

    2017-11-01

    Full Text Available Background: Obesity is regarded as the epidemic of diseases correlated with an unhealthy lifestyle. The avoidance of inactivity could prevent obesity and its relevant issues. The present study aimed to explore the effectiveness of the theory of planned behavior (TPB to improve obesity-preventive lifestyle among Iranian students. Materials and Methods: The current study was a quasi-experimental study. Using multistage sampling, 100 Junior High-school students in Khoy, Iran in 2016 were selected and assigned to two groups, namely intervention (n=50 and control (n=50. To collect the study data, researchers utilized a researcher-made questionnaire including items about demographic information and TPB constructs such as attitudes, subjective norms, perceived behavioral control (PBC, behavioral intention, and behaviors related to physical activities, television watching, and computer-game playing. The data were analyzed using SPSS software version 20.0. Results: The mean age of the intervention group was 13.88 ± 0.79 and that of the control group was 14.12 ± 0.77 years. Prior to the intervention, there was no significant difference between the two groups in the mean of the scores of both the TPB constructs and their health performances. However, three months after the intervention, the mean score of attitudes, subjective norms, perceived behavioral control and behavior of students changed, and all these changes were statistically significant between two groups (p

  1. Interventional study plan to investigate the training effects on physical and psychological outcomes awareness of smoking in teenagers.

    Science.gov (United States)

    Mohamadian, Fathola; Baghri, Maryam; Delpisheh, Ali; Veisani, Yousef

    2017-01-01

    Studies have found that nearly 90% of the first use of tobacco takes place before high school graduation (teenagers) and training discussion due to prevention can be useful, therefore, here, we aimed to determine the effects of training on awareness of cigarette outcomes (physical and psychological) in male teenagers. We conducted an interventional study using Solomon's four-group plan, which used a two-stage cluster sampling in four groups (two experimental groups and two control groups). The three sessions of at least 2 h of education intervention including visual displaying using photo, film, and short scientific texts were held for the interventional group. After 1 month, all four groups took posttest, and research groups were followed up after 8 months of intervention. All data were analyzed using one-way analysis of variance and covariance in SPSS. According to the results, the mean of posttest scores had increased rather than pretest scores, and generally, a significant difference was observed ( P ≤ 0.001). These results were significant in the aspect of both physical and psychological outcomes awareness. The difference between the mean of scores in follow-up period and posttest was not statistically significant, and it shows training retention after 8 months ( P teenagers about physical and psychological outcomes of cigarette smoking that this can have an important role in smoking prevention.

  2. A Review of Interventions Aimed at Facilitating Successful Transition Planning and Transfer to Adult Care Among Youth with Chronic Illness.

    Science.gov (United States)

    Weissberg-Benchell, Jill; Shapiro, Jenna B

    2017-05-01

    This article reviews studies that developed interventions aimed at facilitating the transition process and/or the transfer of youth with chronic illness to adult programs during the past decade. Three key intervention approaches have been studied. Data assessing the impact of transition coordinators suggest that the most successful outcomes occur when coordinators meet with patients prior to the transfer of care, support them as they negotiate the adult programs, and facilitate appointment keeping. Data assessing the impact of transition clinics suggest that the key to positive outcomes is helping patients develop a trusting relationship with the adult providers before fully transferring their care to the adult clinic. Similar conclusions can be drawn for transition programs, where it appears that the opportunity to discuss and plan transition with a pediatric provider over time and to meet with both the pediatric and adult providers simultaneously are beneficial for facilitating successful transfer to adult care. Although aspects of these care processes appear promising for improving transition success, this review identifies areas that need further study. We argue that studies are needed that examine individual patient and family-focused interventions as well as looking at other potential interventions in the health care system. [Pediatr Ann. 2017;46(5):e182-e187.]. Copyright 2017, SLACK Incorporated.

  3. Effect of Educational Intervention on the Fruit and Vegetables Consumption among the Students: Applying Theory of Planned Behavior.

    Science.gov (United States)

    Taghdisi, Mohammad Hossein; Babazadeh, Towhid; Moradi, Fatemeh; Shariat, Fariba

    2016-01-01

    The importance of consuming fruits and vegetables (F&V) in prevention of chronic diseases is known. Childhood play an important role in formation of healthy eating habits. The purpose of this study was to examine the effect of education, with application of the theory of planned behavior, on improvement of F&V consumption. In this quasi-experimental study, 184 fourth, fifth, and sixth-grade students participated were enrolled from Jan 2013 to Jun 2014. The samples were selected from 6 schools in Chalderan County, West Azerbaijan, Iran through cluster random sampling method. Two out of 6 schools were randomly selected and each was employed in either experimental or control group. The data collection instruments included a researcher-made questionnaire and a 24-h F&V recall. Data were collected after verification of the reliability and validity of the questionnaire. Before the intervention, no significant difference was observed between the intervention and control group regarding attitude, subjective norms, perceived behavioral control, behavioral intention and fruits and vegetables consumption (P>0.05). However, after the educational intervention, the mean scores of attitude, subjective norms, perceived behavioral control, behavioral intention variables and fruits and vegetables were significantly higher in the intervention group when compared to the control group(Pbehavioral intention, attitude, subjective norms, and perceived behavioral control can promote F&V consumption among the students.

  4. The acceptability and feasibility of an intercultural birth center in the highlands of Chiapas, Mexico.

    Science.gov (United States)

    Tucker, Kathryn; Ochoa, Hector; Garcia, Rosario; Sievwright, Kirsty; Chambliss, Amy; Baker, Margaret C

    2013-04-16

    An intercultural birthing house was established in the Highlands of Chiapas, Mexico, as an intervention to reduce maternal mortality among indigenous women. This birth center, known locally as the Casa Materna, is a place where women can come to give birth with their traditional birth attendant. However, three months after opening, no woman had used the birthing house. This study reports on the knowledge, attitudes and practices related to childbirth and use of the Casa Materna from the perspective of the health workers, traditional birth attendants and the program's target population. Structured interviews, in-depth interviews and focus group discussions were conducted with participants from each of these groups. Data was searched for emerging themes and coded. Findings show that the potential success of this program is jeopardized by lack of transport and a strong cultural preference for home births. The paper highlights the importance of community participation in planning and implementing such an intervention and of establishing trust and mutual respect among key actors. Recommendations are provided for moving forward the maternal health agenda of indigenous women in Chiapas.

  5. Birth cohorts

    DEFF Research Database (Denmark)

    Andersen, Anne-Marie Nybo; Madsen, Mia

    2009-01-01

    ; provides practical guidance on how to set-up and maintain birth cohorts for completing family-based studies in life course epidemiology; describes how to undertake appropriate statistical analyses of family-based studies and correctly interpret results from these analyses; and provides examples...

  6. A quality improvement plan for hypertension control: the INCOTECA Project (INterventions for COntrol of hyperTEnsion in CAtalonia

    Directory of Open Access Journals (Sweden)

    Vallès-Fernandez Roser

    2009-03-01

    Full Text Available Abstract Background Different studies have shown insufficient blood pressure (BP control in hypertensive patients. Multiple factors influence hypertension management, and the quality of primary care is one of them. We decided therefore to evaluate the effectiveness of a quality improvement plan directed at professionals of Primary Health Care Teams (PHCT with the aim to achieve a better control of hypertension. The hypothesis of the study is that the implementation of a quality improvement plan will improve the control of hypertension. The primary aim of this study will be to evaluate the effectiveness of this plan. Methods and design Design: multicentric study quasi-experimental before – after with control group. The non-randomised allocation of the intervention will be done at PHCT level. Setting: 18 PHCT in the Barcelona province (Spain. Sample: all patients with a diagnosis of hypertension (population based study. Exclusion criteria: patients with a diagnosis of hypertension made later than 01/01/2006 and patients younger than 18 years. Intervention: a quality improvement plan, which targets primary health care professionals and includes educational sessions, feedback to health professionals, audit and implementation of recommended clinical practice guidelines for the management of hypertensive patients. Measurements: age, sex, associated co-morbidity (diabetes mellitus type I and II, heart failure and renal failure. The following variables will be recorded: BP measurement, cardiovascular risk and antihypertensive drugs used. Results will be measured before the start of the intervention and twelve months after the start of the study. Dependent variable: prevalence of hypertensive patients with poor BP control. Analysis: Chi-square test and Student's t-test will be used to measure the association between independent qualitative and quantitative variables, respectively. Non-parametric tests will be used for the analysis of non

  7. Clinical Reasoning in the Assessment and Intervention Planning for Writing Disorder

    Science.gov (United States)

    Harrison, Gina L.; McManus, Kelly L.

    2017-01-01

    The incidence of writing disorder is as common as reading disorder, but it is frequently under-identified and rarely targeted for intervention. Increasing clinical understanding on various subtypes of writing disorder through assessment guided by data-driven decision making may alleviate this disparity for students with writing disorders. The…

  8. Intervention use and action planning in a web-based computer-tailored weight management program for overweight adults: Randomized controlled trial

    NARCIS (Netherlands)

    Genugten, L. van; Empelen, P. van; Oenema, A.

    2014-01-01

    Background: There are many online interventions aiming for health behavior change but it is unclear how such interventions and specific planning tools are being used. Objective: The aim of this study is to identify which user characteristics were associated with use of an online, computer-tailored

  9. Intervention use and action planning in a web-based computer-tailored weight management program for overweight adults: Randomized controlled trial

    NARCIS (Netherlands)

    L. van Genugten (Lenneke); P. van Empelen (Pepijn); A. Oenema (Anke)

    2014-01-01

    textabstractThere are many online interventions aiming for health behavior change but it is unclear how such interventions and specific planning tools are being used. Objective: The aim of this study is to identify which user characteristics were associated with use of an online, computer-tailored

  10. Planned development interventions and contested development in the Casamance Region, Senegal: an enquiry into the ongoing struggles for autonomy and progres by the Casamance peasantry

    NARCIS (Netherlands)

    Ndiame, Fadel

    2017-01-01

    This thesis analyses the relationships between i) planned development interventions which took place in the Casamance over the last 100 years; ii) the advent and co-existence of different forms of endogenous responses to state interventions, and iii) the conflictive

  11. Planning Community-Based Assessments of HIV Educational Intervention Programs in Sub-Saharan Africa

    Science.gov (United States)

    Kelcey, Ben; Shen, Zuchao

    2017-01-01

    A key consideration in planning studies of community-based HIV education programs is identifying a sample size large enough to ensure a reasonable probability of detecting program effects if they exist. Sufficient sample sizes for community- or group-based designs are proportional to the correlation or similarity of individuals within communities.…

  12. Bullying in Secondary Schools: Action Planning Using a Positive Behavior Intervention and Support Framework

    Science.gov (United States)

    Lawrence, Tory De Shannon

    2017-01-01

    Bullying behavior is not a new issue, but despite the efforts of many, the problem continues to plague our students and schools, particularly in secondary schools. Secondary school leaders need a school-wide strategic plan for bullying prevention. Students need to be engaged in learning how to resolve conflicts and in understanding how bullying…

  13. Evaluation and harmonization of the planning of countermeasures and the use of intervention levels

    International Nuclear Information System (INIS)

    Hedemann Jensen, P.

    1990-12-01

    Radiation protection philosophy for exposure situations following an accident has been developed by international organisations such as the IEAE, ICRP, NEA/OECD, FAO/WHO, and the CEC during the last decade. After the Chernobyl accident, the radiation protection principles for pre-existing situations such as exposure from accidental contamination or radon in dwellings were further developed. This process is still in progress, and one of the outstanding and still unsolved problems is the mix up of radiological and socio-political objectives in radiation protection optimization. The socio-political objectives should not become a part of the radiation protection optimization but should be left for the decision maker to be used in the decision making process. A review of the work on intervention policy in the international organisations during the last ten years is given. Simple illustrative examples on intervention level setting for relocation and foodstuff restrictions are derived from the optimization principle. Optimized Derived Intervention Levels have been determined to be about 10 mSv . month -1 for relocation/resettlement and 10,000-60,000 Bq . kg -1 for restrictions on various foodstuffs contaminated with 137 Cs and 131 I. (author) 15 refs

  14. STD/HIV prevention in Turkey: planning a sequence of interventions.

    Science.gov (United States)

    Aral, S O; Fransen, L

    1995-12-01

    This study was initiated to assess which mix of early STD/HIV prevention interventions would potentially be effective, cost-effective and sustainable in Turkey; and to program an intervention sequence to maximize synergy among the interventions. During rapid assessment we: 1) reviewed past issues of 3 leading newspapers; 2) collected information on TV coverage; 3) interviewed key informants including taxicab drivers, hotel employees, grocery store owners, academicians in public health and law, investigators of STD/HIV and reproductive tract infections, and officials in the ministry of health; 4) reviewed available evidence on STD/HIV morbidity, sexual behavior patterns, migration patterns and same/opposite gender sex trade. We found: 1) discrepancies between decision makers' perceptions and social realities with respect to the epidemiology of sexual behavior and STDs, and the state of public health programs; 2) discrepancies between sexual practices and public expression regarding sexual practices; 3) economic, demographic, and political pressures in Turkey and in surrounding countries for the expansion of prostitution; 4) a sexual double standard and gender specific migration patterns which sustain a high demand for commercial sex; 5) patterns of health care seeking behaviors and provision of STD clinical services which indicate other STDs may play a very important role in spread of HIV infection; 6) an important mass media role in opinion formation; 7) consensual denial of risk for the majority based on beliefs embedded in machismo, nationalism and religion, and a resulting marginalization and externalization of STD/HIV risk; 8) high prevalence of syphilis among both Turkish and immigrant female prostitutes in Istanbul (early latent 8 and 13%; late latent 0 and 4%; previous history 9 and 22%) 9) and high rates of syphilis among male prostitutes (early latent 11%, late latent 21% and previous history 58%). We concluded that interventions should initially include

  15. Developing an intervention to prevent acute kidney injury: using the Plan, Do, Study, Act (PDSA) service improvement approach.

    Science.gov (United States)

    Byrne, Jo; Xu, Gang; Carr, Sue

    2015-03-01

    In the UK, recent National Institute for Health and Care Excellence guidelines for acute kidney injury point to the need for interventions to help prevent this condition. Effective medicines management is of prime importance in reducing the risk of AKI. Part of this challenge is to increase patients' awareness of their medicines and the possible need to temporarily withhold certain medications when acutely unwell. The objectives were to use a service improvement approach (the Plan, Do, Study, Act cycle) to develop an intervention and to evaluate current delivery of acute kidney injury management and to test and generate new ideas relating to patients' needs. A postal feedback form sent to a random sample of over 200 patients with chronic kidney disease. The feedback form collected information on: what patients know about acute kidney injury and managing medicines; where patients get their information from; whether patients want more information and where from; and what patients feel about self-managing their medicines. Completed feedback forms were received from 113 participants. Of these, 92% said they had received no advice, 77% of respondents wanted more advice but only 17% said they would feel comfortable to stop their own medication without medical consent. The PDSA cycle offered a very useful framework to evaluate the current service delivery and to test and generate new ideas for the development of an AKI intervention. Our findings highlighted that the current service is limited and more robust research is needed. © 2014 European Dialysis and Transplant Nurses Association/European Renal Care Association.

  16. Developing novel evidence-based interventions to promote asthma action plan use: a cross-study synthesis of evidence from randomised controlled trials and qualitative studies.

    Science.gov (United States)

    Ring, Nicola; Jepson, Ruth; Pinnock, Hilary; Wilson, Caroline; Hoskins, Gaylor; Wyke, Sally; Sheikh, Aziz

    2012-11-20

    Long-standing randomised controlled trial (RCT) evidence indicates that asthma action plans can improve patient outcomes. Internationally, however, these plans are seldom issued by professionals or used by patients/carers. To understand how the benefits of such plans might be realised clinically, we previously investigated barriers and facilitators to their implementation in a systematic review of relevant RCTs and synthesised qualitative studies exploring professional and patient/carer views. Our final step was to integrate these two separate studies. First, a theoretical model of action plan implementation was proposed, derived from our synthesis of 19 qualitative studies, identifying elements which, if incorporated into future interventions, could promote their use. Second, 14 RCTs included in the quantitative synthesis were re-analysed to assess the extent to which these elements were present within their interventions (that is, 'strong', 'weak' or 'no' presence) and with what effect. Matrices charted each element's presence and strength, facilitating analysis of element presence and action plan implementation. Four elements (professional education, patient/carer education, (patient/carer and professional) partnership working and communication) were identified in our model as likely to promote asthma plan use. Thirteen interventions reporting increased action plan implementation contained all four elements, with two or more strongly present. One intervention reporting no effect on action plan implementation contained only weakly present elements. Intervention effectiveness was reported using a narrow range of criteria which did not fully reflect the four elements. For example, no study assessed whether jointly developed action plans increased use. Whilst important from the professional and patient/carer perspectives, the integral role of these elements in intervention delivery and their effect on study outcomes was under-acknowledged in these RCTs. Our novel

  17. Satisfaction with caregivers during labour among low risk women in the Netherlands: The association with planned place of birth and transfer of care during labour

    NARCIS (Netherlands)

    Geerts, C.C.; Dillen, J. van; Klomp, T.; Lagro-Janssen, A.; Jonge, A de

    2017-01-01

    BACKGROUND: The caregiver has an important influence on women's birth experiences. When transfer of care during labour is necessary, care is handed over from one caregiver to the other, and this might influence satisfaction with care. It is speculated that satisfaction with care is affected in

  18. A prospective study of effects of psychological factors and sleep on obstetric interventions, mode of birth, and neonatal outcomes among low-risk British Columbian women

    OpenAIRE

    Hall, Wendy A; Stoll, Kathrin; Hutton, Eileen K; Brown, Helen

    2012-01-01

    Abstract Background Obstetrical interventions, including caesarean sections, are increasing in Canada. Canadian women’s psychological states, fatigue, and sleep have not been examined prospectively for contributions to obstetric interventions and adverse neonatal outcomes. Context and purpose of the study: The prospective study was conducted in British Columbia (BC), Canada with 650 low-risk pregnant women. Of those women, 624 were included in this study. Women were recruited through provider...

  19. Timing of nutritional interventions in very-low-birth-weight infants: optimal neurodevelopment compared with the onset of the metabolic syndrome.

    Science.gov (United States)

    Lafeber, Harrie N; van de Lagemaat, Monique; Rotteveel, Joost; van Weissenbruch, Mirjam

    2013-08-01

    Recent nutritional research in very-low-birth-weight (VLBW) infants is focused on the prevention of protein malnutrition during the first postnatal weeks. At this early age, nutritional protein fortification depends on amino acid infusion via a central vein because of the immature gastrointestinal tract. In 2010 new guidelines on nutrition were proposed by the European Society of Paediatric Gastroenterology, Hepatology, and Nutrition nutrition committee. In particular, the relative increase in the protein fraction in the nutrition of these infants aims to prevent early postnatal weight loss, to prevent morbidity, and to stimulate neurodevelopment. On the other hand, an increasing number of follow-up studies in VLBW infants indicate that, in particular, those infants who show rapid growth after preterm birth are at risk of metabolic consequences and cardiovascular disease later in life. In this review, we describe the quest to develop a customized diet that offers optimal nutrition at several time points of growth and development during the first year of life. This diet should prevent early malnutrition, enhance neurodevelopment, and limit the increase in total body fat during the first 6 mo. We question whether one type of early diet suffices for normal neurodevelopment with a normal body composition in later life or whether we need several types of diet at various stages of development.

  20. Potency and Characteristics of Bali Cattle Twin Birth

    OpenAIRE

    Utami, Anastasia Sischa Jati; Suyasa, I Nyoman

    2015-01-01

    Cattle twin birth is a rare occurrence that might be due to two factors, natural factors or external interventions such as the use of hormones. This study was aimed to determine to what extent Bali cattle were potential to deliver twin birth. Natural twin birth observation was conducted by survey method and data service while for super ovulation was conducted on 6 cows that never gave birth to twins. The Intervention method used a variety of hormonal preparations started with installing CIDR ...

  1. Planning and self-efficacy interventions encouraging replacing energy-dense foods intake with fruit and vegetable: A longitudinal experimental study.

    Science.gov (United States)

    Luszczynska, Aleksandra; Horodyska, Karolina; Zarychta, Karolina; Liszewska, Natalia; Knoll, Nina; Scholz, Urte

    2016-01-01

    This longitudinal experimental study compared effects of self-efficacy, planning and education-based conditions, encouraging adolescents to eat fruit and vegetable in place of energy-dense foods. Data were collected among 506 adolescents (13-18 years old) who were randomly assigned to control (n = 181), planning (n = 153) or self-efficacy (n = 172) conditions. Measurements were taken at baseline (T1), at a 2-month follow-up (T2), and at a 14-month follow-up (T3). Interventions/control group procedures were delivered at T1 and T2. Self-reports of fruit and vegetable intake (FVI) and energy-dense foods intake were collected at three times. Cognitive mediators (self-efficacy and planning) were assessed at T1 and T2. Body weight and height were objectively measured at T1 and T3. Similar significant increases of FVI were found for planning and self-efficacy interventions (T3). The planning intervention did not influence energy-dense food intake (T3), but the self-efficacy intervention tended to result in stabilising intake (compared to an increase found in the control group). There were no effects on body weight. Similar patterns were found for the total sample and for a subsample of adolescents with overweight/obesity. The effects of interventions on FVI were mediated by respective cognitions.

  2. An intervention to promote walking amongst the general population based on an 'extended' theory of planned behaviour: a waiting list randomised controlled trial.

    Science.gov (United States)

    Darker, C D; French, D P; Eves, F F; Sniehotta, F F

    2010-01-01

    Theory of planned behaviour (TPB) studies have identified perceived behavioural control (PBC) as the key determinant of walking intentions. The present study investigated whether an intervention designed to alter PBC and create walking plans increased TPB measures concerning walking more, planning and objectively measured walking. One hundred and thirty UK adults participated in a waiting-list randomised controlled trial. The intervention consisted of strategies to boost PBC, plus volitional strategies to enact walking intentions. All TPB constructs were measured, along with self-reported measures of action planning and walking, and an objective pedometer measure of time spent walking. The intervention increased PBC, attitudes, intentions and objectively measured walking from 20 to 32 min a day. The effects of the intervention on intentions and behaviour were mediated by PBC, although the effects on PBC were not mediated by control beliefs. At 6 weeks follow-up, participants maintained their increases in walking. The findings of this study partially support the proposed causal nature of the extended TPB as a framework for developing and evaluating health behaviour change interventions. This is the first study using the TPB to develop, design and evaluate the components of an intervention which increased objectively measured behaviour, with effects mediated by TPB variables.

  3. Off-site intervention plan of the public health authorities for emergencies at the Caorso nuclear power plant

    International Nuclear Information System (INIS)

    Fabbri, S.; Sogni, R.; Boeri, G.; Cencetti, S.; Melandri, G.; Paterlini, L.

    1986-01-01

    The Caorso nuclear power plant, which is near Piacenza and has an 875 MW boiling water reactor, has been generating electricity on a regular basis since 1978. The off-site intervention plan of the public health authorities, based on an analysis of hypothetical accidents, was approved in 1977 and subsequently revised. A study of the radiological consequences of these accidents for man and the environment indicates that the highest doses likely to be received by inhalation of 131 I would be no more than a few rem, whereas the levels of soil contamination, even at a distance of 40 km, could exceed 1 μCi/m 2 . The main problems caused by such accidents are therefore related to environmental contamination. Under the intervention plan, the provincial prefect is responsible for co-ordinating the work of all the civil, military and medical authorities. Teams from ENEL, the fire service and the local health services (USL) monitor the concentration of 131 I in the air and the exposure level, and take samples within a radius of 10 km around the site. The police and army control road traffic and are responsible, if necessary, for the evacuation of the population. A radiometry co-ordination centre (CCRI) is set up to process the readings made by the teams and provides the prefect with the technical information he requires to take decisions The local medical services (USL) run the centre where the population is assembled and monitor superficial contamination, apply initial decontamination measures, and provide medical assistance in general. The Piacenza USL also takes action by sending out its mobile radiometry laboratory, using its measurement equipment and providing logistic support to the CCRI. It is also to play a major role in informing the population in the event of an alarm. (author)

  4. Birth rights.

    Science.gov (United States)

    Hawkin, R

    1980-06-01

    Despite the marked decline in Singapore's crude birth rate from 42.7/1000 population to 22.1/1000 population from 1957 to 1970, the government adopted a policy of sterilization by coercion with the passage in 1970 of the Voluntary Sterilisation Act. Although sterilization is supposedly voluntary, various regulations make it extremely difficult for couples who wish to retain their fertility. Couples under 40 years of age with more than 2 children must agree to accept sterilization or their children are assigned to a low priority category in regard to primary school admittance. An individual who wishes to marry a non-Singaporean cannot obtain a marriage application unless one of the parties to the marriage agrees to have a sterilization after the birth of their 2nd child. Singapore, with a population density of almost 4000/square kilometer, needs to be concerned about population growth; however, since the population had for the most part already adopted a 2 child family norm, these coercive policies appear to be blatantly excessive.

  5. A Knowledge-Based System For Analysis, Intervention Planning and Prevention of Defects in Immovable Cultural Heritage Objects and Monuments

    Science.gov (United States)

    Valach, J.; Cacciotti, R.; Kuneš, P.; ČerÅanský, M.; Bláha, J.

    2012-04-01

    The paper presents a project aiming to develop a knowledge-based system for documentation and analysis of defects of cultural heritage objects and monuments. The MONDIS information system concentrates knowledge on damage of immovable structures due to various causes, and preventive/remedial actions performed to protect/repair them, where possible. The currently built system is to provide for understanding of causal relationships between a defect, materials, external load, and environment of built object. Foundation for the knowledge-based system will be the systemized and formalized knowledge on defects and their mitigation acquired in the process of analysis of a representative set of cases documented in the past. On the basis of design comparability, used technologies, materials and the nature of the external forces and surroundings, the developed software system has the capacity to indicate the most likely risks of new defect occurrence or the extension of the existing ones. The system will also allow for a comparison of the actual failure with similar cases documented and will propose a suitable technical intervention plan. The system will provide conservationists, administrators and owners of historical objects with a toolkit for defect documentation for their objects. Also, advanced artificial intelligence methods will offer accumulated knowledge to users and will also enable them to get oriented in relevant techniques of preventive interventions and reconstructions based on similarity with their case.

  6. Identification of a system of ecologically homogeneous areas and of priority intervention levels for forest plantation planning in Sicily

    Directory of Open Access Journals (Sweden)

    Pizzurro GM

    2008-10-01

    Full Text Available Afforestation and reforestation activities in Sicily have been widespreaded in the last century. The results of forestation activities indicate the need to adopt a operational tools to promote the extension of forest surface at regional and sub-regional levels. In this view, with the aim to produce useful tools for forest plantation planning, the entire regional area was analysed and ecologically homogeneous areas have been identified to join and target arboriculture and/or forestation plantation activities, to choose tree and shrub species for different environments and to identify priority areas of intervention. The map of Rivas-Martinez bioclimate and the map of litological types were used as basic information layers to map pedo-climatic homogeneous areas. In order to mitigate disruptive hydrogeological effects and to reduce desertification risk and forest fragmentation, the Corine Land Cover map (CLC2000, the hydrogeological bond map and the desertification risk map were used to identify areas characterized by urgent need of forest activities at high priority level. A total of 23 ecologically homogeneous areas have been identified in Sicily, while more than a quarter of the regional surface has been characterized as highest priority intervention level. At sub-regional level, the target of the analysis was carried out at administrative province and at hydrographic basin level.

  7. Increasing chlamydia screening tests in general practice: a modified Zelen prospective Cluster Randomised Controlled Trial evaluating a complex intervention based on the Theory of Planned Behaviour.

