WorldWideScience

Sample records for maternal stimulant medication

  1. Gender and injuries predict stimulant medication

    DEFF Research Database (Denmark)

    Dalsgaard, Søren; Leckman, James F.; Nielsen, Helena Skyt

    2014-01-01

    Objective: The purpose of this article was to examine whether injuries in early childhood and gender predict prescriptions of stimulant medication in three groups of children: With attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), and other psychiatric disorders (OPD...... follow-up of all cases. We found that the number of injuries prior to diagnosis was associated with initiation of stimulant treatment in all three groups of patients. In addition, male gender predicted treatment with ADHD medications. Our results suggest that the number of injuries early in life prior...

  2. Maternal medical risks during pregnancy and childhood externalizing behavior.

    Science.gov (United States)

    Jackson, Dylan B; Vaughn, Michael G

    2018-04-25

    Research has indicated that maternal health during the prenatal period and at delivery carries far reaching significance for the development of offspring. Even so, the role of the accumulation of maternal medical risks during pregnancy in the development of externalizing behavior during childhood has generally been overlooked. The present study investigates whether the accumulation of maternal medical risks during the prenatal period is positively associated with childhood externalizing behavior, and whether this association is stronger among male offspring. We examined a large, nationally representative sample of children who participated in the Early Childhood Longitudinal Study, Birth Cohort (ECLS-B). Information concerning maternal medical history, including the presence of a number of medical risks during pregnancy, was obtained through hospital records. A subsample of children with both parent and teacher reports of externalizing behavior during kindergarten was employed in the present study. A greater number of maternal medical risks during pregnancy increased the odds of childhood externalizing behavior across settings, but only among male offspring. The predicted probability of persistent externalizing behavior among males increased from .084 in the absence of maternal medical risks during pregnancy to .241 in the presence of three or more maternal medical risks during pregnancy. Our findings suggest that maternal medical risks during the prenatal period can have far-reaching consequences for the behavioral development of male offspring. Treatment of medical risks among expectant mothers may have the added benefit of reducing the likelihood of childhood externalizing behavior among male progeny. Copyright © 2018 Elsevier Ltd. All rights reserved.

  3. Stimulant ADHD Medications -- Methylphenidate and Amphetamines

    Science.gov (United States)

    ... g., to help study or boost grades in school; see box). Stimulant ADHD Medications • January 2014 • Page 1 Because they may ... taken by people who do not actually have ADHD. Also, research has shown that ... have lower GPAs in high school and college than those who don’t. How ...

  4. Evaluating medical and systemic factors related to maternal and ...

    African Journals Online (AJOL)

    Background: This study examined maternal morbidity and mortality and neonatal mortality over a multi-year period from de-identified retrospective medical records at Nyakahanga Designated District Hospital in north-western Tanzania. The study aimed to examine factors related to maternal mortality (MMR) and morbidity in ...

  5. Maternal Mortality at Federal Medical Centre Yola, Adamawa State ...

    African Journals Online (AJOL)

    the management of the Federal Medical centre Yola before the .... response to emergencies may help reduce deaths from obstetric ... HIV, anesthetic deaths and Diabetic ketoacidosis (DKA) were the indirect causes of maternal mortality.

  6. Maternal medication and breastfeeding: Current recommendations ...

    African Journals Online (AJOL)

    The benefits of breastfeeding for infants in the first year of life in developing countries1 and developed countries2 are well established. In addition, maternal benefits such as earlier return to pre-pregnant weight,3 increased child spacing,4 improved bone re-mineralization postpartum,5 reduction in hip fractures in the ...

  7. Medical back belt with integrated neuromuscular electrical stimulation

    NARCIS (Netherlands)

    Bottenberg, E. (Eliza); Brinks, G.J. (Ger); Hesse, J. (Jenny)

    2014-01-01

    The medical back belt with integrated neuromuscular electrical stimulation is anorthopedic device, which has two main functions. The first function is to stimulate the backmuscles by using a neuromuscular electrical stimulation device that releases regular,electrical impulses. The second function of

  8. Prevalence of Self-Medication of Psychoactive Stimulants and ...

    African Journals Online (AJOL)

    Purpose: To evaluate the prevalence of self-medication of psychoactive stimulants and antidepressants among pharmacy students of Pakistan. Methods: A cross-sectional survey on self-medication of psychoactive stimulants and antidepressants among pharmacy students was conducted with a structured and validated ...

  9. Stimulant ADHD medication and risk for substance abuse.

    Science.gov (United States)

    Chang, Zheng; Lichtenstein, Paul; Halldner, Linda; D'Onofrio, Brian; Serlachius, Eva; Fazel, Seena; Långström, Niklas; Larsson, Henrik

    2014-08-01

    There are persistent concerns of long-term effects of stimulant ADHD medication on the development of substance abuse. Using Swedish national registers, we studied all individuals born between 1960 and 1998 and diagnosed with ADHD (26,249 men and 12,504 women). We investigated the association between stimulant ADHD medication in 2006 and substance abuse during 2009. Substance abuse was indexed by substance-related death, crime, or hospital visits. ADHD medication was not associated with increased rate of substance abuse. Actually, the rate during 2009 was 31% lower among those prescribed ADHD medication in 2006, even after controlling for medication in 2009 and other covariates (hazard ratio: 0.69; 95% confidence interval: 0.57-0.84). Also, the longer the duration of medication, the lower the rate of substance abuse. Similar risk reductions were suggested among children and when investigating the association between stimulant ADHD medication and concomitant short-term abuse. We found no indication of increased risks of substance abuse among individuals prescribed stimulant ADHD medication; if anything, the data suggested a long-term protective effect on substance abuse. Although stimulant ADHD medication does not seem to increase the risk for substance abuse, clinicians should remain alert to the potential problem of stimulant misuse and diversion in ADHD patients. © 2013 The Authors. Journal of Child Psychology and Psychiatry © 2013 Association for Child and Adolescent Mental Health.

  10. Cognitive Functioning in Toddlerhood: The Role of Gestational Age, Attention Capacities, and Maternal Stimulation

    Science.gov (United States)

    de Jong, Marjanneke; Verhoeven, Marjolein; Hooge, Ignace T. C.; Maingay-Visser, Arnoldina P. G. F.; Spanjerberg, Louise; van Baar, Anneloes L.

    2018-01-01

    Why do many preterm children show delays in development? An integrated model of biological risk, children's capacities, and maternal stimulation was investigated in relation to cognitive functioning at toddler age. Participants were 200 Dutch children (gestational age = 32-41 weeks); 51% boys, 96% Dutch nationality, 71.5% highly educated mothers.…

  11. Maternal and fetal outcomes associated with vagus nerve stimulation during pregnancy

    DEFF Research Database (Denmark)

    Sabers, Anne; Battino, Dina; Bonizzoni, Erminio

    2017-01-01

    OBJECTIVE: To access the effect of vagus nerve stimulation (VNS) on the outcome of pregnancy. METHODS: We used the International Registry of Antiepileptic Drugs and Pregnancy (EURAP) and its network to search for women receiving adjunctive VNS during pregnancy. Data on maternal and fetal outcomes...

  12. Stimulating medical education research in the Netherlands

    NARCIS (Netherlands)

    Jaarsma, Debbie; Scherpbier, Albert; Van Der Vleuten, Cees; Ten Cate, Olle

    BACKGROUND: Since the 1970s, the Dutch have been active innovators and researchers in the medical education domain. With regards to the quantity of publications in the medical education literature, the Netherlands rank second among countries in Europe and fourth worldwide over the past years,

  13. Maternal and littermate deprivation disrupts maternal behavior and social-learning of food preference in adulthood: tactile stimulation, nest odor, and social rearing prevent these effects.

    Science.gov (United States)

    Melo, Angel I; Lovic, Vedran; Gonzalez, Andrea; Madden, Melissa; Sinopoli, Katia; Fleming, Alison S

    2006-04-01

    Maternal and littermate (social) separation, through artificial rearing (AR), disrupts the development of subsequent maternal behavior and social learning in rats. The addition of maternal-licking-like stimulation during AR, partially reverses some of these effects. However, little is know about the role of social stimuli from littermates and nest odors during the preweaning period, in the development of the adult maternal behavior and social learning. The purpose of this study was to examine the effects of peer- and peer-and-odor rearing on the development of maternal behavior and social learning in rats. Female pups were reared with mothers (mother reared-MR) or without mothers (AR) from postnatal day (PND) 3. AR rats received three different treatments: (1) AR-CONTROL group received minimal tactile stimulation, (2) AR-ODOR females received exposure to maternal nest material inside the AR-isolation-cup environment, (3) AR-SOCIAL group was reared in the cup with maternal nest material and a conspecific of the same-age and same-sex and received additional tactile stimulation. MR females were reared by their mothers in the nest and with conspecifics. In adulthood, rats were tested for maternal behavior towards their own pups and in a social learning task. Results confirm our previous report that AR impairs performance of maternal behavior and the development of a social food preference. Furthermore, social cues from a littermate, in combination with tactile stimulation and the nest odor, reversed the negative effects of complete isolation (AR-CONTROL) on some of the above behaviors. Exposure to the odor alone also had effects on some of these olfactory-mediated behaviors. These studies indicate that social stimulation from littermates during the preweaning period, in combination with odor from the nest and tactile stimulation, contributes to the development of affiliative behaviors. Copyright (c) 2006 Wiley Periodicals, Inc.

  14. Effects of Stimulant Medication under Varied Motivational Operations

    Science.gov (United States)

    Mace, F. Charles; Prager, Kevin L.; Thomas, Karen; Kochy, Jane; Dyer, Tim J.; Perry, Lora; Pritchard, Duncan

    2009-01-01

    We evaluated the evocative effects of four conditions (high- and low-preference activities, low and divided attention) and stimulant medication on the behavior of a 16-year-old boy with attention deficit hyperactivity disorder and moderate mental retardation. All behavior (activity engagement, activity changes, inappropriate touching, rude…

  15. Stimulant Medication and the Hyperactive Adolescent: Myths and Facts.

    Science.gov (United States)

    Clampit, M. K.; Pirkle, Jane B.

    1983-01-01

    Reviews literature that describes the rational and nonrational factors sustaining the myth that stimulant medication is ineffective for hyperactive adolescents. Discusses methodological problems and factors--such as increasing size, misbehavior and misattribution, and perceived relationship to drug abuse--that influence treatment decisions. (JAC)

  16. Maternal tissue is involved in stimulant reception by seeds of the parasitic plant Orobanche.

    Science.gov (United States)

    Plakhine, Dina; Tadmor, Yaakov; Ziadne, Hammam; Joel, Daniel M

    2012-04-01

    A fundamental element in the evolution of obligate root-parasitic angiosperms is their ability to germinate only in response to chemical stimulation by roots, to ensure contact with a nearby nourishing host. The aim of this study was to explore inheritance of the unique germination control in this group of plants. Analysis was made of the segregation of spontaneous (non-induced) germination that appeared in hybrid progenies derived from crosses between Orobanche cernua and O. cumana, which, like all other Orobanche species, are totally dependent on chemical stimulation for the onset of germination, and show negligible spontaneous germination in their natural seed populations. F(1) and F(2) seeds did not germinate in the absence of chemical stimulation, but significant spontaneous germination was found in some F(3) seed families. This indicates that the prevention of non-induced germination in Orobanche seeds, i.e. dependence on an external chemical stimulation for seed germination, is genetically controlled, that this genetic control is expressed in a seed tissue with maternal origin (presumably the perisperm that originates from the nucellus) and that genetic variation for this trait exists in Orobanche species. Similar segregation results were obtained in reciprocal crosses, suggesting that stimulated germination is controlled by nuclear genes.

  17. Maternal role attainment with medically fragile infants: Part 2. relationship to the quality of parenting.

    Science.gov (United States)

    Holditch-Davis, Diane; Miles, Margaret Shandor; Burchinal, Margaret R; Goldman, Barbara Davis

    2011-02-01

    We examined which components of maternal role attainment (identity, presence, competence) influenced quality of parenting for 72 medically fragile infants, controlling for maternal education and infant illness severity. Maternal competence was related to responsiveness. Maternal presence and technology dependence were inversely related to participation. Greater competence and maternal education were associated with better normal caregiving. Presence was negatively related although competence was positively related to illness-related caregiving. Mothers with lower competence and more technology dependent children perceived their children as more vulnerable and child cues as more difficult to read. Maternal role attainment influenced parenting quality for these infants more than did child illness severity; thus interventions are needed to help mothers develop their maternal role during hospitalization and after discharge. © 2010 Wiley Periodicals, Inc. Res Nurs Health 34:35-48, 2011. Copyright © 2010 Wiley Periodicals, Inc.

  18. A comparison of maternal sensitivity and verbal stimulation as unique predictors of infant social-emotional and cognitive development.

    Science.gov (United States)

    Page, Melissa; Wilhelm, Mari S; Gamble, Wendy C; Card, Noel A

    2010-02-01

    Although maternal sensitivity has been shown to influence social-emotional development, the role of verbal stimulation on infant developmental outcomes has received less exploration. Recent research has focused on intentional behaviors within the context of a mother-infant interaction as a critical influence and as distinct from sensitivity. In this investigation 6377 mother-infant dyads participated in a teaching task as part of the sample from the Early Childhood Longitudinal Study Birth Cohort (ECLS-B). Analyses focused in deciphering the role of maternal sensitivity and verbal stimulation as contributors to the infant's social-emotional (S-E) and cognitive (Cog) development. We further hypothesized that inclusion of infant age as a moderator of maternal behaviors would illuminate any differences between younger and older infants. For the infant's S-E development, our hypothesis that maternal sensitivity would be a stronger predictor than verbal stimulation was not supported; nor did we find support for our hypothesis that the association would be moderated by age. For Cog development, only verbal stimulation had a direct positive effect on the infant's cognitive ability; our findings for moderation showed that mothers spoke more to older infants than younger infants. Identification of specific maternal behaviors associated with infant outcomes informs the child development field, and also provides strategies for early intervention to assist mothers with developing or maintaining a consistent relationship that includes sensitivity and verbal stimulation. Published by Elsevier Inc.

  19. Enabling coordination within medical settings: case of a maternity ward

    Directory of Open Access Journals (Sweden)

    Fouzi LEZZAR

    2013-06-01

    Full Text Available Purpose: This study evaluates the planning process issues in healthcare institutions that can be considered as a high risk environment. Most recent healthcare research has focused on methods mainly based on communication, rather than collaboration supports. Material Methods: We followed then a collaborative-based planning approach which constitutes an evolution of planning environment toward new shared workspaces supporting collaboration. Our work led us first, to analyse the related tasks in an Algerian maternity ward in order to highlight the vital collaborative medical tasks that need to be modelled. Results: the paper summaries basic design concepts of our collaborative planning system that is designed to make group interaction support flexible for care coordination and continuity. Conclusion: after development and test of our collaborative planning system, we noticed that our collaborative and planning system can increase awareness and hence decrease coordination breakdowns, reduce costs of information collecting and sharing. All these factors constitute a crucial aspect of an efficient management of a hospital.

  20. A Comparison of Medical Birth Register Outcomes between Maternity Health Clinics and Integrated Maternity and Child Health Clinics in Southwest Finland.

    Science.gov (United States)

    Tuominen, Miia; Kaljonen, Anne; Ahonen, Pia; Mäkinen, Juha; Rautava, Päivi

    2016-07-08

    Primary maternity care services are globally provided according to various organisational models. Two models are common in Finland: a maternity health clinic and an integrated maternity and child health clinic. The aim of this study was to clarify whether there is a relation between the organisational model of the maternity health clinics and the utilisation of maternity care services, and certain maternal and perinatal health outcomes. A comparative, register-based cross-sectional design was used. The data of women (N = 2741) who had given birth in the Turku University Hospital area between 1 January 2009 and 31 December 2009 were collected from the Finnish Medical Birth Register. Comparisons were made between the women who were clients of the maternity health clinics and integrated maternity and child health clinics. There were no clinically significant differences between the clients of maternity health clinics and integrated maternity and child health clinics regarding the utilisation of maternity care services or the explored health outcomes. The organisational model of the maternity health clinic does not impact the utilisation of maternity care services or maternal and perinatal health outcomes. Primary maternity care could be provided effectively when integrated with child health services.

  1. First-trimester maternal serum human thyroid-stimulating hormone in chromosomally normal and Down syndrome pregnancies

    NARCIS (Netherlands)

    Pratt, JJ; de Wolf, BTHM; Mantingh, A

    Maternal serum human thyroid-stimulating hormone (TSH) levels were investigated in chromosomally normal and Down syndrome pregnancies to determine whether TSH can be used as a marker for Down syndrome in the first trimester. Measurements were conducted on stored serum samples collected from 23 Down

  2. Medical record validation of maternally reported history of preeclampsia

    NARCIS (Netherlands)

    M. Coolman (Marianne); C.J.M. de Groot (Christianne); V.W.V. Jaddoe (Vincent); A. Hofman (Albert); H. Raat (Hein); E.A.P. Steegers (Eric)

    2010-01-01

    textabstractObjective: In this study, we assessed the validity of maternally self-reported history of preeclampsia. Study Design and Setting: This study was embedded in the Generation R Study, a population-based prospective cohort study. Data were obtained from prenatal questionnaires and one

  3. Neonatal immune responses to TLR2 stimulation: Influence of maternal atopy on Foxp3 and IL-10 expression

    Directory of Open Access Journals (Sweden)

    Gold Diane R

    2006-03-01

    Full Text Available Abstract Background Maternal atopic background and stimulation of the adaptive immune system with allergen interact in the development of allergic disease. Stimulation of the innate immune system through microbial exposure, such as activation of the innate Toll-like-receptor 2 (TLR2, may reduce the development of allergy in childhood. However, little is known about the immunological effects of microbial stimulation on early immune responses and in association with maternal atopy. Methods We analyzed immune responses of cord blood mononuclear cells (CBMC from 50 healthy neonates (31 non-atopic and 19 atopic mothers. Cells were stimulated with the TLR2 agonist peptidoglycan (Ppg or the allergen house dust mite Dermatophagoides farinae (Derf1, and results compared to unstimulated cells. We analyzed lymphocyte proliferation and cytokine secretion of CBMC. In addition, we assessed gene expression associated with T regulatory cells including the transcription factor Foxp3, the glucocorticoid-induced TNF receptor (GITR, and the cytotoxic lymphocyte antigen 4 (CTLA4. Lymphocyte proliferation was measured by 3H-Thymidine uptake, cytokine concentrations determined by ELISA, mRNA expression of T cell markers by real-time RT-PCR. Results Ppg stimulation induced primarily IL-10 cytokine production, in addition to IFN-γ, IL-13 and TNF-α secretion. GITR was increased following Ppg stimulation (p = 0.07. Ppg-induced IL-10 production and induction of Foxp3 were higher in CBMC without, than with maternal atopy (p = 0.04, p = 0.049. IL-10 production was highly correlated with increased expression of Foxp3 (r = 0.53, p = 0.001, GITR (r = 0.47, p = 0.004 and CTLA4 (r = 0.49, p = 0.003, independent of maternal atopy. Conclusion TLR2 stimulation with Ppg induces IL-10 and genes associated with T regulatory cells, influenced by maternal atopy. Increased IL-10 and Foxp3 induction in CBMC of non-atopic compared to atopic mothers, may indicate an increased capacity to

  4. Advanced maternal age: ethical and medical considerations for assisted reproductive technology.

    Science.gov (United States)

    Harrison, Brittany J; Hilton, Tara N; Rivière, Raphaël N; Ferraro, Zachary M; Deonandan, Raywat; Walker, Mark C

    2017-01-01

    This review explores the ethical and medical challenges faced by women of advanced maternal age who decide to have children. Assisted reproductive technologies (ARTs) make post-menopausal pregnancy physiologically plausible, however, one must consider the associated physical, psychological, and sociological factors involved. A quasi-systematic review was conducted in PubMed and Ovid using the key terms post-menopause, pregnancy + MeSH terms [donations, hormone replacement therapy, assisted reproductive technologies, embryo donation, donor artificial insemination, cryopreservation]. Overall, 28 papers encompassing two major themes (ethical and medical) were included in the review. There are significant ethical considerations and medical (maternal and fetal) complications related to pregnancy in peri- and post-menopausal women. When examining the ethical and sociological perspective, the literature portrays an overall positive attitude toward pregnancy in advanced maternal age. With respect to the medical complications, the general consensus in the evaluated studies suggests that there is greater risk of complication for spontaneous pregnancy when the mother is older (eg, >35 years old). This risk can be mitigated by careful medical screening of the mother and the use of ARTs in healthy women. In these instances, a woman of advanced maternal age who is otherwise healthy can carry a pregnancy with a similar risk profile to that of her younger counterparts when using donated oocytes.

  5. Prevalence and Correlates of Stimulant Medication Misuse among the Collegiate Population

    Science.gov (United States)

    Prosek, Elizabeth A.; Giordano, Amanda L.; Turner, Kori D.; Bevly, Cynthia M.; Reader, Emily A.; LeBlanc, Yvette; Molina, Citlali E.; Vera, Ryan A.; Garber, Sage Ann

    2018-01-01

    Misuse of stimulant medication is pervasive among college students. In this study, we surveyed undergraduate college students (N = 3,038) at a large-sized Southwestern university. We examined unique characteristics of students misusing stimulant medication with a prescription (n = 74) and those misusing without a prescription (n = 356). Both…

  6. Association of Maternal Self-Medication and Over-the-Counter Analgesics for Children

    DEFF Research Database (Denmark)

    Jensen, Janne Fangel; Gottschau, Mathilde; Siersma, Volkert Dirk

    2014-01-01

    Self-medication with over-the-counter (OTC) analgesics, such as paracetamol (PCM), among children and adolescents is increasing and constitutes an important public health issue internationally. Reasons for this development are unclear; parental influence is suggested. Our objective was to examine...... whether self-medication with OTC analgesics among school-aged children is influenced by maternal self-reported health and medicine use, taking the child's frequency of pain into account....

  7. Maternal stress-associated cortisol stimulation may protect embryos from cortisol excess in zebrafish

    OpenAIRE

    Faught, Erin; Best, Carol; Vijayan, Mathilakath M.

    2016-01-01

    Abnormal embryo cortisol level causes developmental defects and poor survival in zebrafish (Danio rerio). However, no study has demonstrated that maternal stress leads to higher embryo cortisol content in zebrafish. We tested the hypothesis that maternal stress-associated elevation in cortisol levels increases embryo cortisol content in this asynchronous breeder. Zebrafish mothers were fed cortisol-spiked food for 5 days, to mimic maternal stress, followed by daily breeding for 10 days to mon...

  8. [Changing medical practices and nosocomial infection rates in French maternity units from 1997 to 2000].

    Science.gov (United States)

    Vincent-Boulétreau, A; Caillat-Vallet, E; Dumas, A M; Ayzac, L; Chapuis, C; Emery, M N; Girard, R; Haond, C; Lafarge-Leboucher, J; Tissot-Guerraz, F; Fabry, J

    2005-04-01

    In this study we describe the changes in medical practices and nosocomial infection rates in obstetrics observed through a surveillance network in the South East of France. The maternity units which belong to this network participated in voluntary surveillance using the network's methodology. The criteria for the diagnosis of nosocomial infections were in accordance with the methods described by the Centers for Disease Control and Prevention. 101240 pregnancies including 18503 caesareans (18.3%) were included in the network from 1997 to 2000. During the study period, nosocomial infection rates following caesarean section and vaginal delivery decreased respectively from 7.8% to 4.3% (p infection control programs in maternity units has been confirmed by the results of this surveillance network. During the study period, both obstetrics-related risk factors for nosocomial infection and observed hospital-acquired infection rates were dramatically reduced, what prove an improvement of quality of care in maternity units.

  9. Advanced maternal age: ethical and medical considerations for assisted reproductive technology

    Directory of Open Access Journals (Sweden)

    Harrison BJ

    2017-08-01

    Full Text Available Brittany J Harrison,1 Tara N Hilton,1 Raphaël N Rivière,1 Zachary M Ferraro,1–3 Raywat Deonandan,4 Mark C Walker1–3,51Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada; 2Division of Maternal-Fetal Medicine, University of Ottawa, The Ottawa Hospital, Ottawa, ON, Canada; 3Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, ON, Canada; 4University of Ottawa Interdisciplinary School of Health Sciences, Ottawa, ON, Canada; 5Department of Obstetrics, Gynecology and Newborn Care, The Ottawa Hospital, Ottawa, ON, CanadaObjectives: This review explores the ethical and medical challenges faced by women of advanced maternal age who decide to have children. Assisted reproductive technologies (ARTs make post-menopausal pregnancy physiologically plausible, however, one must consider the associated physical, psychological, and sociological factors involved.Methods: A quasi-systematic review was conducted in PubMed and Ovid using the key terms post-menopause, pregnancy + MeSH terms [donations, hormone replacement therapy, assisted reproductive technologies, embryo donation, donor artificial insemination, cryopreservation]. Overall, 28 papers encompassing two major themes (ethical and medical were included in the review.Conclusion: There are significant ethical considerations and medical (maternal and fetal complications related to pregnancy in peri- and post-menopausal women. When examining the ethical and sociological perspective, the literature portrays an overall positive attitude toward pregnancy in advanced maternal age. With respect to the medical complications, the general consensus in the evaluated studies suggests that there is greater risk of complication for spontaneous pregnancy when the mother is older (eg, >35 years old. This risk can be mitigated by careful medical screening of the mother and the use of ARTs in healthy women. In these instances, a woman of advanced maternal age who is otherwise healthy can carry a

  10. Pharmacological interventions for adolescents and adults with ADHD: stimulant and nonstimulant medications and misuse of prescription stimulants

    Directory of Open Access Journals (Sweden)

    Weyandt LL

    2014-09-01

    Full Text Available Lisa L Weyandt, Danielle R Oster, Marisa E Marraccini, Bergljot Gyda Gudmundsdottir, Bailey A Munro, Brynheld Martinez Zavras, Ben Kuhar Department of Psychology, University of Rhode Island, Kingston, RI, USA Abstract: Attention-deficit/hyperactivity disorder (ADHD is a neurodevelopmental disorder characterized by symptoms of inattention, hyperactivity, and impulsivity that cause functional impairment. Recent research indicates that symptoms persist into adulthood in the majority of cases, with prevalence estimates of approximately 5% in the school age population and 2.5%–4% in the adult population. Although students with ADHD are at greater risk for academic underachievement and psychosocial problems, increasing numbers of students with ADHD are graduating from high school and pursuing higher education. Stimulant medications are considered the first line of pharmacotherapy for individuals with ADHD, including college students. Although preliminary evidence indicates that prescription stimulants are safe and effective for college students with ADHD when used as prescribed, very few controlled studies have been conducted concerning the efficacy of prescription stimulants with college students. In addition, misuse of prescription stimulants has become a serious problem on college campuses across the US and has been recently documented in other countries as well. The purpose of the present systematic review was to investigate the efficacy of prescription stimulants for adolescents and young adults with ADHD and the nonmedical use and misuse of prescription stimulants. Results revealed that both prostimulant and stimulant medications, including lisdexamfetamine dimesylate, methylphenidate, amphetamines, and mixed-amphetamine salts, are effective at reducing ADHD symptoms in adolescents and adults with ADHD. Findings also suggest that individuals with ADHD may have higher rates of stimulant misuse than individuals without the disorder, and

  11. Gastroschisis in Europe - A Case-malformed-Control Study of Medication and Maternal Illness during Pregnancy as Risk Factors

    DEFF Research Database (Denmark)

    Given, Joanne E; Loane, Maria; Garne, Ester

    2017-01-01

    BACKGROUND: Gastroschisis, a congenital anomaly of the abdomen, is associated with young maternal age and has increased in prevalence in many countries. Maternal illness and medication exposure are among environmental risk factors implicated in its aetiology. METHODS: A population-based case-malf...

  12. Competing risks model in screening for preeclampsia by maternal characteristics and medical history.

    Science.gov (United States)

    Wright, David; Syngelaki, Argyro; Akolekar, Ranjit; Poon, Leona C; Nicolaides, Kypros H

    2015-07-01

    The purpose of this study was to develop a model for preeclampsia based on maternal demographic characteristics and medical history. This was a screening study of 120,492 singleton pregnancies at 11-13 weeks' gestation, including 2704 pregnancies (2.2%) that experienced preeclampsia. A survival-time model for the gestational age at delivery with preeclampsia was developed from variables of maternal characteristics and history. This approach assumes that, if the pregnancy was to continue indefinitely, all women would experience preeclampsia and that whether they do so or not before a specified gestational age depends on competition between delivery before or after development of preeclampsia. A 5-fold cross validation study was conducted to compare the performance of the new model with the National Institute for Health and Clinical Excellence (NICE) guidelines. In the new model, increased risk for preeclampsia, with a consequent shift in the Gaussian distribution of the gestational age at delivery with preeclampsia to the left, is provided by advancing maternal age, increasing weight, Afro-Caribbean and South Asian racial origin, medical history of chronic hypertension, diabetes mellitus and systemic lupus erythematosus or antiphospholipid syndrome, family history and personal history of preeclampsia, and conception by in vitro fertilization. The risk for preeclampsia decreases with increasing maternal height and in parous women with no previous preeclampsia; in the latter, the protective effect, which is related inversely to the interpregnancy interval, persists beyond 15 years. At a screen-positive rate of 11%, as defined by NICE, the new model predicted 40%, 48%, and 54% of cases of total preeclampsia and preeclampsia requiring delivery at preeclampsia. Such estimation of the a priori risk for preeclampsia is an essential first step in the use of Bayes theorem to combine maternal factors with biomarkers for the continuing development of more effective methods of

  13. What does quality maternity care mean in a context of medical pluralism? Perspectives of women in Nigeria

    Science.gov (United States)

    Izugbara, Chimaraoke O; Wekesah, Frederick

    2018-01-01

    Abstract User priorities regarding quality care in contexts of medical pluralism are poorly documented. Drawing on group and individual interviews with women, we interrogate ideas of quality maternity care in the context of Nigeria’s medical pluralism. We found complex utilization patterns for conventional, complementary and alternative maternity care services as well as ideas of quality maternity care that stress effective coordination and integration of different typologies of maternity health services; socially sensitive and truthful providers; and socioeconomic, physical and parochial forms of safety. Informal providers were the commonly reported source of maternal health services in the study. Maternal health services in the country were also generally viewed as poor quality, characterized by pervasive abuse, quackery and lack of commitment to the needs and sensitivities of women. Convenience, availability and affordability of maternal health services, as well as sociocultural factors were major influences on women’s use of services. Results demonstrate the embeddedness of women’s quality of care notions in the vast socioeconomic inequities that typify Nigeria’s particular form of poorly regulated medical pluralism, raising need for strategies to strengthen the delivery, coordination and supervision of maternal health services in the country. PMID:29036530

  14. Protection of workers during medical application of transcranial magnetic stimulation

    International Nuclear Information System (INIS)

    Mischke, Marian

    2017-01-01

    Transcranial magnetic stimulation (TMS) is used in various applications in medicine. TMS is accompanied by relevant exposures by (extremely) low frequency magnetic fields. The applications can pose a threat to workers' health and safety at work through direct and indirect effects. Since the end of last year, the EMFV has been published to specify the obligations of the employer in association to ''Arbeitsschutzgesetz'' with regards to electromagnetic fields. Based on conventional types of equipment for the TMS, a possible procedure is presented for the employer to fulfill his duties.

  15. Subthalamic deep brain stimulation and dopaminergic medication in Parkinson's disease: Impact on inter-limb coupling.

    Science.gov (United States)

    Daneault, Jean-François; Carignan, Benoit; Sadikot, Abbas F; Duval, Christian

    2016-10-29

    Patients with Parkinson's disease (PD) often present with bimanual coordination deficits whose exact origins remain unclear. One aspect of bimanual coordination is inter-limb coupling. This is characterized by the harmonization of movement parameters between limbs. We assessed different aspects of bimanual coordination in patients with PD, including inter-limb coupling, and determined whether they are altered by subthalamic (STN) deep brain stimulation (DBS) or dopaminergic medication. Twenty PD patients were tested before STN DBS surgery; with and without medication. Post- surgery, patients were tested with their stimulators on and off as well as with and without medication. Patients were asked to perform a unimanual and bimanual rapid repetitive diadochokinesis task. The difference in mean amplitude and mean duration of cycles between hands was computed in order to assess inter-limb coupling. Also, mean angular velocity of both hands and structural coupling were computed for the bimanual task. There was a positive effect of medication and stimulation on mean angular velocity, which relates to clinical improvement. PD patients exhibited temporal inter-limb coupling that was not altered by either medication or STN stimulation. However, PD patients did not exhibit spatial inter-limb coupling. Again, this was not altered by medication or stimulation. Collectively, the results suggest that structures independent of the dopaminergic system and basal ganglia may mediate temporal and spatial inter-limb coupling. Copyright © 2016 IBRO. Published by Elsevier Ltd. All rights reserved.

  16. Effects of maternal sensitivity and cognitive and linguistic stimulation on cochlear implant users' language development over four years.

    Science.gov (United States)

    Quittner, Alexandra L; Cruz, Ivette; Barker, David H; Tobey, Emily; Eisenberg, Laurie S; Niparko, John K

    2013-02-01

    To examine the effects of observed maternal sensitivity (MS), cognitive stimulation (CS), and linguistic stimulation on the 4-year growth of oral language in young, deaf children receiving a cochlear implant. Previous studies of cochlear implants have not considered the effects of parental behaviors on language outcomes. In this prospective, multisite study, we evaluated parent-child interactions during structured and unstructured play tasks and their effects on oral language development in 188 deaf children receiving a cochlear implant and 97 normal-hearing children as controls. Parent-child interactions were rated on a 7-point scale using the National Institute of Child Health and Human Development's Early Childcare Study codes, which have well-established psychometric properties. Language was assessed using the MacArthur Bates Communicative Development Inventories, the Reynell Developmental Language Scales, and the Comprehensive Assessment of Spoken Language. We used mixed longitudinal modeling to test our hypotheses. After accounting for early hearing experience and child and family demographics, MS and CS predicted significant increases in the growth of oral language. Linguistic stimulation was related to language growth only in the context of high MS. The magnitude of effects of MS and CS on the growth of language was similar to that found for age at cochlear implantation, suggesting that addressing parenting behaviors is a critical target for early language learning after implantation. Copyright © 2013 Mosby, Inc. All rights reserved.

  17. Occipital nerve stimulation in medically intractable, chronic cluster headache. The ICON study

    DEFF Research Database (Denmark)

    Wilbrink, Leopoldine A; Teernstra, Onno Pm; Haan, Joost

    2013-01-01

    study is performed. DISCUSSION: The ICON study will show if ONS is an effective preventive therapy for patients suffering medically intractable chronic cluster headache and if there is a difference between high- and low-amplitude stimulation. The innovative design of the study will, for the first time......BACKGROUND: About 10% of cluster headache patients have the chronic form. At least 10% of this chronic group is intractable to or cannot tolerate medical treatment. Open pilot studies suggest that occipital nerve stimulation (ONS) might offer effective prevention in these patients. Controlled...

  18. Poverty and maternal mortality in Nigeria: towards a more viable ethics of modern medical practice

    Directory of Open Access Journals (Sweden)

    Lanre-Abass Bolatito A

    2008-04-01

    Full Text Available Abstract Poverty is often identified as a major barrier to human development. It is also a powerful brake on accelerated progress toward the Millennium Development Goals. Poverty is also a major cause of maternal mortality, as it prevents many women from getting proper and adequate medical attention due to their inability to afford good antenatal care. This Paper thus examines poverty as a threat to human existence, particularly women's health. It highlights the causes of maternal deaths in Nigeria by questioning the practice of medicine in this country, which falls short of the ethical principle of showing care. Since high levels of poverty limit access to quality health care and consequently human development, this paper suggests ways of reducing maternal mortality in Nigeria. It emphasizes the importance of care ethics, an ethical orientation that seeks to rectify the deficiencies of medical practice in Nigeria, notably the problem of poor reproductive health services. Care ethics as an ethical orientation, attends to the important aspects of our shared lives. It portrays the moral agent (in this context the physician as a self who is embedded in webs of relations with others (pregnant women. Also central to this ethical orientation is responsiveness in an interconnected network of needs, care and prevention of harm. This review concludes by stressing that many human relationships involve persons who are vulnerable, including pregnant women, dependent, ill and or frail, noting that the desirable moral response is that prescribed by care ethics, which thus has implications for the practice of medicine in Nigeria.

  19. Law and the medicalization of maternity, paternity, and childbirth in Cuba

    Directory of Open Access Journals (Sweden)

    García-Jordá D

    2012-05-01

    Full Text Available The childbirth is a transcendental moment in personal and family life. During this event, some aspects are revised related with femininity and masculinity. Objective: from this perspective, was carried out this research with the purpose of understand how the maternity representation, the medical system that attend childbirth and the laws influence in the conception and practice of maternity and paternity during the pregnant, labour, and puerperium. Methodology: some qualitative techniques were used, as interviews and open observation to women and their partners (spouses or common laws who were attended in three hospitals of Havana. Results: the results show as the traditional gender roles are reinforced by the laws, institutional regulations and the medical practice in hospitals. This traditional view has been that women take on most child care responsibilities and men are relegated of this. Parallel with this, a new form of masculinity emerges as a result of the increasing of participation of men in the event and in household activities and the externalization of feelings when they know their children. Conclusion: New gender policies are needed in order to deconstruct the patriarchal culture and develop egalitarian and democratic relationships in Cuban society

  20. Informed consent and stimulant medication: adolescents' and parents' ability to understand information about benefits and risks of stimulant medication for the treatment of attention-deficit/hyperactivity disorder.

    Science.gov (United States)

    Schachter, Debbie; Tharmalingam, Sukirtha; Kleinman, Irwin

    2011-04-01

    This study of informed consent examines understanding of information needed to consent to stimulant treatment for attention-deficit/hyperactivity disorder (ADHD). The understanding of adolescents with ADHD, their parents, control adolescents, and their parents is compared. Fifty-eight ADHD and 64 control adolescents between the ages of 12 and 16 and their parents were studied. Baseline understanding of information was determined. Subjects received information relevant to informed consent for stimulation medication and afterward were evaluated on their recall understanding and their final understanding. Knowledge was increased after the information session for all subjects. There was no significant difference between unadjusted baseline, recall, and final knowledge of control adolescents and parents. Although unadjusted baseline, recall, and final knowledge of ADHD adolescents is significantly less than that of parents, 78% of ADHD adolescents had final understanding scores within 2 standard deviations of parents' scores. After controlling for baseline understanding and cognitive variables, there was no significant difference between understanding of ADHD adolescents and ADHD parents, whereas control adolescents understanding scores were higher than that of their parents. Understanding was highly associated with mathematics achievement in all groups. The majority of adolescents with ADHD, both with and without a history of stimulant medication treatment, have understanding that is similar to their parents and their inclusion in the informed consent process should be encouraged. Extra care should be afforded to those adolescents with low numeracy or literacy to ensure their understanding.