    Science.gov (United States)

    McNulty, Cliodna A M; Hogan, Angela H; Ricketts, Ellie J; Wallace, Louise; Oliver, Isabel; Campbell, Rona; Kalwij, Sebastian; O'Connell, Elaine; Charlett, Andre

    2014-05-01

    To determine if a structured complex intervention increases opportunistic chlamydia screening testing of patients aged 15-24 years attending English general practitioner (GP) practices. A prospective, Cluster Randomised Controlled Trial with a modified Zelen design involving 160 practices in South West England in 2010. The intervention was based on the Theory of Planned Behaviour (TPB). It comprised of practice-based education with up to two additional contacts to increase the importance of screening to GP staff and their confidence to offer tests through skill development (including videos). Practical resources (targets, posters, invitation cards, computer reminders, newsletters including feedback) aimed to actively influence social cognitions of staff, increasing their testing intention. Data from 76 intervention and 81 control practices were analysed. In intervention practices, chlamydia screening test rates were 2.43/100 15-24-year-olds registered preintervention, 4.34 during intervention and 3.46 postintervention; controls testing rates were 2.61/100 registered patients prior intervention, 3.0 during intervention and 2.82 postintervention. During the intervention period, testing in intervention practices was 1.76 times as great (CI 1.24 to 2.48) as controls; this persisted for 9 months postintervention (1.57 times as great, CI 1.27 to 2.30). Chlamydia infections detected increased in intervention practices from 2.1/1000 registered 15-24-year-olds prior intervention to 2.5 during the intervention compared with 2.0 and 2.3/1000 in controls (Estimated Rate Ratio intervention versus controls 1.4 (CI 1.01 to 1.93). This complex intervention doubled chlamydia screening tests in fully engaged practices. The modified Zelen design gave realistic measures of practice full engagement (63%) and efficacy of this educational intervention in general practice; it should be used more often. The trial was registered on the UK Clinical Research Network Study Portfolio database

  8. Strategies to Prevent Preterm Birth

    Science.gov (United States)

    Newnham, John P.; Dickinson, Jan E.; Hart, Roger J.; Pennell, Craig E.; Arrese, Catherine A.; Keelan, Jeffrey A.

    2014-01-01

    After several decades of research, we now have evidence that at least six interventions are suitable for immediate use in contemporary clinical practice within high-resource settings and can be expected to safely reduce the rate of preterm birth. These interventions involve strategies to prevent non-medically indicated late preterm birth; use of maternal progesterone supplementation; surgical closure of the cervix with cerclage; prevention of exposure of pregnant women to cigarette smoke; judicious use of fertility treatments; and dedicated preterm birth prevention clinics. Quantification of the extent of success is difficult to predict and will be dependent on other clinical, cultural, societal, and economic factors operating in each environment. Further success can be anticipated in the coming years as other research discoveries are translated into clinical practice, including new approaches to treating intra-uterine infection, improvements in maternal nutrition, and lifestyle modifications to ameliorate maternal stress. The widespread use of human papillomavirus vaccination in girls and young women will decrease the need for surgical interventions on the cervix and can be expected to further reduce the risk of early birth. Together, this array of clinical interventions, each based on a substantial body of evidence, is likely to reduce rates of preterm birth and prevent death and disability in large numbers of children. The process begins with an acceptance that early birth is not an inevitable and natural feature of human reproduction. Preventative strategies are now available and need to be applied. The best outcomes may come from developing integrated strategies designed specifically for each health-care environment. PMID:25477878

  9. Effectiveness, Mediators, and Effect Predictors of Internet Interventions for Chronic Cancer-Related Fatigue: The Design and an Analysis Plan of a 3-Armed Randomized Controlled Trial.

    Science.gov (United States)

    Wolvers, Marije Dj; Bruggeman-Everts, Fieke Z; Van der Lee, Marije L; Van de Schoot, Rens; Vollenbroek-Hutten, Miriam Mr

    2015-06-23

    Internet interventions offer advantages that especially cancer survivors who suffer from fatigue could benefit from. Given the growing number of such patients, Internet interventions could supplement and strengthen currently available health care. This paper describes the design and analysis plan that will be used to study 2 Internet interventions aimed at reducing severe fatigue in cancer survivors: a mobile ambulant activity feedback therapy supported through a weekly email by a physiotherapist and a weekly Web- and mindfulness-based cognitive therapy supported online by a psychologist. The data resulting from this trial will be used to (1) investigate the effectiveness, (2) investigate potential mediators of these interventions, and (3) explore participant characteristics that can predict the effect of these interventions. A 3-armed randomized controlled trial is proposed that compares both Internet interventions with an active control condition that solely consists of receiving psycho-educational emails. The intervention period is 9 weeks for all 3 conditions. Six months after baseline, participants in the control condition can choose to follow 1 of the 2 experimental Internet interventions. Outcomes are measured in terms of fatigue severity, mental health, and self-perceived work ability. All are Web-assessed at baseline, 2 weeks after the intervention period, and at 6 and 12 months after baseline. Fatigue severity, mindfulness, physical activity, expectations and credibility of the intervention, therapeutic working alliance, sleep quality, and sense of control over fatigue are assessed 3 times during the intervention period for identifying mediators of the interventions. Recruitment is performed nationally throughout the Netherlands through patient organizations and their websites, newspapers, and by informing various types of health professionals. All participants register at an open-access website. We aim at including 330 cancer survivors who have finished

  10. Home birth matters-for all women.

    Science.gov (United States)

    Armstrong, Elizabeth Mitchell

    2010-01-01

    Although it remains rare in the United States, planned home birth has drawn increasing attention and criticism in the mainstream media and has come under attack from organized medicine. Yet, recent peer-reviewed studies contribute to the evidence base supporting home birth as a safe option for low-risk women attended by skilled midwives. The author of this editorial argues that home birth is an important cultural touchstone in the landscape of American maternity care.

  11. The Evaluation of Effects of Educational Intervention Based on Planned Behavior Theory on Reduction of Unhealthy Snack Consumption among Kermanshah Elementary School Students, 2015- 2016

    Directory of Open Access Journals (Sweden)

    Arezoo Nazari

    2016-06-01

    Full Text Available Sedentary lifestyle and great advertising of high calorie junk foodstuffs cause the change of the nutritional pattern of children and adolescents. This study has been carried out with this objective: determining the effect of educational intervention based on the theory of planned behavior on reducing consumption of unhealthy snacks in the elementary students in Kermanshah City in 2015-2016. This research is a quasi-experimental study. Research setting was the primary schools in Kermanshah city. Sampling was conducted in multi-stage random method. Three hundred and fourteen female and male students were selected randomly. They were divided into two groups of Case and Control. The data collection tool in this study was a questionnaire. Status of snacks consumption among students in both study groups was examined after four weeks. Descriptive statistics and inferential statistics were used in order to analyze data. Before intervention, there were no significant differences between two groups of case and control. The average grades of the theory of planned behavior structures have increased in case group after intervention and it shows a significant difference (P < 0.05. No significant differences were observed in each structure in control group after intervention. The results indicate the positive effect of educational intervention based on the theory of planned behavior on reducing consumption of unhealthy snacks in elementary students. Theory-based educational intervention has also increased students’ willingness to consume healthy snacks.

  12. Theory of reasoned action and theory of planned behavior-based dietary interventions in adolescents and young adults: a systematic review

    OpenAIRE

    Hackman CL; Knowlden AP

    2014-01-01

    Christine L Hackman, Adam P KnowldenDepartment of Health Science, The University of Alabama, Tuscaloosa, AL, USABackground: Childhood obesity has reached epidemic proportions in many nations around the world. The theory of planned behavior (TPB) and the theory of reasoned action (TRA) have been used to successfully plan and evaluate numerous interventions for many different behaviors. The aim of this study was to systematically review and synthesize TPB and TRA-based dietary behavior interven...

  13. HIV sexual risk behaviors and perception of risk among college students: implications for planning interventions

    Directory of Open Access Journals (Sweden)

    Balogun Joseph A

    2009-08-01

    below the age of 20 years perceived themselves as not having any chance of being infected with HIV. Predictors of moderate/good perception of HIV risk were drug and alcohol use, inconsistent condom use, and multiple partnerships. Conclusion Students in the study sample engaged in various HIV risk behaviors but have a poor appreciation of their risk of HIV infection. While low rates of condom use was a problem among older students (30 years and older, multiple partnerships were more common among younger students, and marijuana and alcohol use were related to low condom use among females. Our findings support the need for targeted HIV prevention interventions on college campuses.

  14. Helping mothers survive bleeding after birth

    DEFF Research Database (Denmark)

    Nelissen, Ellen; Ersdal, Hege; Ostergaard, Doris

    2014-01-01

    OBJECTIVE: To evaluate "Helping Mothers Survive Bleeding After Birth" (HMS BAB) simulation-based training in a low-resource setting. DESIGN: Educational intervention study. SETTING: Rural referral hospital in Northern Tanzania. POPULATION: Clinicians, nurse-midwives, medical attendants, and ambul......OBJECTIVE: To evaluate "Helping Mothers Survive Bleeding After Birth" (HMS BAB) simulation-based training in a low-resource setting. DESIGN: Educational intervention study. SETTING: Rural referral hospital in Northern Tanzania. POPULATION: Clinicians, nurse-midwives, medical attendants...

  15. Evaluation of the Homework, Organization, and Planning Skills (HOPS) Intervention for Middle School Students with ADHD as Implemented by School Mental Health Providers.

    Science.gov (United States)

    Langberg, Joshua M; Epstein, Jeffery N; Becker, Stephen P; Girio-Herrera, Erin; Vaughn, Aaron J

    2012-09-01

    The purpose of the study was to evaluate the Homework, Organization, and Planning Skills (HOPS) intervention for middle school students with Attention-Deficit/Hyperactivity Disorder (ADHD) as implemented by school mental health (SMH) providers using a randomized trial design. Seventeen SMH providers from five school districts implemented the HOPS intervention. Forty-seven middle school students with ADHD (grades 6-8) were randomly assigned to receive the HOPS intervention or to a waitlist comparison group. Parent and teacher ratings of organizational skills and homework problems were collected pre- and post-intervention and at a 3-monoth follow-up, and school grades were also collected. Intervention participants demonstrated significant improvements relative to the waitlist comparison across parent-rated organized action ( d = .88), materials management ( d = .63), planning ( d = 1.05), and homework completion behaviors ( d = .85). Intervention participants did not make significant improvements relative to the comparison group according to teacher ratings. SMH providers were able to implement the HOPS intervention with fidelity despite the fact that no formal ongoing consultation was provided.

  16. The effects of a brief intervention to promote walking on Theory of Planned Behavior constructs: a cluster randomized controlled trial in general practice.

    Science.gov (United States)

    Williams, Stefanie L; Michie, Susan; Dale, Jeremy; Stallard, Nigel; French, David P

    2015-05-01

    Perceived behavioral control (PBC) is a consistent predictor of intentions to walk more. A previously successful intervention to promote walking by altering PBC has been adapted for delivery in general practice. This study aimed to evaluate the effect of this intervention on Theory of Planned Behavior (TPB) constructs in this context. Cluster randomized controlled trial, with n = 315 general practice patients. Practice nurses and Healthcare Assistants delivered a self-regulation intervention or information provision (control). Questionnaires assessed TPB variables at baseline, post-intervention, 6 weeks and 6 months. Walking was measured by pedometer. The control group reported significantly higher subjective norm at all follow-up time points. There were no significant differences between the two groups in PBC, intention, attitude or walking behavior. TPB variables significantly predicted intentions to walk more, but not objective walking behavior, after accounting for clustering. The lack of effect of the intervention was probably due to a failure to maintain intervention fidelity, and the unsuitability of the behavior change techniques included in the intervention for the population investigated. This previously successful intervention was not successful when delivered in this context, calling into question whether practice nurses are best placed to deliver such interventions. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  17. The Effect of Teacher Training on the Knowledge of Positive Behavior Support and the Quality of Behavior Intervention Plans: A Preliminary Study in Taiwan

    Science.gov (United States)

    Wu, Pei-Fang

    2017-01-01

    The purpose of this study was to investigate whether through a series of teacher training. The participants could acquire better knowledge on Positive Behavior Support (PBS), and develop high quality behavior intervention plans. Thirty-six teachers from three public schools participated in the study. The competency-based training consisted of 12…

  18. The theory of planned behavior and physical activity change: Outcomes of the aging well and healthily intervention program for older adults

    NARCIS (Netherlands)

    Stolte, E.; Hopman-Rock, M.; Aartsen, M.J.; Tilburg, T.G. van; Chorus, A.

    2017-01-01

    The predictive value of the Theory of Planned Behavior (TPB) on intention and physical activity (PA) over time was examined. Data from the Aging Well and Healthily intervention program (targeting perceived behavioral control and attitude, not subjective norm) were analyzed, including pretest (T0),

  19. Utilizing the RE-AIM Framework in formative evaluation and program planning for a healthy food choice intervention in the Lower Mississippi Delta

    Science.gov (United States)

    A robust approach to program planning is needed for the development and execution of effective and sustainable behavioral interventions with large public health impact. The purpose of this formative research was to apply dimensions of the RE-AIM (i.e., Reach, Effectiveness, Adoption, Implementation,...

  20. Evaluation of the Homework, Organization, and Planning Skills (HOPS) Intervention for Middle School Students with Attention Deficit Hyperactivity Disorder as Implemented by School Mental Health Providers

    Science.gov (United States)

    Langberg, Joshua M.; Epstein, Jeffery N.; Becker, Stephen P.

    2012-01-01

    The purpose of the study was to evaluate the Homework, Organization, and Planning Skills (HOPS) intervention for middle school students with attention deficit hyperactivity disorder (ADHD) as implemented by school mental health (SMH) providers using a randomized trial design. Seventeen SMH providers from five school districts implemented the HOPS…

  1. Using the RE-AIM Framework in formative evaluation and program planning for a nutrition intervention in the Lower Mississippi Delta.

    Science.gov (United States)

    Huye, Holly F; Connell, Carol L; Crook, LaShaundrea B; Yadrick, Kathy; Zoellner, Jamie

    2014-01-01

    Identification of prominent themes to be considered when planning a nutrition intervention using the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework. Qualitative formative research. Women's social and civic organizations in the Lower Mississippi Delta. Thirty-seven (5 white and 32 black) women with a college degree or higher. Impact of dietary and contextual factors related to the Lower Mississippi Delta culture on intervention planning. Case analysis strategy using question-by-question coding. Major themes that emerged were "healthy eating focus" and "promoting a healthy lifestyle" when recruiting organizations (Reach); "positive health changes" as a result of the intervention (Effectiveness); "logistics: time commitment, location, and schedule" to initiate a program (Adoption); "expense of healthy foods" and "cooking and meal planning" as barriers to participation (Implementation); and "resources and training" and "motivation" as necessary for program continuation (Maintenance). The "health of the Delta" theme was found across all dimensions, which reflected participants' compassion for their community. Results were used to develop an implementation plan promoting optimal reach, effectiveness, adoption, implementation, and maintenance of a nutrition intervention. This research emphasizes the benefits of formative research using a systematic process at organizational and individual levels. Copyright © 2014 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

  2. Birth control pills - combination

    Science.gov (United States)

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

  3. Birth Control Explorer

    Science.gov (United States)

    ... Relationships STIs Media Facebook Twitter Tumblr Shares · 582 Birth Control Explorer Sort by all methods most effective ... MORE You are here Home » Birth Control Explorer Birth Control Explorer If you’re having sex —or ...

  4. Accredited Birth Centers

    Science.gov (United States)

    ... Administrative Staff Donate Contact MENU CLOSE back Accredited Birth Centers You are here: Home Accredited Birth Centers ... not CABC-accredited. How do you find a birth center here? Skip Instructions! Get to the Map… ...

  5. Essure Permanent Birth Control

    Science.gov (United States)

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

  6. Warning Signs After Birth

    Science.gov (United States)

    ... care > Warning signs after birth Warning signs after birth E-mail to a friend Please fill in ... health problems new moms may have after giving birth? Chances are that you’ll be healthy after ...

  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. European birth cohorts for environmental health research

    DEFF Research Database (Denmark)

    Vrijheid, Martine; Casas, Maribel; Bergström, Anna

    2012-01-01

    Many pregnancy and birth cohort studies investigate the health effects of early-life environmental contaminant exposure. An overview of existing studies and their data is needed to improve collaboration, harmonization, and future project planning.......Many pregnancy and birth cohort studies investigate the health effects of early-life environmental contaminant exposure. An overview of existing studies and their data is needed to improve collaboration, harmonization, and future project planning....

  9. Engaging with community-based public and private mid-level providers for promoting the use of modern contraceptive methods in rural Pakistan: results from two innovative birth spacing interventions.

    Science.gov (United States)

    Azmat, Syed Khurram; Hameed, Waqas; Hamza, Hasan Bin; Mustafa, Ghulam; Ishaque, Muhammad; Abbas, Ghazunfer; Khan, Omar Farooq; Asghar, Jamshaid; Munroe, Erik; Ali, Safdar; Hussain, Wajahat; Ali, Sajid; Ahmed, Aftab; Ali, Moazzam; Temmerman, Marleen

    2016-03-17

    Family planning (FP) interventions aimed at reducing population growth have negligible during the last two decades in Pakistan. Innovative FP interventions that help reduce the growing population burden are the need of the hour. Marie Stopes Society--Pakistan implemented an operational research project--'Evidence for Innovating to Save Lives', to explore effective and viable intervention models that can promote healthy timing and spacing of pregnancy in rural and under-served communities of Sindh, Punjab and Khyber Pakhtunkhwa provinces of Pakistan. We conducted a quasi-experimental (pre- and post-intervention with control arm) study to assess the effectiveness of each of the two intervention models, (1) Suraj model (meaning 'Sun' in English), which uses social franchises (SF) along with a demand-side financing (DSF) approach using free vouchers, and (2) Community Midwife (CMW) model, in promoting the use of modern contraceptive methods compared to respective controls. Baseline and endline cross-sectional household surveys were conducted, 24 months apart, by recruiting 5566 and 6316 married women of reproductive age (MWRA) respectively. We used Stata version 8 to report the net effect of interventions on outcome indicators using difference-in-differences analysis. Multivariate Cox proportional hazard regression analysis was used to assess the net effect of the intervention on current contraceptive use, keeping time constant and adjusting for other variables in the model. The Suraj model was effective in significantly increasing awareness about FP methods among MWRA by 14% percentage points, current contraceptive use by 5% percentage points and long term modern method--intrauterine device (IUD) use by 6% percentage points. The CMW model significantly increased contraceptive awareness by 28% percentage points, ever use of contraceptives by 7% percentage points and, IUD use by 3% percentage points. Additionally the Suraj intervention led to a 35% greater prevalence

  10. Perceptions of risk and risk management among 735 women who opted for a home birth.

    Science.gov (United States)

    Lindgren, Helena E; Rådestad, Ingela J; Christensson, Kyllike; Wally-Bystrom, Kristina; Hildingsson, Ingegerd M

    2010-04-01

    home birth is not included in the Swedish health-care system and the rate for planned home births is less than one in a thousand. The aim of this study was to describe women's perceptions of risk related to childbirth and the strategies for managing these perceived risks. a nationwide study including all women who had given birth at home in Sweden was conducted between 1 January 1992 and 31 July 2005. a total of 735 women had given birth to 1038 children. Of the 1038 questionnaires sent to the women, 1025 (99%) were returned. two open questions regarding risk related to childbirth and two questions answered using a scale were investigated by content analysis. regarding perceived risks about hospital birth, three categories, all related to loss of autonomy, were identified: (1) being in the hands of strangers; (2) being in the hands of routines and unnecessary interventions; and (3) being in the hands of structural conditions. Perceived risks related to a home birth were associated with a sense of being beyond help: (1) worst-case scenario; and (2) distance to the hospital. The perceived risks were managed by using extrovert activities and introvert behaviour, and by avoiding discussions concerning risks with health-care professionals. women who plan for a home birth in Sweden do consider risks related to childbirth but they avoid talking about the risks with health-care professionals. to understand why women choose to give birth at home, health-care professionals must learn about the perceived beneficial effect of doing so. Copyright 2008 Elsevier Ltd. All rights reserved.

  11. A tailored online safety and health intervention for women experiencing intimate partner violence: the iCAN Plan 4 Safety randomized controlled trial protocol

    Directory of Open Access Journals (Sweden)

    Marilyn Ford-Gilboe

    2017-03-01

    Full Text Available Abstract Background Intimate partner violence (IPV threatens the safety and health of women worldwide. Safety planning is a widely recommended, evidence-based intervention for women experiencing IPV, yet fewer than 1 in 5 Canadian women access safety planning through domestic violence services. Rural, Indigenous, racialized, and immigrant women, those who prioritize their privacy, and/or women who have partners other than men, face unique safety risks and access barriers. Online IPV interventions tailored to the unique features of women’s lives, and to maximize choice and control, have potential to reduce access barriers, and improve fit and inclusiveness, maximizing effectiveness of these interventions for diverse groups. Methods/Design In this double blind randomized controlled trial, 450 Canadian women who have experienced IPV in the previous 6 months will be randomized to either a tailored, interactive online safety and health intervention (iCAN Plan 4 Safety or general online safety information (usual care. iCAN engages women in activities designed to increase their awareness of safety risks, reflect on their plans for their relationships and priorities, and create a personalize action plan of strategies and resources for addressing their safety and health concerns. Self-reported outcome measures will be collected at baseline and 3, 6, and 12 months post-baseline. Primary outcomes are depressive symptoms (Center for Epidemiological Studies Depression Scale, Revised and PTSD Symptoms (PTSD Checklist, Civilian Version. Secondary outcomes include helpful safety actions, safety planning self-efficacy, mastery, and decisional conflict. In-depth qualitative interviews with approximately 60 women who have completed the trial and website utilization data will be used to explore women’s engagement with the intervention and processes of change. Discussion This trial will contribute timely evidence about the effectiveness of online safety and

  12. Use of mouth rinse during pregnancy to improve birth and neonatal outcomes: a randomized controlled trial.

    Science.gov (United States)

    Jiang, Hong; Xiong, Xu; Buekens, Pierre; Su, Yi; Qian, Xu

    2015-11-25

    Poor oral health, such as periodontal (gum) disease, has been found to be associated with an increased risk of adverse pregnancy outcomes including preterm birth, low birth weight, and neonatal and infant mortality, especially in low-and middle-income countries. However, there is little or no access to preventive dental care in most low-and middle-income countries. We propose to develop and test a "Mouth Rinse Intervention" among pregnant women to prevent the progression of periodontal disease during pregnancy and reduce adverse birth and neonatal outcomes in a rural county of China. This is a randomized controlled clinical trial. A sample of 468 (234 in each arm of the study) women in early pregnancy with periodontal disease will be recruited for the study. Periodontal disease will be diagnosed through the methods of Periodontal Screening and Recording. All women diagnosed with periodontal disease will be randomly allocated into the intervention or control group. Women assigned in the intervention group will be provided with non-alcohol antimicrobial mouth rinse containing cetylpyridinium chloride throughout the pregnancy and oral health education. Women in the control group will receive a package of tooth brush and paste, plus oral hygiene education. Women will be followed-up to childbirth until the 42nd day postpartum. The main outcomes include mean birthweight (gram) and mean gestational age (week). Compared with conventional mechanical 'scaling and root planning' periodontal treatment during pregnancy, our proposed mouth rinse intervention could be a simple, cost-effective, and sustainable solution to improve both mother's oral health and neonate outcomes. If the mouth rinse is confirmed to be effective, it would demonstrate great potential for the application in other low- or middle-income countries to prevent adverse birth outcomes such as preterm birth and low birth weight and to reduce neonatal and infant mortality. This trial was registered with Chinese

  13. Natural recovery and planned intervention in coastal wetlands: Venice Lagoon (northern Adriatic Sea, Italy) as a case study.

    Science.gov (United States)

    Facca, Chiara; Ceoldo, Sonia; Pellegrino, Nicola; Sfriso, Adriano

    2014-01-01

    The goals of conservation and sustainable use of environmental ecosystems have increased the need for detailed knowledge of ecological evolution and responses to both anthropogenic pressures and recovery measures. The present study shows the effects of natural processes and planned intervention in terms of reducing nutrient inputs in a highly exploited coastal lagoon, describing its evolution over a 16-year period from the late 1980s (when eutrophication was at its peak) until 2003. Changes in nutrient and carbon concentrations in the top layer of sediments were investigated in parallel with macroalgal and seagrass biomass in the most anthropized basin of Venice Lagoon in four surveys conducted in accordance with the same protocols in 1987, 1993, 1998, and 2003. A pronounced reduction in trophic state (mainly total nitrogen, organic phosphorus, and organic carbon concentrations) and macroalgal biomass was recorded, together with the progressive expansion of seagrass meadows. General considerations are also made on the effects of Manila clam farming and the shift from illegal to managed clam farming.

  14. The effect of prenatal education classes on the birth expectations of Spanish women.

    Science.gov (United States)

    Soriano-Vidal, F J; Vila-Candel, R; Soriano-Martín, P J; Tejedor-Tornero, A; Castro-Sánchez, E

    2018-05-01

    Maternity care has focused on lowering maternal and neonatal morbidity, though women's beliefs and expectations of care have been set aside. Women face childbirth with preconceived expectations, some of which could be expressed on their birth plan. The latter could beinfluenced by health professionals through prenatal education classes, though this has not been measured before. Antenatal classes have been argued against,since no resulting improvement in childbirth experience has been demonstrated, though some advantages may be seen: they favour communication and give time for expressing maternal expectations and beliefs. The present study evaluates the influence of prenatal educational classes led by midwives upon women birth preferences. A multicentre, observational, prospective study was carried out, measuring variables in pregnant women attending prenatal educational classes in different health centres within the health districts in Valencia (Spain) over the period January-October 2012. Birth plan preferences were compared prior to and upon completion of the classes. A total of 212 eligible pregnant women (78.3% nulliparous) with an average age of 31.39±4.0 years consented to participate in the study. There were significant differences in birth plan preferences prior to and upon completion of the prenatal classes. Three items showed an increase between the initial session and the end of the intervention: the ability to push spontaneously, episiotomy avoidance, and early breastfeeding. An adjusted general linear model was used to compare pre-post results in relation to sociodemographic and obstetric variables. The changes in birth plans could suggest that prenatal educational classes exert an influence upon maternal birth preferences. Copyright © 2018 Elsevier Ltd. All rights reserved.

  15. Mapping Environmental Inequalities Relevant for Health for Informing Urban Planning Interventions-A Case Study in the City of Dortmund, Germany.

    Science.gov (United States)

    Flacke, Johannes; Schüle, Steffen Andreas; Köckler, Heike; Bolte, Gabriele

    2016-07-13

    Spatial differences in urban environmental conditions contribute to health inequalities within cities. The purpose of the paper is to map environmental inequalities relevant for health in the City of Dortmund, Germany, in order to identify needs for planning interventions. We develop suitable indicators for mapping socioeconomically-driven environmental inequalities at the neighborhood level based on published scientific evidence and inputs from local stakeholders. Relationships between socioeconomic and environmental indicators at the level of 170 neighborhoods were analyzed continuously with Spearman rank correlation coefficients and categorically applying chi-squared tests. Reclassified socioeconomic and environmental indicators were then mapped at the neighborhood level in order to determine multiple environmental burdens and hotspots of environmental inequalities related to health. Results show that the majority of environmental indicators correlate significantly, leading to multiple environmental burdens in specific neighborhoods. Some of these neighborhoods also have significantly larger proportions of inhabitants of a lower socioeconomic position indicating hotspots of environmental inequalities. Suitable planning interventions mainly comprise transport planning and green space management. In the conclusions, we discuss how the analysis can be used to improve state of the art planning instruments, such as clean air action planning or noise reduction planning towards the consideration of the vulnerability of the population.

  16. Birthing Healthy Babies (A Minute of Health with CDC)

    Centers for Disease Control (CDC) Podcasts

    2018-01-11

    Birth defects are common, costly, and critical. If you’re pregnant or planning to get pregnant, you can take steps to improve your chances of giving birth to a healthy child. This podcast discusses ways to prevent birth defects.  Created: 1/11/2018 by MMWR.   Date Released: 1/11/2018.

  17. Informed consent to breech birth in New Zealand.

    Science.gov (United States)

    Powell, Rhonda; Walker, Shawn; Barrett, Alison

    2015-08-07

    The authors note significant room for improvement in facilitating informed consent in the management of breech presentation. New Zealand maternity care providers, including midwives, general practitioners and specialist obstetricians, have legal duties to provide full and unbiased information about risks and benefits of all relevant treatment options. In the case of breech presentation, such options include the interventions of external cephalic version or planned caesarean section, as well as the option to decline intervention and proceed with a planned vaginal breech birth. Information should be presented in a balanced and accessible way and not limited to the provider's personal preferences. Women have legal rights to make an informed choice, to give or refuse consent, to a second opinion and to co-operation among providers. The right of competent persons to refuse medical treatment, including the right to refuse caesarean section, is well established. Clinical policies therefore should include appropriate and non-coercive care for women who choose to birth their breech-presenting baby vaginally, compliance with such policies should be the norm, and consideration should be given to any institutional reforms or educational priorities needed to achieve this.

  18. New Option in the Lives Saved Tool (LiST) Allows for the Conversion of Prevalence of Small-for-Gestational-Age and Preterm Births to Prevalence of Low Birth Weight.

    Science.gov (United States)

    Kozuki, Naoko; Katz, Joanne; Clermont, Adrienne; Walker, Neff

    2017-11-01

    Background: The Lives Saved Tool (LiST) is a software model that estimates the health impact of scaling up interventions on maternal and child health. One of the outputs of the model is an estimation of births by fetal size [appropriate-for-gestational-age (AGA) or small-for-gestational-age (SGA)] and by length of gestation (term or preterm), both of which influence birth weight. LiST uses prevalence estimates of births in these categories rather than of birth weight categories, because the causes and health consequences differ between SGA and preterm birth. The World Health Assembly nutrition plan, however, has set the prevalence of low birth weight (LBW) as a key indicator, with a specific goal of a 30% reduction in LBW prevalence by 2025. Objective: The objective of the study is to develop an algorithm that will allow LiST users to estimate changes in prevalence of LBW on the basis of changes in coverage of interventions and the resulting impact on prevalence estimates of SGA and preterm births. Methods: The study used 13 prospective cohort data sets from low- and middle-income countries (LMICs; 4 from sub-Saharan Africa, 5 from Asia, and 4 from Latin America), with reliable measures of gestational age and birth weight. By calculating the proportion of LBW births among SGA and preterm births in each data set and meta-analyzing those estimates, we calculated region-specific pooled rates of LBW among SGA and preterm births. Results: In Africa, 0.4% of term-AGA, 36.7% of term-SGA, 49.3% of preterm-AGA, and 100.0% of preterm-SGA births were LBW. In Asia, 1.0% of term-SGA, 47.0% of term-SGA, 36.7% of preterm-AGA, and 100.0% of preterm-SGA births were LBW. In Latin America, 0.4% of term-AGA, 34.4% of term-SGA, 32.3% of preterm-AGA, and 100.0% of preterm-SGA births were LBW. Conclusions: The simple conversion factor proposed here allows for the estimation of LBW within LiST for most LMICs. This will allow LiST users to approximate the impact of their health programs on

  19. Increasing chlamydia screening tests in general practice: a modified Zelen prospective Cluster Randomised Controlled Trial evaluating a complex intervention based on the Theory of Planned Behaviour

    Science.gov (United States)

    McNulty, Cliodna A M; Hogan, Angela H; Ricketts, Ellie J; Wallace, Louise; Oliver, Isabel; Campbell, Rona; Kalwij, Sebastian; O'Connell, Elaine; Charlett, Andre

    2014-01-01

    Objective To determine if a structured complex intervention increases opportunistic chlamydia screening testing of patients aged 15–24 years attending English general practitioner (GP) practices. Methods A prospective, Cluster Randomised Controlled Trial with a modified Zelen design involving 160 practices in South West England in 2010. The intervention was based on the Theory of Planned Behaviour (TPB). It comprised of practice-based education with up to two additional contacts to increase the importance of screening to GP staff and their confidence to offer tests through skill development (including videos). Practical resources (targets, posters, invitation cards, computer reminders, newsletters including feedback) aimed to actively influence social cognitions of staff, increasing their testing intention. Results Data from 76 intervention and 81 control practices were analysed. In intervention practices, chlamydia screening test rates were 2.43/100 15–24-year-olds registered preintervention, 4.34 during intervention and 3.46 postintervention; controls testing rates were 2.61/100 registered patients prior intervention, 3.0 during intervention and 2.82 postintervention. During the intervention period, testing in intervention practices was 1.76 times as great (CI 1.24 to 2.48) as controls; this persisted for 9 months postintervention (1.57 times as great, CI 1.27 to 2.30). Chlamydia infections detected increased in intervention practices from 2.1/1000 registered 15–24-year-olds prior intervention to 2.5 during the intervention compared with 2.0 and 2.3/1000 in controls (Estimated Rate Ratio intervention versus controls 1.4 (CI 1.01 to 1.93). Conclusions This complex intervention doubled chlamydia screening tests in fully engaged practices. The modified Zelen design gave realistic measures of practice full engagement (63%) and efficacy of this educational intervention in general practice; it should be used more often. Trial registration The trial was

  20. Planned development and evaluation protocol of two versions of a web-based computer-tailored nutrition education intervention aimed at adults, including cognitive and environmental feedback.

    Science.gov (United States)

    Springvloet, Linda; Lechner, Lilian; Oenema, Anke

    2014-01-17

    Despite decades of nutrition education, the prevalence of unhealthy dietary patterns is still high and inequalities in intake between high and low socioeconomic groups still exist. Therefore, it is important to innovate and improve existing nutrition education interventions. This paper describes the development, design and evaluation protocol of a web-based computer-tailored nutrition education intervention for adults targeting fruit, vegetable, high-energy snack and fat intake. This intervention innovates existing computer-tailored interventions by not only targeting motivational factors, but also volitional and self-regulation processes and environmental-level factors. The intervention development was guided by the Intervention Mapping protocol, ensuring a theory-informed and evidence-based intervention. Two versions of the intervention were developed: a basic version targeting knowledge, awareness, attitude, self-efficacy and volitional and self-regulation processes, and a plus version additionally addressing the home environment arrangement and the availability and price of healthy food products in supermarkets. Both versions consist of four modules: one for each dietary behavior, i.e. fruit, vegetables, high-energy snacks and fat. Based on the self-regulation phases, each module is divided into three sessions. In the first session, feedback on dietary behavior is provided to increase awareness, feedback on attitude and self-efficacy is provided and goals and action plans are stated. In the second session goal achievement is evaluated, reasons for failure are explored, coping plans are stated and goals can be adapted. In the third session, participants can again evaluate their behavioral change and tips for maintenance are provided. Both versions will be evaluated in a three-group randomized controlled trial with measurements at baseline, 1-month, 4-months and 9-months post-intervention, using online questionnaires. Both versions will be compared with a generic

  1. Comparison of the dose delivered in interventional neuroradiology between brightness amplifiers and plan captors;Comparaison de la dose delivree en neuroradiologie interventionnelle entre amplificateurs de brillance et capteurs plans

    Energy Technology Data Exchange (ETDEWEB)

    Vogue-Brasier, C.; Kazemi, A.; Aho, S.; Ricolfi, F.; Ben Salem, D.; Boutarbouch, M.

    2009-10-15

    Objective: comparative analysis of the dose.surface product (D.S.P.) between the brightness amplifier bi plans rooms and the plans captors during diagnosis and interventional neuroradiological procedures. Results: a multi various analysis finds a significant statistical correlation (p< 10{sup -3}) between the D.S.P. in one hand and the sex, age, type of room, number of series, nature of the gesture in the other hand. The plan captors give an average 31.82 Gy.cm{sup 2} (+-7.4) more comparatively to the brightness amplifiers. Conclusions: The D.S.P. delivered by the plan captors is statistically superior to this one delivered by the brightness amplifiers, after matching on the number of series made by procedure. (N.C.)

  2. Process evaluation of an environmental health risk audit and action plan intervention to reduce alcohol related violence in licensed premises.

    Science.gov (United States)

    Williams, Annie; Moore, Simon C; Shovelton, Claire; Moore, Laurence; Murphy, Simon

    2016-05-28

    Alcohol-related violence is associated with licensed premise environments and their management. There is a lack of evidence for effective interventions to address these, and there are significant barriers to implementation. This study aims to understand how development and implementation processes can facilitate intervention reach, fidelity and receipt and therefore provides key process data necessary to interpret the results of the randomised controlled trial conducted in parallel. A process evaluation, embedded within a randomised controlled trial. Intervention development and implementation were assessed via focus groups (n = 2) and semi-structured interviews (n = 22) with Environmental Health Practitioners (EHPs). Reach and fidelity were assessed via routinely collected intervention data, which was was collected from 276 licenced premises across Wales, UK. Case study semi-structured interviews with licensed premises proprietors (n = 30) explored intervention receipt. Intervention co-production with senior EHPs facilitated organisational adoption and implementation. Training events for EHPs played an important role in addressing wider organisational concerns regarding partnership working and the contextual integration of the intervention. EHPs delivered the intervention to 98 % of intervention premises; 35 % of premises should have received a follow up enforcement visit, however EHP confidence in dealing with alcohol risk factors meant only 7 % of premises received one. Premises therefore received a similar intervention dose regardless of baseline risk. Intervention receipt appeared to be greatest in premises with an existing commitment to prevention and those in urban environments. The study suggests that a collaborative approach to the development and diffusion of interventions is associated with high levels of organisational adoption, implementation and reach. However, the lack of enforcement visits represents implementation failure for a key

  3. Mobile Technology for Improved Family Planning (MOTIF): the development of a mobile phone-based (mHealth) intervention to support post-abortion family planning (PAFP) in Cambodia.

    Science.gov (United States)

    Smith, Chris; Vannak, Uk; Sokhey, Ly; Ngo, Thoai D; Gold, Judy; Free, Caroline

    2016-01-05

    The objective of this paper is to outline the formative research process used to develop the MOTIF mobile phone-based (mHealth) intervention to support post-abortion family planning in Cambodia. The formative research process involved literature reviews, interviews and focus group discussions with clients, and consultation with clinicians and organisations implementing mHealth activities in Cambodia. This process led to the development of a conceptual framework and the intervention. Key findings from the formative research included identification of the main reasons for non-use of contraception and patterns of mobile phone use in Cambodia. We drew on components of existing interventions and behaviour change theory to develop a conceptual framework. A multi-faceted voice-based intervention was designed to address health concerns and other key determinants of contraception use. Formative research was essential in order to develop an appropriate mHealth intervention to support post-abortion contraception in Cambodia. Each component of the formative research contributed to the final intervention design.

  4. The Theory of Planned Behavior and Physical Activity Change: Outcomes of the Aging Well and Healthily Intervention Program for Older Adults.

    Science.gov (United States)

    Stolte, Elske; Hopman-Rock, Marijke; Aartsen, Marja J; van Tilburg, Theo G; Chorus, Astrid

    2017-07-01

    The predictive value of the Theory of Planned Behavior (TPB) on intention and physical activity (PA) over time was examined. Data from the Aging Well and Healthily intervention program (targeting perceived behavioral control and attitude, not subjective norm) were analyzed, including pretest (T0), posttest (T1, except subjective norm) and 4-6 months follow-up (T2, PA outcomes only) (N = 387, M age 72 years). Structural equation modeling was used to test a TPB model. PA was measured subjectively using the Voorrips sports subscale (T0 and T2), items measured perceived increase in PA (T1), and adherence to exercises (T1 and T2). Model fit was good. The TPB explained variation in intention well (R 2 .54-.60) and some PA behavior (R 2 .13-.16). The intervention successfully got participants to exercise independent of the measured TPB concepts. More TPB studies in the context of interventions are needed.

  5. The Examination of the Effectiveness of an Educational Intervention based on the Planned Behavior Theory on Improving Pubertal Health Behavior in Female High School Students

    Directory of Open Access Journals (Sweden)

    Farnaz Eslamimehr

    2017-09-01

    Full Text Available Background: Puberty is a period of psychological, physical, mental, emotional and social growth that stability and development of personality occurs in this period. This study aimed to determine the effect of planned behavior theory on improving pubertal health behavior in female first grade high school students. Materials and Methods:  A quasi-experimental intervention was conducted in female high school in Khamir city, Iran in 2015. One of the schools were randomly assigned to the control group and other to the experimental group. Using the formula sample, 60 students were selected from each school. Samples were evaluated in two stages through pre-test and two months later via post-test by administered questionnaire including questions about demographic characteristics and structures of planned behavior theory. The content of training was presented through lecture group discussion with teaching aids such as booklet and pamphlet. The collected data were analyzed using SPSS version 22. Results: The intervention group mean age at first menstrual period was 12.30 ± 0.84 years old and for control group was 12.25 ± 0.79 years old. The results showed that two months after the intervention, health behaviors, subjective norms, behavioral intention, perceived behavioral control, and attitude, were significantly higher than pre- intervention (P

  6. The systematic development of a brief intervention to increase walking in the general public using an "extended" theory of planned behavior.

    Science.gov (United States)

    French, David P; Darker, Catherine D; Eves, Frank F; Sniehotta, Falko F

    2013-09-01

    The Theory of Planned Behavior (TPB) has been extensively used in predictive studies, but there have been considerably fewer experimental tests of the theory. One reason for this is that the guidance on developing concrete intervention strategies from the abstract theory is vague, and there are few exemplars of how to do this. The aim of this article is to provide such an exemplar. The development of an intervention to increase walking in the general public is described, based on the TPB, extended to include postvolitional processes. Identification of target constructs, elicitation of key salient beliefs underpinning these constructs, selection of appropriate behavior change techniques, and technique refinement. Each step is based on available evidence and consistent with theory. Perceived behavioral control (PBC) was identified as the key determinant of walking intentions, with an "intention-behavior gap" noted. A brief intervention was developed, using techniques to increase PBC by rehearsal of previous successful performance of behavior, along with planning techniques to translate motivation into behavior. This systematic approach taken should provide a model for others. The intervention has demonstrated efficacy in producing large changes in objectively measured walking behavior, in 2 separate evaluations reported elsewhere.

  7. [The participation of patients with dementia in individualised intervention plan meetings: the impact on their well-being and the quality of life].

    Science.gov (United States)

    Villar, Feliciano; Vila-Miravent, Josep; Celdrán, Montserrat; Fernández, Elena

    2013-01-01

    An individualised intervention plan (IIP) offers a new paradigm in the care of the elderly with dementia, with the aim of increasing their quality of life through personalisation, respect for their freedom, and their participation in the decisions that affect their lives. To evaluate the impact of the residential home patient with dementia and their quality of care when they take part in the interdisciplinary meeting in which their care plan is decided. A total of 52 elderly patients with dementia took part in the study. They were distributed into two groups, one experimental (37 residents) and another control (15 residents). The Dementia Care Mapping (DCM) tool was used to assess the well-being and quality of care of the residents. This tool was used twice, before and after the intervention. The well-being of the resident, evaluated using the DCM, was similar before and after the intervention in the experimental group. No differences were observed either on comparing the control and experimental groups. However, some indicators of carer behaviour were different before and after the intervention, and when the control and experimental group were compared. The inclusion of elderly persons with dementia in their IIP meeting had a positive effect in the interaction of the staff with the residents, but not on the well-being of the resident. Copyright © 2012 SEGG. Published by Elsevier Espana. All rights reserved.

  8. Process evaluation of an environmental health risk audit and action plan intervention to reduce alcohol related violence in licensed premises

    Directory of Open Access Journals (Sweden)

    Annie Williams

    2016-05-01

    Full Text Available Abstract Background Alcohol-related violence is associated with licensed premise environments and their management. There is a lack of evidence for effective interventions to address these, and there are significant barriers to implementation. This study aims to understand how development and implementation processes can facilitate intervention reach, fidelity and receipt and therefore provides key process data necessary to interpret the results of the randomised controlled trial conducted in parallel. Methods A process evaluation, embedded within a randomised controlled trial. Intervention development and implementation were assessed via focus groups (n = 2 and semi-structured interviews (n = 22 with Environmental Health Practitioners (EHPs. Reach and fidelity were assessed via routinely collected intervention data, which was was collected from 276 licenced premises across Wales, UK. Case study semi-structured interviews with licensed premises proprietors (n = 30 explored intervention receipt. Results Intervention co-production with senior EHPs facilitated organisational adoption and implementation. Training events for EHPs played an important role in addressing wider organisational concerns regarding partnership working and the contextual integration of the intervention. EHPs delivered the intervention to 98 % of intervention premises; 35 % of premises should have received a follow up enforcement visit, however EHP confidence in dealing with alcohol risk factors meant only 7 % of premises received one. Premises therefore received a similar intervention dose regardless of baseline risk. Intervention receipt appeared to be greatest in premises with an existing commitment to prevention and those in urban environments. Conclusions The study suggests that a collaborative approach to the development and diffusion of interventions is associated with high levels of organisational adoption, implementation and reach. However, the lack

  9. Effectiveness of a healthy lifestyle intervention for low back pain and osteoarthritis of the knee: protocol and statistical analysis plan for two randomised controlled trials

    Directory of Open Access Journals (Sweden)

    Kate M. O’Brien

    Full Text Available ABSTRACT Background These trials are the first randomised controlled trials of telephone-based weight management and healthy lifestyle interventions for low back pain and knee osteoarthritis. This article describes the protocol and statistical analysis plan. Method These trials are parallel randomised controlled trials that investigate and compare the effect of a telephone-based weight management and healthy lifestyle intervention for improving pain intensity in overweight or obese patients with low back pain or knee osteoarthritis. The analysis plan was finalised prior to initiation of analyses. All data collected as part of the trial were reviewed, without stratification by group, and classified by baseline characteristics, process of care and trial outcomes. Trial outcomes were classified as primary and secondary outcomes. Appropriate descriptive statistics and statistical testing of between-group differences, where relevant, have been planned and described. Conclusions A protocol for standard analyses was developed for the results of two randomised controlled trials. This protocol describes the data, and the pre-determined statistical tests of relevant outcome measures. The plan demonstrates transparent and verifiable use of the data collected. This a priori protocol will be followed to ensure rigorous standards of data analysis are strictly adhered to.

  10. Effectiveness of a healthy lifestyle intervention for low back pain and osteoarthritis of the knee: protocol and statistical analysis plan for two randomised controlled trials

    Science.gov (United States)

    O’Brien, Kate M.; Williams, Amanda; Wiggers, John; Wolfenden, Luke; Yoong, Serene; Campbell, Elizabeth; Kamper, Steven J.; McAuley, James; Attia, John; Oldmeadow, Chris; Williams, Christopher M.

    2016-01-01

    ABSTRACT Background These trials are the first randomised controlled trials of telephone-based weight management and healthy lifestyle interventions for low back pain and knee osteoarthritis. This article describes the protocol and statistical analysis plan. Method These trials are parallel randomised controlled trials that investigate and compare the effect of a telephone-based weight management and healthy lifestyle intervention for improving pain intensity in overweight or obese patients with low back pain or knee osteoarthritis. The analysis plan was finalised prior to initiation of analyses. All data collected as part of the trial were reviewed, without stratification by group, and classified by baseline characteristics, process of care and trial outcomes. Trial outcomes were classified as primary and secondary outcomes. Appropriate descriptive statistics and statistical testing of between-group differences, where relevant, have been planned and described. Conclusions A protocol for standard analyses was developed for the results of two randomised controlled trials. This protocol describes the data, and the pre-determined statistical tests of relevant outcome measures. The plan demonstrates transparent and verifiable use of the data collected. This a priori protocol will be followed to ensure rigorous standards of data analysis are strictly adhered to. PMID:27683839

  11. Effects of a short behavioural intervention for dental flossing : randomized-controlled trial on planning when, where and how

    OpenAIRE

    Schüz, Benjamin; Wiedemann, Amelie U.; Mallach, Natalie; Scholz, Urte

    2009-01-01

    Regular dental flossing has been widely recommended to prevent periodontal diseases. Nevertheless, compliance is below a desirable level. This study evaluates the effects of a brief behavioural intervention on dental flossing and determines whether the effects of such an intervention are stronger in a specific subgroup of individuals (those intending to floss regularly=implemental mindset).

  12. 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

  13. CHARM, a gender equity and family planning intervention for men and couples in rural India: protocol for the cluster randomized controlled trial evaluation.

    Science.gov (United States)

    Yore, Jennifer; Dasgupta, Anindita; Ghule, Mohan; Battala, Madhusadana; Nair, Saritha; Silverman, Jay; Saggurti, Niranjan; Balaiah, Donta; Raj, Anita

    2016-02-20

    Globally, 41% of all pregnancies are unintended, increasing risk for unsafe abortion, miscarriage and maternal and child morbidities and mortality. One in four pregnancies in India (3.3 million pregnancies, annually) are unintended; 2/3 of these occur in the context of no modern contraceptive use. In addition, no contraceptive use until desired number and sex composition of children is achieved remains a norm in India. Research shows that globally and in India, the youngest and most newly married wives are least likely to use contraception and most likely to report husband's exclusive family planning decision-making control, suggesting that male engagement and family planning support is important for this group. Thus, the Counseling Husbands to Achieve Reproductive Health and Marital Equity (CHARM) intervention was developed in recognition of the need for more male engagement family planning models that include gender equity counseling and focus on spacing contraception use in rural India. For this study, a multi-session intervention delivered to men but inclusive of their wives was developed and evaluated as a two-armed cluster randomized controlled design study conducted across 50 mapped clusters in rural Maharashtra, India. Eligible rural young husbands and their wives (N = 1081) participated in a three session gender-equity focused family planning program delivered to the men (Sessions 1 and 2) and their wives (Session 3) by village health providers in rural India. Survey assessments were conducted at baseline and 9&18 month follow-ups with eligible men and their wives, and pregnancy tests were obtained from wives at baseline and 18-month follow-up. Additional in-depth understanding of how intervention impact occurred was assessed via in-depth interviews at 18 month follow-up with VHPs and a subsample of couples (n = 50, 2 couples per intervention cluster). Process evaluation was conducted to collect feedback from husbands, wives, and VHPs on program

  14. Effect of an End-of-Life Planning Intervention on the completion of advance directives in homeless persons: a randomized trial.

    Science.gov (United States)

    Song, John; Ratner, Edward R; Wall, Melanie M; Bartels, Dianne M; Ulvestad, Nancy; Petroskas, Dawn; West, Melissa; Weber-Main, Anne Marie; Grengs, Leah; Gelberg, Lillian

    2010-07-20

    Few interventions have focused on improving end-of-life care for underserved populations, such as homeless persons. To determine whether homeless persons will complete a counseling session on advance care planning and fill out a legal advance directive designed to assess care preferences and preserve the dignity of marginalized persons. Prospective, single-blind, randomized trial comparing self-guided completion of an advance directive with professionally assisted advance care planning. (ClinicalTrials.gov registration number: NCT00546884) 8 sites serving homeless persons in Minneapolis, Minnesota. 262 homeless persons recruited between November 2007 and August 2008. Minimal, self-guided intervention consisting of advance directive forms and written educational information versus a one-on-one advance planning intervention consisting of counseling and completing an advance directive with a social worker. Rate of advance directive completion, assessed by inspection of completed documents. The overall completion rate for advance directives was 26.7% (95% CI, 21.5% to 32.5%), with a higher rate in the counselor-guided group (37.9%) than in the self-guided group (12.8%) (CI of adjusted difference, 15.3 to 34.3 percentage points). This difference persisted across all sites and most subgroups. The advance directive's 4 clinical scenarios found a preference for surrogate decision making in 29% to 34% of written responses. Sampling was limited to a more stable subset of the homeless population in Minneapolis and may have been subject to selection bias. Modest compensation to complete the preintervention survey could have influenced participants to complete advance directives. Both a simple and complex intervention successfully engaged a diverse sample of homeless persons in advance care planning. One-on-one assistance significantly increased the completion rate. Homeless persons can respond to an intervention to plan for end-of-life care and can express specific preferences

  15. Birth control pills - overview

    Science.gov (United States)

    ... from taking birth control pills include: Blood clots Heart attack High blood pressure Stroke Birth control pills without estrogen are much less likely to cause these problems. The risk is higher for women ...

  16. Preterm Labor and Birth

    Science.gov (United States)

    ... Facebook Twitter Pinterest Email Print Preterm Labor and Birth In general, a normal human pregnancy lasts about ... is called preterm labor (or premature labor). A birth that occurs before 37 weeks is considered a ...

  17. Birth control pill - slideshow

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/presentations/100108.htm Birth control pill - series—Normal female anatomy To use ... to produce a successful pregnancy. To prevent pregnancy, birth control pills affect how these organs normally function. ...

  18. Vaginal birth - slideshow

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/presentations/100198.htm Vaginal birth - series—Normal anatomy To use the sharing features ... vaginal delivery. Please keep in mind that every birth is unique, and your labor and delivery may ...

  19. [Prevention of spontaneous preterm birth in asymptomatic twin pregnancies].

    Science.gov (United States)

    Sentilhes, L; Bouhours, A-C; Bouet, P-E; Boussion, F; Biquard, F; Gillard, P; Descamps, P

    2009-12-01

    To determine prenatal methods to predict and prevent spontaneous preterm birth in asymptomatic twin pregnancies. Articles were searched using PubMed, Embase and Cochrane library. Uterine activity monitoring and bacterial vaginosis screening are not useful to predict preterm birth (EL2 and EL3 respectively). Current literature data are contradictory and insufficient to determine whether fetal fibronectin and digital cervical assessment are predictors of preterm birth. History of preterm birth (EL4), and cervical length measurement by transvaginal ultrasonography (EL2) predict preterm birth. Nevertheless, there are no intervention studies that have evaluated cervical length measurement in the prevention of preterm birth. Hospital bedrest, prophylactic tocolytic and progesterone therapy, and prophylactic cervical cerclage in patients with or without short cervix have not been shown to be effective in preventing preterm birth. Prenatal methods to prevent spontaneous preterm birth in asymptomatic twin pregnancies are currently very limited. Copyright © 2009 Elsevier Masson SAS. All rights reserved.

  20. Adolescent perceptions of teen births.

    Science.gov (United States)

    Herrman, Judith W

    2008-01-01

    To investigate teens' perceptions of the costs and rewards of teen births, potential interventions to prevent teen pregnancy, and the presence of someone with whom teens could discuss sexuality. Seventeen focus groups were conducted to solicit individual views, group interactions, and shared meanings. Purposive methods accessed a sample of teens considered at risk of teen pregnancy based on their membership in selected community service and teen groups. Teen parents and nonparents (n = 120), from 12 to 19 years of age, were asked about their lives and stresses and the costs and rewards related to teen births. This study yielded rich data about the consequences of teen births. Data were organized in the domains of Impact on relationships, Impact on vocation, and Impact on self. The data reflected the cost and reward themes in each domain. Though teens believed that there were positives of teen births, early childbearing was considered "hard" in many aspects. These perceptions may be used to guide programs, policies, messages, and curricula with the intent to prevent teen pregnancy. These initiatives may be more effective if informed by teens and guided by their perceptions.

  1. Study protocol for reducing childbirth fear: a midwife-led psycho-education intervention.

    Science.gov (United States)

    Fenwick, Jennifer; Gamble, Jenny; Creedy, Debra K; Buist, Anne; Turkstra, Erika; Sneddon, Anne; Scuffham, Paul A; Ryding, Elsa L; Jarrett, Vivian; Toohill, Jocelyn

    2013-10-20

    Childbirth fear has received considerable attention in Scandinavian countries, and the United Kingdom, but not in Australia. For first-time mothers, fear is often linked to a perceived lack of control and disbelief in the body's ability to give birth safely, whereas multiparous women may be fearful as a result of previous negative and/or traumatic birth experiences. There have been few well-designed intervention studies that test interventions to address women's childbirth fear, support normal birth, and diminish the possibility of a negative birth experience. Pregnant women in their second trimester of pregnancy will be recruited and screened from antenatal clinics in Queensland, Australia. Women reporting high childbirth fear will be randomly allocated to the intervention or control group. The psycho-educational intervention is offered by midwives over the telephone at 24 and 34 weeks of pregnancy. The intervention aims to review birth expectations, work through distressing elements of childbirth, discuss strategies to develop support networks, affirm that negative childbirth events can be managed and develop a birth plan. Women in the control group will receive standard care offered by the public funded maternity services in Australia. All women will receive an information booklet on childbirth choices. Data will be collected at recruitment during the second trimester, 36 weeks of pregnancy, and 4-6 weeks after birth. This study aims to test the efficacy of a brief, midwife-led psycho-education counselling (known as BELIEF: Birth Emotions - Looking to Improve Expectant Fear) to reduce women's childbirth fear. 1) Relative to controls, women receiving BELIEF will report lower levels of childbirth fear at term; 2) less decisional conflict; 3) less depressive symptoms; 4) better childbirth self-efficacy; and 5) improved health and obstetric outcomes. Australian New Zealand Controlled Trials Registry ACTRN12612000526875.