  1. Maternity patients' access to their electronic medical records: use and perspectives of a patient portal.

    Science.gov (United States)

    Megan Forster, Megan; Dennison, Kerrie; Callen, Joanne; Andrew, Andrew; Westbrook, Johanna I

    Patients have been able to access clinical information from their paper-based health records for a number of years. With the advent of Electronic Medical Records (EMRs) access to this information can now be achieved online using a secure electronic patient portal. The purpose of this study was to investigate maternity patients' use and perceptions of a patient portal developed at the Mater Mothers' Hospital in Brisbane, Australia. A web-based patient portal, one of the first developed and deployed in Australia, was introduced on 26 June 2012. The portal was designed for maternity patients booked at Mater Mothers' Hospital, as an alternative to the paper-based Pregnancy Health Record. Through the portal, maternity patients are able to complete their hospital registration form online and obtain current health information about their pregnancy (via their EMR), as well as access a variety of support tools to use during their pregnancy such as tailored public health advice. A retrospective cross-sectional study design was employed. Usage statistics were extracted from the system for a one year period (1 July 2012 to 30 June 2013). Patients' perceptions of the portal were obtained using an online survey, accessible by maternity patients for two weeks in February 2013 (n=80). Descriptive statistics were employed to analyse the data. Between July 2012 and June 2013, 10,892 maternity patients were offered a patient portal account and access to their EMR. Of those 6,518 created one (60%; 6,518/10,892) and 3,104 went on to request access to their EMR (48%; 3,104/6,518). Of these, 1,751 had their access application granted by 30 June 2013. The majority of maternity patients submitted registration forms online via the patient portal (56.7%). Patients could view their EMR multiple times: there were 671 views of the EMR, 2,781 views of appointment schedules and 135 birth preferences submitted via the EMR. Eighty survey responses were received from EMR account holders, (response

  2. Globus Pallidus Interna Deep Brain Stimulation in a Patient with Medically Intractable Meige Syndrome

    Directory of Open Access Journals (Sweden)

    Dae-Woong Bae

    2014-10-01

    Full Text Available Medical therapies in patients with Meige syndrome, including botulinum toxin injection, have been limited because of incomplete response or adverse side effects. We evaluated a patient with Meige syndrome who was successfully treated with deep brain stimulation (DBS in the globus pallidus interna (GPi. This case report and other previous reports suggest that bilateral GPi DBS may be an effective treatment for medically refractory Meige syndrome, without significant adverse effects.

  3. Serum alpha-fetoprotein in the three trimesters of pregnancy: effects of maternal characteristics and medical history.

    Science.gov (United States)

    Bredaki, F E; Sciorio, C; Wright, A; Wright, D; Nicolaides, K H

    2015-07-01

    To define the contribution of maternal variables which influence the measured level of maternal serum alpha-fetoprotein (AFP) in screening for pregnancy complications. Maternal characteristics and medical history were recorded and serum AFP was measured in women with a singleton pregnancy attending for three routine hospital visits at 11 + 0 to 13 + 6, 19 + 0 to 24 + 6 and 30 + 0 to 34 + 6 weeks' gestation. For pregnancies delivering phenotypically normal live births or stillbirths ≥ 24 weeks' gestation, variables from maternal demographic characteristics and medical history that are important in the prediction of AFP were determined from a linear mixed-effects multiple regression. Serum AFP was measured in 17 071 cases in the first trimester, 8583 in the second trimester and 8607 in the third trimester. Significant independent contributions to serum AFP were provided by gestational age, maternal weight, racial origin, gestational age at delivery and birth-weight Z-score of the neonate of the previous pregnancy and interpregnancy interval. Cigarette smoking was found to significantly affect serum AFP in the first trimester only. The machine used to measure serum AFP was also found to have a significant effect. Random-effects multiple regression analysis was used to define the contribution of maternal variables that influence the measured level of serum AFP and express the values as multiples of the median (MoMs). The model was shown to provide an adequate fit of MoM values for all covariates, both in pregnancies that developed pre-eclampsia and in those without this pregnancy complication. A model was fitted to express measured serum AFP across the three trimesters of pregnancy as MoMs, after adjusting for variables from maternal characteristics and medical history that affect this measurement. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd.

  4. Parental perceptions and satisfaction with stimulant medication for attention-deficit hyperactivity disorder.

    Science.gov (United States)

    Dosreis, Susan; Zito, Julie Magno; Safer, Daniel J; Soeken, Karen L; Mitchell, John W; Ellwood, Leslie C

    2003-06-01

    Few reports have documented parental perceptions of stimulants for attention-deficit hyperactivity disorder (ADHD), despite the recent increased use of stimulants among youths. Of 302 parents recruited from six pediatric primary care clinics, 84% completed a survey of their knowledge, attitudes, and satisfaction with the medication their child was taking for ADHD. Two thirds of the parents believed that sugar and diet affect hyperactivity. Although few parents believed that stimulants could lead to drug abuse, 55% initially were hesitant to use medication on the basis of information in the lay press, and 38% believed that too many children receive medication for ADHD. Parents were more satisfied with the behavioral and academic improvement relative to improvement in their child's self-esteem. Attitudes were positively correlated with satisfaction and were more positive among white than nonwhite parents. The findings highlight parental misconceptions and reservations about ADHD medication treatment that require clarification as to whether race/ethnicity, income, and social status influence their views and use of treatments.

  5. Sustained Medication Reduction Following Unilateral VIM Thalamic Stimulation for Essential Tremor.

    Science.gov (United States)

    Resnick, Andrew S; Okun, Michael S; Malapira, Teresita; Smith, Donald; Vale, Fernando L; Sullivan, Kelly; Miller, Amber; Jahan, Israt; Zesiewicz, Theresa

    2012-01-01

    Deep brain stimulation (DBS) is an increasingly utilized therapeutic modality for the management of medication refractory essential tremor (ET). The aim of this study was to determine whether DBS allowed for anti-tremor medication reduction within the year after the procedure was performed. We conducted a retrospective chart review and telephone interviews on 34 consecutive patients who had been diagnosed with ET, and who had undergone unilateral DBS surgery. Of the 34 patients in our cohort, 31 patients (91%) completely stopped all anti-tremor medications either before surgery (21 patients, 62%) or in the year following DBS surgery (10 patients, 29%). Patients who discontinued tremor medications before DBS surgery did so because their tremors either became refractory to anti-tremor medication, or they developed adverse events to tremor medications. Patients who stopped tremor medications after DBS surgery did so due to sufficient tremor control. Only three patients (9%) who were taking tremor medications at the time of surgery continued the use of a beta-blocker post-operatively for the purpose of hypertension management in all cases. The data from this study indicate that medication cessation is common following unilateral DBS for ET.

  6. Sustained Medication Reduction Following Unilateral VIM Thalamic Stimulation for Essential Tremor

    Directory of Open Access Journals (Sweden)

    Andrew S. Resnick

    2012-04-01

    Full Text Available Background: Deep brain stimulation (DBS is an increasingly utilized therapeutic modality for the management of medication refractory essential tremor (ET. The aim of this study was to determine whether DBS allowed for anti-tremor medication reduction within the year after the procedure was performed. Methods: We conducted a retrospective chart review and telephone interviews on 34 consecutive patients who had been diagnosed with ET, and who had undergone unilateral DBS surgery. Results: Of the 34 patients in our cohort, 31 patients (91% completely stopped all anti-tremor medications either before surgery (21 patients, 62% or in the year following DBS surgery (10 patients, 29%. Patients who discontinued tremor medications before DBS surgery did so because their tremors either became refractory to anti-tremor medication, or they developed adverse events to tremor medications. Patients who stopped tremor medications after DBS surgery did so due to sufficient tremor control. Only three patients (9% who were taking tremor medications at the time of surgery continued the use of a beta-blocker post-operatively for the purpose of hypertension management in all cases. Discussion: The data from this study indicate that medication cessation is common following unilateral DBS for ET. 

  7. Risk of amphetamine use disorder and mortality among incident users of prescribed stimulant medications in the Veterans Administration.

    Science.gov (United States)

    Westover, Arthur N; Nakonezny, Paul A; Halm, Ethan A; Adinoff, Bryon

    2018-05-01

    Non-medical use of prescribed stimulant medications is a growing concern. This study's aims were to ascertain the demographics of stimulant medication users compared with non-users, examine temporal trends of stimulant medication use and estimate risk factors for development of amphetamine use disorder (AUD) and mortality among new users of stimulant medications. Cox proportional hazards regression in a retrospective cohort adjusted by baseline covariates. United States, national administrative database of the Veterans Affairs (VA) health-care system. Adult incident users of stimulant medications (n = 78 829) from fiscal years (FY) 2001 to 2012. Primary outcomes were time-to-event: (1) occurrence of AUD diagnosis and (2) death. Baseline covariates included demographic information, Food and Drug Administration (FDA)-approved indications for stimulant use, substance use disorders (SUD) and depression. Stimulant users compared with non-users were younger, more likely to be non-Hispanic white and female. Incident stimulant medication users increased threefold from FY2001-FY2012 and eightfold among adults aged 18-44 years. Nearly one in 10 incident users in FY2012 had a comorbid baseline SUD. Off-label use was common-nearly three of every five incident users in FY2012. Comorbid SUDs among incident stimulant medication users were risk factors for occurrence of AUD during follow-up, with adjusted hazard ratio (AHR) estimates ranging from 1.54 to 2.83 (Ps users in the Veterans Affairs health-care system, measured from fiscal years 2001 to 2012, comorbid substance use disorders were common and were risk factors for development of an amphetamine use disorder (AUD). Increased mortality risk among incident users of stimulant medications was observed among both those who developed an AUD later and those whose use was defined as off-label. © 2017 Society for the Study of Addiction.

  8. Estimates of Maternal Mortality Ratio and the associated medical causes in Orissa and Rajasthan States - A cross sectional study

    Directory of Open Access Journals (Sweden)

    Abha Rani Aggarwal

    2015-03-01

    Full Text Available Background: Maternal Mortality Ratio (MMR is an important indicator of reproductive health and its reduction remains a challenge in India. Aims &Objective: This study was conducted with the aim of estimating MMR in two states Orissa and Rajasthan having high MMR as well as to identify the associated medical causes of maternal mortality. Material Methods: This survey was conducted from October 2010-June 2012 on a sample of 13 Primary Health Centres (PHCs in Orissa and 15 PHCs in Rajasthan. These numbers have been derived after estimating the total number of live births using MMR and birth rate from Sample Registration System. 1997-2003.An adapted snowball technique was adopted wherein maternal deaths were captured by snowball technique and the numbers of live births were taken from the available records from the various health facilities in the study.  Results: The overall birth rate in Orissa was found to be 19 per 1000 population while in Rajasthan it was 24 per 1000 population. The study revealed that 17% additional maternal deaths could be captured by snowball technique as against the official record. The overall weighted estimate of MMR was 252 per one lakh live births (95% CI: 246-259 per 1,00,000 live births in Orissa and 209 per one lakh live births (95% CI: 207-211 per one lakh live births in Rajasthan. The main causes of maternal deaths were post-partum haemorrhage, anaemia and septicaemia. More than 25% maternal deaths could be attributed to indirect causes including suicide, accident and infectious diseases. Conclusion: There appears to be a positive trend towards reduction of maternal mortality in Orissa and Rajasthan. Greater care is essential to reduce medical as well as incidental causes of death during pregnancy.

  9. Estimates of Maternal Mortality Ratio and the associated medical causes in Orissa and Rajasthan States - A cross sectional study

    Directory of Open Access Journals (Sweden)

    Abha Rani Aggarwal

    2015-03-01

    Full Text Available Background: Maternal Mortality Ratio (MMR is an important indicator of reproductive health and its reduction remains a challenge in India. Aims &Objective: This study was conducted with the aim of estimating MMR in two states Orissa and Rajasthan having high MMR as well as to identify the associated medical causes of maternal mortality. Material Methods: This survey was conducted from October 2010-June 2012 on a sample of 13 Primary Health Centres (PHCs in Orissa and 15 PHCs in Rajasthan. These numbers have been derived after estimating the total number of live births using MMR and birth rate from Sample Registration System. 1997-2003.An adapted snowball technique was adopted wherein maternal deaths were captured by snowball technique and the numbers of live births were taken from the available records from the various health facilities in the study.  Results: The overall birth rate in Orissa was found to be 19 per 1000 population while in Rajasthan it was 24 per 1000 population. The study revealed that 17% additional maternal deaths could be captured by snowball technique as against the official record. The overall weighted estimate of MMR was 252 per one lakh live births (95% CI: 246-259 per 1,00,000 live births in Orissa and 209 per one lakh live births (95% CI: 207-211 per one lakh live births in Rajasthan. The main causes of maternal deaths were post-partum haemorrhage, anaemia and septicaemia. More than 25% maternal deaths could be attributed to indirect causes including suicide, accident and infectious diseases. Conclusion: There appears to be a positive trend towards reduction of maternal mortality in Orissa and Rajasthan. Greater care is essential to reduce medical as well as incidental causes of death during pregnancy.

  10. Machine Learning Approach to Optimizing Combined Stimulation and Medication Therapies for Parkinson's Disease.

    Science.gov (United States)

    Shamir, Reuben R; Dolber, Trygve; Noecker, Angela M; Walter, Benjamin L; McIntyre, Cameron C

    2015-01-01

    Deep brain stimulation (DBS) of the subthalamic region is an established therapy for advanced Parkinson's disease (PD). However, patients often require time-intensive post-operative management to balance their coupled stimulation and medication treatments. Given the large and complex parameter space associated with this task, we propose that clinical decision support systems (CDSS) based on machine learning algorithms could assist in treatment optimization. Develop a proof-of-concept implementation of a CDSS that incorporates patient-specific details on both stimulation and medication. Clinical data from 10 patients, and 89 post-DBS surgery visits, were used to create a prototype CDSS. The system was designed to provide three key functions: (1) information retrieval; (2) visualization of treatment, and; (3) recommendation on expected effective stimulation and drug dosages, based on three machine learning methods that included support vector machines, Naïve Bayes, and random forest. Measures of medication dosages, time factors, and symptom-specific pre-operative response to levodopa were significantly correlated with post-operative outcomes (P < 0.05) and their effect on outcomes was of similar magnitude to that of DBS. Using those results, the combined machine learning algorithms were able to accurately predict 86% (12/14) of the motor improvement scores at one year after surgery. Using patient-specific details, an appropriately parameterized CDSS could help select theoretically optimal DBS parameter settings and medication dosages that have potential to improve the clinical management of PD patients. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. Prescription Stimulant Medication Misuse: Where Are We and Where Do We Go from Here?

    OpenAIRE

    Weyandt, Lisa L.; Oster, Danielle R.; Marraccini, Marisa Ellen; Gudmundsdottir, Bergljot Gyda; Munro, Bailey A.; Rathkey, Emma S.; Mccallum, Alison

    2016-01-01

    Prescription stimulants, including methylphenidate (e.g., Ritalin) and amphetamine compounds (e.g., dextroamphetamine; Adderall), have been approved by the U.S. Food and Drug Administration for the treatment of attention deficit hyperactivity disorder (ADHD) and are classified by the United States Drug Enforcement Administration (DEA) as Schedule II medications due to their high potential for abuse and dependence (DEA, U.S. Department of Justice, 2015). Despite the potential health and judici...

  12. Effect of Stimulant Medication Use by Children with ADHD on Heart Rate and Perceived Exertion

    Science.gov (United States)

    Mahon, Anthony D.; Woodruff, Megan E.; Horn, Mary P.; Marjerrison, Andrea D.; Cole, Andrew S.

    2012-01-01

    The effect of stimulant medication use by children with attention deficit/hyperactivity disorder (ADHD) on the rating of perceived exertion (RPE)--heart rate (HR) relationship was examined. Children with ADHD (n = 20; 11.3 [plus or minus] 1.8 yrs) and children without ADHD (n = 25; 11.2 [plus or minus] 2.1 yrs) were studied. Children with ADHD…

  13. Differentiated effects of deep brain stimulation and medication on somatosensory processing in Parkinson's disease.

    Science.gov (United States)

    Sridharan, Kousik Sarathy; Højlund, Andreas; Johnsen, Erik Lisbjerg; Sunde, Niels Aagaard; Johansen, Lars Gottfried; Beniczky, Sándor; Østergaard, Karen

    2017-07-01

    Deep brain stimulation (DBS) and dopaminergic medication effectively alleviate the motor symptoms in Parkinson's disease (PD) patients, but their effects on the sensory symptoms of PD are still not well understood. To explore early somatosensory processing in PD, we recorded magnetoencephalography (MEG) from thirteen DBS-treated PD patients and ten healthy controls during median nerve stimulation. PD patients were measured during DBS-treated, untreated and dopaminergic-medicated states. We focused on early cortical somatosensory processing as indexed by N20m, induced gamma augmentation (31-45Hz and 55-100Hz) and induced beta suppression (13-30Hz). PD patients' motor symptoms were assessed by UPDRS-III. Using Bayesian statistics, we found positive evidence for differentiated effects of treatments on the induced gamma augmentation (31-45Hz) with highest gamma in the dopaminergic-medicated state and lowest in the DBS-treated and untreated states. In contrast, UPDRS-III scores showed beneficial effects of both DBS and dopaminergic medication on the patients' motor symptoms. Furthermore, treatments did not affect the amplitude of N20m. Our results suggest differentiated effects of DBS and dopaminergic medication on cortical somatosensory processing in PD patients despite consistent ameliorating effects of both treatments on PD motor symptoms. The differentiated effect suggests differences in the effect mechanisms of the two treatments. Copyright © 2017 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.

  14. Paediatricians' decision making about prescribing stimulant medications for children with attention-deficit/hyperactivity disorder.

    Science.gov (United States)

    Chow, S-J; Sciberras, E; Gillam, L H; Green, J; Efron, D

    2014-05-01

    Attention-deficit/hyperactivity disorder (ADHD) is now the most common reason for a child to present to a paediatrician in Australia. Stimulant medications are commonly prescribed for children with ADHD, to reduce symptoms and improve function. In this study we investigated the factors that influence paediatricians' decisions about prescribing stimulant medications. In-depth, semi-structured interviews were conducted with paediatricians (n = 13) who were purposively recruited so as to sample a broad demographic of paediatricians working in diverse clinical settings. Paediatricians were recruited from public outpatient and private paediatrician clinics in Victoria, Australia. The interviews were audio-recorded and transcribed verbatim for thematic analysis. Paediatricians also completed a questionnaire describing their demographic and practice characteristics. Our findings showed that the decision to prescribe is a dynamic process involving two key domains: (1) weighing up clinical factors; and (2) interacting with parents and the patient along the journey to prescribing. Five themes relating to this process emerged from data analysis: comprehensive assessments that include history, examination and information from others; influencing factors such as functional impairment and social inclusion; previous success; facilitating parental understanding including addressing myths and parental confusion; and decision-making model. Paediatricians' decisions to prescribe stimulant medications are influenced by multiple factors that operate concurrently and interdependently. Paediatricians do not make decisions about prescribing in isolation; rather, they actively involve parents, teachers and patients, to arrive at a collective, well-informed decision. © 2013 John Wiley & Sons Ltd.

  15. Persistent Handwriting Difficulties in Children With ADHD After Treatment With Stimulant Medication.

    Science.gov (United States)

    Brossard-Racine, Marie; Shevell, Michael; Snider, Laurie; Bélanger, Stacey Ageranioti; Julien, Marilyse; Majnemer, Annette

    2015-07-01

    Children with ADHD often present with handwriting difficulties. However, the extent to which motor and attention skills influence performance in this group has not yet been explored. The objective of this study was to examine the factors associated with change in handwriting performance. This study examines the factors associated with change in handwriting performance of 49 children newly diagnosed with ADHD (mean age = 8.4 [SD=1.3] years) prior to and 3 months following use of a stimulant medication. Handwriting legibility and speed improved significantly at follow-up evaluation. However, most of the children with legibility difficulties at baseline continued to demonstrate difficulties when evaluated 3 months after initiation of medication. Change in handwriting legibility was best determined by improvements in visual-motor integration skills (β = 0.07-0.10; p Handwriting difficulties are common in children with ADHD, and medication alone is not sufficient to resolve these challenges. © 2012 SAGE Publications.