  2. Cranial birth trauma

    International Nuclear Information System (INIS)

    Papanagiotou, P.; Roth, C.; Politi, M.; Zimmer, A.; Reith, W.; Rohrer, T.

    2009-01-01

    Injuries to an infant that result during the birth process are categorized as birth trauma. Cranial injuries due to mechanical forces such as compression or traction include caput succedaneum, cephalhematoma, subgaleal hematoma and intracranial hemorrhaging. Hypoxic ischemic encephalopathy is the consequence of systemic asphyxia occurring during birth. (orig.) [de

  3. Encyclopedia of Birth Control.

    Science.gov (United States)

    Rengel, Marian

    This encyclopedia brings together in more than 200 entries, arranged in A-to-Z format, a portrait of the complex modern issue that birth control has become with advances in medicine and biochemistry during the 20th century. It is aimed at both the student and the consumer of birth control. Entries cover the following topics: birth control…

  4. Birth Control Shot

    Science.gov (United States)

    ... Staying Safe Videos for Educators Search English Español Birth Control Shot KidsHealth / For Teens / Birth Control Shot What's in this article? What Is ... español La inyección anticonceptiva What Is It? The birth control shot is a long-acting form of ...

  5. Birth Control Pill

    Science.gov (United States)

    ... Staying Safe Videos for Educators Search English Español Birth Control Pill KidsHealth / For Teens / Birth Control Pill What's in this article? What Is ... español La píldora anticonceptiva What Is It? The birth control pill (also called "the Pill") is a ...

  6. Birth Control Ring

    Science.gov (United States)

    ... Staying Safe Videos for Educators Search English Español Birth Control Ring KidsHealth / For Teens / Birth Control Ring What's in this article? What Is ... español Anillo vaginal anticonceptivo What Is It? The birth control ring is a soft, flexible, doughnut-shaped ...

  7. Allostatic Load and Preterm Birth

    Directory of Open Access Journals (Sweden)

    David M. Olson

    2015-12-01

    Full Text Available Preterm birth is a universal health problem that is one of the largest unmet medical needs contributing to the global burden of disease. Adding to its complexity is that there are no means to predict who is at risk when pregnancy begins or when women will actually deliver. Until these problems are addressed, there will be no interventions to reduce the risk because those who should be treated will not be known. Considerable evidence now exists that chronic life, generational or accumulated stress is a risk factor for preterm delivery in animal models and in women. This wear and tear on the body and mind is called allostatic load. This review explores the evidence that chronic stress contributes to preterm birth and other adverse pregnancy outcomes in animal and human studies. It explores how allostatic load can be used to, firstly, model stress and preterm birth in animal models and, secondly, how it can be used to develop a predictive model to assess relative risk among women in early pregnancy. Once care providers know who is in the highest risk group, interventions can be developed and applied to mitigate their risk.

  8. Theory of reasoned action and theory of planned behavior-based dietary interventions in adolescents and young adults: a systematic review.

    Science.gov (United States)

    Hackman, Christine L; Knowlden, Adam P

    2014-01-01

    Childhood obesity has reached epidemic proportions in many nations around the world. The theory of planned behavior (TPB) and the theory of reasoned action (TRA) have been used to successfully plan and evaluate numerous interventions for many different behaviors. The aim of this study was to systematically review and synthesize TPB and TRA-based dietary behavior interventions targeting adolescents and young adults. THE FOLLOWING DATABASES WERE SYSTEMATICALLY SEARCHED TO FIND ARTICLES FOR THIS REVIEW: Academic Search Premier; Cumulative Index to Nursing and Allied Health (CINAHL); Education Resources Information Center (ERIC); Health Source: Nursing/Academic Edition; Cochrane Central Register of Controlled Trials (CENTRAL); and MEDLINE. Inclusion criteria for articles were: 1) primary or secondary interventions, 2) with any quantitative design, 3) published in the English language, 4) between January 2003 and March 2014, 5) that targeted adolescents or young adults, 6) which included dietary change behavior as the outcome, and 7) utilized TPB or TRA. Of the eleven intervention studies evaluated, nine resulted in dietary behavior change that was attributed to the treatment. Additionally, all but one study found there to be a change in at least one construct of TRA or TPB, while one study did not measure constructs. All of the studies utilized some type of quantitative design, with two employing quasi-experimental, and eight employing randomized control trial design. Among the studies, four utilized technology including emails, social media posts, information on school websites, web-based activities, audio messages in classrooms, interactive DVDs, and health-related websites. Two studies incorporated goal setting and four employed persuasive communication. Interventions directed toward changing dietary behaviors in adolescents should aim to incorporate multi-faceted, theory-based approaches. Future studies should consider utilizing randomized control trial design and

  9. Effects of a workplace travel plan intervention encouraging active travel to work: outcomes from a three-year time-series study.

    Science.gov (United States)

    Petrunoff, N; Wen, L M; Rissel, C

    2016-06-01

    To evaluate the effects of a three-year workplace travel plan intervention on increasing active travel to work. A time-series study with staff was conducted in 2011 (n = 804), 2012 (n = 904), 2013 (n = 872) and 2014 (n = 687). A travel plan was implemented at a large, outer-suburban worksite in Sydney, Australia. Implementation was assessed by reviewing annual reports including travel plan actions and their status. Annual cross-sectional on-line surveys assessed primary outcomes which included change in the proportion of staff travelling to work via active modes. Multivariate logistic regression was used to adjust for confounders. Strategies to encourage active travel were partially implemented. An average survey response rate was 23% (n = 817). The proportion of staff travelling actively to work increased by 4%-6% across intervention years compared to the baseline, and this increase was significant in 2012 (P = 0.04) and 2013 (P = 0.003). Compared to baseline, after adjusting for distances staff lived from work staff had 33% (95% CI 1%-74%) greater odds of travelling to work via active modes in 2012, and 50% (95% CI 15%-96%) greater odds in 2013. There was no evidence of change in physical activity levels. A workplace travel plan which only included strategies to encourage active travel to work achieved small but significant increases in active travel. Workplace travel plans appear to be a promising way to increase active travel to work. Copyright © 2016 The Royal Society for Public Health. All rights reserved.

  10. Women's motivations for choosing a high risk birth setting against medical advice in the Netherlands: a qualitative analysis.

    Science.gov (United States)

    Hollander, Martine; de Miranda, Esteriek; van Dillen, Jeroen; de Graaf, Irene; Vandenbussche, Frank; Holten, Lianne

    2017-12-16

    Home births in high risk pregnancies and unassisted childbirth seem to be increasing in the Netherlands. Until now there were no qualitative data on women's motivations for these choices in the Dutch maternity care system where integrated midwifery care and home birth are regular options in low risk pregnancies. We aimed to examine women's motivations for birthing outside the system in order to provide medical professionals with insight and recommendations regarding their interactions with women who have birth wishes that go against medical advice. An exploratory qualitative research design with a constructivist approach and a grounded theory method were used. In-depth interviews were performed with 28 women on their motivations for going against medical advice in choosing a high risk childbirth setting. Open, axial and selective coding of the interview data was done in order to generate themes. A focus group was held for a member check of the findings. Four main themes were found: 1) Discrepancy in the definition of superior knowledge, 2) Need for autonomy and trust in the birth process, 3) Conflict during negotiation of the birth plan, and 4) Search for different care. One overarching theme emerged that covered all other themes: Fear. This theme refers both to the participants' fear (of interventions and negative consequences of their choices) and to the providers' fear (of a bad outcome). Where for some women it was a positive choice, for the majority of women in this study the choice for a home birth in a high risk pregnancy or an unassisted childbirth was a negative one. Negative choices were due to previous or current negative experiences with maternity care and/or conflict surrounding the birth plan. The main goal of working with women whose birthing choices do not align with medical advice should not be to coerce them into the framework of protocols and guidelines but to prevent negative choices. Recommendations for maternity caregivers can be summarized as

  11. Failure mode and effect analysis oriented to risk-reduction interventions in intraoperative electron radiation therapy: The specific impact of patient transportation, automation, and treatment planning availability

    International Nuclear Information System (INIS)

    López-Tarjuelo, Juan; Bouché-Babiloni, Ana; Santos-Serra, Agustín; Morillo-Macías, Virginia; Calvo, Felipe A.; Kubyshin, Yuri

    2014-01-01

    Background and purpose: Industrial companies use failure mode and effect analysis (FMEA) to improve quality. Our objective was to describe an FMEA and subsequent interventions for an automated intraoperative electron radiotherapy (IOERT) procedure with computed tomography simulation, pre-planning, and a fixed conventional linear accelerator. Material and methods: A process map, an FMEA, and a fault tree analysis are reported. The equipment considered was the radiance treatment planning system (TPS), the Elekta Precise linac, and TN-502RDM-H metal–oxide-semiconductor-field-effect transistor in vivo dosimeters. Computerized order-entry and treatment-automation were also analyzed. Results: Fifty-seven potential modes and effects were identified and classified into ‘treatment cancellation’ and ‘delivering an unintended dose’. They were graded from ‘inconvenience’ or ‘suboptimal treatment’ to ‘total cancellation’ or ‘potentially wrong’ or ‘very wrong administered dose’, although these latter effects were never experienced. Risk priority numbers (RPNs) ranged from 3 to 324 and totaled 4804. After interventions such as double checking, interlocking, automation, and structural changes the final total RPN was reduced to 1320. Conclusions: FMEA is crucial for prioritizing risk-reduction interventions. In a semi-surgical procedure like IOERT double checking has the potential to reduce risk and improve quality. Interlocks and automation should also be implemented to increase the safety of the procedure

  12. Failure mode and effect analysis oriented to risk-reduction interventions in intraoperative electron radiation therapy: the specific impact of patient transportation, automation, and treatment planning availability.

    Science.gov (United States)

    López-Tarjuelo, Juan; Bouché-Babiloni, Ana; Santos-Serra, Agustín; Morillo-Macías, Virginia; Calvo, Felipe A; Kubyshin, Yuri; Ferrer-Albiach, Carlos

    2014-11-01

    Industrial companies use failure mode and effect analysis (FMEA) to improve quality. Our objective was to describe an FMEA and subsequent interventions for an automated intraoperative electron radiotherapy (IOERT) procedure with computed tomography simulation, pre-planning, and a fixed conventional linear accelerator. A process map, an FMEA, and a fault tree analysis are reported. The equipment considered was the radiance treatment planning system (TPS), the Elekta Precise linac, and TN-502RDM-H metal-oxide-semiconductor-field-effect transistor in vivo dosimeters. Computerized order-entry and treatment-automation were also analyzed. Fifty-seven potential modes and effects were identified and classified into 'treatment cancellation' and 'delivering an unintended dose'. They were graded from 'inconvenience' or 'suboptimal treatment' to 'total cancellation' or 'potentially wrong' or 'very wrong administered dose', although these latter effects were never experienced. Risk priority numbers (RPNs) ranged from 3 to 324 and totaled 4804. After interventions such as double checking, interlocking, automation, and structural changes the final total RPN was reduced to 1320. FMEA is crucial for prioritizing risk-reduction interventions. In a semi-surgical procedure like IOERT double checking has the potential to reduce risk and improve quality. Interlocks and automation should also be implemented to increase the safety of the procedure. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  13. Saving lives at birth

    DEFF Research Database (Denmark)

    Daysal, N. Meltem; Trandafir, Mircea; van Ewijk, Reyn

    2015-01-01

    Many developed countries have recently experienced sharp increases in home birth rates. This paper investigates the impact of home births on the health of low-risk newborns using data from the Netherlands, the only developed country where home births are widespread. To account for endogeneity...... in location of birth, we exploit the exogenous variation in distance from a mother’s residence to the closest hospital. We find that giving birth in a hospital leads to substantial reductions in newborn mortality. We provide suggestive evidence that proximity to medical technologies may be an important...

  14. Early discharge following birth

    DEFF Research Database (Denmark)

    Nilsson, Ingrid M. S.; Kronborg, Hanne; Knight, Christopher H.

    2017-01-01

    of discharge after birth. Results In total 34% mothers were discharged within 12 hours (very early) and 25% between 13 and 50 hours (early), respectively. Vaginal birth and multiparity were the most influential predictors, as Caesarean section compared to vaginal birth had an OR of 0.35 (CI 0....... Smoking, favourable social support and breastfeeding knowledge were significantly associated with discharge within 12 hours. Finally time of discharge varied significantly according to region and time of day of birth. Conclusions Parity and birth related factors were the strongest predictors of early...

  15. Community-based educational intervention on necklace method as a natural family planning amongst reproductive age group women in India

    Directory of Open Access Journals (Sweden)

    Jyothi Ramesh

    2018-01-01

    Conclusions: Nurses play a vital role in educating women and creating awareness regarding modern and safe family planning methods. These methods are effective and essential to avoid unwanted pregnancy and thus greatly impact the health of women.

  16. Understanding Pregnancy and Birth Issues

    Science.gov (United States)

    ... Home Current Issue Past Issues Understanding Pregnancy and Birth Issues Past Issues / Winter 2008 Table of Contents ... about NICHD preeclampsia research in the sidebar.) Preterm Birth Preterm (premature) birth is birth before the baby ...

  17. Upgrade the intervention levels derived for water and foods, to be include in the PERE 607 procedure the external radiological emergency plan in the Laguna Verde nuclear power plant

    International Nuclear Information System (INIS)

    Llado Castillo, R.; Aguilar Pacheco, R.

    1998-01-01

    The work shows the results obtained in the upgrade the intervention levels derived for water and foods, to be include in the PERE 607 procedure the external radiological emergency plan in the Laguna Verde nuclear power plant

  18. A clinical nurse specialist-led intervention to enhance medication adherence using the plan-do-check-act cycle for continuous self-improvement.

    Science.gov (United States)

    Russell, Cynthia L

    2010-01-01

    A clinical nurse specialist-led intervention to improve medication adherence in chronically ill adults using renal transplant recipients as an exemplar population is proposed. Meta-analyses and systematic reviews of chronically ill and transplant patients indicate that patient-specific characteristics not only are poor and inconsistent predictors for medication nonadherence but also are not amenable to intervention. Adherence has not meaningfully improved, despite meta-analyses and systematic narrative reviews of randomized controlled trials (RCTs) dealing with medication nonadherence in acutely and chronically ill persons and RCTs dealing with transplant patients. Interventions with a superior potential to enhance medication adherence must be developed. Use of a clinical nurse specialist-led continuous self-improvement intervention with adult renal transplant recipients is proposed. Continuous self-improvement focuses on improving personal systems thinking and behavior using the plan-do-check-act process. Electronic medication monitoring reports, one of several objective measures of medication adherence, are used by the clinician to provide patient feedback during the check process on medication-taking patterns. Continuous self-improvement as an intervention holds promise in supporting patient self-management and diminishing the blame that clinicians place on patients for medication nonadherence. Using an objective measure of medication adherence such as an electronic monitoring report fosters collaborative patient-clinician discussions of daily medication-taking patterns. Through collaboration, ideas for improving medication taking can be explored. Changes can be followed and evaluated for effectiveness through the continuous self-improvement process. Future studies should include RCTs comparing educational and/or behavioral interventions to improve medication adherence.

  19. Economic costs associated with moderate and late preterm birth: a prospective population-based study.

    Science.gov (United States)

    Khan, K A; Petrou, S; Dritsaki, M; Johnson, S J; Manktelow, B; Draper, E S; Smith, L K; Seaton, S E; Marlow, N; Dorling, J; Field, D J; Boyle, E M

    2015-10-01

    We sought to determine the economic costs associated with moderate and late preterm birth. An economic study was nested within a prospective cohort study. Infants born between 32(+0) and 36(+6)  weeks of gestation in the East Midlands of England. A sample of infants born at ≥37 weeks of gestation acted as controls. Data on resource use, estimated from a National Health Service (NHS) and personal social services perspective, and separately from a societal perspective, were collected between birth and 24 months corrected age (or death), and valued in pounds sterling, at 2010-11 prices. Descriptive statistics and multivariable analyses were used to estimate the relationship between gestational age at birth and economic costs. Cumulative resource use and economic costs over the first two years of life. Of all eligible births, 1146 (83%) preterm and 1258 (79%) term infants were recruited. Mean (standard error) total societal costs from birth to 24 months were £12 037 (£1114) and £5823 (£1232) for children born moderately preterm (32(+0) -33(+6)  weeks of gestation) and late preterm (34(+0) -36(+6)  weeks of gestation), respectively, compared with £2056 (£132) for children born at term. The mean societal cost difference between moderate and late preterm and term infants was £4657 (bootstrap 95% confidence interval, 95% CI £2513-6803; P economic costs over the first 2 years of life. Our economic estimates can be used to inform budgetary and service planning by clinical decision-makers, and economic evaluations of interventions aimed at preventing moderate and late preterm birth or alleviating its adverse consequences. Moderate and late preterm birth is associated with increased economic costs over the first 2 years of life. © 2015 Royal College of Obstetricians and Gynaecologists.

  20. Theory of reasoned action and theory of planned behavior-based dietary interventions in adolescents and young adults: a systematic review

    Directory of Open Access Journals (Sweden)

    Hackman CL

    2014-06-01

    Full Text Available Christine L Hackman, Adam P KnowldenDepartment of Health Science, The University of Alabama, Tuscaloosa, AL, USABackground: Childhood obesity has reached epidemic proportions in many nations around the world. The theory of planned behavior (TPB and the theory of reasoned action (TRA have been used to successfully plan and evaluate numerous interventions for many different behaviors. The aim of this study was to systematically review and synthesize TPB and TRA-based dietary behavior interventions targeting adolescents and young adults.Methods: The following databases were systematically searched to find articles for this review: Academic Search Premier; Cumulative Index to Nursing and Allied Health (CINAHL; Education Resources Information Center (ERIC; Health Source: Nursing/Academic Edition; Cochrane Central Register of Controlled Trials (CENTRAL; and MEDLINE. Inclusion criteria for articles were: 1 primary or secondary interventions, 2 with any quantitative design, 3 published in the English language, 4 between January 2003 and March 2014, 5 that targeted adolescents or young adults, 6 which included dietary change behavior as the outcome, and 7 utilized TPB or TRA.Results: Of the eleven intervention studies evaluated, nine resulted in dietary behavior change that was attributed to the treatment. Additionally, all but one study found there to be a change in at least one construct of TRA or TPB, while one study did not measure constructs. All of the studies utilized some type of quantitative design, with two employing quasi-experimental, and eight employing randomized control trial design. Among the studies, four utilized technology including emails, social media posts, information on school websites, web-based activities, audio messages in classrooms, interactive DVDs, and health-related websites. Two studies incorporated goal setting and four employed persuasive communication.Conclusion: Interventions directed toward changing dietary behaviors

  1. The Importance of Natural Change in Planning School-Based Intervention for Children with Developmental Language Impairment (DLI)

    Science.gov (United States)

    Botting, Nicola; Gaynor, Marguerite; Tucker, Katie; Orchard-Lisle, Ginnie

    2016-01-01

    Some reports suggest that there is an increase in the number of children identified as having developmental language impairment (Bercow, 2008). yet resource issues have meant that many speech and language therapy services have compromised provision in some way. Thus, efficient ways of identifying need and prioritizing intervention are required.…

  2. An Open Trial of the Anxiety Action Plan ("AxAP"): A Brief Pediatrician-Delivered Intervention for Anxious Youth

    Science.gov (United States)

    Ginsburg, Golda S.; Drake, Kelly L.; Winegrad, Heather; Fothergill, Kate; Wissow, Lawrence S.

    2016-01-01

    Background: Anxiety disorders in youth are among the most common psychiatric disorders, yet the majority of affected youth do not receive treatment. One approach to improving access to care is identification and intervention within the primary care setting. Objective: This manuscript presents data from a single group pre-post open trial of the…

  3. Self-management interventions including action plans for exacerbations versus usual care in patients with chronic obstructive pulmonary disease

    NARCIS (Netherlands)

    Lenferink, Anke; Brusse-Keizer, Marjolein; van der Valk, Paul D.L.P.M.; Frith, Peter A.; Zwerink, Marlies; Monninkhof, Evelyn M.; van der Palen, Job; Effing-Tijdhof, Tanja W

    2017-01-01

    Background: Chronic Obstructive Pulmonary Disease (COPD) self-management interventions should be structured but personalised and often multi-component, with goals of motivating, engaging and supporting the patients to positively adapt their behaviour(s) and develop skills to better manage disease.

  4. Pain relief strategies used by older people with chronic pain: an exploratory survey for planning patient-centred intervention.

    Science.gov (United States)

    Tse, Mimi M Y; Pun, Sandra P Y; Benzie, Iris F F

    2005-03-01

    To explore pain relief interventions used by older people with chronic pain in Hong Kong. The frequency and perceived effectiveness of non-prescription measures were also explored. With increasing life expectancy, the incidence of chronic illness and chronic pain also increases. Chronic pain robs older people of their quality of life. This was a descriptive qualitative study. Forty-four older people (37 female and seven male) who were residents of a nursing home in Hong Kong took part in this study. Their ages ranged from 65 to 82 years, median age was 75 years. Almost 80% had experienced moderate to severe pain during the previous three months. The most common sites of pain were muscles and joints; 35% of subjects reported continuous pain, 27% reported pain associated with activities of daily living, and 38% reported pain during exercise but not at rest. Only a few of the study group had taken prescribed medication to relieve pain, and only two of the 44 subjects studied had used a combination of drug and non-prescription intervention for pain relief. The majority of participants used non-prescription intervention only and the most commonly used were topical analgesics with massage. The majority (58%) of the subjects perceived the used of non-prescription intervention to be very effective in pain relief. The prevalence of pain was found to be high among older people in this study. Yet, they were taking a pro-active and responsible role in treating their chronic pain by using non-pharmacological patient-initiated intervention; also older people perceive themselves to have control over their pain status. This active role of older people in their pain relief is likely to enhance the effect of education seminars and workshops aimed at novel, non-pharmacological pain relief strategies for older people with chronic pain.

  5. Why are young Canadians afraid of birth? A survey study of childbirth fear and birth preferences among Canadian University students.

    Science.gov (United States)

    Stoll, Kathrin; Hall, Wendy; Janssen, Patricia; Carty, Elaine

    2014-02-01

    to examine attitudes towards birth that may be common among young adults who have been socialised into a medicalised birth culture. Specifically, we were interested in examining factors that might be associated with fear of birth and preferences for elective obstetric interventions among the next generation of maternity care consumers. secondary analysis of an online survey of university students. British Columbia, Canada. students from the University of British Columbia (n=3680). A quarter of the sample comprised Asian students, which allowed for analysis of cultural differences in attitudes towards birth. Both male and female students participated in the study; results are reported for the full sample, and by gender. a six item fear of childbirth scale was developed, as well as a 4 item index that measures students' concerns over physical changes following pregnancy and birth and a 2 item scale that assesses students' attitudes towards obstetric technology. as we hypothesised, students who were more fearful of birth preferred epidural anaesthesia and birth by CS. Worries over physical changes following pregnancy and birth, favourable attitudes towards obstetric technology, and exposure to pregnancy and birth information via the media were also significantly associated with a preference for CS. Fear of birth scores were highest among students who reported that the media had shaped their attitudes towards pregnancy and birth. Asian students had significantly higher fear of birth scores and were more likely to prefer CS, compared to Caucasian students. young adults are contemplating pregnancy and birth in an increasingly technology-dependent society. Educational programmes aimed at reducing fear of childbirth and concerns over physical changes following pregnancy and childbirth might contribute to vaginal birth intentions among young adults. Midwives may use the findings to identify and counsel nulliparas who exhibit fear of birth and other childbirth attitudes that

  6. Birth outcomes in Colorado's undocumented immigrant population

    Directory of Open Access Journals (Sweden)

    Battaglia Catherine

    2005-10-01

    Full Text Available Abstract Background The birth outcomes of undocumented women have not been systematically studied on a large scale. The growing number of undocumented women giving birth in the United States has important implications for clinical care and public health policy. The objective of this study was to describe birth outcomes of undocumented immigrants in Colorado. Methods Retrospective descriptive study of singleton births to 5961 undocumented women using birth certificate data for 1998–1999. Results Undocumented mothers were younger, less educated, and more likely to be single. They had higher rates of anemia, were less likely to gain enough weight, and less likely to receive early prenatal care. They were much less likely to use alcohol or tobacco. Undocumented women had a lower rate of low birth weight (5.3% v 6.5%, P Conclusion Undocumented women have lower rates of preterm delivery and low birth weight infants, but higher rates of pregnancy related risk factors. Higher prevalence of some risk factors which are amenable to medical intervention reveals the need for improved prenatal care in this group.

  7. 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.

  8. Family Planning and AIDS/HIV Intervention from a Cross-Cultural Perspective: Enhancing the Pharmacist's Role.

    Science.gov (United States)

    Day, Randal D.; And Others

    1993-01-01

    A study compared perceptions of pharmacy students in three different cultures (Malaysia, Thailand, United States) concerning pharmacist counseling about contraceptive use for family planning and AIDS prevention. Results indicate students in each culture, by gender, had different comfort levels with such counseling, implying need for different…

  9. Implementation intention and planning interventions in Health Psychology : Recommendations from the Synergy Expert Group for research and practice

    NARCIS (Netherlands)

    Hagger, M.S.; Luszczynska, A.; de Wit, J.; Benyamini, Y.; Burkert, S.; Chamberland, P.-E.; Chater, A.; Dombrowski, S.U.; van Dongen, A.; French, D.P.; Gauchet, A.; Hankonen, N.; Karekla, M.; Kinney, A.Y.; Kwasnicka, D.; Lo, S.H.; López-Roig, S.; Meslot, C.; Marques, M.M.; Neter, E.; Plass, A.M.; Potthoff, S.; Rennie, L.; Scholz, U.; Stadler, G.; Stolte, E.; ten Hoor, G.; Verhoeven, A.A.C.; Wagner, M.; Oettingen, G.; Sheeran, P.; Gollwitzer, P.M.

    2016-01-01

    The current article details a position statement and recommendations for future research and practice on planning and implementation intentions in health contexts endorsed by the Synergy Expert Group. The group comprised world-leading researchers in health and social psychology and behavioural

  10. Implementation intention and planning interventions in Health Psychology: Recommendations from the Synergy Expert Group for research and practice

    NARCIS (Netherlands)

    Hagger, M.S.; Luszczynska, A.; de Wit, J.; Benyamini, Y.; Burkert, S.; Chamberland, P.E.; Chater, A.; Dombrowski, S.U.; van Dongen, A.; French, D.P.; Gauchet, A.; Hankonen, N.; Karekla, M.; Kinney, A.Y.; Kwasnicka, D.; Lo, S.H.; López-Roig, S.; Meslot, C.; Marques, M.M.; Neter, E.; Plass, A.M.; Potthoff, S.; Rennie, L.; Scholz, U; Stadler, G.; Stolte, E.; Ten Hoor, G.; Verhoeven, A.; Wagner, M.; Oettingen, G.; Sheeran, P.; Gollwitzer, P.M.

    2016-01-01

    The current article details a position statement and recommendations for future research and practice on planning and implementation intentions in health contexts endorsed by the Synergy Expert Group. The group comprised world-leading researchers in health and social psychology and behavioural

  11. Tracking planning and implementation interventions across regions and institutional boundaries: Failure to establish a uniform reporting language across government

    CSIR Research Space (South Africa)

    Brits, A

    2006-11-01

    Full Text Available There is a growing concern that performance in service delivery does not match the rate of progress required for poverty reduction. These concerns are focusing attention on the need for a better understanding of ‘planning and implementation...

  12. Epidemiology of preterm birth.

    Science.gov (United States)

    Purisch, Stephanie E; Gyamfi-Bannerman, Cynthia

    2017-11-01

    Preterm birth is a worldwide epidemic with a global incidence of 15 million per year. Though rates of preterm birth in the United States have declined over the last decade, nearly 1 in 10 babies is still born preterm. The incidence, gestational age, and underlying etiology of preterm birth is highly variable across different racial and ethnic groups and geographic boundaries. In this article, we review the epidemiology of preterm birth in the United States and globally, with a focus on temporal trends and racial, ethnic, and geographic disparities. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. Increasing male involvement in family planning decision making: trial of a social-cognitive intervention in rural Vietnam.

    Science.gov (United States)

    Ha, Bui Thi Thu; Jayasuriya, Rohan; Owen, Neville

    2005-10-01

    We tested a social-cognitive intervention to influence contraceptive practices among men living in rural communes in Vietnam. It was predicted that participants who received a stage-targeted program based on the Transtheoretical Model (TTM) would report positive movement in their stage of motivational readiness for their wife to use an intrauterine device (IUD) compared to those in a control condition. A quasi-experimental design was used, where the primary unit for allocation was villages. Villages were allocated randomly to a control condition or to two rounds of intervention with stage-targeted letters and interpersonal counseling. There were 651 eligible married men in the 12 villages chosen. A significant positive movement in men's stage of readiness for IUD use by their wife occurred in the intervention group, with a decrease in the proportions in the precontemplation stage from 28.6 to 20.2% and an increase in action/maintenance from 59.8 to 74.4% (P social-cognitive theory can increase men's involvement in IUD use in rural Vietnam and should assist in reducing future rates of unwanted pregnancy.

  14. Effectiveness of planned teaching intervention on knowledge and practice of breast self-examination among first year midwifery students

    OpenAIRE

    Abera, Hiwot; Mengistu, Daniel; Bedaso, Asres

    2017-01-01

    Introduction The prevalence of cancer is growing rapidly in all parts of the word and Ethiopia is no exception. Secondary prevention, as simple as monthly breast self-examination, is the best option to tackle the rising of this epidemic. Health awareness programs on screening and early detection are the corner stones to reduce the morbidity and mortality resulting from breast cancer. Objective The aim of the study is to assess the effectiveness of planned teaching program on knowledge and pra...

  15. Brazilian multicentre study on preterm birth (EMIP: prevalence and factors associated with spontaneous preterm birth.

    Directory of Open Access Journals (Sweden)

    Renato Passini

    account for two thirds of them. A better understanding of the factors associated with spontaneous preterm birth is of utmost importance for planning effective measures to reduce the burden of its increasing rates.

  16. Health Instruction Packages: Consumer--Birth Control.

    Science.gov (United States)

    Pries, Rose Mary; And Others

    Designed for the general public, these three learning modules utilize text, illustrations, and exercises to describe various methods of birth control. The first module, "All about Contraception for the Teenage New Mother" by Rose Mary Pries, discusses the desirability of planned pregnancy and reviews the effectiveness and side effects of…

  17. European Birth Cohorts for Environmental Health Research

    Czech Academy of Sciences Publication Activity Database

    Vrijheid, M.; Casas, M.; Bergström, A.; Carmichael, A.; Cordier, S.; Eggesbø, M.; Eller, E.; Fantini, M. P.; Fernández, M. F.; Fernández-Somoano, A.; Gehring, U.; Grazuleviciene, R.; Hohmann, C.; Karvonen, A. M.; Keil, T.; Kogevinas, M.; Koppen, G.; Krämer, U.; Kuehni, C. E.; Magnus, P.; Majewska, R.; Andersen, A. M. N.; Patelarou, E.; Petersen, M. S.; Pierik, F. H.; Polanska, K.; Porta, D.; Richiardi, L.; Santos, A. C.; Slama, R.; Šrám, Radim; Thijs, C.; Tischer, C.; Toft, G.; Trnovec, T.; Vandentorren, S.; Vrijkotte, T. G. M.; Wilhelm, M.; Wright, J.; Nieuwenhuijsen, M.

    2012-01-01

    Roč. 120, č. 1 (2012), s. 29-37 ISSN 0091-6765 Institutional research plan: CEZ:AV0Z50390703 Keywords : environment pollution * child health * European birth cohorts Subject RIV: DN - Health Impact of the Environment Quality Impact factor: 7.260, year: 2012

  18. Resettlement and Birth Rates

    African Journals Online (AJOL)

    GB

    effect on mothers' age at first birth (p < 0.001), the number of children born within the five years of the survey (p<0.001), and the total number of ... approach that compares reported numbers of births for settlers and non-settlers in ... 1Department of Geography, Sonoma State University, USA. 2. Department of Epidemiology ...

  19. Birth Control Methods

    Science.gov (United States)

    ... Women can choose from many different types of birth control methods. These include, in order of most effective to least effective at preventing pregnancy: Female and male sterilization (female tubal ligation or occlusion, male vasectomy) — Birth control that prevents pregnancy for the rest of ...

  20. Extremely Preterm Birth

    Science.gov (United States)

    ... Search FAQs Extremely Preterm Birth Page Navigation ▼ ACOG Pregnancy Book Patient Education FAQs Patient Education Pamphlets - Spanish FAQ173, June 2016 ... Labor and Birth (FAQ087) Tobacco, Alcohol, Drugs, and Pregnancy (FAQ170) Patient Education ... Committee Opinions Practice Bulletins Patient ...

  1. Elizabeth Belle's Birth Story.

    Science.gov (United States)

    Boro, Jessica; Boro, Samuel

    2014-01-01

    In this article, Jessica and Samuel Boro share the story of the birth of their daughter, Elizabeth Belle. With the physical and emotional support of her husband and her doula, this mother was able to cope with a long labor and have the natural birth she wanted. Her husband describes how important the doula was for him.

  2. birth-weight infants

    African Journals Online (AJOL)

    hours of life was more strongly associated with death than four traditional risk factors (birth weight, short gestation, male sex and the diagnosis of respiratory distress syndrome). Furthermore, mean pH in the first 12 hours was as strongly associated with death as was birth weight. Previous research in our neonatal population ...

  3. Engagement with the TeenDrivingPlan and diversity of teens' supervised practice driving: lessons for internet-based learner driver interventions.

    Science.gov (United States)

    Winston, Flaura K; Mirman, Jessica H; Curry, Allison E; Pfeiffer, Melissa R; Elliott, Michael R; Durbin, Dennis R

    2015-02-01

    Inexperienced, less-skilled driving characterises many newly licensed drivers and contributes to high crash rates. A randomised trial of TeenDrivingPlan (TDP), a new learner driver phase internet-based intervention, demonstrated effectiveness in improving safety relevant, on-road driving behaviour, primarily through greater driving practice diversity. To inform future learner driver interventions, this analysis examined TDP use and its association with practice diversity. Posthoc analysis of data from teen/parent dyads (n=107), enrolled early in learner phase and assigned to treatment arm in randomised trial. Inserted software beacons captured TDP use data. Electronic surveys completed by parents and teens assessed diversity of practice driving and TDP usability ratings at 24 weeks (end of study period). Most families (84%) used TDP early in the learner period; however, the number of TDP sessions in the first week was three times higher among dyads who achieved greater practice diversity than those with less. By week five many families still engaged with TDP, but differences in TDP use could not be detected between families with high versus low practice diversity. Usability was not a major issue for this sample based on largely positive user ratings. An engaging internet-based intervention, such as TDP, can support families in achieving high practice diversity. Future learner driver interventions should provide important information early in the learner period when engagement is greatest, encourage continued learning as part of logging practice drives, and incorporate monitoring software for further personalisation to meet family needs. NCT01498575. 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.

  4. Narcissism and birth order.

    Science.gov (United States)

    Eyring, W E; Sobelman, S

    1996-04-01

    The purpose of this investigation was to clarify the relationship between birth-order position and the development of narcissism, while refining research and theory. The relationship between birth-order status and narcissism was examined with a sample of 79 undergraduate students (55 women and 24 men). These subjects were placed in one of the four following birth-order categories of firstborn, second-born, last-born, and only children. These categories were chosen given their significance in Adlerian theory. Each subject completed the Narcissistic Personality Inventory and a demographic inventory. Based on psychodynamic theory, it was hypothesized that firstborn children were expected to score highest, but statistical significance was not found for an association between narcissism and birth order. Further research is urged to investigate personality theory as it relates to parenting style and birth order.

  5. A Template Analysis of Intimate Partner Violence Survivors' Experiences of Animal Maltreatment: Implications for Safety Planning and Intervention.

    Science.gov (United States)

    Collins, Elizabeth A; Cody, Anna M; McDonald, Shelby Elaine; Nicotera, Nicole; Ascione, Frank R; Williams, James Herbert

    2018-03-01

    This study explores the intersection of intimate partner violence (IPV) and animal cruelty in an ethnically diverse sample of 103 pet-owning IPV survivors recruited from community-based domestic violence programs. Template analysis revealed five themes: (a) Animal Maltreatment by Partner as a Tactic of Coercive Power and Control, (b) Animal Maltreatment by Partner as Discipline or Punishment of Pet, (c) Animal Maltreatment by Children, (d) Emotional and Psychological Impact of Animal Maltreatment Exposure, and (e) Pets as an Obstacle to Effective Safety Planning. Results demonstrate the potential impact of animal maltreatment exposure on women and child IPV survivors' health and safety.

  6. 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.

  7. Birth Control Practices and Levels of Development in India.

    Science.gov (United States)

    Karan, P.P.; And Others

    1978-01-01

    Analyzes the spatial patterns of acceptance of birth control practices in India and examines the relationship between these patterns and levels of economic development. Suggests implications of the area differences in acceptance patterns for family planning program policymakers. (Author)

  8. Mothers and Fathers in NICU: The Impact of Preterm Birth on Parental Distress

    Directory of Open Access Journals (Sweden)

    Chiara Ionio

    2016-11-01

    Full Text Available Preterm birth is a stressful event for families. In particular, the unexpectedly early delivery may cause negative feelings in mothers and fathers. The aim of this study was to examine the relationship between preterm birth, parental stress and negative feelings, and the environmental setting of NICU. 21 mothers (age = 36.00 ± 6.85 and 19 fathers (age = 34.92 ± 4.58 of preterm infants (GA = 30.96 ± 2.97 and 20 mothers (age = 40.08 ± 4.76 and 20 fathers (age = 40.32 ± 6.77 of full-term infants (GA = 39.19 ± 1.42 were involved. All parents filled out the Parental Stressor Scale: Neonatal Intensive Care Unit, the Impact of Event Scale Revised, Profile of Mood States, the Multidimensional Scale of Perceived Social Support and the Post-Partum Bonding Questionnaire. Our data showed differences in emotional reactions between preterm and full-term parents. Results also revealed significant differences between mothers and fathers’ responses to preterm birth in terms of stress, negative feelings, and perceptions of social support. A correlation between negative conditions at birth (e.g., birth weight and Neonatal Intensive Care Unit stay and higher scores in some scales of Impact of Event Scale Revised, Profile of Mood States and Post-Partum Bonding Questionnaire were found. Neonatal Intensive Care Unit may be a stressful place both for mothers and fathers. It might be useful to plan, as soon as possible, interventions to help parents through the experience of the premature birth of their child and to begin an immediately adaptive mode of care.

  9. Feedback GAP: pragmatic, cluster-randomized trial of goal setting and action plans to increase the effectiveness of audit and feedback interventions in primary care.

    Science.gov (United States)

    Ivers, Noah M; Tu, Karen; Young, Jacqueline; Francis, Jill J; Barnsley, Jan; Shah, Baiju R; Upshur, Ross E; Moineddin, Rahim; Grimshaw, Jeremy M; Zwarenstein, Merrick

    2013-12-17

    Audit and feedback to physicians is a commonly used quality improvement strategy, but its optimal design is unknown. This trial tested the effects of a theory-informed worksheet to facilitate goal setting and action planning, appended to feedback reports on chronic disease management, compared to feedback reports provided without these worksheets. A two-arm pragmatic cluster randomized trial was conducted, with allocation at the level of primary care clinics. Participants were family physicians who contributed data from their electronic medical records. The 'usual feedback' arm received feedback every six months for two years regarding the proportion of their patients meeting quality targets for diabetes and/or ischemic heart disease. The intervention arm received these same reports plus a worksheet designed to facilitate goal setting and action plan development in response to the feedback reports. Blood pressure (BP) and low-density lipoprotein cholesterol (LDL) values were compared after two years as the primary outcomes. Process outcomes measured the proportion of guideline-recommended actions (e.g., testing and prescribing) conducted within the appropriate timeframe. Intention-to-treat analysis was performed. Outcomes were similar across groups at baseline. Final analysis included 20 physicians from seven clinics and 1,832 patients in the intervention arm (15% loss to follow up) and 29 physicians from seven clinics and 2,223 patients in the usual feedback arm (10% loss to follow up). Ten of 20 physicians completed the worksheet at least once during the study. Mean BP was 128/72 in the feedback plus worksheet arm and 128/73 in the feedback alone arm, while LDL was 2.1 and 2.0, respectively. Thus, no significant differences were observed across groups in the primary outcomes, but mean haemoglobin A1c was lower in the feedback plus worksheet arm (7.2% versus 7.4%, pplanning worksheet to an externally produced audit and feedback intervention did not lead to

  10. Understanding Recent Home-Birth Research: An Interview With Drs. Melissa Cheyney and Jonathan Snowden.

    Science.gov (United States)

    Cheyney, Melissa

    2016-01-01

    In the past month, two new studies have been released-one in The New England Journal of Medicine (NEJM; Snowden et al., 2015) and the other in the Canadian Medical Association Journal (Hutton et al., 2015)-comparing out-of-hospital birth outcomes to hospital birth outcomes. These studies join a growing body of literature that consistently shows high rates of obstetric intervention in hospitals and also show low risk to neonates regardless of setting. However, the recent NEJM study found a small but statistically significant increase in risk for perinatal mortality for babies born out of hospital. Jeanette McCulloch of BirthSwell (http://www.birthswell.com) interviews Melissa Cheyney, PhD, CPM, LDM, medical anthropologist, chair of the Midwives Alliance Division of Research, and lead author on the largest study of outcomes for planned home births in the United States to date (Cheyney et al., 2014a), and Jonathan Snowden, PhD, epidemiologist and assistant professor in the Department of Obstetrics and Gynecology and School of Public Health at Oregon Health and Science University. Snowden is also the lead author of the recent NEJM study.

  11. An energy-saving development initiative increases birth rate and childhood malnutrition in rural Ethiopia.

    Directory of Open Access Journals (Sweden)

    Mhairi A Gibson

    2006-04-01

    Full Text Available Evolutionary life history theory predicts that, in the absence of contraception, any enhancement of maternal condition can increase human fertility. Energetic trade-offs are likely to be resolved in favour of maximizing reproductive success rather than health or longevity. Here we find support for the hypothesis that development initiatives designed to improve maternal and child welfare may also incur costs associated with increased family sizes if they do not include a family planning component.Demographic and anthropometric data were collected in a rural Ethiopian community benefiting from a recent labour-saving development technology that reduces women's energetic expenditure (n = 1,976 households. Using logistic hazards models and general linear modelling techniques, we found that whilst infant mortality has declined, the birth rate has increased, causing greater scarcity of resources within households.This study is, to our knowledge, the first to demonstrate a link between a technological development intervention and an increase in both birth rate and childhood malnutrition. Women's nutritional status was not improved by the energy-saving technology, because energy was diverted into higher birth rates. We argue that the contribution of biological processes to increased birth rates in areas of the developing world without access to modern contraception has been overlooked. This highlights the continued need for development programmes to be multisectoral, including access to and promotion of contraception.

  12. Induced abortions and birth outcomes of women with a history of severe psychosocial problems in adolescence.

    Science.gov (United States)

    Lehti, V; Gissler, M; Suvisaari, J; Manninen, M

    2015-09-01

    To increase knowledge on the reproductive health of women who have been placed in a residential school, a child welfare facility for adolescents with severe psychosocial problems. All women (n=291) who lived in the Finnish residential schools on the last day of the years 1991, 1996, 2001 and 2006 were included in this study and compared with matched general population controls. Register-based information on induced abortions and births was collected until the end of the year 2011. Compared to controls, women with a residential school history had more induced abortions. A higher proportion of their births took place when they were teenagers or even minors. They were more often single, smoked significantly more during pregnancy and had a higher risk of having a preterm birth or a baby with a low birth weight. The findings have implications for the planning of preventive and supportive interventions that aim to increase the well-being of women with a residential school history and their offspring. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  13. Birth control pills - progestin only

    Science.gov (United States)

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

  14. Screening Tests for Birth Defects

    Science.gov (United States)

    ... Advocacy For Patients About ACOG Screening Tests for Birth Defects Home For Patients Search FAQs Screening Tests ... FAQ165, April 2014 PDF Format Screening Tests for Birth Defects Pregnancy What is a birth defect? What ...

  15. The clientele of traditional birth homes in rural southeastern Nigeria.

    Science.gov (United States)

    Izugbara, C Otutubikey; Ukwayi, J Kinuabeye

    2003-03-01

    Although it is widely documented that traditional birth homes (TBHs) do more than deliver babies, little is known about the other functions in addition to child delivery, which TBHs perform. Drawing on in-depth individual interviews with 13 traditional birth attendants (TBAs) and 147 users of TBHs, we profile the characteristics and health conditions of the clientele of TBHs in four rural communities in southeastern Nigeria. We found that TBHs provide their clients, who are mainly less educated women and girls, health services that range from child delivery, child sex selection, and abortion to family planning and cures for vaginal bleeding. Women are attracted to TBHs because the services are low cost, the women require privacy about their conditions, the TBHs are close by, and the women are confident in the abilities of TBHs. Rural women are bound by poverty, culture, and local values in their choices of services. We assert that health interventions to local people will need to be couched within frameworks that are responsive to their socioeconomic and cultural sensitivities if they are to deliver their expected impact.

  16. BCG vaccination at birth and early childhood hospitalisation

    DEFF Research Database (Denmark)

    Stensballe, Lone Graff; Sørup, Signe; Aaby, Peter

    2017-01-01

    vaccination at birth would reduce early childhood hospitalisation in Denmark, a high-income setting. METHODS: Pregnant women planning to give birth at three Danish hospitals were invited to participate. After parental consent, newborn children were allocated to BCG or no intervention within 7 days of age....... Randomisation was stratified by prematurity. The primary study outcome was number of all-cause hospitalisations analysed as repeated events. Hospitalisations were identified using The Danish National Patient Register. Data were analysed by Cox proportional hazards models in intention-to-treat and per...... compared with 1003 hospitalisations among 2133 control children (mean 0.47), resulting in a HR comparing BCG versus no BCG of 1.05 (95% CI 0.93 to 1.18) (intention-to-treat analysis). The effect of BCG was the same in children born at term (1.05 (0.92 to 1.18)) and prematurely (1.07 (0.63 to 1.81), p=0...

  17. 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.

  18. A DSM-based “2.0” System for Human Intervention Planning and Scheduling in Facilities Emitting Ionizing Radiations

    CERN Document Server

    Baudin, M; De Jonghe, J

    2012-01-01

    To efficiently and safely plan, schedule and control its interventions in underground facilities, which are subject to ionizing radiations, CERN is currently developing a collaborative Web-based system. A similar project for maintenance management is also under way. On top of presenting their key requirements, this paper shows how the implementation of DSM can enhance a so-called Web 2.0 or collaborative dimension by bringing an intuitive and fair way of taking the dependencies between several activities into account. It is also discussed that the incoherencies brought in DSM by collaborative use (for instance regarding the time intervals) can be addressed by enlarging the binary DSM span of dependencies to ones of the Allen’s interval algebra or at least a subset of its dependencies.

  19. Birthing postures and birth canal lacerations.

    Science.gov (United States)

    Suzuki, Shunji

    2017-05-01

    This study was performed to assess the differences in the birth canal lacerations following the lateral and fours posture deliveries compared with those following the supine posture deliveries. We examined the birth canal lacerations of our "low risk" pregnant women under the midwife-led delivery care at Japanese Red Cross Katsushika Maternity Hospital between April 2006 and March 2015. There were 3826, 1754 and 719 women who delivered with supine, lateral and fours postures. The rate of no laceration in the women who delivered with lateral posture was significant lower than that in the women who delivered with supine posture (OR 0.630, 95% CI 0.56-0.71, p < 0.01); however, the incidence of perineal laceration in the women who delivered with lateral posture was significant lower than that in the women who delivered with supine posture (OR 0.856, 95% CI 0.76-0.90, p < 0.01). The incidence of perineal laceration of third- or fourth-degree in the women who delivered with fours posture was significant higher than that in the women who delivered with supine posture (OR 2.28, 95% CI 1.2-4.2, p < 0.01). The current results may be to help for self-determination of birthing postures in prenatal women.

  20. A cluster-randomised trial of a multifaceted quality improvement intervention in Brazilian intensive care units (Checklist-ICU trial): statistical analysis plan.

    Science.gov (United States)

    Damiani, Lucas P; Cavalcanti, Alexandre B; Moreira, Frederico R; Machado, Flavia; Bozza, Fernando A; Salluh, Jorge I F; Campagnucci, Valquiria P; Normilio-Silva, Karina; Chiattone, Viviane C; Angus, Derek C; Berwanger, Otavio; Chou H Chang, Chung-

    2015-06-01

    The Checklist During Multidisciplinary Visits for Reduction of Mortality in Intensive Care Units (Checklist- ICU) trial is a pragmatic, two-arm, cluster-randomised trial involving 118 intensive care units in Brazil, with the primary objective of determining if a multifaceted qualityimprovement intervention with a daily checklist, definition of daily care goals during multidisciplinary daily rounds and clinician prompts can reduce inhospital mortality. To describe our trial statistical analysis plan (SAP). This is an ongoing trial conducted in two phases. In the preparatory observational phase, we collect three sets of baseline data: ICU characteristics; patient characteristics, processes of care and outcomes; and completed safety attitudes questionnaires (SAQs). In the randomised phase, ICUs are assigned to the experimental or control arms and we collect patient data and repeat the SAQ. Our SAP includes the prespecified model for the primary and secondary outcome analyses, which account for the cluster-randomised design and availability of baseline data. We also detail the multiple mediation models that we will use to assess our secondary hypothesis (that the effect of the intervention on inhospital mortality is mediated not only through care processes targeted by the checklist, but also through changes in safety culture). We describe our approach to sensitivity and subgroup analyses and missing data. We report our SAP before closing our study database and starting analysis. We anticipate that this should prevent analysis bias and enhance the utility of results.

  1. Intertwining of birth-and-death processes

    Czech Academy of Sciences Publication Activity Database

    Swart, Jan M.

    2011-01-01

    Roč. 47, č. 1 (2011), s. 1-14 ISSN 0023-5954 R&D Projects: GA ČR GA201/09/1931 Institutional research plan: CEZ:AV0Z10750506 Keywords : Intertwining of Markov process es * birth and death process * averaged Markov process * first passage time * coupling * eigenvalues Subject RIV: BA - General Mathematics Impact factor: 0.454, year: 2011 http://library.utia.cas.cz/separaty/2011/SI/swart-intertwining of birth- and -death process es.pdf

  2. Particular intervention plan of the national defense nuclear facilities of Brest and Ile Longue as approved by order of the Prefect no. 2013205-0001 on July 24, 2013

    International Nuclear Information System (INIS)

    2013-01-01

    The Particular intervention plan (PPI in French) is an emergency plan which foresees the measures and means to be implemented to address the potential risks of the presence and operation of a nuclear facility. This plan is implemented and developed by the Prefect in case of nuclear accident (or incident leading to a potential accident), the impact of which extending beyond the facility perimeter. It represents a special section of the organisation plan for civil protection response (ORSEC plan). The PPI foresees the necessary measures and means for crisis management during the first hours following the accident and is triggered by the Department Prefect according to the information provided by the facility operator. Its aim is to protect the populations leaving within 10 km of the facility against a potential radiological hazard. The PPI describes: the facility, the intervention area, the protection measures for the population, the conditions of emergency plan triggering, the crisis organisation, the action forms of the different services, and the post-accident stage. This document is the public version of the Particular intervention plan of the national defense nuclear facilities of Brest and Ile Longue naval bases (Brittany, France). It comprises 2 parts: an operational part describing the actions to take in case of emergency, and a complementary part describing the facilities and the possible risks for the Brest and Crozon peninsula areas

  3. Transition from the Lactational Amenorrhea Method to other modern family planning methods in rural Bangladesh: barrier analysis and implications for behavior change communication program intervention design.

    Science.gov (United States)

    Kouyaté, Robin Anthony; Ahmed, Salahuddin; Haver, Jaime; McKaig, Catharine; Akter, Nargis; Nash-Mercado, Angela; Baqui, Abdullah

    2015-06-01

    The timely transition from Lactational Amenorrhea Method (LAM)(2) to another modern family planning method contributes to healthy spacing of pregnancies by increasing the adoption of family planning during the first year postpartum. Yet, literature suggests challenges in completing a timely LAM transition. To guide program implementation in Bangladesh, this study identified factors influencing women's transition decisions. Eighty postpartum women, comprising 40 who transitioned from LAM(3) and 40 who did not,(4) participated. Half of each group participated in in-depth interviews to explore the decision-making process. All participants responded to a "Barrier Analysis" questionnaire to identify differences in eight behavioral determinants. More than half of transitioners switched to another modern method before or within the same month that LAM ended. Of the 18 transitioners who delayed,(5) 15 waited for menses to return. For non-transitioners, key barriers included waiting for menses to return, misconceptions on return to fertility, and perceived lack of familial support. The LAM transition can help women prevent unintended pregnancy during the first year postpartum. Increased emphasis on counseling women about the risk of pregnancy, and misconceptions about personal fertility patterns are critical for facilitating the transition. Strategies should also include interventions that train health workers and improve social support. Copyright © 2015. Published by Elsevier Ltd.

  4. Recovering from Birth

    Science.gov (United States)

    ... Know your pregnancy rights Getting ready for baby Birthing, breastfeeding, and parenting classes Breastfeeding Circumcision Health care for baby Making your home safe for baby Last-minute to-dos Childbirth ...

  5. Labor and Birth

    Science.gov (United States)

    ... Know your pregnancy rights Getting ready for baby Birthing, breastfeeding, and parenting classes Breastfeeding Circumcision Health care for baby Making your home safe for baby Last-minute to-dos Childbirth ...

  6. Contraception and Birth Control

    Science.gov (United States)

    ... NICHD Research Information Find a Study More Information Pharmacology Condition Information NICHD Research Information Find a Study ... discuss birth control methods with one’s sexual partner. General methods of contraception include: Barrier —physically interferes with ...

  7. Preterm Labor and Birth

    Science.gov (United States)

    ... NICHD Research Information Find a Study More Information Pharmacology Condition Information NICHD Research Information Find a Study ... Pinterest Email Print Preterm Labor and Birth In general, a normal human pregnancy lasts about 40 weeks, ...

  8. Birth Control Patch

    Science.gov (United States)

    ... Things That Help Feelings Expert Answers Q&A Movies & More for Teens Teens site Sitio para adolescentes ... and effective method of birth control. Most young women who use the patch have no side effects. ...

  9. Theoretical domains framework to assess barriers to change for planning health care quality interventions: a systematic literature review.

    Science.gov (United States)

    Mosavianpour, Mirkaber; Sarmast, Hamideh Helen; Kissoon, Niranjan; Collet, Jean-Paul

    2016-01-01

    Theoretical domains framework (TDF) provides an integrative model for assessing barriers to behavioral changes in order to suggest interventions for improvement in behavior and ultimately outcomes. However, there are other tools that are used to assess barriers. The objective of this study is to determine the degree of concordance between domains and constructs identified in two versions of the TDF including original (2005) and refined version (2012) and independent studies of other tools. We searched six databases for articles that studied barriers to health-related behavior changes of health care professionals or the general public. We reviewed quantitative papers published in English which included their questionnaires in the article. A table including the TDF domains of both original and refined versions and related constructs was developed to serve as a reference to describe the barriers assessed in the independent studies; descriptive statistics were used to express the results. Out of 552 papers retrieved, 50 were eligible to review. The barrier domains explored in these articles belonged to two to eleven domains of the refined TDF. Eighteen articles (36%) used constructs outside of the refined version. The spectrum of barrier constructs of the original TDF was broader and could meet the domains studied in 48 studies (96%). Barriers in domains of "environmental context and resources", "beliefs about consequences", and "social influences" were the most frequently explored in 42 (84%), 37 (74%), and 33 (66%) of the 50 articles, respectively. Both refined and original TDFs cataloged barriers measured by the other studies that did not use TDF as their framework. However, the original version of TDF explored a broader spectrum of barriers than the refined version. From this perspective, the original version of the TDF seems to be a more comprehensive tool for assessing barriers in practice.

  10. Hypnotherapy for birth.

    Science.gov (United States)

    Howell, Maggie

    2014-05-01

    There are many misunderstandings about hypnotherapy for birth and how best to support a woman who has chosen to use it. This article brings together experiences of midwives who have attended women in labour using hypnotherapy, and aims to help birth professionals understand a bit more about hypnotherapy and how they can best support women who are using it. It is a personal account from a hypnotherapy trainer reflecting on her encounters with midwives as they share experiences of observing hypnotherapy in action.