  16. Environmental stimulation rescues maternal high fructose intake-impaired learning and memory in female offspring: Its correlation with redistribution of histone deacetylase 4.

    Science.gov (United States)

    Wu, Kay L H; Wu, Chih-Wei; Tain, You-Lin; Huang, Li-Tung; Chao, Yung-Mei; Hung, Chun-Ying; Wu, Jin-Cheng; Chen, Siang-Ru; Tsai, Pei-Chia; Chan, Julie Y H

    2016-04-01

    Impairment of learning and memory has been documented in the later life of offspring to maternal consumption with high energy diet. Environmental stimulation enhances the ability of learning and memory. However, potential effects of environmental stimulation on the programming-associated deficit of learning and memory have not been addressed. Here, we examined the effects of enriched-housing on hippocampal learning and memory in adult female offspring rats from mother fed with 60% high fructose diet (HFD) during pregnancy and lactation. Impairment of spatial learning and memory performance in HFD group was observed in offspring at 3-month-old. Hippocampal brain-derived neurotrophic factor (BDNF) was decreased in the offspring. Moreover, the HFD group showed an up-regulation of histone deacetylase 4 (HDAC4) in the nuclear fractions of hippocampal neurons. Stimulation to the offspring for 4weeks after winning with an enriched-housing environment effectively rescued the decrease in cognitive function and hippocampal BDNF level; alongside a reversal of the increased distribution of nuclear HDAC4. Together these results suggest that later life environmental stimulation effectively rescues the impairment of hippocampal learning and memory in female offspring to maternal HFD intake through redistributing nuclear HDAC4 to increase BDNF expression. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. Non-Medical Prescription Stimulant Use in Graduate Students: Relationship With Academic Self-Efficacy and Psychological Variables.

    Science.gov (United States)

    Verdi, Genevieve; Weyandt, Lisa L; Zavras, Brynheld Martinez

    2016-09-01

    The objective of this study was to examine graduate students' non-medical use of prescription stimulant medication, and the relationship between non-medical use of prescription stimulants with academic self-efficacy, psychological factors (i.e., anxiety, depression, and stress), and internal restlessness. The sample consisted of 807 graduate students from universities located in five geographic regions of the United States. Past-year rates of self-reported non-medical use were determined to be 5.9%, with overall lifetime prevalence of 17.5%. Observed self-reported non-medical use of prescription stimulant medications was significantly correlated with self-reported levels of anxiety and stress, various aspects of internal restlessness, and perceived safety of the medications. Findings support graduate students' motivations of non-medical prescription stimulant use to be both academic and social in nature. Effective prevention and education efforts are needed to help address the non-medical use of prescription stimulants by graduate students on university campuses. © The Author(s) 2014.

  18. Claims about Medical Malpractices Resulting in Maternal and Perinatal Mortality Referred to Iranian Legal Medicine Organization During 2011–2012

    Science.gov (United States)

    Taghizadeh, Ziba; Pourbakhtiar, Maryam; Ghadipasha, Masoud; Soltani, Kamran; Azimi, Khadijeh

    2017-01-01

    Background: Obstetricians, gynecologists, and midwives are the most common specialists of the medical sciences group against whom medical malpractices are claimed, many of which are avoidable and preventable. Therefore, the present study was conducted to investigate the causes of claims regarding medical malpractices resulting in maternal and perinatal mortality. Materials and Methods: A descriptive cross-sectional study was conducted and 7616 claims of medical malpractices in the field of obstetrics, gynecology, and midwifery that were referred from all 31 provinces to the central commission of legal medicine were studied during 2011–2012. Therefore, the present research is a national inclusive study covering all the provinces across Iran. To collect information from the transcript of medical malpractices cases, a researcher-made checklist was used, and the collected data were analyzed. Results: The results of the present study showed that among all the medical malpractice claims regarding pregnancy and childbirth (42.24%), the majority concerned perinatal death (71.82%) and maternal death (28.16%). Conclusions: Medical malpractice complaints are increasing; although, most of these claims are preventable. To achieve this aim, it is necessary for obstetricians, gynecologists, and midwives to try to reduce the complaints by paying more attention to the signs and symptoms of diseases, performing all the diagnostic and therapeutic measures according to the scientific criteria, and fully document patients' records. In addition, patients' acquaintance with the importance of measurements and examinations, before and during pregnancy care and even after childbirth is crucial. PMID:28904542

  19. Non-medical use of prescription stimulants for academic purposes among college students: a test of social learning theory.

    Science.gov (United States)

    Ford, Jason A; Ong, Julianne

    2014-11-01

    The current research examines whether measures associated with Akers' social learning theory are related to non-medical use of prescription stimulants for academic reasons among college students. We examine data from a sample of 549 undergraduate students at one public university in the Southeastern United States. We estimate several logistic regression models to test our hypotheses. The findings indicated that roughly 17% of students reported non-medical use of prescription stimulants for academic reasons during the past year. In separate models, all four of the social learning measures were significantly correlated to non-medical use. In the complete model, the risk of non-medical prescription stimulant use for academic reasons was increased for respondents who reported more of their friends used and also for respondents who believed that prescription stimulants were an effective study aid. The current research fills an important gap in the literature regarding theoretical explanations for non-medical prescription stimulant use. Given the high prevalence of non-medical prescription stimulant use and the known risks associated with non-medical use this research can help inform intervention strategies for college populations. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  20. Stimulant and atypical antipsychotic medications for children placed in foster homes.

    Directory of Open Access Journals (Sweden)

    L Oriana Linares

    Full Text Available The purpose of this study is to examine the use of prescribed psychoactive medications in a prospective cohort of children shortly after they entered foster homes; and to identify demographics, maltreatment history, psychiatric diagnoses including ADHD comorbidity, and level of aggression that contribute to prescribed use of stimulant and atypical antipsychotic medication over time.The sample included N = 252 children (nested in 95 sibling groups followed for three years up to 4 yearly waves.Nearly all (89% met criteria for at least one of eight psychiatric diagnoses and 31% (75/252 used one or more prescribed psychoactive medications. Over half (55% were diagnosed with Attention Deficit Hyperactivity Disorder (ADHD; of these 38% used stimulants and 36% used atypical antipsychotics. Of the 75 medicated children, 19% received ≥3 different classes of drugs over the course of the study. Stimulants (69% and atypical antipsychotics (65% were the most frequently used drugs among medicated children. Adjusted odds ratios (AOR showed that male gender (AOR = 3.2; 95% CI = 1.5-9.3, African American vs Latino ethnicity (AOR = 5.4; 95% CI = 2.1-14.2, ADHD regardless of Oppositional Defiant (ODD or Conduct (CD comorbidity (AOR = 6.0, 95% CI = 1.3-27.5, ODD or CD (AOR = 11.1, 95% CI = 2.1-58.6, and Separation Anxiety (AOR = 2.0, 95% CI = 1.0-4.0 psychiatric disorders were associated with the use of prescribed stimulants; while male gender (AOR = 3.8, 95% CI = 1.5-9.3, African American vs Latino (AOR = 5.1, 95% CI = 1.2-9.2 or Mixed/Other ethnicity (AOR = 3.3, 95% CI = 1.9-13.7, ADHD regardless of ODD or CD comorbidity (AOR = 5.8, 95% CI = 1.2-28.7, ODD or CD (AOR = 13.9, 95% CI = 3.3-58.5, Major Depression/Dysthymia (AOR = 2.8, 95% CI = 1.1-6.7 psychiatric disorders, and history of sexual abuse (AOR = 4.6, 95% CI = 1.3-18.4 were associated with the use of

  1. Treatment of ADHD with Stimulant Medications: Response to Nissen Perspective in the New England Journal of Medicine

    Science.gov (United States)

    Biederman, Joseph; Spencer, Thomas J.; Wilens, Timothy E.; Prince, Jefferson B.; Faraone, Stephen V.

    2006-01-01

    This article is a response to Dr. Steven E. Nissen's comments (Nissen, 2006) about attention deficit/hyperactivity disorder (ADHD) and its treatment with stimulant medications. In this article, the authors refute his arguments and provide accurate information. Here, they answer the questions, such as: (1) Do stimulants increase the risk for sudden…

  2. Daily left prefrontal repetitive transcranial magnetic stimulation for medication-resistant burning mouth syndrome.

    Science.gov (United States)

    Umezaki, Y; Badran, B W; Gonzales, T S; George, M S

    2015-08-01

    Burning mouth syndrome (BMS) is a persistent and chronic burning sensation in the mouth in the absence of any abnormal organic findings. The pathophysiology of BMS is unclear and its treatment is not fully established. Although antidepressant medication is commonly used for treatment, there are some medication-resistant patients, and a new treatment for medication-resistant BMS is needed. Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive brain stimulation technology approved by the US Food and Drug Administration (FDA) for the treatment of depression. Recent studies have found beneficial effects of TMS for the treatment of pain. A case of BMS treated successfully with daily left prefrontal rTMS over a 2-week period is reported here. Based on this patient's clinical course and a recent pain study, the mechanism by which TMS may act to decrease the burning pain is discussed. Copyright © 2015 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  3. Recurrent themes in the history of the home use of electrical stimulation: Transcranial direct current stimulation (tDCS) and the medical battery (1870-1920).

    Science.gov (United States)

    Wexler, Anna

    In recent years, neuroscientists and ethicists have warned of the dangers of the unsupervised home use of transcranial direct current stimulation (tDCS), in which individuals stimulate their own brains with low levels of electricity for self-improvement purposes. Although the home use of tDCS is often referred to as a novel phenomenon, in reality the late nineteenth and early twentieth century saw a proliferation of electrical stimulation devices for home use. In particular, the use of an object known as the medical battery bears a number of striking similarities to the modern-day use of tDCS. This article reviews a number of features thought to be unique to the present day home use of brain stimulation, with a particular focus on analogies between tDCS and the medical battery. Archival research was conducted at the Bakken Museum and at the American Medical Association's Historical Health Fraud Archives. Many of the features characterizing the contemporary home use tDCS-a do-it-yourself (DIY) movement, anti-medical establishment themes, conflicts between lay and professional usage-are a repetition of themes that occurred a century ago with regard to the medical battery. A number of features, however, seem to be unique to the present, such as the dominant discourse about risk and safety, the division between cranial and non-cranial stimulation, and utilization for cognitive enhancement purposes. Viewed in the long durée, the contemporary use of electrical stimulation at home is not a novel phenomenon, but rather the latest wave in a series of ongoing attempts by lay individuals to utilize electricity for therapeutic purposes. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Office Visits to Monitor Stimulant Medication Safety and Efficacy: Recommended Care.

    Science.gov (United States)

    Zima, Bonnie T; Norquist, Grayson S; Altchuler, Steven I; Behrens, Jacob; Iles-Shih, Matthew D; Ng, Yiu Kee Warren; Schaepper, Mary Ann

    2018-06-01

    The clinical guidance based on the research article, "Specific Components of Pediatricians' Medication-Related Care Predict Attention-Deficit/Hyperactivity Disorder Improvement," published in the June 2017 issue, 1 might be premature. The authors, Epstein et al., suggest that "Physicians do not need to necessarily rely on office visits to monitor medication response and side effects in the week(s) after initially prescribing medication, but instead could use phone calls or email correspondence to check in with the family" (p. 489). However, this advice has the potential to be misinterpreted that phone or email contact is acceptable clinical practice to monitor stimulant medication safety and efficacy, especially during the maintenance phase. It also could be erroneously interpreted that phone or email contact is sufficient for follow-up care for children receiving medication treatment for attention-deficit/hyperactivity disorder (ADHD) for national quality measures. Copyright © 2018 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

  5. Neuropathic Pain Medication Use Does Not Alter Outcomes of Spinal Cord Stimulation for Lower Extremity Pain.

    Science.gov (United States)

    Maher, Dermot P; Martins, Yuri Chaves; Doshi, Tina; Bicket, Mark; Zhang, Kui; Hanna, George; Ahmed, Shihab

    2018-01-01

    Spinal cord stimulation (SCS) for the treatment of lower extremity pain is believed to the result of increased activity in the descending inhibitory and decreased activity in the ascending excitatory tracts. Evidence suggests that the analgesia afforded by SCS may be altered using certain neuropathic pain medications that also modulate neurotransmitters in these sensory tracts. We hypothesize that neuropathic pain medications may alter the response to SCS therapy. One hundred and fifteen subjects undergoing SCS therapy for lower extremity pain were retrospectively examined. The pharmacologic profile, including stable use of neuropathic and opioid medications, were recorded. Three separate logistic regression models examined the odds ratio of primary outcomes; a successful SCS trial, a 50% decrease in pain or a 50% reduction in opioid use one year after implant. Neither the use of opioids or neuropathic pain medications were associated with changes in the odds of a successful SCS trial or a 50% pain reduction. A higher dose of chronic opioids use prior to a trial was associated with greater odds of having a 50% reduction in opioid use following implant. OR 1.02, 95% CI 1.01-1.02, p-value neuropathic pain medications did not change the odds of either a successful SCS trial, or of experiencing a 50% reduction in pain at one year. The association between higher opioid doses and greater odds of a 50% reduction in opioid use may be the reflective of SCS's ability to reduce opioid reliance in chronic pain patients. © 2017 International Neuromodulation Society.

  6. Stimulant medication use and response to growth hormone therapy: an NCGS database analysis.

    Science.gov (United States)

    Frindik, J Paul; Morales, Alba; Fowlkes, John; Kemp, Stephen; Thrailkill, Kathryn; Lippe, Barbara; Dana, Ken

    2009-01-01

    Determine (1) frequency of attention-deficit hyperactivity disorder (ADHD) treatment and (2) growth responses in growth hormone (GH)-treated children who are receiving ADHD medication versus GH alone. Prepubertal children with idiopathic short stature (ISS) or GH deficiency (IGHD) enrolled in Genentech's National Cooperative Growth Study. ADHD treatment was determined by documentation of psycho-stimulant medication use at enrollment. ADHD medication use increased from 0.8% (7/850) in 1985 to 5.8% (752/12,113) in 2005. First-year GH treatment response for ADHD + IGHD versus IGHD: 8.5 +/- 2.0 vs. 9.4 +/- 2.6 cm/year, but when adjusted for age, sex, and enrollment body mass index, the difference is clinically insignificant (-0.4 cm/year). First-year growth was similar in all ISS: 8.1 +/- 1.9 versus 8.6 +/- 2.1 cm/year (ADHD + ISS vs. ISS, an adjusted -0.2-cm/year difference). Increasing numbers of GH-treated children are taking ADHD medications and their growth responses during the first year of GH therapy are similar to those not taking ADHD medications. Copyright 2009 S. Karger AG, Basel.

  7. Understanding the effects of stimulant medications on cognition in individuals with attention-deficit hyperactivity disorder: a decade of progress.

    Science.gov (United States)

    Swanson, James; Baler, Ruben D; Volkow, Nora D

    2011-01-01

    The use of stimulant drugs for the treatment of children with attention-deficit hyperactivity disorder (ADHD) is one of the most widespread pharmacological interventions in child psychiatry and behavioral pediatrics. This treatment is well grounded on controlled studies showing efficacy of low oral doses of methylphenidate and amphetamine in reducing the behavioral symptoms of the disorder as reported by parents and teachers, both for the cognitive (inattention and impulsivity) and non-cognitive (hyperactivity) domains. Our main aim is to review the objectively measured cognitive effects that accompany the subjectively assessed clinical responses to stimulant medications. Recently, methods from the cognitive neurosciences have been used to provide information about brain processes that underlie the cognitive deficits of ADHD and the cognitive effects of stimulant medications. We will review some key findings from the recent literature, and then offer interpretations of the progress that has been made over the past decade in understanding the cognitive effects of stimulant medication on individuals with ADHD.

  8. Caloric vestibular stimulation as a treatment for conversion disorder: A case report and medical hypothesis

    Directory of Open Access Journals (Sweden)

    Michael eNoll-Hussong

    2014-06-01

    Full Text Available Conversion disorder is a medical condition in which a person has paralysis, blindness, or other neurological symptoms that cannot be clearly explained physiologically. To date, there is neither specific nor conclusive treatment. In this paper, we draw together a number of disparate pieces of knowledge to propose a novel intervention to provide transient alleviation for this condition. As caloric vestibular stimulation (CVS has been demonstrated to modulate transiently a variety of cognitive functions associated with brain activations, especially in the temporal-parietal cortex, anterior cingulate cortex, and insular cortex, there is evidence to assume an effect in specific mental disorders. Therefore, we go on to hypothesize that lateralized cold vestibular caloric stimulation will be effective in treating conversion disorder and we present provisional evidence from one patient that supports this conclusion. If our hypothesis is correct, this will be the first time in psychiatry and neurology that a clinically well-known mental disorder, long considered difficult to understand and to treat, is relieved by a simple or common, non-invasive medical procedure.

  9. Speech disorders in Parkinson's disease: early diagnostics and effects of medication and brain stimulation.

    Science.gov (United States)

    Brabenec, L; Mekyska, J; Galaz, Z; Rektorova, Irena

    2017-03-01

    Hypokinetic dysarthria (HD) occurs in 90% of Parkinson's disease (PD) patients. It manifests specifically in the areas of articulation, phonation, prosody, speech fluency, and faciokinesis. We aimed to systematically review papers on HD in PD with a special focus on (1) early PD diagnosis and monitoring of the disease progression using acoustic voice and speech analysis, and (2) functional imaging studies exploring neural correlates of HD in PD, and (3) clinical studies using acoustic analysis to evaluate effects of dopaminergic medication and brain stimulation. A systematic literature search of articles written in English before March 2016 was conducted in the Web of Science, PubMed, SpringerLink, and IEEE Xplore databases using and combining specific relevant keywords. Articles were categorized into three groups: (1) articles focused on neural correlates of HD in PD using functional imaging (n = 13); (2) articles dealing with the acoustic analysis of HD in PD (n = 52); and (3) articles concerning specifically dopaminergic and brain stimulation-related effects as assessed by acoustic analysis (n = 31); the groups were then reviewed. We identified 14 combinations of speech tasks and acoustic features that can be recommended for use in describing the main features of HD in PD. While only a few acoustic parameters correlate with limb motor symptoms and can be partially relieved by dopaminergic medication, HD in PD seems to be mainly related to non-dopaminergic deficits and associated particularly with non-motor symptoms. Future studies should combine non-invasive brain stimulation with voice behavior approaches to achieve the best treatment effects by enhancing auditory-motor integration.

  10. Maternal Medical Complexity: Impact on Prenatal Health Care Spending among Women at Low Risk for Cesarean Section.

    Science.gov (United States)

    Cunningham, Shayna D; Herrera, Carolina; Udo, Ifeyinwa E; Kozhimannil, Katy B; Barrette, Eric; Magriples, Urania; Ickovics, Jeannette R

    Obstetric procedures are among the most expensive health care services, yet relatively little is known about health care spending among pregnant women, particularly the commercially-insured. The objective of this study was to examine the association between maternal medical complexity, as a result of having one or more comorbid conditions, and health care spending during the prenatal period among a national sample of 95,663 commercially-insured women at low risk for cesarean delivery. We conducted secondary analyses of 2010-2011 inpatient, outpatient, and professional claims for health care services from the Health Care Cost Institute. Allowed charges were summed for the prenatal and childbirth periods. Ordinary least squares regressions tested associations between maternal health conditions and health care expenditures during pregnancy. Thirty-four percent of pregnant women had one or more comorbidities; 8% had two or more. Pregnant women with one or more comorbidities had significantly higher allowed charges than those without comorbidities (p prenatal period was nearly three times higher for women with preexisting diabetes compared with women with no comorbid conditions. Average levels of prenatal period spending associated with maternal comorbidities were similar for women who had vaginal and cesarean deliveries. Patient characteristics accounted for 30% of the variance in prenatal period expenditures. The impact of maternal comorbidities, and in particular preexisting diabetes, on prenatal care expenditures should be taken into account as provider payment reforms, such as pay-for performance incentives and bundled payments for episodes of care, extend to maternal and child health-related services. Copyright © 2017 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

  11. Maternal vaginal microflora during pregnancy and the risk of asthma hospitalization and use of antiasthma medication in early childhood

    DEFF Research Database (Denmark)

    Benn, Christine Stabell; Thorsen, Poul; Jensen, Jørgen Skov

    2002-01-01

    the establishment of the infant flora and, as a consequence, the development of wheezing and allergic diseases. OBJECTIVE: We sought to study the associations between the composition of the maternal vaginal microflora and the development of wheezing and asthma in childhood. METHODS: We performed a population......-based cohort study in Denmark. Vaginal samples for bacterial analysis were obtained during pregnancy. A total of 2927 women (80% of the invited women) completed the study and had 3003 live infants. Infant wheezing was assessed as one or more hospitalizations for asthma between 0 and 3 years of age. Asthma...... was assessed as use of 3 or more packages of antiasthma medication between 4 and 5 years of age. RESULTS: Maternal vaginal colonization with Ureaplasma urealyticum during pregnancy was associated with infant wheezing (odds ratio [OR], 2.0; 95% CI, 1.2-3.6), but not with asthma, during the fifth year of life...

  12. Stimulant and Atypical Antipsychotic Medications For Children Placed in Foster Homes

    Science.gov (United States)

    Linares, L. Oriana; Martinez-Martin, Nuria; Castellanos, F. Xavier

    2013-01-01

    Objectives The purpose of this study is to examine the use of prescribed psychoactive medications in a prospective cohort of children shortly after they entered foster homes; and to identify demographics, maltreatment history, psychiatric diagnoses including ADHD comorbidity, and level of aggression that contribute to prescribed use of stimulant and atypical antipsychotic medication over time. Methods The sample included N = 252 children (nested in 95 sibling groups) followed for three years up to 4 yearly waves. Results Nearly all (89%) met criteria for at least one of eight psychiatric diagnoses and 31% (75/252) used one or more prescribed psychoactive medications. Over half (55%) were diagnosed with Attention Deficit Hyperactivity Disorder (ADHD); of these 38% used stimulants and 36% used atypical antipsychotics. Of the 75 medicated children, 19% received ≥3 different classes of drugs over the course of the study. Stimulants (69%) and atypical antipsychotics (65%) were the most frequently used drugs among medicated children. Adjusted odds ratios (AOR) showed that male gender (AOR = 3.2; 95% CI = 1.5–9.3), African American vs Latino ethnicity (AOR = 5.4; 95% CI = 2.1–14.2), ADHD regardless of Oppositional Defiant (ODD) or Conduct (CD) comorbidity (AOR = 6.0, 95% CI = 1.3–27.5), ODD or CD (AOR = 11.1, 95% CI = 2.1–58.6), and Separation Anxiety (AOR = 2.0, 95% CI = 1.0–4.0) psychiatric disorders were associated with the use of prescribed stimulants; while male gender (AOR = 3.8, 95% CI = 1.5–9.3), African American vs Latino (AOR = 5.1, 95% CI = 1.2–9.2) or Mixed/Other ethnicity (AOR = 3.3, 95% CI = 1.9–13.7), ADHD regardless of ODD or CD comorbidity (AOR = 5.8, 95% CI = 1.2–28.7), ODD or CD (AOR = 13.9, 95% CI = 3.3–58.5), Major Depression/Dysthymia (AOR = 2.8, 95% CI = 1.1–6.7) psychiatric disorders, and history of sexual abuse (AOR = 4.6, 95

  13. Bridging the gap between textbook and maternity patient: a nurse-developed teaching model for first-year medical students.

    Science.gov (United States)

    Cooksey, Nancy Rumsey

    2010-12-01

    Providing more opportunities for first-year medical students to interact with patients in clinical settings is a current discussion topic in medical student education reform. Early clinical experience helps students bridge the gap between textbook and patient while observing patient-centered care, and serves as a first step for students to develop the skills needed to work cooperatively as members of a multidisciplinary health care team. The author developed a model to provide perinatal education to first-year medical students, consistent with the concept of interprofessional education. Primarily first-year medical students participated in the nurse-developed education model, a component of a noncredit extracurricular, student-run perinatal program at a Midwestern university medical center. Students were placed at the bedsides of hospitalized women to provide support and education to them during perinatal procedures, labor, childbirth, and cesarean delivery. A total of 350 students participated over a period of 13 school calendar years. Students remarked that participation in the program reinforced the importance of their concurrent anatomy and physiology classes. They observed interdependence and cooperation among the members of the health care team caring for women, and their evaluations of their experiences at the bedside were highly positive. Women consistently expressed appreciation for the additional individualized attention and education received from our student and nurse team. Nurses can enhance the learning of first-year medical students in the maternity care clinical setting. This nurse-developed education program provided students with a variety of vivid clinical experiences with maternity patients. © 2010, Copyright the Author. Journal compilation © 2010, Wiley Periodicals, Inc.

  14. Consequences of low birth weight, maternal illiteracy and poor access to medical care in rural India: infantile iatrogenic Cushing syndrome

    OpenAIRE

    Karande, Sunil

    2015-01-01

    Home delivery, low birth weight babies and maternal illiteracy among the poor in rural India are frequent. The rural poor prefer to seek healthcare from private providers, most of whom have no formal medical training and buy medicines from private pharmacies without a prescription owing to a weakly regulated environment. This report is of a 4-month-old baby from a remote village in northern India, who presented with exogenous Cushing syndrome. This baby was a full-term low birth weight home d...

  15. Creation and implementation of a flipped jigsaw activity to stimulate interest in biochemistry among medical students.

    Science.gov (United States)

    Williams, Charlene; Perlis, Susan; Gaughan, John; Phadtare, Sangita

    2018-05-06

    Learner-centered pedagogical methods that are based on clinical application of basic science concepts through active learning and problem solving are shown to be effective for improving knowledge retention. As the clinical relevance of biochemistry is not always apparent to health-profession students, effective teaching of medical biochemistry should highlight the implications of biochemical concepts in pathology, minimize memorization, and make the concepts memorable for long-term retention. Here, we report the creation and successful implementation of a flipped jigsaw activity that was developed to stimulate interest in learning biochemistry among medical students. The activity combined the elements of a flipped classroom for learning concepts followed by a jigsaw activity to retrieve these concepts by solving clinical cases, answering case-based questions, and creating concept maps. The students' reception of the activity was very positive. They commented that the activity provided them an opportunity to review and synthesize information, helped to gage their learning by applying this information and work with peers. Students' improved performance especially for answering the comprehension-based questions correctly in the postquiz as well as the depth of information included in the postquiz concept maps suggested that the activity helped them to understand how different clinical scenarios develop owing to deviations in basic biochemical pathways. Although this activity was created for medical students, the format of this activity can also be useful for other health-professional students as well as undergraduate and graduate students. © 2018 by The International Union of Biochemistry and Molecular Biology, 2018. © 2018 The International Union of Biochemistry and Molecular Biology.

  16. A study to assess burnout among nurses of maternity department in Gauhati Medical College Hospital, Assam

    Directory of Open Access Journals (Sweden)

    Marami Baishya

    2016-01-01

    Full Text Available Background: Burnout in healthcare workers, especially among nurses, can have an impact on overall healthcare delivery system. For health in general and maternal health in particular, wellbeing of healthcare workers, including nurses, is of paramount importance. Material and methods: This study aimed to assess burnout among nurses working in the maternity department. One hundred nurses of a tertiary care centre, selected by non-purposive convenient sampling, were examined by a standardised questionnaire. Data were analysed by descriptive statistics. Results: Burnout in depersonalisation was moderate while that in emotional exhaustion and personal achievement were of low-levels. Conclusion: Understanding the nature of the problem of burnout can guide in better management.

  17. Motor Skills of Children Newly Diagnosed with Attention Deficit Hyperactivity Disorder Prior to and Following Treatment with Stimulant Medication

    Science.gov (United States)

    Brossard-Racine, Marie; Shevell, Michael; Snider, Laurie; Belanger, Stacey Ageranioti; Majnemer, Annette

    2012-01-01

    Motor difficulties are common in children with Attention Deficit Hyperactivity Disorder (ADHD). Although preliminary evidence has suggested that methylphenidate can improve the motor skills in children with ADHD and Developmental Coordination Disorder (DCD), the effect of stimulant medication on motor performance in children newly diagnosed with…

  18. Daily maternal separations during stress hyporesponsive period decrease the thresholds of panic-like behaviors to electrical stimulation of the dorsal periaqueductal gray of the adult rat.

    Science.gov (United States)

    Borges-Aguiar, Ana Cristina; Schauffer, Luana Zanoni; de Kloet, Edo Ronald; Schenberg, Luiz Carlos

    2018-05-15

    The present study examined whether early life maternal separation (MS), a model of childhood separation anxiety, predisposes to panic at adulthood. For this purpose, male pups were submitted to 3-h daily maternal separations along postnatal (PN) days of either the 'stress hyporesponsive period' (SHRP) from PN4 to PN14 (MS11) or throughout lactation from PN2 to PN21 (MS20). Pups were further reunited to conscious (CM) or anesthetized (AM) mothers to assess the effect of mother-pup interaction upon reunion. Controls were subjected to brief handling (15 s) once a day throughout lactation (BH20). As adults (PN60), rats were tested for the thresholds to evoke panic-like behaviors upon electrical stimulation of dorsal periaqueductal gray matter and exposed to an elevated plus-maze, an open-field, a forced swim and a sucrose preference test. A factor analysis was also performed to gain insight into the meaning of behavioral tests. MS11-CM rather than MS20-CM rats showed enhanced panic responses and reductions in both swimming and sucrose preference. Panic facilitations were less intense in mother-neglected rats. Although MS did not affect anxiety, MS11-AM showed robust reductions of defecation in an open-field. Factor analysis singled out anxiety, hedonia, exploration, coping and gut activity. Although sucrose preference and coping loaded on separate factors, appetite (adult weight) correlated with active coping in both forced swim and open-field (central area exploration). Concluding, whereas 3h-daily maternal separations during SHRP increased rat's susceptibility to experimental panic attacks, separations throughout lactation had no effects on panic and enhanced active coping. Copyright © 2018 Elsevier B.V. All rights reserved.

  19. Reinforcement and stimulant medication ameliorate deficient response inhibition in children with Attention-Deficit/Hyperactivity Disorder

    Science.gov (United States)

    Rosch, Keri S.; Fosco, Whitney D.; Pelham, William E.; Waxmonsky, James G.; Bubnik, Michelle G.; Hawk, Larry W.

    2015-01-01

    This study examined the degree to which reinforcement, stimulant medication, and their combination impact response inhibition in children with Attention-Deficit/Hyperactivity Disorder (ADHD). Across three studies, participants with ADHD (n=111, 25 girls) and typically-developing (TD) controls (n=33, 6 girls) completed a standard version of the stop signal task (SST) and/or a reinforcement-manipulation SST with performance-contingent points. In two of these studies, these tasks were performed under placebo or 0.3 and 0.6 mg/kg methylphenidate (MPH) conditions. Cross-study comparisons were conducted to test hypotheses regarding the separate and combined effects of reinforcement and methylphenidate on response inhibition among children with ADHD relative to TD controls. Baseline response inhibition was worse among children with ADHD compared to controls. MPH produced dose-related improvements in response inhibition in children with ADHD; compared to non-medicated TD controls, 0.3 mg/kg MPH normalized deficient response inhibition, and 0.6 mg/kg MPH resulted in better inhibition in children with ADHD. Reinforcement improved response inhibition to a greater extent for children with ADHD than for TD children, normalizing response inhibition. The combination of MPH and reinforcement improved response inhibition among children with ADHD compared to reinforcement alone and MPH alone, also resulting in normalization of response inhibition despite repeated task exposure. Deficient response inhibition commonly observed in children with ADHD is significantly improved with MPH and/or reinforcement, normalizing inhibition relative to TD children tested under standard conditions. PMID:25985978

  20. Early postnatal development of electrophysiological and histological properties of sensory sural nerves in male rats that were maternally deprived and artificially reared: Role of tactile stimulation.

    Science.gov (United States)

    Zempoalteca, Rene; Porras, Mercedes G; Moreno-Pérez, Suelem; Ramirez-Funez, Gabriela; Aguirre-Benítez, Elsa L; González Del Pliego, Margarita; Mariscal-Tovar, Silvia; Mendoza-Garrido, Maria E; Hoffman, Kurt Leroy; Jiménez-Estrada, Ismael; Melo, Angel I

    2018-04-01

    Early adverse experiences disrupt brain development and behavior, but little is known about how such experiences impact on the development of the peripheral nervous system. Recently, we found alterations in the electrophysiological and histological characteristics of the sensory sural (SU) nerve in maternally deprived, artificially reared (AR) adult male rats, as compared with maternally reared (MR) control rats. In the present study, our aim was to characterize the ontogeny of these alterations. Thus, male pups of four postnatal days (PND) were (1) AR group, (2) AR and received daily tactile stimulation to the body and anogenital region (AR-Tactile group); or (3) reared by their mother (MR group). At PND 7, 14, or 21, electrophysiological properties and histological characteristics of the SU nerves were assessed. At PND 7, the electrophysiological properties and most histological parameters of the SU nerve did not differ among MR, AR, and AR-Tactile groups. By contrast, at PND 14 and/or 21, the SU nerve of AR rats showed a lower CAP amplitude and area, and a significant reduction in myelin area and myelin thickness, which were accompanied by a reduction in axon area (day 21 only) compared to the nerves of MR rats. Tactile stimulation (AR-Tactile group) partially prevented most of these alterations. These results suggest that sensory cues from the mother and/or littermates during the first 7-14 PND are relevant for the proper development and function of the adult SU nerve. © 2017 Wiley Periodicals, Inc. Develop Neurobiol 78: 351-362, 2018. © 2017 Wiley Periodicals, Inc.

  1. Impact of antipsychotic medication on transcranial direct current stimulation (tDCS) effects in schizophrenia patients.

    Science.gov (United States)

    Agarwal, Sri Mahavir; Bose, Anushree; Shivakumar, Venkataram; Narayanaswamy, Janardhanan C; Chhabra, Harleen; Kalmady, Sunil V; Varambally, Shivarama; Nitsche, Michael A; Venkatasubramanian, Ganesan; Gangadhar, Bangalore N

    2016-01-30

    Transcranial direct current stimulation (tDCS) has generated interest as a treatment modality for schizophrenia. Dopamine, a critical pathogenetic link in schizophrenia, is also known to influence tDCS effects. We evaluated the influence of antipsychotic drug type (as defined by dopamine D2 receptor affinity) on the impact of tDCS in schizophrenia. DSM-IV-TR-diagnosed schizophrenia patients [N=36] with persistent auditory hallucinations despite adequate antipsychotic treatment were administered add-on tDCS. Patients were divided into three groups based on the antipsychotic's affinity to D2 receptors. An auditory hallucinations score (AHS) was measured using the auditory hallucinations subscale of the Psychotic Symptom Rating Scales (PSYRATS). Add-on tDCS resulted in a significant reduction inAHS. Antipsychotic drug type had a significant effect on AHS reduction. Patients treated with high affinity antipsychotics showed significantly lesser improvement compared to patients on low affinity antipsychotics or a mixture of the two. Furthermore, a significant sex-by-group interaction occurred; type of medication had an impact on tDCS effects only in women. Improvement differences could be due to the larger availability of the dopamine receptor system in patients taking antipsychotics with low D2 affinity. Sex-specific differences suggest potential estrogen-mediated effects. This study reports a first-time observation on the clinical utility of antipsychotic drug type in predicting tDCS effects in schizophrenia. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  2. The Brotherhood Medical Center: Collaborative Foundation of Maternity and Children’s Healthcare Facility for Displaced Syrians

    Science.gov (United States)

    Aburas, Rahma; Najeeb, Amina; Baageel, Laila; Mackey, Tim K.

    2018-01-01

    The United Nations has declared the Syrian conflict, with more than 50% of Syria’s population currently displaced, as the worst humanitarian crisis of the twenty-first century. The Syrian conflict has led to a collapse of infrastructure, including access to critical and lifesaving healthcare services. Women and children account for approximately 75% of internally displaced Syrians and refugees. This population is also particularly vulnerable to poor health outcomes, a condition worsened by lack of access to maternal and child health services. In response to this crisis, a partnership of Saudi and Syrian physicians established a non-profit healthcare facility named the Brotherhood Medical Center (BMC) to serve women and children within a safe area near the Syrian–Turkish border. The project began in September 2014 and was implemented in three phases of establishment, phased construction and formal launch and operation. Currently, the BMC is working at about 70% of its capacity and is run in partnership with the Syrian Expatriate Medical Association. Although there was strong initial support from donors, the BMC continues to face many financial and operational challenges, including difficulties in transferring money to Syria, shortage of medical supplies, and lack of qualified medical personnel. Despite these challenges, the BMC represents a critical model and an important case study of the challenges of delivering healthcare services to underserved populations during an ongoing conflict. However, more robust support from the international community is needed to ensure it continues its important health and humanitarian mission. PMID:29721489

  3. The Brotherhood Medical Center: Collaborative Foundation of Maternity and Children’s Healthcare Facility for Displaced Syrians

    Directory of Open Access Journals (Sweden)

    Rahma Aburas

    2018-04-01

    Full Text Available The United Nations has declared the Syrian conflict, with more than 50% of Syria’s population currently displaced, as the worst humanitarian crisis of the twenty-first century. The Syrian conflict has led to a collapse of infrastructure, including access to critical and lifesaving healthcare services. Women and children account for approximately 75% of internally displaced Syrians and refugees. This population is also particularly vulnerable to poor health outcomes, a condition worsened by lack of access to maternal and child health services. In response to this crisis, a partnership of Saudi and Syrian physicians established a non-profit healthcare facility named the Brotherhood Medical Center (BMC to serve women and children within a safe area near the Syrian–Turkish border. The project began in September 2014 and was implemented in three phases of establishment, phased construction and formal launch and operation. Currently, the BMC is working at about 70% of its capacity and is run in partnership with the Syrian Expatriate Medical Association. Although there was strong initial support from donors, the BMC continues to face many financial and operational challenges, including difficulties in transferring money to Syria, shortage of medical supplies, and lack of qualified medical personnel. Despite these challenges, the BMC represents a critical model and an important case study of the challenges of delivering healthcare services to underserved populations during an ongoing conflict. However, more robust support from the international community is needed to ensure it continues its important health and humanitarian mission.

  4. Advanced maternal age: ethical and medical considerations for assisted reproductive technology

    OpenAIRE

    Harrison,Brittany; Hilton,Tara; Rivière,Raphaël; Ferraro,Zachary; Deonandan,Raywat; Walker,Mark

    2017-01-01

    Brittany J Harrison,1 Tara N Hilton,1 Raphaël N Rivière,1 Zachary M Ferraro,1–3 Raywat Deonandan,4 Mark C Walker1–3,51Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada; 2Division of Maternal-Fetal Medicine, University of Ottawa, The Ottawa Hospital, Ottawa, ON, Canada; 3Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, ON, Canada; 4University of Ottawa Interdisciplinary School of Health Sciences, Ottawa, ON, Canada; 5...