  11. Supporting women during labor and birth.

    Science.gov (United States)

    Stager, Leslie

    For many women, the essential ingredients for a safe and satisfying birth include a sense of empowerment and success in coping with or transcending the experience, in addition to having solid, positive encouragement from a support companion. The massage practitioner can enhance these ingredients by adding knowledgeable, caring touch which can decrease pain, increase relaxation, speed labor, and reduce medical interventions. Serving women in labor, witnessing a baby's birth, and positively influencing a mother's responsiveness to her infant are unique and powerful opportunities. Being invited to serve in this capacity indicates that you have skill in helping a woman feel at ease. Keep in mind that your presence and loving touch may have a deeper impact on your client than you even realize, as your presence will forever be a part of her and her child's birth story.

  12. Investigation of educational intervention based on Theory of Planned Behavior on breakfast consumption among middle school students of Qom City in 2012.

    Science.gov (United States)

    Gharlipour, Zabihollah; Ghaffari, Mohtasham; Hoseini, Zahra; Heidarabadi, Akbar Babaei; Tavassoli, Elahe; Hozuri, Mohammad; Jang, Shahram Arsang; Reisi, Mahnoush; Sahraiyan, Maryam

    2015-01-01

    Eating breakfast is crucial for adolescents to be healthy. It also improves students' capacity of learning and doing school homework. Although healthy habits such as eating breakfast, weight control, and regular sleep increase the lifespan in adults, the effects of healthy habits on school-age children have not been studied much. The present study aimed at investigating the impact of an educational program based on Theory of Planned Behavior (TPB) on eating breakfast among middle school students. This interventional study was conducted on sixth-grade students in Qom City during the academic year 2012-2013. First, 97 students were randomly assigned to the experimental group and 97 other students were assigned to the control group. Then, a questionnaire was developed on eating breakfast by the researchers according to the TPB. A pilot study was conducted to assess the reliability of the questionnaire. To assess the validity of the questionnaire, advice by a panel of experts was sought. To carry out a pre-test, both groups answered the questions. After analyzing the pre-test results, the required content was developed for the experimental group. Educational methods included delivering speech, discussion groups, pamphlets, and posters. The required educationalcontent was provided for students during five sessions and for parents in one session. To determine the effect of educational intervention, a post-test study was carried out 2 months after the intervention. Collected data were analyzed using independent t-test, χ,([2]) and repeated measures. In the experimental group, 36.7% of students were eating breakfast at least in a day of a week, before educational intervention. After implementation of the educational program, only 32.7% of them were continuing their past habit. There was a significant difference between themean scores of attitudes, perceived behavioral control, intention, and practice of eating breakfast in the experimental and control groups (P students

  13. Prevention of Postpartum Hemorrhage: Options for Home Births in ...

    African Journals Online (AJOL)

    This paper sought to determine the safety and feasibility of home-based prophylaxis of postpartum hemorrhage (PPH) with misoprostol, including assessment of the need for referrals and additional interventions. In rural Tigray, Ethiopia, traditional birth attendants (TBAs) in intervention areas were trained to administer ...

  14. Effect of Loading Dose of Atorvastatin Prior to Planned Percutaneous Coronary Intervention on Major Adverse Cardiovascular Events in Acute Coronary Syndrome: The SECURE-PCI Randomized Clinical Trial.

    Science.gov (United States)

    Berwanger, Otavio; Santucci, Eliana Vieira; de Barros E Silva, Pedro Gabriel Melo; Jesuíno, Isabella de Andrade; Damiani, Lucas Petri; Barbosa, Lilian Mazza; Santos, Renato Hideo Nakagawa; Laranjeira, Ligia Nasi; Egydio, Flávia de Mattos; Borges de Oliveira, Juliana Aparecida; Dall Orto, Frederico Toledo Campo; Beraldo de Andrade, Pedro; Bienert, Igor Ribeiro de Castro; Bosso, Carlos Eduardo; Mangione, José Armando; Polanczyk, Carisi Anne; Sousa, Amanda Guerra de Moraes Rego; Kalil, Renato Abdala Karam; Santos, Luciano de Moura; Sposito, Andrei Carvalho; Rech, Rafael Luiz; Sousa, Antônio Carlos Sobral; Baldissera, Felipe; Nascimento, Bruno Ramos; Giraldez, Roberto Rocha Corrêa Veiga; Cavalcanti, Alexandre Biasi; Pereira, Sabrina Bernardez; Mattos, Luiz Alberto; Armaganijan, Luciana Vidal; Guimarães, Hélio Penna; Sousa, José Eduardo Moraes Rego; Alexander, John Hunter; Granger, Christopher Bull; Lopes, Renato Delascio

    2018-04-03

    The effects of loading doses of statins on clinical outcomes in patients with acute coronary syndrome (ACS) and planned invasive management remain uncertain. To determine if periprocedural loading doses of atorvastatin decrease 30-day major adverse cardiovascular events (MACE) in patients with ACS and planned invasive management. Multicenter, double-blind, placebo-controlled, randomized clinical trial conducted at 53 sites in Brazil among 4191 patients with ACS evaluated with coronary angiography to proceed with a percutaneous coronary intervention (PCI) if anatomically feasible. Enrollment occurred between April 18, 2012, and October 6, 2017. Final follow-up for 30-day outcomes was on November 6, 2017. Patients were randomized to receive 2 loading doses of 80 mg of atorvastatin (n = 2087) or matching placebo (n = 2104) before and 24 hours after a planned PCI. All patients received 40 mg of atorvastatin for 30 days starting 24 hours after the second dose of study medication. The primary outcome was MACE, defined as a composite of all-cause mortality, myocardial infarction, stroke, and unplanned coronary revascularization through 30 days. Among the 4191 patients (mean age, 61.8 [SD, 11.5] years; 1085 women [25.9%]) enrolled, 4163 (99.3%) completed 30-day follow-up. A total of 2710 (64.7%) underwent PCI, 333 (8%) underwent coronary artery bypass graft surgery, and 1144 (27.3%) had exclusively medical management. At 30 days, 130 patients in the atorvastatin group (6.2%) and 149 in the placebo group (7.1%) had a MACE (absolute difference, 0.85% [95% CI, -0.70% to 2.41%]; hazard ratio, 0.88; 95% CI, 0.69-1.11; P = .27). No cases of hepatic failure were reported; 3 cases of rhabdomyolysis were reported in the placebo group (0.1%) and 0 in the atorvastatin group. Among patients with ACS and planned invasive management with PCI, periprocedural loading doses of atorvastatin did not reduce the rate of MACE at 30 days. These findings do not support the routine use

  15. Helping mothers survive bleeding after birth

    DEFF Research Database (Denmark)

    Nelissen, Ellen; Ersdal, Hege; Ostergaard, Doris

    2014-01-01

    OBJECTIVE: To evaluate "Helping Mothers Survive Bleeding After Birth" (HMS BAB) simulation-based training in a low-resource setting. DESIGN: Educational intervention study. SETTING: Rural referral hospital in Northern Tanzania. POPULATION: Clinicians, nurse-midwives, medical attendants, and ambul......OBJECTIVE: To evaluate "Helping Mothers Survive Bleeding After Birth" (HMS BAB) simulation-based training in a low-resource setting. DESIGN: Educational intervention study. SETTING: Rural referral hospital in Northern Tanzania. POPULATION: Clinicians, nurse-midwives, medical attendants...... low (3% pass rate for basic delivery and management of postpartum hemorrhage). CONCLUSIONS: The HMS BAB simulation-based training has potential to contribute to education of health care providers. We recommend a full day of training and validation of the facilitators to improve the training....

  16. Birth Order and Child Health

    OpenAIRE

    Lundberg, Evelina; Svaleryd, Helena

    2017-01-01

    Previous research has established that birth order affects outcomes such as educational achievements, IQ and earnings. The mechanisms behind these effects are, however, still largely unknown. In this paper, we examine birth-order effects on health, and whether health at young age could be a transmission channel for birth-order effects observed later in life. We find no support for the birth-order effect having a biological origin; rather firstborns have worse health at birth. This disadvantag...

  17. Prevention of preterm birth.

    LENUS (Irish Health Repository)

    Flood, Karen

    2012-02-01

    Preterm birth (delivery before 37 completed weeks of gestation) is common and rates are increasing. In the past, medical efforts focused on ameliorating the consequences of prematurity rather than preventing its occurrence. This approach resulted in improved neonatal outcomes, but it remains costly in terms of both the suffering of infants and their families and the economic burden on society. Increased understanding of the pathophysiology of preterm labor has altered the approach to this problem, with increased focus on preventive strategies. Primary prevention is a limited strategy which involves public education, smoking cessation, improved nutritional status and avoidance of late preterm births. Secondary prevention focuses on recurrent preterm birth which is the most recognisable risk factor. Widely accepted strategies include cervical cerclage, progesterone and dedicated clinics. However, more research is needed to explore the role of antibiotics and anti-inflammatory treatments in the prevention of this complex problem.

  18. Birth room images

    DEFF Research Database (Denmark)

    Bowden, Calida; Sheehan, Athena; Foureur, Maralyn Jean

    2016-01-01

    and implications for practice: as images on the Internet inform and persuade society about stereotypical behaviours, the trends of our time and sociocultural norms, it is important to recognise images of the technological birth room on the Internet may be influential in dictating women's attitudes, choices......Objective: this study examined images of birth rooms in developed countries to analyse the messages and visual discourse being communicated through images. Design: a small qualitative study using Kress and van Leeuwen's (2006) social semiotic theoretical framework for image analysis, a form...... of discourse analysis. Setting/participants: forty images of birth rooms were collected in 2013 from Google Images, Flickr, Wikimedia Commons and midwifery colleagues. The images were from obstetric units, alongside and freestanding midwifery units located in developed countries (Australia, Canada, Europe, New...

  19. Genomics of Preterm Birth

    Science.gov (United States)

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

    2015-01-01

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

  20. Birth outcomes for women using free-standing birth centers in South Auckland, New Zealand.

    Science.gov (United States)

    Bailey, David John

    2017-09-01

    This study investigates maternal and perinatal outcomes for women with low-risk pregnancies laboring in free-standing birth centers compared with laboring in a hospital maternity unit in a large New Zealand health district. The study used observational data from 47 381 births to women with low-risk pregnancies in South Auckland maternity facilities 2003-2010. Adjusted odds ratios with 95% confidence intervals were calculated for instrumental delivery, cesarean section, blood transfusion, neonatal unit admission, and perinatal mortality. Labor in birth centers was associated with significantly lower rates of instrumental delivery, cesarean section and blood transfusion compared with labor in hospital. Neonatal unit admission rates were lower for infants of nulliparous women laboring in birth centers. Intrapartum and neonatal mortality rates for birth centers were low and were not significantly different from the hospital population. Transfers to hospital for labor and postnatal complications occurred in 39% of nulliparous and 9% of multiparous labors. Risk factors identified for transfer were nulliparity, advanced maternal age, and prolonged pregnancy ≥41 weeks' gestation. Labor in South Auckland free-standing birth centers was associated with significantly lower maternal intervention and complication rates than labor in the hospital maternity unit and was not associated with increased perinatal morbidity. © 2017 Wiley Periodicals, Inc.

  1. Effectiveness of the Self-Regulation eHealth Intervention "MyPlan1.0." on Physical Activity Levels of Recently Retired Belgian Adults: A Randomized Controlled Trial

    Science.gov (United States)

    Van Dyck, Delfien; Plaete, Jolien; Cardon, Greet; Crombez, Geert; De Bourdeaudhuij, Ilse

    2016-01-01

    The study purpose was to test the effectiveness of the self-regulation eHealth intervention "MyPlan1.0." to increase physical activity (PA) in recently retired Belgian adults. This study was a randomized controlled trial with three points of follow-up/modules (baseline to 1-week to 1-month follow-up). In total, 240 recently retired…

  2. Seeking control in the midst of uncertainty: Women's experiences of choosing mode of birth after caesarean.

    Science.gov (United States)

    Munro, Sarah; Janssen, Patricia; Corbett, Kitty; Wilcox, Elizabeth; Bansback, Nick; Kornelsen, Jude

    2017-04-01

    Clinical practice guidelines indicate that over 80% of women with a previous caesarean should be offered a planned vaginal birth after caesarean (VBAC), however only one third of eligible women choose to plan a VBAC. To support informed choices for birth after caesarean, it is necessary to understand the factors that influence women's decision-making. The goal of this study was to explore attitudes towards and experiences with decision-making for mode of delivery after caesarean from the perspectives of Canadian women. In-depth, semi-structured interviews were conducted with 23 women eligible for VBAC in three rural and two urban communities in British Columbia, Canada, during summer 2015. Constructivist grounded theory informed iterative data collection and analysis. Women's decision-making experiences were a process of "seeking control in the midst of uncertainty." Women formed early preferences for mode of delivery after their primary caesareans and engaged in careful deliberation during their inter-pregnancy interval, consisting of: reflecting on their birth, clarifying their values, becoming informed, considering the feasibility of options, deliberating with the care team, and making an actual choice. Women struggled to make trade-offs between having a healthy baby and social attributes of delivery, such as uninterrupted bonding with their newborn. Women begin decision-making for birth after caesarean earlier than previously reported and their choices are influenced by personal experience and psychosocial concerns. Future interventions to support choice of mode of delivery should begin early after the primary caesarean, to reflect when women begin to form preferences. Copyright © 2016 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  3. Media Representations of Breech Birth: A Prospective Analysis of Web-Based News Reports.

    Science.gov (United States)

    Petrovska, Karolina; Sheehan, Athena; Homer, Caroline S E

    2017-07-01

    Recent research has demonstrated that the media presentation of childbirth is highly medicalized, often portraying birth as risky and dramatic. Media representation of breech presentation and birth is unexplored in this context. This study aimed to explore the content and tone of news media reports relating to breech presentation and breech birth. Google alerts were created using the terms breech and breech birth in online English-language news sites over a 3-year period from January 1, 2013, to December 31, 2015. Alerts were received daily and filed for analysis, and data were analyzed to generate themes. A total of 138 web-based news reports were gathered from 9 countries. Five themes that arose from the data included the problem of breech presentation, the high drama of vaginal breech birth, the safe option of cesarean birth versus dangers of vaginal breech birth, the defiant mother versus the saintly mother, and vaginal breech birth and medical misadventure. Media reports in this study predominantly demonstrated negative views toward breech presentation and vaginal breech birth. Cesarean birth was portrayed as the safe option for breech birth, while vaginal breech birth was associated with poor outcomes. Media presentations may impact decision making about mode of birth for pregnant women with a breech fetus. Health care providers can play an important role in balancing the media depiction of planned vaginal breech birth by providing nonjudgmental, evidence-based information to such women to facilitate informed decision making for birth. © 2017 by the American College of Nurse-Midwives.

  4. Cerebral oxygenation after birth

    DEFF Research Database (Denmark)

    Hessel, Trine W; Hyttel-Sorensen, Simon; Greisen, Gorm

    2014-01-01

    AIM: To compare absolute values of regional cerebral tissue oxygenation (cStO2 ) during haemodynamic transition after birth and repeatability during steady state for two commercial near-infrared spectroscopy (NIRS) devices. METHODS: In a prospective observational study, the INVOS 5100C and FORE......: The INVOS and FORE-SIGHT cStO2 estimates showed oxygenation-level-dependent difference during birth transition. The better repeatability of FORE-SIGHT could be due to the lower response to change in saturation....

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

    African Journals Online (AJOL)

    elearning

    Columbia, China, India and Bangladesh have successfully applied family planning programs as a panacea for overpopulation14, 15. Nigeria has also adopted ..... WOA (World Overpopulation Awareness. www.overpopulation org. visited 27/1/07. 8. Illingworth, B. Birth control in developing nations. Planned Parenthood.

  6. The birth and routinization of IVF in China

    DEFF Research Database (Denmark)

    Wahlberg, Ayo

    2016-01-01

    comprehensive family planning programmes aimed at preventing birth was being rolled out. IVF was not merely imported into China, rather it was experimentally developed within China into a form suitable for its restrictive family planning regulations. As a result, IVF and other assisted reproductive technologies...

  7. To Each According to His Birth

    Czech Academy of Sciences Publication Activity Database

    Smith, Michael

    -, - (2006) ISSN 1214-1615 Institutional research plan: CEZ:AV0Z70280505 Keywords : education Subject RIV: AO - Sociology, Demography http://www.tol.cz/look/TOL/article.tpl?IdLanguage=1&IdPublication=4&NrIssue=164&NrSection=2&NrArticle=16850&search=search&SearchKeywords=To+Each+According+to+His+Birth&SearchMode=on&SearchLevel=0

  8. Using the theory of planned behaviour to develop targets for interventions to enhance patient communication during pharmacy consultations for non-prescription medicines.

    Science.gov (United States)

    Watson, Margaret C; Johnston, Marie; Entwistle, Vikki; Lee, Amanda J; Bond, Christine M; Fielding, Shona

    2014-12-01

    To identify modifiable factors that influence patients' information-giving behaviour about their health during consultations with pharmacy staff. A theory of planned behaviour questionnaire was posted to 3000 individuals randomly selected from the Scottish Electoral Register. The 927 respondents confirmed a low rate of disclosure of information about their health to pharmacy staff during their last pharmacy visit. Individuals who intended to give information about their health during pharmacy consultations were more likely to do so. Those who intended to give information during consultations had higher subjective norms than those who did not (i.e. intentions were associated with beliefs that people who were important to them, e.g. family members, doctors, thought they should give information during these consultations). Control beliefs, e.g. 'I am confident that I will give information if I have received good advice in the past', and behavioural beliefs, e.g. 'If I give information I will be sold an appropriate medicine', were not associated with intention or behaviour. Future interventions to promote relevant communication between patients and pharmacy staff should target patients' subjective norms rather than control beliefs or behavioural beliefs. © 2014 Royal Pharmaceutical Society.

  9. Assessment and support during early labour for improving birth outcomes.

    Science.gov (United States)

    Kobayashi, Shinobu; Hanada, Nobutsugu; Matsuzaki, Masayo; Takehara, Kenji; Ota, Erika; Sasaki, Hatoko; Nagata, Chie; Mori, Rintaro

    2017-04-20

    The progress of labour in the early or latent phase is usually slow and may include painful uterine contractions. Women may feel distressed and lose their confidence during this phase. Support and assessment interventions have been assessed in two previous Cochrane Reviews. This review updates and replaces these two reviews, which have become out of date. To investigate the effectiveness of assessment and support interventions for women during early labour.In order to measure the effectiveness of the interventions, we compared the duration of labour, the rate of obstetrical interventions, and the rate of other maternal or neonatal outcomes. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register, ClinicalTrials.gov, the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (31 October 2016) and reference lists of retrieved studies. Randomised controlled trials of any assessment or support intervention in the latent phase of labour. We planned to include cluster-randomised trials if they were eligible. We did not include quasi-randomised trials. Two review authors independently assessed trials for inclusion and risk of bias, extracted data and checked them for accuracy. We resolved any disagreement by discussion or by involving a third assessor. The quality of the evidence was assessed using the GRADE approach. We included five trials with a total of 10,421 pregnant women in this review update. The trials were conducted in the UK, Canada and America. The trials compared interventions in early labour versus usual care. We examined three comparisons: early labour assessment versus immediate admission to hospital; home visits by midwives versus usual care (telephone triage); and one-to-one structured midwifery care versus usual care. These trials were at moderate- risk of bias mainly because blinding women and staff to these interventions is not generally feasible. For important outcomes we assessed evidence using

  10. Birth Order Debate Resolved?

    Science.gov (United States)

    Zajonc, R. B.

    2001-01-01

    Critiques Rodgers et al.'s June 2000 research on the relation between birth order and intelligence, which suggests that it is a methodological illusion. Explains how the intellectual environment and the teaching function (whereby older children tutor younger ones) contribute to the growth of intellectual maturity, the first negatively and the…

  11. Finding Autonomy in Birth*

    Science.gov (United States)

    Kukla, Rebecca; Kuppermann, Miriam; Little, Margaret; Lyerly, Anne Drapkin; Mitchell, Lisa M; Armstrong, Elizabeth M.; Harris, Lisa

    2009-01-01

    Over the last several years, as cesarean deliveries have grown increasingly common, there has been a great deal of public and professional interest in the phenomenon of women ‘choosing’ to deliver by cesarean section in the absence of any specific medical indication. The issue has sparked intense conversation, as it raises questions about the nature of autonomy in birth. Whereas mainstream bioethical discourse is used to associating autonomy with having a large array of choices, this conception of autonomy does not seem adequate to capture concerns and intuitions that have a strong grip outside of this discourse. An empirical and conceptual exploration of how delivery decisions ought to be negotiated must be guided by a rich understanding of women’s agency and its placement within a complicated set of cultural meanings and pressures surrounding birth. It is too early to be ‘for’ or ‘against’ women’s access to cesarean delivery in the absence of traditional medical indications - and indeed, a simple pro- or con- position is never going to do justice to the subtlety of the issue. The right question is not whether women ought to be allowed to choose their delivery approach, but rather, taking the value of women’s autonomy in decision-making around birth as a given, what sorts of guidelines, practices, and social conditions will best promote and protect women’s full inclusion in a safe and positive birth process. PMID:19076937

  12. Better Births Initiative

    African Journals Online (AJOL)

    Ensuring that health professionals practise according to evidence-based standards is important since it affects the quality and cost of care patients receive. The purpose of this research was to use a focused change programme (the Better Births Initiative) to influence obstetric practice at 10 hospitals in Gauteng, South Africa.

  13. A hugh marketing research task: birth control.

    Science.gov (United States)

    Simon, J L

    1968-02-01

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

  14. Effects of Intimate Partner Physical Violence on Newborns' Birth Outcomes Among Jordanian Birthing Women.

    Science.gov (United States)

    Abujilban, Sanaa; Mrayan, Lina; Al-Modallal, Hanan; Isaa, Esra'a

    2015-09-07

    Intimate partner physical violence against women (VAW) during pregnancy is a common experience all over the world. In Jordan, the number is double the reported international average. Data on effect of violence on birth outcomes are important for planning, implementing, and evaluating maternal health programs. The research question was, "Does intimate partner physical VAW during pregnancy increase the risk of negative birth outcomes for newborns among birthing women in Jordan?" Natural experiment design was used for this study. A consecutive sampling technique was used for selecting the victims of physical violence (n = 79) and a simple random sampling for selecting non-victims (n = 79). Intimate partner physical violence was measured by using the Arabic version of World Health Organization's (WHO) domestic violence questionnaire, which has an accepted interrater validity. Analysis of covariance (ANCOVA) and chi-square were used to detect the differences in birth outcomes between the victims and non-victims of physical violence. The results showed that there is a significant difference in newborn's birth weight between the victims of violence and non-victims with a small effect size. However, there were no significant differences between the two groups in preterm birth and assisted newborn ventilation. The non-significant effect of violence on the incidence of preterm birth contradicts the published literature. Intimate partner violence (IPV) is rooted in Jordanian culture and widely accepted among married Jordanian women. Midwives, doctors, educators, and policy makers should work together to eradicate violence and detect victims of it, to improve birth outcomes and decrease newborn morbidity and mortality rates. © The Author(s) 2015.

  15. The immune consequences of preterm birth

    Directory of Open Access Journals (Sweden)

    Jacqueline M Melville

    2013-05-01

    Full Text Available Preterm birth occurs in 11% of live births globally and accounts for 35% of all newborn deaths. Preterm newborns have immature immune systems, with reduced innate and adaptive immunity; their immune systems may be further compromised by various factors associated with preterm birth.The immune systems of preterm infants have a smaller pool of monocytes and neutrophils, impaired ability of these cells to kill pathogens, and lower production of cytokines which limits T cell activation and reduces the ability to fight bacteria and detect viruses in cells, compared to term infants.Intrauterine inflammation is a major contributor to preterm birth, and causes premature immune activation and cytokine production. This can induce immune tolerance leading to reduced newborn immune function. Intrauterine inflammation is associated with an increased risk of early-onset sepsis and likely has long-term adverse immune consequences.Requisite medical interventions further impact on immune development and function. Antenatal corticosteroid treatment to prevent newborn respiratory disease is routine but may be immunosuppressive, and has been associated with febrile responses, reductions in lymphocyte proliferation and cytokine production, and increased risk of infection. Invasive medical procedures result in an increased risk of late-onset sepsis. Respiratory support can cause chronic inflammatory lung disease associated with increased risk of long-term morbidity.Colonisation of the infant by microorganisms at birth is a significant contributor to the establishment of the microbiome. Caesarean section affects infant colonisation, potentially contributing to lifelong immune function and wellbeing.Several factors associated with preterm birth alter immune function. A better understanding of perinatal modification of the preterm immune system will allow for the refinement of care to minimise lifelong adverse immune consequences.

  16. Why do women choose an unregulated birth worker to birth at home in Australia: a qualitative study.

    Science.gov (United States)

    Rigg, Elizabeth Christine; Schmied, Virginia; Peters, Kath; Dahlen, Hannah Grace

    2017-03-28

    In Australia the choice to birth at home is not well supported and only 0.4% of women give birth at home with a registered midwife. Recent changes to regulatory requirements for midwives have become more restrictive and there is no insurance product that covers private midwives for intrapartum care at home. Freebirth (planned birth at home with no registered health professional) with an unregulated birth worker who is not a registered midwife or doctor (e.g. Doula, ex-midwife, lay midwife etc.) appears to have increased in Australia. The aim of this study is to explore the reasons why women choose to give birth at home with an unregulated birth worker (UBW) from the perspective of women and UBWs. Nine participants (five women who had UBWs at their birth and four UBWs who had themselves used UBWs in the past for their births) were interviewed in-depth and the data analysed using thematic analysis. Four themes were found: 'A traumatising system', 'An inflexible system'; 'Getting the best of both worlds' and 'Treated with love and respect versus the mechanical arm on the car assembly line'. Women interviewed for this study either experienced or were exposed to mainstream care, which they found traumatising. They were not able to access their preferred birth choices, which caused them to perceive the system as inflexible. They interpreted this as having no choice when choice was important to them. The motivation then became to seek alternative options of care that would more appropriately meet their needs, and help avoid repeated trauma through mainstream care. Women who engaged UBWs viewed them as providing the best of both worlds - this was birthing at home with a knowledgeable person who was unconstrained by rules or regulations and who respected and supported the woman's philosophical view of birth. Women perceived UBWs as not only the best opportunity to achieve a natural birth but also as providing 'a safety net' in case access to emergency care was required.

  17. 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

  18. ["Medical Texts and Jorunals," and Resources on "Prenatal Risk,""Premature and Low Birthweight Infants,""Infant Nutrition and Breastfeeding"; "Effectiveness of Early Intervention." IPHA Birth-to-Three Clearinghouse Bibliographies 5, 6, 7, 8, and 10.

    Science.gov (United States)

    Illinois Public Health Association, Springfield.

    Five separate bibliographies present citations of resources regarding prenatal risk, premature and low birthweight infants, infant nutrition and breastfeeding, and early intervention for infants with disabilities. The first bibliography lists 133 references from medical texts and journals regarding child development, disabilities, diagnosis, and…

  19. Births: Final Data for 2012

    Science.gov (United States)

    ... characteristics. Data are presented for maternal age, live-birth order, race and Hispanic origin, marital status, attendant at ... and fertility rates are presented by age, live-birth order, race and Hispanic origin, and marital status. Selected ...

  20. Birth control - slow release methods

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/007555.htm Birth control - slow release methods To use the sharing features on this page, please enable JavaScript. Certain birth control methods contain man-made forms of hormones. ...

  1. Effectiveness, Mediators, and Effect Predictors of Internet Interventions for Chronic Cancer-Related Fatigue : The Design and an Analysis Plan of a 3-Armed Randomized Controlled Trial

    NARCIS (Netherlands)

    Wolvers, Marije Dj; Bruggeman-Everts, Fieke Z; Van der Lee, Marije L; Van de Schoot, Rens; Vollenbroek-Hutten, Miriam Mr

    2015-01-01

    BACKGROUND: Internet interventions offer advantages that especially cancer survivors who suffer from fatigue could benefit from. Given the growing number of such patients, Internet interventions could supplement and strengthen currently available health care. OBJECTIVE: This paper describes the

  2. Cluster Randomized Controlled Trial Evaluation of a Gender Equity and Family Planning Intervention for Married Men and Couples in Rural India.