  5. Does Childhood Use of Stimulant Medication as a Treatment for ADHD Affect the Likelihood of Future Drug Abuse and Dependence? A Literature Review

    Science.gov (United States)

    Golden, Shawn M.

    2009-01-01

    This article describes the disparate research findings regarding the effects of stimulant medication in subsequent substance abuse and dependence. A minimum of 4 to 5% of children in the United States will be diagnosed with ADHD; thus it is important for parents to be informed when making decisions about the use of stimulant medication to treat…

  6. [Institutional violence, medical authority, and power relations in maternity hospitals from the perspective of health workers].

    Science.gov (United States)

    Aguiar, Janaina Marques de; d'Oliveira, Ana Flávia Pires Lucas; Schraiber, Lilia Blima

    2013-11-01

    The current article discusses institutional violence in maternity hospitals from the health workers' perspective, based on data from a study in the city of São Paulo, Brazil. Eighteen health workers from the public and private sectors were interviewed, including obstetricians, nurses, and nurse technicians. A semi-structured interview was used with questions on professional experience and the definition of violence. The analysis revealed that these health workers acknowledged the existence of discriminatory and disrespectful practices against women during prenatal care, childbirth, and the postpartum. Examples of such practices cited by interviewees included the use of pejorative slang as a form of "humor", threats, reprimands, and negligence in the management of pain. Such practices are not generally viewed by health workers as violent, but rather as the exercise of professional authority in what is considered a "difficult" context. The institutional violence is thus trivialized, disguised as purportedly good practice (i.e., "for the patient's own good"), and rendered invisible in the daily routine of care provided by maternity services.

  7. Weight loss on stimulant medication: how does it affect body composition and bone metabolism? – A prospective longitudinal study

    Directory of Open Access Journals (Sweden)

    Poulton Alison

    2012-12-01

    Full Text Available Abstract Objective Children treated with stimulant medication for attention deficit hyperactivity disorder (ADHD often lose weight. It is important to understand the implications of this during growth. This prospective study was designed to quantify the changes in body composition and markers of bone metabolism on starting treatment. Methods 34 children (29 boys aged 4.7 to 9.1 years newly diagnosed with ADHD were treated with dexamphetamine or methylphenidate, titrating the dose to optimise the therapeutic response. Medication was continued for as long as clinically indicated. Body composition and bone density (dual-energy X-ray absorptiometry were measured at baseline, 6 months and 3 years; changes were analysed in Z-scores based on data from 241 healthy, local children. Markers of bone turnover were measured at baseline, 3 months and 3 years. Results Fat loss of 1.4±0.96kg (total fat 5.7±3.6 to 4.3±3.1kg, p Conclusions Stimulant medication was associated with early fat loss and reduced bone turnover. Lean tissue including bone increased more slowly over 3 years of continuous treatment than would be expected for growth in height. There was long-term improvement in the proportion of central fat for height. This study shows that relatively minor reductions in weight on stimulant medication can be associated with long-term changes in body composition. Further study is required to determine the effects of these changes on adult health.

  8. Consequences of low birth weight, maternal illiteracy and poor access to medical care in rural India: infantile iatrogenic Cushing syndrome.

    Science.gov (United States)

    Karande, Sunil

    2015-08-21

    Home delivery, low birth weight babies and maternal illiteracy among the poor in rural India are frequent. The rural poor prefer to seek healthcare from private providers, most of whom have no formal medical training and buy medicines from private pharmacies without a prescription owing to a weakly regulated environment. This report is of a 4-month-old baby from a remote village in northern India, who presented with exogenous Cushing syndrome. This baby was a full-term low birth weight home delivery. As the baby was not growing well, treatment was started at 1 month by a private doctor with betamethasone drops The mother on her own volition continued giving the betamethasone drops by buying the medicine over the counter from a private pharmacy. This case highlights the gaps in essential health services in rural India and the steps being taken to improve the situation. 2015 BMJ Publishing Group Ltd.

  9. Children who face development risks due to maternal addiction during pregnancy require extra medical and psychosocial resources.

    Science.gov (United States)

    Rangmar, Jenny; Lilja, Maria; Köhler, Marie; Reuter, Antonia

    2018-05-21

    This study examined medical and psychosocial risk factors in children born to women with addiction problems during pregnancy and the children's needs for extra medical and psychosocial resources. Swedish midwives routinely screen pregnant women for drugs and alcohol and refer women with addictions to the Maternity and Child Healthcare Resource Team. We investigated the medical records of 127 children (51% girls) whose mothers were referred to the Resource Team from 2009-2015. Additional data were obtained from local child healthcare services (CHS), which provide routine paediatric care. More than three-quarters (76%) of the children had prenatal exposure to alcohol and drugs and 17% were born with withdrawal symptoms. The mothers had a high rate of psychiatric diagnoses (38%) and were more likely to smoke after delivery and less likely to breastfeed than the general population. However, adherence to the CHS programme was generally high. Additional visits to the nurse, referrals to specialists, collaboration meetings and reports of concerns to social services decreased when the children began attending ordinary CHS centres. Children born to women with addictions during pregnancy faced a high risk of developmental problems and should be offered additional CHS resources to minimise negative long-term consequences. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  10. Priapism associated with the use of stimulant medications and atomoxetine for attention-deficit/hyperactivity disorder in children.

    Science.gov (United States)

    Eiland, Lea S; Bell, Edward A; Erramouspe, John

    2014-10-01

    To review the association of priapism with stimulant medications and atomoxetine commonly used in the treatment of attention-deficit/hyperactivity disorder (ADHD). A comprehensive literature search was conducted through PubMed (1966-May 15, 2014) using the search terms priapism, methylphenidate, amphetamine, atomoxetine, attention-deficit disorder with hyperactivity, and pediatrics. Google Scholar, Scopus, and the Food and Drug Administration (FDA) Web site were also searched. References from identified literature were also reviewed. All identified literature focused on ADHD treatment. Literature regarding priapism caused by methylphenidate, amphetamines, and atomoxetine were included. Stimulant medications and atomoxetine have been linked to the occurrence of priapism in children. Specifically, methylphenidate has been implicated in a recent FDA safety announcement warning as a result of 15 case reports (mean age = 12.5 years), and thus, the drug label and medication guides have been updated to reflect this concern. Prolonged erections and priapism occurred with immediate- and long-acting products, dose increases, and drug withdrawal periods. Priapism has also occurred in 4 patients taking amphetamines and one 11-year-old patient taking atomoxetine for ADHD. Priapism has been associated with stimulants, amphetamines, and atomoxetine use for ADHD in children. Providers and health care practitioners should educate male patients prescribed these ADHD medications as well as caregivers regarding the signs, symptoms, and complications with priapism. Discontinuation and evaluation of the medication is warranted if this adverse drug reaction occurs. Depending on the priapism subtype, other products may be initiated or medications not associated with priapism may be utilized. © The Author(s) 2014.

  11. Medical devices; neurological devices; classification of the transcutaneous electrical nerve stimulator to treat headache. Final order.

    Science.gov (United States)

    2014-07-03

    The Food and Drug Administration (FDA) is classifying the transcutaneous electrical nerve stimulator to treat headache into class II (special controls). The special controls that will apply to the device are identified in this order, and will be part of the codified language for the transcutaneous electrical nerve stimulator to treat headache classification. The Agency is classifying the device into class II (special controls) in order to provide a reasonable assurance of safety and effectiveness of the device.

  12. Medical devices; neurological devices; classification of the transcranial magnetic stimulator for headache. Final order.

    Science.gov (United States)

    2014-07-08

    The Food and Drug Administration (FDA) is classifying the transcranial magnetic stimulator for headache into class II (special controls). The special controls that will apply to the device are identified in this order, and will be part of the codified language for the transcranial magnetic stimulator for headache classification. The Agency is classifying the device into class II (special controls) in order to provide a reasonable assurance of safety and effectiveness of the device.

  13. [Carl Gustav Carus, the first director of the newly established maternity institute of the Dresden Royal Surgical-Medical Academy 1814-1827].

    Science.gov (United States)

    Sarembe, B

    1989-01-01

    Carl Gustav Carus was born in 1789 in Leipzig. He studied at the University of Leipzig. His specialization in Gynecology and Obstetrics took place at the Triersches Maternity Hospital. In 1814 he was named Professor for Obstetrics in Dresden at the Royal-Surgical-Medical-Academy. He was the head of the Maternity Hospital till 1827. Under his direction many midwives, students and physicians were educated. He published numerous articles and books on medical and philosophical-psychological topics. He was a talented artist of the Romantic especially in painting landscapes. He was a friend of Caspar David Friedrich and Johann Wolfgang von Goethe. After 1827 he was the physician in ordinary to 3 saxonian kings. He died in 1869. The Medical Academy in Dresden bears his name "Carl Gustav Carus" since its foundation.

  14. Improving Information on Maternal Medication Use by Linking Prescription Data to Congenital Anomaly Registers

    DEFF Research Database (Denmark)

    de Jonge, Linda; Garne, Ester; Gini, Rosa

    2015-01-01

    INTRODUCTION: Research on associations between medication use during pregnancy and congenital anomalies is significative for assessing the safe use of a medicine in pregnancy. Congenital anomaly (CA) registries do not have optimal information on medicine exposure, in contrast to prescription...... databases. Linkage of prescription databases to the CA registries is a potentially effective method of obtaining accurate information on medicine use in pregnancies and the risk of congenital anomalies. METHODS: We linked data from primary care and prescription databases to five European Surveillance...... of Congenital Anomalies (EUROCAT) CA registries. The linkage was evaluated by looking at linkage rate, characteristics of linked and non-linked cases, first trimester exposure rates for six groups of medicines according to the prescription data and information on medication use registered in the CA databases...

  15. Impact of alcohol and alcohol mixed with energy drinks on non-medical prescription stimulant use in a nationally representative sample of 12th-grade students.

    Science.gov (United States)

    Housman, Jeff M; Williams, Ronald D; Woolsey, Conrad L

    2016-08-01

    Approximately 30% of high school students use energy drinks. Alcohol use and alcohol mixed with energy drink use (AmED) is associated with risky behavior, including non-medical prescription stimulant use. We assessed alcohol-only, AmED and non-medical prescription stimulant use among 12th grade students in the U.S. using a nationally representative secondary data from the 2012 Monitoring the Future Study. Wilcoxon-Mann-Whitney tests and logistic regression analyses were used to determine differences in non-medical prescription stimulant use by students who used alcohol-only versus AmED and to identify covariates of non-medical prescription stimulant use. Pearson-product moment coefficients were used to determine strength of variable relationships. Significant differences were found in frequency of Ritalin (p energy drink and AmED use, as the combined effects of stimulants contained in energy drinks and the depressant effects of alcohol appear to be associated with increased non-medical prescription stimulant use. Research on the influential factors related to energy drinks, alcohol, and non-medical prescription stimulants will help practitioners to more appropriately design prevention and intervention strategies addressing these high-risk behaviors. (Am J Addict 2016;25:378-384). © 2016 American Academy of Addiction Psychiatry.

  16. Medical Devices; Neurological Devices; Classification of the External Vagal Nerve Stimulator for Headache. Final order.

    Science.gov (United States)

    2017-12-27

    The Food and Drug Administration (FDA or we) is classifying the external vagal nerve stimulator for headache into class II (special controls). The special controls that apply to the device type are identified in this order and will be part of the codified language for the external vagal nerve stimulator for headache's classification. We are taking this action because we have determined that classifying the device into class II (special controls) will provide a reasonable assurance of safety and effectiveness of the device. We believe this action will also enhance patients' access to beneficial innovative devices, in part by reducing regulatory burdens.

  17. The Influence of Maternal and Household Resources, and Parental Psychosocial Child Stimulation on Early Childhood Development: A Cross-Sectional Study of Children 36–59 Months in Honduras

    Science.gov (United States)

    Urke, Helga Bjørnøy; Contreras, Mariela; Matanda, Dennis Juma

    2018-01-01

    Optimal early childhood development (ECD) is currently jeopardized for more than 250 million children under five in low- and middle-income countries. The Sustainable Development Goals has called for a renewed emphasis on children’s wellbeing, encompassing a holistic approach that ensures nurturing care to facilitate optimal child development. In vulnerable contexts, the extent of a family’s available resources can influence a child’s potential of reaching its optimal development. Few studies have examined these relationships in low- and middle-income countries using nationally representative samples. The present paper explored the relationships between maternal and paternal psychosocial stimulation of the child as well as maternal and household resources and ECD among 2729 children 36–59 months old in Honduras. Data from the Demographic and Health Surveys conducted in 2011–2012 was used. Adjusted logistic regression analyses showed that maternal psychosocial stimulation was positively and significantly associated with ECD in the full, rural, and lowest wealth quintile samples. These findings underscore the importance of maternal engagement in facilitating ECD but also highlight the role of context when designing tailored interventions to improve ECD. PMID:29735895

  18. The Influence of Maternal and Household Resources, and Parental Psychosocial Child Stimulation on Early Childhood Development: A Cross-Sectional Study of Children 36⁻59 Months in Honduras.

    Science.gov (United States)

    Urke, Helga Bjørnøy; Contreras, Mariela; Matanda, Dennis Juma

    2018-05-07

    Optimal early childhood development (ECD) is currently jeopardized for more than 250 million children under five in low- and middle-income countries. The Sustainable Development Goals has called for a renewed emphasis on children’s wellbeing, encompassing a holistic approach that ensures nurturing care to facilitate optimal child development. In vulnerable contexts, the extent of a family’s available resources can influence a child’s potential of reaching its optimal development. Few studies have examined these relationships in low- and middle-income countries using nationally representative samples. The present paper explored the relationships between maternal and paternal psychosocial stimulation of the child as well as maternal and household resources and ECD among 2729 children 36⁻59 months old in Honduras. Data from the Demographic and Health Surveys conducted in 2011⁻2012 was used. Adjusted logistic regression analyses showed that maternal psychosocial stimulation was positively and significantly associated with ECD in the full, rural, and lowest wealth quintile samples. These findings underscore the importance of maternal engagement in facilitating ECD but also highlight the role of context when designing tailored interventions to improve ECD.

  19. The Influence of Maternal and Household Resources, and Parental Psychosocial Child Stimulation on Early Childhood Development: A Cross-Sectional Study of Children 36–59 Months in Honduras

    Directory of Open Access Journals (Sweden)

    Helga Bjørnøy Urke

    2018-05-01

    Full Text Available Optimal early childhood development (ECD is currently jeopardized for more than 250 million children under five in low- and middle-income countries. The Sustainable Development Goals has called for a renewed emphasis on children’s wellbeing, encompassing a holistic approach that ensures nurturing care to facilitate optimal child development. In vulnerable contexts, the extent of a family’s available resources can influence a child’s potential of reaching its optimal development. Few studies have examined these relationships in low- and middle-income countries using nationally representative samples. The present paper explored the relationships between maternal and paternal psychosocial stimulation of the child as well as maternal and household resources and ECD among 2729 children 36–59 months old in Honduras. Data from the Demographic and Health Surveys conducted in 2011–2012 was used. Adjusted logistic regression analyses showed that maternal psychosocial stimulation was positively and significantly associated with ECD in the full, rural, and lowest wealth quintile samples. These findings underscore the importance of maternal engagement in facilitating ECD but also highlight the role of context when designing tailored interventions to improve ECD.

  20. Uso de medicamentos durante a lactação Breastfeeding and maternal medications

    Directory of Open Access Journals (Sweden)

    Roberto G. Chaves

    2004-11-01

    THE FINDINGS: Most of the drugs are compatible with breastfeeding. Few were considered inadequate, such as antineoplastic drugs, radiopharmaceuticals and drugs of abuse. Some drugs require concern, as they may cause adverse effects in breastfed babies or reduce the mother's breast milk volume. However, further knowledge on some medicines during lactation is required. CONCLUSION: The fundamental principle in the prescription of medicines for lactating mothers is mostly based on the concept of risk and benefit. The option must be, as much as possible, for a drug that has already been studied, which is little released in the maternal milk or that does not mean an apparent risk for the infant's health. Medicines that reduce the mother's production of milk should be avoided during the lactation period. The use of galactogogos is reserved for particular situations. Therefore, only safety drugs should be administered during breastfeeding, which should rarely be discouraged or discontinued in such cases.

  1. Processing speed can monitor stimulant-medication effects in adults with attention deficit disorder with hyperactivity.

    Science.gov (United States)

    Nielsen, Niels Peter; Wiig, Elisabeth H; Bäck, Svante; Gustafsson, Jan

    2017-05-01

    Treatment responses to methylphenidate by adults with ADHD are generally monitored against DSM-IV/DSM-V symptomatology, rating scales or interviews during reviews. To evaluate the use of single- and dual-dimension processing-speed and efficiency measures to monitor the effects of pharmacological treatment with methylphenidate after a short period off medication. A Quick Test of Cognitive Speed (AQT) monitored the effects of immediate-release methylphenidate in 40 previously diagnosed and medicated adults with ADHD. Processing speed was evaluated with prior prescription medication, without medication after a 2-day period off ADHD medication, and with low-dose (10/20 mg) and high-dose (20/40 mg) methylphenidate hydrochloride (Medikinet IR). Thirty-three participants responded to the experimental treatments. One-way ANOVA with post-hoc analysis (Scheffe) indicated significant main effects for single dimension colour and form and dual-dimension colour-form naming. Post-hoc analysis indicated statistical differences between the no- and high-dose medication conditions for colour and form, measures of perceptual speed. For colour-form naming, a measure of cognitive speed, there was a significant difference between no- and low-dose medication and between no- and high-dose medications, but not between low- and high-dose medications. Results indicated that the AQT tests effectively monitored incremental effects of the methylphenidate dose on processing speed after a 2-day period off medication. Thus, perceptual (colour and form) and cognitive speed (two-dimensional colour-form naming) and processing efficiency (lowered shift costs) increased measurably with high-dose medication. These preliminary findings warrant validation with added measures of associated behavioural and cognitive changes.

  2. Research priorities in Maternal, Newborn, & Child Health & Nutrition for India: An Indian Council of Medical Research-INCLEN Initiative

    Directory of Open Access Journals (Sweden)

    Narendra K Arora

    2017-01-01

    Full Text Available In India, research prioritization in Maternal, Newborn, and Child Health and Nutrition (MNCHN themes has traditionally involved only a handful of experts mostly from major cities. The Indian Council of Medical Research (ICMR-INCLEN collaboration undertook a nationwide exercise engaging faculty from 256 institutions to identify top research priorities in the MNCHN themes for 2016-2025. The Child Health and Nutrition Research Initiative method of priority setting was adapted. The context of the exercise was defined by a National Steering Group (NSG and guided by four Thematic Research Subcommittees. Research ideas were pooled from 498 experts located in different parts of India, iteratively consolidated into research options, scored by 893 experts against five pre-defined criteria (answerability, relevance, equity, investment and innovation and weighed by a larger reference group. Ranked lists of priorities were generated for each of the four themes at national and three subnational (regional levels [Empowered Action Group & North-Eastern States, Southern and Western States, & Northern States (including West Bengal]. Research priorities differed between regions and from overall national priorities. Delivery domain of research which included implementation research constituted about 70 per cent of the top ten research options under all four themes. The results were endorsed in the NSG meeting. There was unanimity that the research priorities should be considered by different governmental and non-governmental agencies for investment with prioritization on implementation research and issues cutting across themes.

  3. Tibial nerve stimulation for overactive bladder syndrome unresponsive to medical therapy.

    Science.gov (United States)

    Ridout, A E; Yoong, W

    2010-02-01

    Overactive bladder syndrome is defined as a symptom syndrome which includes urinary urgency, with or without urge incontinence, usually accompanied by frequency (>8 micturitions/24 h) and nocturia. Conservative treatment usually comprises behavioural techniques, bladder retraining, pelvic floor re-education and pharmacotherapy but up to 30% of patients will remain refractory to treatment. Although second-line treatment options such as sacral nerve stimulation and intravesical botulinum A injections are valuable additions to the therapeutic arsenal, they are relatively invasive and can have serious side-effects. Inhibition of detrusor activity by peripheral neuromodulation of the posterior tibial nerve was first described in 1983, with recent authors further confirming a 60-80% positive response rate. This review was undertaken to examine published literature on percutaneous tibial nerve stimulation and to discuss outcome measures, maintenance therapy and prognostic factors of this technique.

  4. Effects of psycho-educational training and stimulant medication on visual perceptual skills in children with attention deficit hyperactivity disorder

    Directory of Open Access Journals (Sweden)

    Antigone S Papavasiliou

    2007-01-01

    Full Text Available Antigone S Papavasiliou, Irene Nikaina, Ioanna Rizou, Stratos AlexandrouDepartment of Neurology, Pendeli Children’s Hospital, Athens, GreeceAbstract: Attention deficit hyperactivity disorder (ADHD is treated with stimulants and psycho-educational remedial programs despite limited literature support for the latter. This study aimed to examine changes in a “Test of Visual Perceptual Skills” (TVPS that has not been previously reported in children with ADHD enrolled in such a program.Methods: Sixteen children, 7–11 years old, with ADHD were involved in occupational therapy and special education geared towards attention training. Six months later methylphenidate 1 mg/kg/day was prescribed. It was not taken by eight children because of family choice. The TVPS was given twice, upon diagnosis, and 8 months post-intervention. The groups were compared by a repeated measures analysis of variance (ANOVA with medication as a between groups factor and test-retest scores as within factor.Results: All children demonstrated increases in total scores in the second measurement. Medicated children scored higher but ANOVA showed a nonsignificant F for the two groups, medicated and unmedicated (F = 0.0031, p = 0.9563, indicating a non-differential effect of the two levels of treatment. It revealed a significant F for the pre- and post-treatment total TVPS scores (F = 30.91, p < 0.0001 indicating a significant difference between pre- and post-treatment tests. The interaction between pre-post treatment and level of treatment (medicated–unmedicated was nonsignificant (F = 2.20, p = 0.1604.Conclusion: TVPS scores improved in all children following intervention. Medicated children did better, but differences were nonsignificant.Keywords: ADHD, stimulants, psycho-educational therapy, TVPS

  5. The Study of Maternal Perception of Preterm Infants and Some Related Factors in Selected Hospitals of Iran University of Medical Sciences

    Directory of Open Access Journals (Sweden)

    M. Ghafoorie

    2015-05-01

    Full Text Available Background and Purpose: Appropriate maternal care is necessary to provide Physical growth and mental development of neonate which is related to establishing a good relationship between mother and infant. Positive perception of mothers to their neonates, creates a better relationship between them. Maternal perception of neonates is based on her understanding of biological behavior of the infant. Special features of prematurity, maternal stress and anxiety due to premature delivery are effective on maternal perceptions. The purpose of this study was to determine the maternal perception of premature infants as determining it’s related factors. Methods: In a cross-sectional design, 150 mothers of preterm infants who were been admitted to Neonatal intensive care units of 2 selected hospitals of Iran University of Medical Sciences, entered the study. Broussard questionnaire were used to measure the maternal perception. Data were analyzed by using descriptive statistical analysis and Kay square and Fisher's exact tests were used for analyzing the data. Results: Most of mother’s had a negative perception of their preterm infant. Based on the results, Mather’s job, fathers’ job, mothers’ age, husband’s support, desire about the pregnancy, history of miscarriage and still birth were related with perception of mothers of preterm infants. Discussion: Negative perceptions in mothers of preterm infants are prevalent and in some groups are in higher risk. As negative perception can have a role in developmental processes and cause problems in future, preparing circumstances to decrease mothers’ stress and providing facilities and interventions to increase mother-infant communications are essential. These are treatment team’s duties. The health care team can screen susceptible cases and by supportive interventions, it is possible to create better mother-baby relationship and prepare better care to prevent future developmental problems.

  6. Influence of stimulant medication and response speed on lateralization of movement-related potentials in attention-deficit/hyperactivity disorder.

    Directory of Open Access Journals (Sweden)

    Stephan Bender

    Full Text Available BACKGROUND: Hyperactivity is one of the core symptoms in attention deficit hyperactivity disorder (ADHD. However, it remains unclear in which way the motor system itself and its development are affected by the disorder. Movement-related potentials (MRP can separate different stages of movement execution, from the programming of a movement to motor post-processing and memory traces. Pre-movement MRP are absent or positive during early childhood and display a developmental increase of negativity. METHODS: We examined the influences of response-speed, an indicator of the level of attention, and stimulant medication on lateralized MRP in 16 children with combined type ADHD compared to 20 matched healthy controls. RESULTS: We detected a significantly diminished lateralisation of MRP over the pre-motor and primary motor cortex during movement execution (initial motor potential peak, iMP in patients with ADHD. Fast reactions (indicating increased visuo-motor attention led to increased lateralized negativity during movement execution only in healthy controls, while in children with ADHD faster reaction times were associated with more positive amplitudes. Even though stimulant medication had some effect on attenuating group differences in lateralized MRP, this effect was insufficient to normalize lateralized iMP amplitudes. CONCLUSIONS: A reduced focal (lateralized motor cortex activation during the command to muscle contraction points towards an immature motor system and a maturation delay of the (pre- motor cortex in children with ADHD. A delayed maturation of the neuronal circuitry, which involves primary motor cortex, may contribute to ADHD pathophysiology.

  7. The "Flipped Classroom" Approach: Stimulating Positive Learning Attitudes and Improving Mastery of Histology among Medical Students

    Science.gov (United States)

    Cheng, Xin; Ka Ho Lee, Kenneth; Chang, Eric Y.; Yang, Xuesong

    2017-01-01

    Traditional medical education methodologies have been dramatically impacted by the introduction of new teaching approaches over the past few decades. In particular, the "flipped classroom" format has drawn a great deal of attention. However, evidence regarding the effectiveness of the flipped model remains limited due to a lack of…

  8. Maternal Mortality in Texas.

    Science.gov (United States)

    Baeva, Sonia; Archer, Natalie P; Ruggiero, Karen; Hall, Manda; Stagg, Julie; Interis, Evelyn Coronado; Vega, Rachelle; Delgado, Evelyn; Hellerstedt, John; Hankins, Gary; Hollier, Lisa M

    2017-05-01

    A commentary on maternal mortality in Texas is provided in response to a 2016 article in Obstetrics & Gynecology by MacDorman et al. While the Texas Department of State Health Services and the Texas Maternal Mortality and Morbidity Task Force agree that maternal mortality increased sharply from 2010 to 2011, the percentage change or the magnitude of the increase in the maternal mortality rate in Texas differs depending on the statistical methods used to compute and display it. Methodologic challenges in identifying maternal death are also discussed, as well as risk factors and causes of maternal death in Texas. Finally, several state efforts currently underway to address maternal mortality in Texas are described. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  9. Behavioural outcomes of subthalamic stimulation and medical therapy versus medical therapy alone for Parkinson's disease with early motor complications (EARLYSTIM trial): secondary analysis of an open-label randomised trial.

    Science.gov (United States)

    Lhommée, Eugénie; Wojtecki, Lars; Czernecki, Virginie; Witt, Karsten; Maier, Franziska; Tonder, Lisa; Timmermann, Lars; Hälbig, Thomas D; Pineau, Fanny; Durif, Franck; Witjas, Tatiana; Pinsker, Marcus; Mehdorn, Maximilian; Sixel-Döring, Friederike; Kupsch, Andreas; Krüger, Rejko; Elben, Saskia; Chabardès, Stephan; Thobois, Stéphane; Brefel-Courbon, Christine; Ory-Magne, Fabienne; Regis, Jean-Marie; Maltête, David; Sauvaget, Anne; Rau, Jörn; Schnitzler, Alfons; Schüpbach, Michael; Schade-Brittinger, Carmen; Deuschl, Gunther; Houeto, Jean-Luc; Krack, Paul

    2018-03-01

    Although subthalamic stimulation is a recognised treatment for motor complications in Parkinson's disease, reports on behavioural outcomes are controversial, which represents a major challenge when counselling candidates for subthalamic stimulation. We aimed to assess changes in behaviour in patients with Parkinson's disease receiving combined treatment with subthalamic stimulation and medical therapy over a 2-year follow-up period as compared with the behavioural evolution under medical therapy alone. We did a parallel, open-label study (EARLYSTIM) at 17 surgical centres in France (n=8) and Germany (n=9). We recruited patients with Parkinson's disease who were disabled by early motor complications. Participants were randomly allocated (1:1) to either medical therapy alone or bilateral subthalamic stimulation plus medical therapy. The primary outcome was mean change in quality of life from baseline to 2 years. A secondary analysis was also done to assess behavioural outcomes. We used the Ardouin Scale of Behavior in Parkinson's Disease to assess changes in behaviour between baseline and 2-year follow-up. Apathy was also measured using the Starkstein Apathy Scale, and depression was assessed with the Beck Depression Inventory. The secondary analysis was done in all patients recruited. We used a generalised estimating equations (GEE) regression model for individual items and mixed model regression for subscores of the Ardouin scale and the apathy and depression scales. This trial is registered with ClinicalTrials.gov, number NCT00354133. The primary analysis has been reported elsewhere; this report presents the secondary analysis only. Between July, 2006, and November, 2009, 251 participants were recruited, of whom 127 were allocated medical therapy alone and 124 were assigned bilateral subthalamic stimulation plus medical therapy. At 2-year follow-up, the levodopa-equivalent dose was reduced by 39% (-363·3 mg/day [SE 41·8]) in individuals allocated bilateral

  10. Bio-medical electrical disconnects. [artificial stimulation of muscles for paraylzed patients

    Science.gov (United States)

    Parsons, W. E.

    1973-01-01

    Improvements in medical care during the last two decades have resulted in the survival of an ever-increasing group of patients with severe neuro-muscular disabilities who otherwise would have succumbed to their diseases or injuries. This has created a sizeable population of severely paralyzed persons totally dependent upon society for care. It has been estimated that this population may grow beyond 5,000,000 persons by 1980. A rather fortunate confluence of complementing technologies and surgical techniques offer promise of solving this growing socially significant problem.

  11. Chronic inflammatory diseases are stimulated by current lifestyle: how diet, stress levels and medication prevent our body from recovering

    Directory of Open Access Journals (Sweden)

    Bosma-den Boer Margarethe M

    2012-04-01

    Full Text Available Abstract Serhan and colleagues introduced the term "Resoleomics" in 1996 as the process of inflammation resolution. The major discovery of Serhan's work is that onset to conclusion of an inflammation is a controlled process of the immune system (IS and not simply the consequence of an extinguished or "exhausted" immune reaction. Resoleomics can be considered as the evolutionary mechanism of restoring homeostatic balances after injury, inflammation and infection. Under normal circumstances, Resoleomics should be able to conclude inflammatory responses. Considering the modern pandemic increase of chronic medical and psychiatric illnesses involving chronic inflammation, it has become apparent that Resoleomics is not fulfilling its potential resolving capacity. We suggest that recent drastic changes in lifestyle, including diet and psycho-emotional stress, are responsible for inflammation and for disturbances in Resoleomics. In addition, current interventions, like chronic use of anti-inflammatory medication, suppress Resoleomics. These new lifestyle factors, including the use of medication, should be considered health hazards, as they are capable of long-term or chronic activation of the central stress axes. The IS is designed to produce solutions for fast, intensive hazards, not to cope with long-term, chronic stimulation. The never-ending stress factors of recent lifestyle changes have pushed the IS and the central stress system into a constant state of activity, leading to chronically unresolved inflammation and increased vulnerability for chronic disease. Our hypothesis is that modern diet, increased psycho-emotional stress and chronic use of anti-inflammatory medication disrupt the natural process of inflammation resolution ie Resoleomics.

  12. The "brittle response" to Parkinson's disease medications: characterization and response to deep brain stimulation.

    Directory of Open Access Journals (Sweden)

    Daniel Martinez-Ramirez

    Full Text Available Formulate a definition and describe the clinical characteristics of PD patients with a "brittle response" (BR to medications versus a "non-brittle response" (NBR, and characterize the use of DBS for this population.An UF IRB approved protocol used a retrospective chart review of 400 consecutive PD patients presenting to the UF Center for Movement Disorders and Neurorestoration. Patient records were anonymized and de-identified prior to analysis. SPSS statistics were used to analyze data.Of 345 included patients, 19 (5.5% met criteria for BR PD. The BR group was comprised of 58% females, compared to 29% in the NBR group (P = .008. The former had a mean age of 63.4 compared to 68.1 in the latter. BR patients had lower mean weight (63.5 vs. 79.6, P = <.001, longer mean disease duration (12.6 vs. 8.9 years, P = .003, and had been on LD for more years compared to NBR patients (9.8 vs. 5.9, P = .001. UPDRS motor scores were higher (40.4 vs. 30.0, P = .001 in BR patients. No differences were observed regarding the Schwab and England scale, PDQ-39, and BDI-II. Sixty-three percent of the BR group had undergone DBS surgery compared to 18% (P = .001. Dyskinesias were more common, severe, and more often painful (P = <.001 in the BR group. There was an overall positive benefit from DBS.BR PD occurred more commonly in female patients with a low body weight. Patients with longer disease duration and longer duration of LD therapy were also at risk. The BR group responded well to DBS.

  13. [Hospital maternal mortality: causes and consistency between clinical and autopsy diagnosis at the Northeastern Medical Center of the IMSS, Mexico].

    Science.gov (United States)

    Calderón-Garcidueñas, Ana Laura; Martínez-Salazar, Griselda; Fernández-Díaz, Héctor; Cerda-Flores, Ricardo M

    2002-02-01

    The aim was to study the causes of maternal mortality (MM) and the percent of concordance between the clinical diagnosis and the autopsy findings. The autopsies of maternal death (1980-1999) from the Hospital de Especialidades, Centro Médico del Noreste, IMSS in Monterrey, México, were analyzed. The cases were classified in directly obstetric maternal mortality (DOM) and indirectly obstetric maternal mortality (IOM), the causes were studied and the percent of concordance between pre- and post-mortem diagnosis was determined. There were 124 deaths. Autopsy was performed in 61 (49.1%) women. In 55 cases the clinical file and the autopsy protocol were available. This was our sample for study. Sixty percent of the cases were DO. Causes of DOM were: specific hypertensive pregnancy disease (SHPD) (51.6%), sepsis (35.5%), hypovolemic shock (9.7%), anesthetic accidents (3%); causes of IOM were: sepsis (41.7%), malignancies (16.7%), hematological diseases (12.5%), cardiopathy and systemic arterial hypertension (12.5%), hepatic disorders (12.5%), and Superior Longitudinal Sinus thrombosis (4%). A 100% clinical-pathological concordance was observed in DOM cases, while only a 41.6% was found in IOM cases. In those cases of sepsis (IOM), the etiologic agents were identified only in 20% before death. The early detection and treatment of SHPD and the prevention of sepsis should decrease the MM. This study showed some weakness in the Health Services that should be improved.

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

    NARCIS (Netherlands)

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

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

  15. Effects of Medication and Subthalamic Nucleus Deep Brain Stimulation on Tongue Movements in Speakers with Parkinson's Disease Using Electropalatography: A Pilot Study

    Science.gov (United States)

    Hartinger, Mariam; Tripoliti, Elina; Hardcastle, William J.; Limousin, Patricia

    2011-01-01

    Parkinson's disease (PD) affects speech in the majority of patients. Subthalamic nucleus deep brain stimulation (STN-DBS) is particularly effective in reducing tremor and rigidity. However, its effect on speech is variable. The aim of this pilot study was to quantify the effects of bilateral STN-DBS and medication on articulation, using…

  16. 24/7 Presence of Medical Staff in the Labor Ward; No Day-Night Differences in Perinatal and Maternal Outcomes.

    Science.gov (United States)

    Tavares, Sara; Cavaco-Gomes, João; Moucho, Marina; Severo, Milton; Mateus, Mário; Ramalho, Carla; Visser, Gerard H A; Montenegro, Nuno

    2017-05-01

    Objective  The objective of this study was to assess possible day-night differences in perinatal and maternal labor outcomes in a hospital setting with no day-night differences in the presence of experienced medical staff. Design  This was a retrospective study conducted over 5 years between 2008 and 2012. Setting  This study was set at the obstetric delivery unit in a tertiary hospital. Population  A total of 9,143 singleton deliveries were assessed after 34 weeks of gestation and after exclusion of major congenital malformations, inductions of labor, and elective cesarean sections. Materials and Methods  Data were collected using the hospital electronic medical records. Time periods of 8 hours were defined (daytime between 8 am and 4 pm, evening time between 4 pm and 12 pm, and nighttime between 12 pm and 8 am). Differences between the three time periods were assessed using software R Core Team (2013). Main outcome measures were neonatal birth asphyxia, neonatal intensive care unit admission, and neonatal death. Results  There were no differences in perinatal and maternal outcomes in the course of the day, apart from a higher incidence of third- and fourth-degree tears during the evening. Neonatal outcome after obstetric emergencies (uterine rupture, partial placental abruption, and cord prolapse) also showed no day-night differences. Conclusion  Adverse nighttime-related outcomes may be avoided by the 24/7 presence of experienced medical staff. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  17. Comparing Auditory Noise Treatment with Stimulant Medication on Cognitive Task Performance in Children with Attention Deficit Hyperactivity Disorder: Results from a Pilot Study.

    Science.gov (United States)

    Söderlund, Göran B W; Björk, Christer; Gustafsson, Peik

    2016-01-01

    Recent research has shown that acoustic white noise (80 dB) can improve task performance in people with attention deficits and/or Attention Deficit Hyperactivity Disorder (ADHD). This is attributed to the phenomenon of stochastic resonance in which a certain amount of noise can improve performance in a brain that is not working at its optimum. We compare here the effect of noise exposure with the effect of stimulant medication on cognitive task performance in ADHD. The aim of the present study was to compare the effects of auditory noise exposure with stimulant medication for ADHD children on a cognitive test battery. A group of typically developed children (TDC) took the same tests as a comparison. Twenty children with ADHD of combined or inattentive subtypes and twenty TDC matched for age and gender performed three different tests (word recall, spanboard and n-back task) during exposure to white noise (80 dB) and in a silent condition. The ADHD children were tested with and without central stimulant medication. In the spanboard- and the word recall tasks, but not in the 2-back task, white noise exposure led to significant improvements for both non-medicated and medicated ADHD children. No significant effects of medication were found on any of the three tasks. This pilot study shows that exposure to white noise resulted in a task improvement that was larger than the one with stimulant medication thus opening up the possibility of using auditory noise as an alternative, non-pharmacological treatment of cognitive ADHD symptoms.