    Science.gov (United States)

    Raj, Anita; Ghule, Mohan; Ritter, Julie; Battala, Madhusudana; Gajanan, Velhal; Nair, Saritha; Dasgupta, Anindita; Silverman, Jay G; Balaiah, Donta; Saggurti, Niranjan

    2016-01-01

    Despite ongoing recommendations to increase male engagement and gender-equity (GE) counseling in family planning (FP) services, few such programs have been implemented and rigorously evaluated. This study evaluates the impact of CHARM, a three-session GE+FP counseling intervention delivered by male health care providers to married men, alone (sessions 1&2) and with their wives (session 3) in India. A two-armed cluster randomized controlled trial was conducted with young married couples (N = 1081 couples) recruited from 50 geographic clusters (25 clusters randomized to CHARM and a control condition, respectively) in rural Maharashtra, India. Couples were surveyed on demographics, contraceptive behaviors, and intimate partner violence (IPV) attitudes and behaviors at baseline and 9 &18-month follow-ups, with pregnancy testing at baseline and 18-month follow-up. Outcome effects on contraceptive use and incident pregnancy, and secondarily, on contraceptive communication and men's IPV attitudes and behaviors, were assessed using logistic generalized linear mixed models. Most men recruited from CHARM communities (91.3%) received at least one CHARM intervention session; 52.5% received the couple's session with their wife. Findings document that women from the CHARM condition, relative to controls, were more likely to report contraceptive communication at 9-month follow-up (AOR = 1.77, p = 0.04) and modern contraceptive use at 9 and 18-month follow-ups (AORs = 1.57-1.58, p = 0.05), and they were less likely to report sexual IPV at 18-month follow-up (AOR = 0.48, p = 0.01). Men in the CHARM condition were less likely than those in the control clusters to report attitudes accepting of sexual IPV at 9-month (AOR = 0.64, p = 0.03) and 18-month (AOR = 0.51, p = 0.004) follow-up, and attitudes accepting of physical IPV at 18-month follow-up (AOR = 0.64, p = 0.02). No significant effect on pregnancy was seen. Findings demonstrate that men can be engaged in FP programming in rural

  3. Cluster Randomized Controlled Trial Evaluation of a Gender Equity and Family Planning Intervention for Married Men and Couples in Rural India.

    Directory of Open Access Journals (Sweden)

    Anita Raj

    Full Text Available Despite ongoing recommendations to increase male engagement and gender-equity (GE counseling in family planning (FP services, few such programs have been implemented and rigorously evaluated. This study evaluates the impact of CHARM, a three-session GE+FP counseling intervention delivered by male health care providers to married men, alone (sessions 1&2 and with their wives (session 3 in India.A two-armed cluster randomized controlled trial was conducted with young married couples (N = 1081 couples recruited from 50 geographic clusters (25 clusters randomized to CHARM and a control condition, respectively in rural Maharashtra, India. Couples were surveyed on demographics, contraceptive behaviors, and intimate partner violence (IPV attitudes and behaviors at baseline and 9 &18-month follow-ups, with pregnancy testing at baseline and 18-month follow-up. Outcome effects on contraceptive use and incident pregnancy, and secondarily, on contraceptive communication and men's IPV attitudes and behaviors, were assessed using logistic generalized linear mixed models. Most men recruited from CHARM communities (91.3% received at least one CHARM intervention session; 52.5% received the couple's session with their wife. Findings document that women from the CHARM condition, relative to controls, were more likely to report contraceptive communication at 9-month follow-up (AOR = 1.77, p = 0.04 and modern contraceptive use at 9 and 18-month follow-ups (AORs = 1.57-1.58, p = 0.05, and they were less likely to report sexual IPV at 18-month follow-up (AOR = 0.48, p = 0.01. Men in the CHARM condition were less likely than those in the control clusters to report attitudes accepting of sexual IPV at 9-month (AOR = 0.64, p = 0.03 and 18-month (AOR = 0.51, p = 0.004 follow-up, and attitudes accepting of physical IPV at 18-month follow-up (AOR = 0.64, p = 0.02. No significant effect on pregnancy was seen.Findings demonstrate that men can be engaged in FP programming in

  4. Assessment of diabetic distress and disease related factors in patients with type 2 diabetes in Isfahan: A way to tailor an effective intervention planning in Isfahan-Iran

    Directory of Open Access Journals (Sweden)

    Tol Azar

    2012-10-01

    Full Text Available Abstract Background The purpose of this study was to assess diabetes distress and its related factors among type 2 diabetic patients to better tailor intervention planning in Isfahan-Iran. Methods A cross-sectional study was conducted in 2011. Study population was patients with type 2 diabetes referring to Omolbanin, an outpatient diabetic center in Isfahan. 140 diabetic patients met the inclusion criteria and were all included in the study. Patient’s diabetes distress was measured by DDS. A 17-item self-report diabetes distress scale was used with subscales reflecting 5 domains: 1 Emotional burden (5 items, 2 Physician distress (4 items, 3 Regimen distress (5 items and 4 Interpersonal distress (3 items. The responses to each item were rated between 1 and 6 (1 = not a problem, 2 = a slight problem, 3 = a moderate problem, 4 = somewhat serious problem, 5 = a serious problem, 6 = a very serious problem. The minimum and the maximum of score in the scale were 17 and 114 respectively. Collected data was analyzed by using SPSS software version 11.5. Results Mean age of participants were 53.23 years (SD = 7.82. 54.3% was female, 97.1% was married, and 57.1% had education lower than diploma. The average score of total diabetes distress was 2.96 ± 0.83. The average score of each domain was (3.40 ± 1.18, (2.57 ± 0.88, (2.97 ± 0.90, (2.76 ± 0.91 respectively. ‘Emotional Burden’ was considered as the most important domain in measuring diabetes distress. Total diabetes distress had significant association with age (p = 0.02, duration of diabetes (plc (r = 0.63, p Conclusion It seems some keywords have a main role in diabetes distress such as emotional support, communication with patient and physician, self-efficacy and social support. All of these points are achievable through empowerment approach in diabetes care plan.

  5. 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

  6. Screening for spontaneous preterm birth

    NARCIS (Netherlands)

    van Os, M.A.; van Dam, A.J.E.M.

    2015-01-01

    Preterm birth is the most important cause of perinatal morbidity and mortality worldwide. In this thesis studies on spontaneous preterm birth are presented. The main objective was to investigate the predictive capacity of mid-trimester cervical length measurement for spontaneous preterm birth in a

  7. Planning community-based intervention for speech for children with cleft lip and palate from rural South India: A needs assessment

    Directory of Open Access Journals (Sweden)

    Subramaniyan Balasubramaniyan

    2017-01-01

    Full Text Available Background and Aim: A community-based rehabilitation programme, Sri Ramachandra University-Transforming Faces project, was initiated to provide comprehensive management of communication disorders in individuals with CLP in two districts in Tamil Nadu, India. This community-based programme aims to integrate hospital-based services with the community-based initiatives and to enable long-term care. The programme was initiated in Thiruvannamalai (2005 district and extended to Cuddalore (2011. The aim of this study was to identify needs related to speech among children with CLP, enroled in the above community-based programme in two districts in Tamil Nadu, India. Design: This was a cross–sectional study. Participants and Setting: Ten camps were conducted specifically for speech assessments in two districts over a 12-month period. Two hundred and seventeen individuals (116 males and 101 females> 3 years of age reported to the camps. Methods: Investigator (SLP collected data using the speech protocol of the cleft and craniofacial centre. Descriptive analysis and profiling of speech samples were carried out and reported using universal protocol for reporting speech outcomes. Fleiss' Kappa test was used to estimate inter-rater reliability. Results: In this study, inter-rater reliability between three evaluators revealed good agreement for the parameters: resonance, articulatory errors and voice disorder. About 83.8% (n = 151/180 of the participants demonstrated errors in articulation and 69% (n = 124/180 exhibited abnormal resonance. Velopharyngeal port functioning assessment was completed for 55/124 participants. Conclusion: This study allows us to capture a “snapshot” of children with CLP, living in a specific geographical location, and assist in planning intervention programmes.

  8. Correlates of poor perinatal outcomes in non-hospital births in the context of weak health system: the Nigerian experience.

    Science.gov (United States)

    Nkwo, Peter Onubiwe; Lawani, Lucky Osaheni; Ezugwu, Euzebus Chinonye; Iyoke, Chukwuemeka Anthony; Ubesie, Agozie C; Onoh, Robinson Chukwudi

    2014-09-30

    Nigeria's high perinatal mortality rate (PNMR) could be most effectively reduced by targeting factors that are associated with increased newborn deaths. Low access to skilled birth attendants (SBAs) and weak health system are recognized factors associated with high PNMR but other socio-demographic and reproductive factors could have significant influences as well. Identification of the major factors associated with high PNMR would be required in designing interventions to improve perinatal outcomes. For this cross-sectional study, data from the Nigeria Demographic and Health Survey 2008 were used to estimate the PNMR of non-hospital births in identified socio-demographic and reproductive situations that are known to influence PNMR. The estimated PNMR were compared using logistic regression analysis. The PNMR was 36 per 1000 live births. North central region had the lowest PNMR while the south east region had the highest rate (odds ratio 1.59; 95% CI: 1.03, 2.45). Other correlates of high PNMR were belonging to the poorest wealth quintile (odds ratio 1.87; 95% CI: 1.30, 2.70), maternal age group 15-19 years (odds ratio 1.59; 95% CI: 1.05, 2.22), multiple birth (odds ratio 3.12; 95% CI: 2.11, 4.59), history of previous perinatal death (odds ratio 3.31; 95% CI: 2.73, 4.02), birth interval shorter than 18 months (odds ratio 1.65; 95% CI: 1.26, 2.17) and having a small birth size (odds ratio 2.56; 95% CI 1.79, 3.69). Birth attendant, place of birth, parity, maternal education and rural/urban residence had no association with PNMR. Reproductive factors that require midwifery skills were found to contribute most to PNMR. We recommend general strengthening of the health system, recruitment of SBAs and retraining of available birth attendants with emphasis on identification and referral of complicated cases. Family planning should be a core MCH activity to address the issues of teenage pregnancy and short pregnancy intervals.

  9. New Delhi Birth Cohort

    Indian Academy of Sciences (India)

    First page Back Continue Last page Overview Graphics. New Delhi Birth Cohort. In childhood Less than 1% were obese (IOTF 30 kg/m2). Mean BMI SD ranged from –0.4 to –1.0 (CDC). At 26-32 years 10% were obese (BMI >30 kg/m2). ~50% overweight (BMI > 25 kg/m2);. ~65% overweight (BMI > 23 kg/m2). 10% had IGT.

  10. Birth defects and genetic disorders among Arab Americans--Michigan, 1992-2003.

    Science.gov (United States)

    Yanni, Emad A; Copeland, Glenn; Olney, Richard S

    2010-06-01

    Birth defects and genetic disorders are leading causes of infant morbidity and mortality in many countries. Population-based data on birth defects among Arab-American children have not been documented previously. Michigan has the second largest Arab-American community in the United States after California. Using data from the Michigan Birth Defects Registry (MBDR), which includes information on parents' country of birth and ancestry, birth prevalences were estimated in offspring of Michigan women of Arab ancestry for 21 major categories of birth defects and 12 congenital endocrine, metabolic, and hereditary disorders. Compared with other non-Hispanic white children in Michigan, Arab-American children had similar or lower birth prevalences of the selected types of structural birth defects, with higher rates of certain hereditary blood disorders and three categories of metabolic disorders. These estimates are important for planning preconception and antenatal health care, genetic counseling, and clinical care for Arab Americans.

  11. Prevention of premature birth: do pediatricians have a role?

    Science.gov (United States)

    Hall, R T

    2000-05-01

    The rate of prematurity in the United States has increased over the past 15 years despite a reduction in overall infant mortality and birth weight-specific mortality. The major factors contributing to premature birth exist before pregnancy and therefore will require intervention strategies in the pediatric patient. The high-risk factors include young age at conception (16 years), use of illicit drugs and smoking, poor nutritional status, and certain vaginal infections. Pediatric intervention strategies should include sociologic as well as health education stressing heightened self-esteem and communication skills, avoidance of pregnancy and unprotected sexual activity, avoidance of smoking and drug use, and promotion of a good nutritional status.

  12. Mode of birth in twins: data and reflections.

    Science.gov (United States)

    Reitter, A; Daviss, B A; Krimphove, M J; Johnson, K C; Schlößer, R; Louwen, F; Bisits, A

    2018-02-12

    Our primary objective was to compare neonatal and maternal outcomes in women with twin pregnancies, beyond 32 weeks, having a planned vaginal birth or a planned caesarean section (CS). This was a retrospective cohort study from a single tertiary centre over nine years. 534 sets of twins ≥32 + 0 weeks of gestation were included. 401 sets were planned vaginally and 133 sets were planned by CS. We compared a composite adverse perinatal outcome (perinatal mortality or serious neonatal morbidity; five minute APGAR score ≤4, neurological abnormality and need for intubation) and a composite maternal adverse outcome (major haemorrhage, trauma or infection) between the groups. There were no significant differences. Given the similarity of these results with several other larger studies of twin birth, we sought to look at reasons why there is still a rising rate of CS for twin births. We further make suggestions for keeping this rate to a sensible minimum. Impact statement What is already known on this subject? The largest randomised controlled study comparing planned vaginal birth with planned CSs for lower risk twins between 32 and 39 weeks of gestation, showed no added safety from planned CS. However, in most of the Western countries this conclusion has failed to increase the number of planned vaginal births for lower risk twins. What do the results of this study add? This observational study from a single tertiary centre provides external validation of the twin trial results in a practical day-to-day setting. It also provides insights as to how planned vaginal birth can be developed and maintained, with a key focus on safety and maternal participation in decision making. It does focus on consent and providing accurate data. What are the implications of these findings for clinical practice and/or further research? There are good grounds to encourage vaginal birth for low-risk twin pregnancies. The trend of rising caesarean rates in low-risk twin

  13. Family Planning: Bosnian, Russian, Spanish, Nuer.

    Science.gov (United States)

    Anoka County Community Health and Environmental Services, Coon Rapids, MN.

    This guide provides information in English, Bosnian, Russian, Spanish, and Nuer on family planning. Topics covered include a variety of birth control methods: abstinence, condoms, contraceptive foam, birth control pills, the Depo-Provera shot, the Norplant implant, diaphragms, intrauterine devices, natural family planning, sterilization, and the…

  14. Detailed statistical analysis plan for a cluster randomised controlled trial of the Healthy Lifestyles Programme (HeLP), a novel school-based intervention to prevent obesity in school children.

    Science.gov (United States)

    Creanor, Siobhan; Lloyd, Jenny; Hillsdon, Melvyn; Dean, Sarah; Green, Colin; Taylor, Rod S; Ryan, Emma; Wyatt, Katrina

    2016-12-15

    The Healthy Lifestyles Programme (HeLP) trial is being conducted to determine whether a novel school-based intervention is effective and cost-effective in preventing obesity in 9-10 year-old children. This article describes the detailed statistical analysis plan for the HeLP trial, including an amendment (and rationale for amendment) made to originally planned sensitivity analyses. The HeLP trial is a definitive, pragmatic, superiority, cluster randomised controlled trial with two parallel groups and blinded outcome assessment. This update article describes in detail (1) the primary and secondary outcomes, (2) the statistical analysis principles (including which children will be included in each analysis, how the clustered nature of the study design will be accounted for, which covariates will be included in each analysis, how the results will be presented), (3) planned sensitivity analyses, planned subgroup analyses and planned adherence-adjusted analyses for the primary outcome, (4) planned analyses for the secondary outcomes and (e) planned longitudinal analyses. International Standard Randomised Controlled Trial Number (ISRCTN) register: ISRCTN15811706 . Registered on 1 May 2012.

  15. Nonspecific effect of BCG vaccination at birth on early childhood infections

    DEFF Research Database (Denmark)

    Kjærgaard, Jesper; Birk, Nina Marie; Nissen, Thomas N

    2016-01-01

    BACKGROUND: Childhood infections are common and Bacillus Calmette-Guérin (BCG) vaccination at birth may prevent these via nonspecific effects. METHODS: A randomized, clinical multicenter trial. All women planning to give birth (n = 16,521) at the three study sites were invited during the recruitm......BACKGROUND: Childhood infections are common and Bacillus Calmette-Guérin (BCG) vaccination at birth may prevent these via nonspecific effects. METHODS: A randomized, clinical multicenter trial. All women planning to give birth (n = 16,521) at the three study sites were invited during...... during the first 3 mo....

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

    Science.gov (United States)

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

    2013-12-09

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

  17. Interventions in the workplace to support breastfeeding for women in employment.

    Science.gov (United States)

    Abdulwadud, Omar A; Snow, Mary Elizabeth

    2012-10-17

    In recent years there has been a rise in the participation rate of women in employment. Some may become pregnant while in employment and subsequently deliver their babies. Most may decide to return early to work after giving birth for various reasons. Unless these mothers get support from their employers and fellow employees, they might give up breastfeeding when they return to work. As a result, the duration and exclusivity of breastfeeding to the recommended age of the babies would be affected.Workplace environment can play a positive role to promote breastfeeding. For women going back to work, various types of workplace support interventions are available and this should not be ignored by employers. Notably, promoting breastfeeding in a workplace may have benefits for the women, the baby and also the employer. To assess the effectiveness of workplace interventions to support and promote breastfeeding among women returning to paid work after the birth of their children, and its impact on process outcomes pertinent to employees and employers. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (2 August 2012). Two authors independently assessed all identified studies for randomised controlled trials and quasi-randomised controlled trials that compared workplace interventions with no intervention or two or more workplace interventions against each other. Two authors planned to evaluate the methodological quality of the eligible trials and extract data. There were no randomised controlled trials or quasi-randomised controlled trials identified. No trials have evaluated the effectiveness of workplace interventions in promoting breastfeeding among women returning to paid work after the birth of their child. The impact of such intervention on process outcomes is also unknown. Randomised controlled trials are required to establish the benefits of various types of workplace interventions to support, encourage and promote breastfeeding among working

  18. Does prenatal exposure to vitamin D-fortified margarine and milk alter birth weight?

    DEFF Research Database (Denmark)

    Jensen, Camilla B; Berentzen, Tina L; Gamborg, Michael

    2014-01-01

    The present study examined whether exposure to vitamin D from fortified margarine and milk during prenatal life influenced mean birth weight and the risk of high or low birth weight. The study was based on the Danish vitamin D fortification programme, which was a societal intervention with mandat......The present study examined whether exposure to vitamin D from fortified margarine and milk during prenatal life influenced mean birth weight and the risk of high or low birth weight. The study was based on the Danish vitamin D fortification programme, which was a societal intervention...... the initiation and termination of vitamin D fortification programmes. In total, four sets of analyses were performed. Information on birth weight was available in the Copenhagen School Health Record Register for all school children in Copenhagen. The mean birth weight was lower among the exposed than non...

  19. FEATURES OF PLATELET HEMOSTASIS IN PATIENTS WITH VARIOUS SENSITIVITY TO ANTIPLATELET THERAPY IN STABLE ANGINA PECTORIS AFTER PLANNED PERCUTANEOUS CORONARY INTERVENTION

    Directory of Open Access Journals (Sweden)

    Pronko T. P.

    2018-02-01

    Full Text Available Background. One of the significant problems of using double antiplatelet therapy (DATT in patients with ischemic heart disease is the development of resistance to acetylsalicylic acid (ASA and to clopidogrel. Purpose of the study. Evaluation of the features of platelet hemostasis in patients with different sensitivity to DATT with stable angina pectoris (SAP who have undergone scheduled percutaneous coronary intervention (PCI. Material and methods. Sixty patients with stable angina pectoris who underwent planned PCI and received DATT were examined. A blood test and a study of the morphometric parameters of platelets: MPV, PDW, PCT, P-LCR were performed by means of cytoflowing method on the automatic hemo-analyzer Sysmex XS-500i, Japan. Platelet aggregation was evaluated on an impedance 5-channel Multiplateaggregometer (VerumDiagnostica GmbH, Germany with several aggregation inducers. Results. 45% of patients with insufficient response to DAPT were detected – SG2. TRAP-test was 90.62 ± 18.37 U in SG1, 110.7 ± 19.83 U in SG2, p <0.05; MPV was 8.87 ± 1.71 fl in SG1, 9.85 ± 1.42 fl in SG2, p <0.05; P-LCR was 29.74 ± 5.38% in SG1, 33.96 ± 5.70% in SG2, p <0.05. Conclusions. In 45% of patients with SAP, there is an inadequate response to DATT, of which 18 patients (30% to ASA, 15 people to clopidogrel (25%, to two drugs at the same time - 6 people (10%. In patients with an inadequate response to DATT, MPV and P-LCR are significantly higher than those with normal response to DATT. Correlation analysis revealed interrelations between the MPV, PCT, PLC-R indices and aggregation values, which confirm the idea that one of the factors reducing the effectiveness of DATT is the initially high platelet activity and their high heterogeneity in size.

  20. Effectiveness of the self-regulation eHealth intervention 'MyPlan1.0.' on physical activity levels of recently retired Belgian adults: a randomized controlled trial.

    Science.gov (United States)

    Van Dyck, Delfien; Plaete, Jolien; Cardon, Greet; Crombez, Geert; De Bourdeaudhuij, Ilse

    2016-10-01

    The study purpose was to test the effectiveness of the self-regulation eHealth intervention 'MyPlan1.0.' to increase physical activity (PA) in recently retired Belgian adults. This study was a randomized controlled trial with three points of follow-up/modules (baseline to 1-week to 1-month follow-up). In total, 240 recently retired adults (intervention group [IG]: n = 89; control group [CG]: n = 151) completed all three modules. The IG filled in evaluation questionnaires and received 'MyPlan1.0.', an intervention focusing on both pre- and post-intentional processes for behavioural change. The CG only filled in evaluation questionnaires. Self-reported PA was assessed using the long International Physical Activity Questionnaire, usual week version. Repeated-measures multivariate analysis of variances were conducted in SPSS 22.0. On the short-term (baseline to 1 week), the intervention significantly increased walking for transport (IG: +11 min/week, CG: -6 min/week; P < 0.01). On the intermediate-term (baseline to 1 month), the intervention increased transport-related walking (IG: +14 min/week, CG: +6 min/week; P < 0.01), leisure-time walking (IG: +26 min/week, CG: -14 min/week; P < 0.10), leisure-time vigorous PA (IG: +16 min/week, CG: -4 min/week; P < 0.01), moderate-intensity gardening (IG: +4 min/week, CG: -34 min/week; P < 0.10) and voluntary work-related vigorous PA (IG: +28 min/week, CG: +13 min/week; P < 0.10). Results show that our eHealth intervention is effective in recently retired adults. Future studies should include long-term follow-up to examine whether the effects persist over a longer period. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  1. Perineal injuries and birth positions among 2992 women with a low risk pregnancy who opted for a homebirth

    DEFF Research Database (Denmark)

    Edqvist, Malin; Blix, Ellen; Hegaard, Hanne K

    2016-01-01

    at home and to compare the prevalence of perineal injuries, SPT and episiotomy in different birth positions in four Nordic countries. METHODS: A population-based prospective cohort study of planned home births in four Nordic countries. To assess medical outcomes a questionnaire completed after birth...... by the attending midwife was used. Descriptive statistics, bivariate analysis and logistic regression were used to analyze the data. RESULTS: Two thousand nine hundred ninety-two women with planned home births, who birthed spontaneously at home or after transfer to hospital, between 2008 and 2013 were included.......26-1.79). Flexible sacrum positions were associated with fewer episiotomies (OR 0.20; CI 95 % 0.10-0.54). CONCLUSION: A low prevalence of SPT and episiotomy was found among women opting for a home birth in four Nordic countries. Women used a variety of birth positions and a majority gave birth in flexible sacrum...

  2. Seasonally adjusted birth frequencies follow the Poisson distribution.

    Science.gov (United States)

    Barra, Mathias; Lindstrøm, Jonas C; Adams, Samantha S; Augestad, Liv A

    2015-12-15

    Variations in birth frequencies have an impact on activity planning in maternity wards. Previous studies of this phenomenon have commonly included elective births. A Danish study of spontaneous births found that birth frequencies were well modelled by a Poisson process. Somewhat unexpectedly, there were also weekly variations in the frequency of spontaneous births. Another study claimed that birth frequencies follow the Benford distribution. Our objective was to test these results. We analysed 50,017 spontaneous births at Akershus University Hospital in the period 1999-2014. To investigate the Poisson distribution of these births, we plotted their variance over a sliding average. We specified various Poisson regression models, with the number of births on a given day as the outcome variable. The explanatory variables included various combinations of years, months, days of the week and the digit sum of the date. The relationship between the variance and the average fits well with an underlying Poisson process. A Benford distribution was disproved by a goodness-of-fit test (p variables is significantly improved (p variable. Altogether 7.5% more children are born on Tuesdays than on Sundays. The digit sum of the date is non-significant as an explanatory variable (p = 0.23), nor does it increase the explained variance. INERPRETATION: Spontaneous births are well modelled by a time-dependent Poisson process when monthly and day-of-the-week variation is included. The frequency is highest in summer towards June and July, Friday and Tuesday stand out as particularly busy days, and the activity level is at its lowest during weekends.

  3. 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.

  4. Motor development related to duration of exclusive breastfeeding, B vitamin status and B12 supplementation in infants with a birth weight between 2000-3000 g, results from a randomized intervention trial.

    Science.gov (United States)

    Torsvik, Ingrid Kristin; Ueland, Per Magne; Markestad, Trond; Midttun, Øivind; Bjørke Monsen, Anne-Lise

    2015-12-18

    Exclusive breastfeeding for 6 months is assumed to ensure adequate micronutrients for term infants. Our objective was to investigate the effects of prolonged breastfeeding on B vitamin status and neurodevelopment in 80 infants with subnormal birth weights (2000-3000 g) and examine if cobalamin supplementation may benefit motor function in infants who developed biochemical signs of impaired cobalamin function (total homocysteine (tHcy) > 6.5 μmol/L) at 6 months. Levels of cobalamin, folate, riboflavin and pyridoxal 5´-phosphate, and the metabolic markers tHcy and methylmalonic acid (MMA), were determined at 6 weeks, 4 and 6 months (n = 80/68/66). Neurodevelopment was assessed with the Alberta Infants Motor Scale (AIMS) and the parental questionnaire Ages and Stages (ASQ) at 6 months. At 6 months, 32 of 36 infants with tHcy > 6.5 μmol/L were enrolled in a double blind randomized controlled trial to receive 400 μg hydroxycobalamin intramuscularly (n = 16) or sham injection (n = 16). Biochemical status and neurodevelopment were evaluated after one month. Except for folate, infants who were exclusively breastfed for >1 month had lower B vitamin levels at all assessments and higher tHcy and MMA levels at 4 and 6 months. At 6 months, these infants had lower AIMS scores (p = 0.03) and ASQ gross motor scores (p = 0.01). Compared to the placebo group, cobalamin treatment resulted in a decrease in plasma tHcy (p motor scores (p = 0.03). The findings suggest that prolonged exclusive breastfeeding may not provide sufficient B vitamins for small infants, and that this may have a negative effect on early gross motor development. In infants with mild cobalamin deficiency at 6 months, cobalamin treatment significantly improvement cobalamin status and motor function, suggesting that the observed impairment in motor function associated with long-term exclusive breastfeeding, may be due to cobalamin deficiency. Clinical

  5. The Birth of Matter

    CERN Multimedia

    2005-01-01

    To mark the World Year of Physics, the Physics Section of the University of Geneva is organising a series of lectures for the uninitiated. Each lecture will begin with a demonstration in the auditorium of the detection of cosmic rays and, in collaboration with Professor E. Ellberger of the Conservatoire de Musique de Genève, of how these signals from the farthest reaches of the Universe can be used to create 'cosmic music'. The fourth lecture in the series, entitled 'The Birth of Matter', will take place on Tuesday 3 May 2005 and will be given by CERN's theoretical physicist, John Ellis. Where does matter come from? Where do the structures that surround us, such as galaxies, come from? Are we living in a world of invisible matter? Why is the universe so old and so big? John Ellis will show how elementary particle physics and, in particular, the LHC under construction at CERN, can answer these questions. The Birth of Matter Professor John Ellis Tuesday 3 May, starting 8.00 p.m. Main Auditorium...

  6. The Birth of Matter

    CERN Multimedia

    2005-01-01

    To mark the World Year of Physics, the Physics Section of the University of Geneva is organising a series of lectures for the uninitiated. Each lecture will begin with a demonstration in the auditorium of the detection of cosmic rays and, in collaboration with Professor E. Ellberger of the Conservatoire de Musique de Genève, of how these signals from the farthest reaches of the Universe can be used to create "cosmic music". The fourth lecture in the series, entitled "The Birth of Matter", will take place on Tuesday 3 May 2005 and will be given by CERN's theoretical physicist, John Ellis. Where does matter come from? Where do the structures that surround us, such as galaxies, come from? Are we living in a world of invisible matter? Why is the universe so old and so big? John Ellis will show how elementary particle physics and, in particular, the LHC under construction at CERN, can answer these questions. The Birth of Matter Professor John Ellis Tuesday 3 May, starting 8.00 p.m. Main Audito...

  7. Revising acute care systems and processes to improve breastfeeding and maternal postnatal health: a pre and post intervention study in one English maternity unit

    Directory of Open Access Journals (Sweden)

    Bick Debra

    2012-06-01

    Full Text Available Abstract Background Most women in the UK give birth in a hospital labour ward, following which they are transferred to a postnatal ward and discharged home within 24 to 48 hours of the birth. Despite policy and guideline recommendations to support planned, effective postnatal care, national surveys of women’s views of maternity care have consistently found in-patient postnatal care, including support for breastfeeding, is poorly rated. Methods Using a Continuous Quality Improvement approach, routine antenatal, intrapartum and postnatal care systems and processes were revised to support implementation of evidence based postnatal practice. To identify if implementation of a multi-faceted QI intervention impacted on outcomes, data on breastfeeding initiation and duration, maternal health and women’s views of care, were collected in a pre and post intervention longitudinal survey. Primary outcomes included initiation, overall duration and duration of exclusive breastfeeding. Secondary outcomes included maternal morbidity, experiences and satisfaction with care. As most outcomes of interest were measured on a nominal scale, these were compared pre and post intervention using logistic regression. Results Data were obtained on 741/1160 (64% women at 10 days post-birth and 616 (54% at 3 months post-birth pre-intervention, and 725/1153 (63% and 575 (50% respectively post-intervention. Post intervention there were statistically significant differences in the initiation (p = 0.050, duration of any breastfeeding (p = 0.020 and duration of exclusive breastfeeding to 10 days (p = 0.038 and duration of any breastfeeding to three months (p = 0.016. Post intervention, women were less likely to report physical morbidity within the first 10 days of birth, and were more positive about their in-patient care. Conclusions It is possible to improve outcomes of routine in-patient care within current resources through continuous quality

  8. perspective on opportunities for research and interventions provided

    African Journals Online (AJOL)

    2013-06-11

    Jun 11, 2013 ... babies died within the first 28 days of life (7). A birth in sub-Saharan Africa (SSA) is more likely to end up ... for her and baby, birth planning, CMNH programme informs an individual pregnant mother of her options .... Kangaroo mother care to prevent neonatal deaths due to preterm birth complications.

  9. Periconception folic acid supplementation, fetal growth and the risks of low birth weight and preterm birth: the Generation R Study.

    Science.gov (United States)

    Timmermans, Sarah; Jaddoe, Vincent W V; Hofman, Albert; Steegers-Theunissen, Régine P M; Steegers, Eric A P

    2009-09-01

    Countries worldwide, including the Netherlands, recommend that women planning pregnancy use a folic acid supplement during the periconception period. Some countries even fortify staple foods with folic acid. These recommendations mainly focus on the prevention of neural tube defects, despite increasing evidence that folic acid may also influence birth weight. We examined whether periconception folic acid supplementation affects fetal growth and the risks of low birth weight, small for gestational age (SGA) and preterm birth, in the Generation R Study in Rotterdam, the Netherlands. Main outcome measures were fetal growth measured in mid- and late pregnancy by ultrasound, birth weight, SGA and preterm birth in relation to periconception folic supplementation (0.4-0.5 mg). Data on 6353 pregnancies were available. Periconception folic acid supplementation was positively associated with fetal growth. Preconception folic acid supplementation was associated with 68 g higher birth weight (95 % CI 37.2, 99.0) and 13 g higher placental weight (95 % CI 1.1, 25.5), compared to no folic acid supplementation. In these analyses parity significantly modified the effect estimates. Start of folic acid supplementation after pregnancy confirmation was associated with a reduced risk of low birth weight (OR 0.61, 95 % CI 0.40, 0.94). Similarly, reduced risks for low birth weight and SGA were observed for women who started supplementation preconceptionally, compared to those who did not use folic acid (OR 0.43, 95 % CI 0.28, 0.69 and OR 0.40, 95 % CI 0.22, 0.72). In conclusion, periconception folic acid supplementation is associated with increased fetal growth resulting in higher placental and birth weight, and decreased risks of low birth weight and SGA.

  10. Birth preparedness and place of birth in Tandahimba district, Tanzania: what women prepare for birth, where they go to deliver, and why.

    Science.gov (United States)

    Tancred, Tara; Marchant, Tanya; Hanson, Claudia; Schellenberg, Joanna; Manzi, Fatuma

    2016-07-16

    the importance of these practices, with an emphasis on emergency preparedness, would be valuable. Alongside education delivered as part of focussed antenatal care, community-based interventions that aim to increase engagement of men in birth preparedness, and support agency among women, are recommended.

  11. The birth of joseph gabriel.

    Science.gov (United States)

    Cantine, Anne Touhill

    2013-01-01

    In this column, a mother shares the story of the birth of her first child. With confidence in the process of birth and in her ability to give birth, and with the support, confidence, and encouragement of her mother and sisters, Anne manages to cope with strong contractions through a busy day. Finally, her husband realizes how fast labor is progressing. Baby Joseph was born less than 2 hours after arrival at the hospital.

  12. Roentgenodiagnosis of vertebrae birth injury

    International Nuclear Information System (INIS)

    Mikhajlov, M.K.

    1983-01-01

    Birth injuries of vertebrae and spinal cord is the new problem of child neutropathology. Basic roentgenological symptoms of birth injuries of vertebrae and spinal cord of different localizations have been described for the first time. These data are compared with neurological, electrophysiological, and Morphological data, that enables not only to describe each symptom, but also to evaluate its clinical significance. Roeptgenological classification of birth injuries of vertebrae and spinal cord in children is suggested

  13. [Relations between hypertensive disorders in pregnancy and subsequent risk of early-term birth: a birth cohort study].

    Science.gov (United States)

    Li, F Y; Yan, S Q; Huang, K; Mao, L J; Pan, W J; Ge, X; Han, Y; Hao, J H; Tao, F B

    2017-12-10

    Objective: To evaluate the relations between hypertensive disorders (HDP) in pregnancy and early-term birth. Methods: A total of 3 474 pregnant women were consecutively recruited. Demographic information was collected in early pregnancy. HDP was diagnosed in the first, second and third trimesters, respectively. On the basis of precise evaluation on gestation age, early-term birth was defined as gestational age of 37-38 weeks+6 days. Logistic regression models were conducted to examine the associations between HDP and early-term birth. Results: The current study included 3 260 pregnant women, with the rates of HDP, pregnancy-induced hypertension syndrome and pre-eclampsia as 6.0% ( n =194), 4.2% ( n =137) and 1.8% ( n =57), respectively. After controlling for potential confounders, no significant differences between pregnancy-induced hypertension syndrome and earlyterm birth ( OR =1.49, 95% CI : 0.94-2.36) were found. Pre-eclampsia appeared to have increased the risk of early-term birth ( OR =4.46, 95% CI : 2.09-9.54). Conclusion: Pre-eclampsia could significantly increase the risk of early-term birth. This finding suggested that early detection and intervention programs were helpful in reducing the risk of early-term birth.

  14. Effects of a computerized decision support system on care planning for pressure ulcers and malnutrition in nursing homes: an intervention study.

    Science.gov (United States)

    Fossum, Mariann; Ehnfors, Margareta; Svensson, Elisabeth; Hansen, Linda M; Ehrenberg, Anna

    2013-10-01

    Nursing documentation is essential for facilitating the flow of information to guarantee continuity, quality and safety in care. High-quality nursing documentation is frequently lacking; the implementation of computerized decision support systems is expected to improve clinical practice and nursing documentation. The present study aimed at investigate the effects of a computerized decision support system and an educational program as intervention strategies for improved nursing documentation practice on pressure ulcers and malnutrition in nursing homes. An intervention study with two intervention groups and one control group was used. Fifteen nursing homes in southern Norway were included. A convenience sample of electronic healthcare records from 46 units was included. Inclusion criteria were records with presence of pressure ulcers and/or malnutrition. The residents were assessed before and after an intervention of a computerized decision support system in the electronic healthcare records. Data were collected through a review of 150 records before (2007) and 141 records after the intervention (2009). The nurses in intervention group 1 were offered educational sessions and were trained to use the computerized decision support system, which they used for eight months in 2008 and 2009. The nurses in intervention group 2 were offered the same educational program but did not use the computerized decision support system. The nurses in the control group were not subject to any intervention. The resident records were examined for the completeness and comprehensiveness of the documentation of pressure ulcers and malnutrition with three data collection forms and the data were analyzed with non-parametric statistics. The implementation of the computerized decision support system and the educational program resulted in a more complete and comprehensive documentation of pressure ulcer- and malnutrition-related nursing assessments and nursing interventions. This study

  15. FAmily CEntered (FACE) advance care planning: Study design and methods for a patient-centered communication and decision-making intervention for patients with HIV/AIDS and their surrogate decision-makers.

    Science.gov (United States)

    Kimmel, Allison L; Wang, Jichuan; Scott, Rachel K; Briggs, Linda; Lyon, Maureen E

    2015-07-01

    Although the human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) has become a chronic illness, disease-specific advance care planning has not yet been evaluated for the palliative care needs of adults with HIV/AIDS. This prospective, longitudinal, randomized, two-arm controlled clinical trial aims to test the efficacy of FAmily CEntered advance care planning among adults living with AIDS and/or HIV with co-morbidities on congruence in treatment preferences, healthcare utilization, and quality of life. The FAmily CEntered intervention arm is two face-to-face sessions with a trained, certified facilitator: Session 1) Disease-Specific Advance Care Planning Respecting Choices Interview; Session 2) Completion of advance directive. The Healthy Living Control arm is: Session 1) Developmental/Relationship History; Session 2) Nutrition. Follow-up data will be collected at 3, 6, 12, and 18 months post-intervention. A total of 288 patient/surrogate dyads will be enrolled from five hospital-based, out-patient clinics in Washington, District of Columbia. Participants will be HIV positive and ≥ 21 years of age; surrogates will be ≥ 18 years of age. Exclusion criteria are homicidality, suicidality, psychosis, and impaired cognitive functioning. We hypothesize that this intervention will enhance patient-centered communication with a surrogate decision-maker about end of life treatment preferences over time, enhance patient quality of life and decrease health care utilization. We further hypothesize that this intervention will decrease health disparities for Blacks in completion of advance directives. If proposed aims are achieved, the benefits of palliative care, particularly increased treatment preferences about end-of-life care and enhanced quality of life, will be extended to people living with AIDS. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. Resultado de partos domiciliares atendidos por enfermeiras de 2005 a 2009 em Florianópolis, SC Resultado de partos domiciliares atendidos por enfermeras de 2005 a 2009 en Florianópolis, Sur de Brasil Outcomes of planned home birth assisted by nurses, from 2005 to 2009, in Florianópolis, Brazil

    Directory of Open Access Journals (Sweden)

    Joyce Green Koettker

    2012-08-01

    Full Text Available Estudo transversal sobre resultados obstétricos e neonatais dos partos domiciliares planejados assistidos por enfermeiras obstétricas em Florianópolis, SC. Dados coletados nos prontuários de 100 parturientes assistidas de 2005 a 2009 apontam 11 transferências hospitalares, sendo nove submetidas a cesariana. A maioria das que pariram no domicílio apresentou batimentos cardíacos fetais (94,0% e evolução no partograma normais (61,0%, adotou posição vertical na água, no período expulsivo (71,9%, e os recém-nascidos receberam Apgar do 5° minuto > 7 (98,9%. A frequência de episiotomia foi 1,0%, 49,4% não necessitaram sutura perineal. Os resultados indicam que o parto domiciliar é seguro.Estudio transversal sobre resultados obstétricos y neonatales de los partos domiciliares planificados asistidos por enfermeras obstétricas en Florianópolis, Sur de Brasil. Datos colectados en los prontuarios de 100 parturientas asistidas de 2005 a 2009, señalan 11 transferencias hospitalarias, siendo nueve sometidas a cesárea. La mayoría de las que parieron en el domicilio presentó pulsaciones cardíacas fetales (94,0% y evolución en el partograma normales (61,0%, adoptó posición vertical en el agua, en el período expulsivo (71,9%, y los recién nacidos recibieron Apgar al 5° minuto >7 (98,9%. La frecuencia de episiotomía fue 1,0%, 49,4% no necesitaron sutura perineal. Los resultados indican que el parto domiciliar es seguro.A cross-sectional study was performed to analyze obstetric and neonatal results of planned home births assisted by obstetric nurses in the city of Florianópolis, Southern Brazil. Data collected from the medical records of 100 parturient women cared for between 2005 and 2009 indicated 11 hospital transfers, nine of which underwent a Cesarean section. The majority of women who had a home birth showed normal fetal heart beat (94.0% and progress on the partogram (61.0%, vertical water delivery was the position most

  17. Predictors and birth outcomes: An investigation of birth and ...

    African Journals Online (AJOL)

    Objective: Birth and emergency preparedness is a safe motherhood strategy which encourages early decision making and minimizes delays in health care seeking in the event of obstetric complications. The aim of this study was to determine individual level factors influencing birth and emergency preparedness. Methods: A ...

  18. The influence of maternal body composition on birth weight.

    LENUS (Irish Health Repository)

    Farah, Nadine

    2012-02-01

    OBJECTIVE: To identify the maternal body composition parameters that independently influence birth weight. STUDY DESIGN: A longitudinal prospective observational study in a large university teaching hospital. One hundred and eighty-four non-diabetic caucasian women with a singleton pregnancy were studied. In early pregnancy maternal weight and height were measured digitally in a standardised way and the body mass index (BMI) was calculated. At 28 and 37 weeks\\' gestation maternal body composition was assessed using segmental multifrequency bioelectrical impedance analysis. At delivery the baby was weighed and the clinical details were recorded. RESULTS: Of the women studied, 29.2% were overweight and 34.8% were obese. Birth weight did not correlate with maternal weight or BMI in early pregnancy. Birth weight correlated with gestational weight gain (GWG) before the third trimester (r=0.163, p=0.027), but not with GWG in the third trimester. Birth weight correlated with maternal fat-free mass, and not fat mass at 28 and 37 weeks gestation. Birth weight did not correlate with increases in maternal fat and fat-free masses between 28 and 37 weeks. CONCLUSIONS: Contrary to previous reports, we found that early pregnancy maternal BMI in a non-diabetic population does not influence birth weight. Interestingly, it was the GWG before the third trimester and not the GWG in the third trimester that influenced birth weight. Our findings have implications for the design of future intervention studies aimed at optimising gestational weight gain and birth weight. CONDENSATION: Maternal fat-free mass and gestational weight gain both influence birth weight.

  19. 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.

  20. Should implementation intentions interventions be implemented in obesity prevention: the impact of if-then plans on daily physical activity in Dutch adults.

    NARCIS (Netherlands)

    de Vet, E.W.M.L.; Oenema, A.; Sheeran, P.; Brug, J.

    2009-01-01

    Background: Forming implementation intentions (specifying when, where and how to act) has been proposed as a potentially effective and inexpensive intervention, but has mainly been studied in controlled settings for straightforward behaviors. Purpose: To examine if forming implementation intentions

  1. Should implementation intentions interventions be implemented in obesity prevention: the impact of if-then plans on daily physical activity in Dutch adults.

    NARCIS (Netherlands)

    E. Vet (Emely); A. Oenema (Anke); P. Sheeran (Paschal); J. Brug (Hans)

    2009-01-01

    textabstractBackground Forming implementation intentions (specifying when, where and how to act) has been proposed as a potentially effective and inexpensive intervention, but has mainly been studied in controlled settings for straightforward behaviors. Purpose To examine if forming

  2. Birth order and myopia.

    Science.gov (United States)

    Guggenheim, Jeremy A; McMahon, George; Northstone, Kate; Mandel, Yossi; Kaiserman, Igor; Stone, Richard A; Lin, Xiaoyu; Saw, Seang Mei; Forward, Hannah; Mackey, David A; Yazar, Seyhan; Young, Terri L; Williams, Cathy

    2013-12-01

    An association between birth order and reduced unaided vision (a surrogate for myopia) has been observed previously. We examined the association between birth order and myopia directly in four subject groups. Subject groups were participants in (1) the Avon Longitudinal Study of Parents and Children (ALSPAC; UK; age 15 years; N = 4401), (2) the Singapore Cohort Study of Risk Factors for Myopia (SCORM; Singapore; age 13 years; N = 1959), (3) the Raine Eye Health Study (REHS; Australia; age 20 years; N = 1344), and (4) Israeli Defense Force Pre-recruitment Candidates (IDFC; Israel; age 16-22 years; N = 888,277). The main outcome was odds ratios (OR) for myopia in first-born versus non-first-born individuals after adjusting for potential risk factors. The prevalence of myopia was numerically higher in first-born versus non-first-born individuals in all study groups, but the strength of evidence varied widely. Adjusted ORs (95% confidence intervals, CIs) were: ALSPAC, 1.31 (1.05-1.64); SCORM, 1.25 (0.89-1.77); REHS, 1.18 (0.90-1.55); and IDFC, 1.04 (1.03-1.06). In the large IDFC sample, the effect size was greater (a) for the first-born versus fourth- or higher-born comparison than for the first-born versus second/third-born comparison (p 4000 participants provided strong statistical support for the association. The available evidence suggested the relationship was independent of established risk factors such as time outdoors/reading, and thus may arise through a different causal mechanism.

  3. 5. Natural Family Planning

    African Journals Online (AJOL)

    Sitwala

    need to intensify Health Education in this area. KEY WORDS: Abstinence, Couple, Determinants,. Family Planning (FP) ... the potential benefits of FP, it is important to any community when the births of children are spread. .... education 16.3% (67) and College level 4.9% (20) .8.3% (34) had no education at all (table 4). The.

  4. Messages on pregnancy and family planning that providers give women living with HIV in the context of a Positive Health, Dignity, and Prevention intervention in Mozambique

    Directory of Open Access Journals (Sweden)

    Hilliard S

    2014-12-01

    Full Text Available Starr Hilliard, Sarah A Gutin, Carol Dawson Rose Department of Community Health Systems, School of Nursing, University of California at San Francisco, San Francisco, CA, USA Background: Family planning is an important HIV prevention tool for women living with HIV (WLHIV. In Mozambique, the prevalence of HIV among women of reproductive age is 13.1% and the average fertility rate is high. However, family planning and reproductive health for WLHIV are under-addressed in Mozambique. This study explores provider descriptions of reproductive health messages in order to identify possible barriers and facilitators to successfully addressing family planning and pregnancy concerns of WLHIV. Methods: In 2006, a Positive Health, Dignity, and Prevention program was introduced in Mozambique focused on training health care providers to work with patients to reduce their transmission risks. Providers received training on multiple components, including family planning and prevention of mother-to-child transmission (PMTCT. In-depth interviews were conducted with 31 providers who participated in the training in five rural clinics in three provinces. Data were analyzed using qualitative content analysis. Results: Analysis showed that providers' clinical messages on family planning, pregnancy, and PMTCT for WLHIV could be arranged along a continuum. Provider statements ranged from saying that WLHIV should not become pregnant and condoms are the only valid form of family planning for WLHIV, to suggesting that WLHIV can have safe pregnancies. Conclusion: These data indicate that many providers continue to believe that WLHIV should not have children and this represents a challenge for integrating family planning into the care of WLHIV. Also, not offering WLHIV a full selection of family planning methods severely limits their ability to protect themselves from unintended pregnancies and to fully exercise their reproductive rights. Responding to the reproductive health

  5. Praxis and guidelines for planned homebirths in the Nordic countries - an overview

    DEFF Research Database (Denmark)

    Lindgren, Helena; Kjaergaard, Hanne; Olafsdottir, Olof Asta

    2014-01-01

    ). DESIGN AND SETTING: National documents on homebirth and midwifery and recommendations regarding management and registration of planned homebirths in the included countries were investigated. FINDINGS: Guidelines regarding planned home birth were found in four of the included countries. In Denmark any...... to a midwife attending the birth varies geographically. In the Stockholm County Council guidelines have been developed for publicly funding of planned home births; for the rest of Sweden no national guidelines have been formulated and the service is privately funded. KEY CONCLUSION: Inconsistencies in the home...... data on planned home births in this region. Additional data collection is needed since national registers do not sufficiently cover the planned place of birth....

  6. Correlates of Unwanted Births in Bangladesh: A Study through Path Analysis.

    Directory of Open Access Journals (Sweden)

    Tapan Kumar Roy

    Full Text Available Unwanted birth is an important public health concern due to its negative association with adverse outcomes of mothers and children as well as socioeconomic development of a country. Although a number of studies have been investigated the determinants of unwanted births through logistic regression analysis, an extensive assessment using path model is lacking. In the current study, we applied path analysis to know the important covariates for unwanted births in Bangladesh.The study used data extracted from Bangladesh Demographic and Health Survey (BDHS 2011. It considered sub-sample consisted of 7,972 women who had given most recent births five years preceding the date of interview or who were currently pregnant at survey time. Correlation analysis was used to find out the significant association with unwanted births. This study provided the factors affecting unwanted births in Bangladesh. The path model was used to determine the direct, indirect and total effects of socio-demographic factors on unwanted births.The result exhibited that more than one-tenth of the recent births were unwanted in Bangladesh. The differentials of unwanted births were women's age, education, age at marriage, religion, socioeconomic status, exposure of mass-media and use of family planning. In correlation analysis, it showed that unwanted births were positively correlated with women age and place of residence and these relationships were significant. On the contrary, unwanted births were inversely significantly correlated with education and social status. The total effects of endogenous variables such as women age, place of residence and use of family planning methods had favorable effect on unwanted births.Policymakers and program planners need to design programs and services carefully to reduce unwanted births in Bangladesh, especially, service should focus on helping those groups of women who were identified in the analysis as being at increased risks of unwanted

  7. Correlates of Unwanted Births in Bangladesh: A Study through Path Analysis.

    Science.gov (United States)

    Roy, Tapan Kumar; Singh, Brijesh P

    2016-01-01

    Unwanted birth is an important public health concern due to its negative association with adverse outcomes of mothers and children as well as socioeconomic development of a country. Although a number of studies have been investigated the determinants of unwanted births through logistic regression analysis, an extensive assessment using path model is lacking. In the current study, we applied path analysis to know the important covariates for unwanted births in Bangladesh. The study used data extracted from Bangladesh Demographic and Health Survey (BDHS) 2011. It considered sub-sample consisted of 7,972 women who had given most recent births five years preceding the date of interview or who were currently pregnant at survey time. Correlation analysis was used to find out the significant association with unwanted births. This study provided the factors affecting unwanted births in Bangladesh. The path model was used to determine the direct, indirect and total effects of socio-demographic factors on unwanted births. The result exhibited that more than one-tenth of the recent births were unwanted in Bangladesh. The differentials of unwanted births were women's age, education, age at marriage, religion, socioeconomic status, exposure of mass-media and use of family planning. In correlation analysis, it showed that unwanted births were positively correlated with women age and place of residence and these relationships were significant. On the contrary, unwanted births were inversely significantly correlated with education and social status. The total effects of endogenous variables such as women age, place of residence and use of family planning methods had favorable effect on unwanted births. Policymakers and program planners need to design programs and services carefully to reduce unwanted births in Bangladesh, especially, service should focus on helping those groups of women who were identified in the analysis as being at increased risks of unwanted births- older women

  8. determinants of referral practices of clients by traditional birth ...

    African Journals Online (AJOL)

    GBENGY

    of the mothers during labour and child birth.10. Other maternal and child health services being provided by TBAs include mobilizing for immunization and family planning. They also provide non-maternal and child health services such as treatment of common ailments.10. A number of community members espe- cially in the ...

  9. Contraceptive use, birth spacing, and child survival in Matlab, Bangladesh

    NARCIS (Netherlands)

    Saha, U.R.; van Soest, A.H.O.

    To reduce infant mortality through improved family planning, a better understanding of the factors driving contraceptive use and how this decision affects infant survival is needed. Using dynamic panel-data models of infant deaths, birth intervals, and contraceptive use, this study analyzes the

  10. Maternal employment and birth outcomes

    DEFF Research Database (Denmark)

    Wüst, Miriam

    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 f...... explanation, namely, that exclusion from employment may stress mothers in countries with high-female employment rates....

  11. NEONATES (BIRTH – 1 MONTH)

    African Journals Online (AJOL)

    Chantel

    western Johannesburg and also at the. Donald Gordon Medical Centre. Neonatal skin, like the respiratory system, bears the brunt of the extreme change in external environment that characterises birth. NEONATES. 488 CME September 2004 Vol.22 No.9. NEONATES (BIRTH – 1 MONTH). Fig. 1. Café-au-lait macule. Fig. 2.

  12. Birth defects surveillance·

    African Journals Online (AJOL)

    1989-07-01

    Jul 1, 1989 ... A pilot birth defects surveillance system was established in. 1982 as part of an epidemiological baseline study pertaining to potential changes in water quality in the Cape Peninsula. The methodology used for reporting birth defects for two information systems, one hospital-based and the other popu-.

  13. Prediction of Spontaneous Preterm Birth

    NARCIS (Netherlands)

    Dijkstra, Karolien

    2002-01-01

    Preterm birth is a leading cause of neonatal morbidity and mortality. It is a major goal in obstetrics to lower the incidence of spontaneous preterm birth (SPB) and related neonatal morbidity and mortality. One of the principal objectives is to discover early markers that would allow us to identify

  14. Variation in home-birth rates between midwifery practices in the Netherlands.

    NARCIS (Netherlands)

    Wiegers, T.A.; Zee, J. van der; Kerssens, J.J.; Keirse, M.J.N.C.

    2000-01-01

    Objective: to examine the reasons for the variation in home-birth rates between midwifery practices. method: multi-level analysis of client and midwife associated, case-specific and structural factors in relation to 4420 planned and actual home or hospital births in 42 midwifery practices. Findings:

  15. Mode of birth and women’s psychological and physical wellbeing in the postnatal period

    Directory of Open Access Journals (Sweden)

    Rowlands Ingrid J

    2012-11-01

    Full Text Available Abstract Background Physical and psychological problems after childbirth are common, and may have a significant negative and long-term impact on women’s wellbeing and daily functioning. The method of birth may be a particularly important factor influencing women’s health and wellbeing following birth, however, population-wide evidence is limited. This study uses data from 5,332 women who responded to a national survey of women’s experiences of maternity care in England. We examined women’s postnatal wellbeing in the first three months after birth, and whether these varied by mode of birth. Methods This is a secondary analysis of survey data using a random sample of women selected from birth registration. We used multinomial logistic regression models to examine the association between women’s self-reported psychological symptoms, health problems and mode of birth. Results Women who had forceps-assisted vaginal births and unplanned caesarean section births reported the poorest health and wellbeing, while those of women who had unassisted vaginal births and planned caesarean section births were less affected by the birth process. Most women’s physical and emotional health appeared to improve with time, however, those who had a forceps-assisted vaginal birth were more likely to report ongoing posttraumatic-type symptoms several months after the birth. Conclusions Mode of birth was associated with differences in outcomes at three months. By comparison to women who had unassisted vaginal births, the risk of reduced postnatal health and wellbeing was higher amongst the women who had forceps-assisted vaginal births but not amongst women who had ventouse-assisted vaginal births. This would suggest that it is important to differentiate the different types of instrumental birth in outcome studies. Of concern was the higher rate of posttrau