  18. Comparing Auditory Noise Treatment with Stimulant Medication on Cognitive Task Performance in Children with Attention Deficit Hyperactivity Disorder: Results from a Pilot Study

    Directory of Open Access Journals (Sweden)

    Göran B W Söderlund

    2016-09-01

    Full Text Available Background: Recent research has shown that acoustic white noise (80 dB can improve task performance in people with attention deficits and/or Attention Deficit Hyperactivity Disorder (ADHD. This is attributed to the phenomenon of stochastic resonance in which a certain amount of noise can improve performance in a brain that is not working at its optimum. We compare here the effect of noise exposure with the effect of stimulant medication on cognitive task performance in ADHD. The aim of the present study was to compare the effects of auditory noise exposure with stimulant medication for ADHD children on a cognitive test battery. A group of typically developed children (TDC took the same tests as a comparison.Methods: Twenty children with ADHD of combined or inattentive subtypes and twenty typically developed children matched for age and gender performed three different tests (word recall, spanboard and n-back task during exposure to white noise (80 dB and in a silent condition. The ADHD children were tested with and without central stimulant medication.Results: In the spanboard- and the word recall tasks, but not in the 2-back task, white noise exposure led to significant improvements for both non-medicated and medicated ADHD children. No significant effects of medication were found on any of the three tasks.Conclusion: This pilot study shows that exposure to white noise resulted in a task improvement that was larger than the one with stimulant medication thus opening up the possibility of using auditory noise as an alternative, non-pharmacological treatment of cognitive ADHD symptoms.

  19. How medical education can contribute towards the reduction of maternal mortality in Angola: the teaching/learning process of Gynecology and Obstetrics.

    Science.gov (United States)

    Mendes, M; Barbosa, J; Loureiro, E; Ferreira, M A

    2014-03-01

    In Angola the maternal mortality ratio is among the highest in the world. Medical students are an important target for intervention. To evaluate how students perceive the curricular unit of Gynecology and Obstetrics (G&O) in a public institution of reference in Angola. The study involved a sample of 147 students of the faculty of Medicine of the University Agostinho Neto, Luanda, Angola, attending the curricular unit of G&O in the 5th and 6th years of the medical course. Data were obtained through surveys of opinion. The information of the scales was summarized through the construction of scores from the original items using the Principal Components Analysis. Students evaluated positively the curricular unit although emphasizing the lack of human and physical resources. The 5th year scored with higher values Teacher Performance and 6th year Students' Performance. Both years considered to have insufficient skills to meet the learning objectives. Constraints were identified in the outcomes of the teaching/learning program. Several points emerged as crucial from this study: widespread the areas of teaching/learning, increase the number and quality of teaching staff, improve the monitoring of students and provide adequate infrastructures and medical equipment to support the teaching/learning program.

  20. A Prospective Examination of the Association of Stimulant Medication History and Drug Use Outcomes among Community Samples of ADHD Youths

    Science.gov (United States)

    Winters, Ken C.; Lee, Susanne; Botzet, Andria; Fahnhorst, Tamara; Realmuto, George M.; August, Gerald J.

    2011-01-01

    A continuing debate in the child psychopathology literature is the extent to which pharmacotherapy for children with attention-deficit/hyperactivity disorder (ADHD), in particular stimulant treatment, confers a risk of subsequent drug abuse. If stimulant treatment for ADHD contributes to drug abuse, then the risk versus therapeutic benefits of…

  1. Maternal and fetal mechanisms of B cell regulation during pregnancy: human Chorionic Gonadotropin stimulates B cells to produce IL-10 while alpha-fetoprotein drives them into apoptosis

    Directory of Open Access Journals (Sweden)

    Franziska Fettke

    2016-12-01

    Full Text Available Maternal immune tolerance towards the fetus is an essential requisite for pregnancy. While T cell functions are well documented, little is known about the participation of B cells. We have previously suggested that IL-10 producing B cells are involved in pregnancy tolerance in mice and humans. By employing murine and human systems, we report now that fetal trophoblasts positively regulate the generation of IL-10 producing B cells. We next studied the participation of hormones produced by the placenta as well as the fetal protein alpha-fetoprotein (AFP in B cell modulation. Human Chorionic Gonadotropin (hCG, but not progesterone, estrogen or a combination of both, was able to promote changes in B cell phenotype and boost their IL-10 production, which was abolished after blocking hCG. The hCG-induced B cell phenotype was not associated with augmented galactosylation, sialylation or fucosylation of IgG subclasses in their Fc. In vitro, hCG induced the synthesis of asymmetrically glycosylated antibodies in their Fab region. Interestingly, AFP had dual effects depending on the concentration. At concentrations corresponding to maternal serum levels, it did not modify the phenotype or IL-10 secretion of B cells. At fetal concentrations, however, AFP was able to drive B cells into apoptosis, which may indicate a protective mechanism to avoid maternal B cells to reach the fetus.Our data suggests that the fetus secrete factors that promote a pregnancy-friendly B cell phenotype, unraveling interesting aspects of B cell function and modulation by pregnancy hormones and fetal proteins.

  2. Processing of Continuously Provided Punishment and Reward in Children with ADHD and the Modulating Effects of Stimulant Medication: An ERP Study

    OpenAIRE

    Groen, Yvonne; Tucha, Oliver; Wijers, Albertus A.; Althaus, Monika

    2013-01-01

    OBJECTIVES: Current models of ADHD suggest abnormal reward and punishment sensitivity, but the exact mechanisms are unclear. This study aims to investigate effects of continuous reward and punishment on the processing of performance feedback in children with ADHD and the modulating effects of stimulant medication. METHODS: 15 Methylphenidate (Mph)-treated and 15 Mph-free children of the ADHD-combined type and 17 control children performed a selective attention task with three feedback conditi...

  3. Improving Information on Maternal Medication Use by Linking Prescription Data to Congenital Anomaly Registers : A EUROmediCAT Study

    NARCIS (Netherlands)

    de Jonge, Linda; Garne, Ester; Gini, Rosa; Jordan, Susan E.; Klungsoyr, Kari; Loane, Maria; Neville, Amanda J.; Pierini, Anna; Puccini, Aurora; Thayer, Daniel S.; Tucker, David; Hansen, Anne Vinkel; Bakker, Marian K.

    2015-01-01

    Research on associations between medication use during pregnancy and congenital anomalies is significative for assessing the safe use of a medicine in pregnancy. Congenital anomaly (CA) registries do not have optimal information on medicine exposure, in contrast to prescription databases. Linkage of

  4. Risk assessment of medically assisted reproduction and advanced maternal ages in the development of Prader-Willi syndrome due to UPD(15)mat.

    Science.gov (United States)

    Matsubara, K; Murakami, N; Fukami, M; Kagami, M; Nagai, T; Ogata, T

    2016-05-01

    Recent studies have suggested that disomic oocyte-mediated uniparental disomy 15 (UPD(15)mat) is increased in patients with Prader-Willi syndrome (PWS) born after medically assisted reproduction (MAR). However, it remains unknown whether the increase is primarily due to MAR procedure itself or advanced maternal childbearing ages as a predisposing factor for the disomic oocyte production. To examine this matter, we studied 122 naturally conceived PWS patients (PWS-NC group) and 13 MAR-conceived patients (PWS-MAR group). The relative frequency of disomic oocyte-mediated UPD(15)mat was significantly higher in PWS-MAR group than in PWS-NC group (7/13 vs 20/122, p = 0.0045), and the maternal childbearing ages were significantly higher in PWS-MAR group than in PWS-NC group [median (range), 38 (26-45) vs 30 (19-42), p = 0.0015]. However, the logistic regression analysis revealed no significant association between the occurrence of disomic oocyte-mediated UPD(15)mat and MAR, after adjusting for childbearing age (p = 0.25). Consistent with this, while the frequency of assisted reproductive technology (ART)-conceived livebirths was higher in the PWS patients than in the Japanese general population (6.4% vs 1.1%, p = 0.00018), the distribution of childbearing ages was significantly skewed to the increased ages in the PWS patients (p < 2.2 × 10(-16) ). These results argue against a positive association of MAR procedure itself with the development of UPD(15)mat. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  5. Cannabis Use During the Perinatal Period in a State With Legalized Recreational and Medical Marijuana: The Association Between Maternal Characteristics, Breastfeeding Patterns, and Neonatal Outcomes.

    Science.gov (United States)

    Crume, Tessa L; Juhl, Ashley L; Brooks-Russell, Ashley; Hall, Katelyn E; Wymore, Erica; Borgelt, Laura M

    2018-03-28

    To evaluate state-level prevalence estimates of prenatal and early postnatal cannabis use in a state with legalized medical and recreational marijuana and the association with adverse neonatal outcomes. We conducted a cross-sectional study on 3,207 respondents from the 2014-2015 Colorado Pregnancy Risk Assessment Monitoring System with state-developed questions on cannabis use. Differences in perinatal cannabis use were evaluated according to maternal characteristics, breastfeeding patterns, and pregnancy intendedness. Multiple logistic regression models evaluated the relationship between prenatal cannabis use and adverse neonatal outcomes including low birth weight, small for gestational age, preterm birth, and admission to the neonatal intensive care unit. The self-reported prevalence of cannabis use at any time during pregnancy was 5.7 ± 0.5% and the prevalence of early postnatal cannabis use among women who breastfed was 5.0% (95% CI, 4.1%-6.2%). Prenatal cannabis use was associated with a 50% increased likelihood of low birth weight, independent of maternal age, race/ethnicity, level of education, and tobacco use during pregnancy (OR, 1.5; 95% CI, 1.1-2.1; P = .02). Small for gestational age, preterm birth, and neonatal intensive care unit admission were not associated with prenatal cannabis use, independent of prenatal tobacco use. Our findings underscore the importance of screening for cannabis use during prenatal care and the need for provider counselling about the adverse health consequences of continued use during pregnancy and lactation. Copyright © 2018 Elsevier Inc. All rights reserved.

  6. [Maternal death: unequal risks].

    Science.gov (United States)

    Defossez, A C; Fassin, D

    1989-01-01

    Nearly 99% of maternal deaths in the world each year occur in developing countries. New efforts have recently been undertaken to combat maternal mortality through research and action. The medical causes of such deaths are coming to be better understood, but the social mechanisms remain poorly grasped. Maternal mortality rates in developing countries are difficult to interpret because they tend to exclude all deaths not occurring in health care facilities. The countries of Europe and North America have an average maternal mortality rate of 30/100,000 live births, representing about 6000 deaths each year. The developing countries of Asia, Africa, and Latin America have rates of 270-640/100,000, representing some 492,000 deaths annually. For a true comparison of the risks of maternal mortality in different countries, the risk itself and the average number of children per woman must both be considered. A Nigerian woman has 375 times greater risk of maternal death than a Swedish woman, but since she has about 4 times more children, her lifetime risk of maternal death is over 1500 times greater than that of the Swedish woman. The principal medical causes of maternal death are known: hemorrhages due to placenta previa or retroplacental hematoma, mechanical dystocias responsible for uterine rupture, toxemia with eclampsia, septicemia, and malaria. The exact weight of abortion in maternal mortality is not known but is probably large. The possible measures for improving such rates are of 3 types: control of fertility to avoid early, late, or closely spaced pregnancies; effective medical surveillance of the pregnancy to reduce the risk of malaria, toxemia, and hemorrhage, and delivery in an obstetrical facility, especially for high-risk pregnancies. Differential access to high quality health care explains much of the difference between mortality rates in urban and rural, wealthy and impoverished areas of the same country. The social determinants of high maternal mortality

  7. Questioning the causal link between maternal smoking during pregnancy and offspring use of psychotropic medication: a sibling design analysis.

    Directory of Open Access Journals (Sweden)

    Lovisa Söderström

    Full Text Available A recent population-based, longitudinal study from Finland observed a dose-response association between smoking during pregnancy (SDP and use of psychotropic medications in exposed children and young adults. However, this association may be confounded by unmeasured familial characteristics related to both SDP and offspring mental health. Consequently, we aim to investigate the effect of SDP by means of a sibling design that to some extent allows controlling for unknown environmental and genetic confounders. Using the Swedish Medical Birth Register (1987-1993, which was linked to the Swedish Prescribed Drugs Register (July 2005-December 2008, we investigated 579,543 children and among them 39, 007 were discordant for use of psychotropic medication and 4,021 siblings discordant for both use of psychotropic medication and for smoking exposure. Replicating the Finnish study using traditional logistic regression methods we found an association between exposure to ≥10 cigarettes per day during pregnancy and psychotropic drug use (odds ratio = 1.61, 95% confidence interval 1.56, 1.66. Similar in size to the association reported from Finland (odds ratio = 1.63; 95% confidence interval 1.53, 1.74. However, in the adjusted sibling analysis using conditional logistic regression, the association was considerably reduced (odds ratio 1.22; 95% confidence interval 1.08, 1.38. Preventing smoking is of major public health importance. However, SDP per se appears to have less influence on offspring psychotropic drug use than previously suggested.

  8. Stimulating the clinical academics of tomorrow: a survey of research opportunities for medical students in New Zealand.

    Science.gov (United States)

    Al-Busaidi, Ibrahim S; Wells, Cameron I

    2017-09-22

    Developing the clinical academic workforce of the future is a priority of international relevance. Despite a number of measures implemented to address this challenge, a small proportion of medical students engage in research. Lack of knowledge of available research opportunities, and difficulty finding projects and suitable mentors are key barriers to undergraduate medical research. To date, there is no consolidated source of information on undergraduate research training opportunities and their outcomes available to medical students in New Zealand. Based on a comprehensive review of the published and grey literature and the authors' personal experiences of research training activities as medical students, this article presents an overview of the research training opportunities available to medical students in New Zealand. Challenges facing medical student research involvement are discussed and current knowledge gaps in the literature are highlighted. The article concludes with suggested strategies to help promote research training opportunities and support students through their research experience.

  9. [Maternal phenylketonuria].

    Science.gov (United States)

    Bókay, János; Kiss, Erika; Simon, Erika; Szőnyi, László

    2013-05-05

    Elevated maternal phenylalanine levels during pregnancy are teratogenic, and may result in embryo-foetopathy, which could lead to stillbirth, significant psychomotor handicaps and birth defects. This foetal damage is known as maternal phenylketonuria. Women of childbearing age with all forms of phenylketonuria, including mild variants such as hyperphenylalaninaemia, should receive detailed counselling regarding their risks for adverse foetal effects, optimally before contemplating pregnancy. The most assured way to prevent maternal phenylketonuria is to maintain the maternal phenylalanine levels within the optimal range already before conception and throughout the whole pregnancy. Authors review the comprehensive programme for prevention of maternal phenylketonuria at the Metabolic Center of Budapest, they survey the practical approach of the continuous maternal metabolic control and delineate the outcome of pregnancies of mothers with phenylketonuria from the introduction of newborn screening until most recently.

  10. Assessment of mothers’ satisfaction with the care of maternal care in Specialized Educational-Medical Centers in obstetrics and gynecological disease in Northwest, Iran

    Directory of Open Access Journals (Sweden)

    Simin Taghavi

    2015-06-01

    Full Text Available Introduction: Patients satisfaction includes the assessment of healthcare which she/he received. This study aims at assessment of mothers’ satisfaction with the care of maternal care in Specialized Educational-Medical Centers in obstetrics and gynecological disease in Northwest, Iran. Methods: In an analytic-descriptive cross-sectional study, 1000 female patients who admitted in educational-medical centers of Northwest were studied during a 2 years period (2010-2012. They asked to fill a 34-item closed-answer questionnaire (ranking from very unsatisfied to very satisfied responses following their discharge. Validity of the questionnaire was improved by gynecologist’s experts comments, and reliability of the questionnaire were assessed by test-retest methods (α = 0.946. Results: The satisfaction score (satisfied or very satisfied responses were 61.2, 55.8, 61.8 and 59.5 percent for admitting process, primary care services, treatments and therapeutic interventions and overall, respectively. The satisfaction score for access to doctors was highest in the morning and lowest at the night shifts. The satisfaction score about the personnel’s behavior was lowest during the night shifts. The satisfaction score about the residents’ behavior was highest for the morning shifts. There was no significant difference between the three working shifts regarding psychological feelings, humanitarian respect, and issues like nutrition and private and public hygiene. There was a significant direct correlation between the mean score of satisfaction and patients’ age (Spearman’s rho = 0.117, P < 0.001. Conclusion: The satisfaction level of patients hospitalized in Northwest of Iran's Hospitals was intermediate. Planning new strategies in this regard with emphasis on the main limitations may improve the satisfaction rate in the future.

  11. AN AUDIT OF MATERNAL DEATHS

    Directory of Open Access Journals (Sweden)

    Basavana Gowda

    2015-03-01

    Full Text Available OBJECTIVES: A study of maternal death conducted to evaluate various factors responsible for maternal deaths. To identify complications in pregnancy, a childbirth which result in maternal death, and to identify opportunities for preventive intervention and understand the events leading to death; so that improving maternal health and reducing maternal mortality rate significantly. To analyze the causes and epidemiological amounts maternal mortality e.g. age parity, socioeconomic status and literacy. In order to reduce maternal mortality and to implement safe motherhood program and complications of pregnancy and to find out safe motherhood program. METHODS: The data collected was a retrograde by a proforma containing particulars of the diseased, detailed history and relatives were interviewed for additional information. The data collected was analysed. RESULTS: Maternal mortality rate in our own institution is 200/ 100,000 live births. Among 30 maternal deaths, 56% deaths (17 were among low socio - economic status, groups 60% deaths among unbooked 53.5% deaths more along illiterates evidenced by direct and indirect deaths about 25% of deaths were preventable. CONCLUSION: Maternal death is a great tragedy in the family life. It is crusade to know not just the medical cause of the death but the circumstances what makes these continued tragic death even more unacceptable is that deaths are largely preventable

  12. Risperidone added to parent training and stimulant medication: effects on attention-deficit/hyperactivity disorder, oppositional defiant disorder, conduct disorder, and peer aggression.

    Science.gov (United States)

    Gadow, Kenneth D; Arnold, L Eugene; Molina, Brooke S G; Findling, Robert L; Bukstein, Oscar G; Brown, Nicole V; McNamara, Nora K; Rundberg-Rivera, E Victoria; Li, Xiaobai; Kipp, Heidi L; Schneider, Jayne; Farmer, Cristan A; Baker, Jennifer L; Sprafkin, Joyce; Rice, Robert R; Bangalore, Srihari S; Butter, Eric M; Buchan-Page, Kristin A; Hurt, Elizabeth A; Austin, Adrienne B; Grondhuis, Sabrina N; Aman, Michael G

    2014-09-01

    In this study, we aimed to expand on our prior research into the relative efficacy of combining parent training, stimulant medication, and placebo (Basic therapy) versus parent training, stimulant, and risperidone (Augmented therapy) by examining treatment effects for attention-deficit/hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and conduct disorder (CD) symptoms and peer aggression, symptom-induced impairment, and informant discrepancy. Children (6-12 years of age; N = 168) with severe physical aggression, ADHD, and co-occurring ODD/CD received an open trial of parent training and stimulant medication for 3 weeks. Participants failing to show optimal clinical response were randomly assigned to Basic or Augmented therapy for an additional 6 weeks. Compared with Basic therapy, children receiving Augmented therapy experienced greater reduction in parent-rated ODD severity (p = .002, Cohen's d = 0.27) and peer aggression (p = .02, Cohen's d = 0.32) but not ADHD or CD symptoms. Fewer children receiving Augmented (16%) than Basic (40%) therapy were rated by their parents as impaired by ODD symptoms at week 9/endpoint (p = .008). Teacher ratings indicated greater reduction in ADHD severity (p = .02, Cohen's d = 0.61) with Augmented therapy, but not for ODD or CD symptoms or peer aggression. Although both interventions were associated with marked symptom reduction, a relatively large percentage of children were rated as impaired for at least 1 targeted disorder at week 9/endpoint by parents (Basic 47%; Augmented 27%) and teachers (Basic 48%; Augmented 38%). Augmented therapy was superior to Basic therapy in reducing severity of ADHD and ODD symptoms, peer aggression, and symptom-induced impairment, but clinical improvement was generally context specific, and effect sizes ranged from small to moderate. Clinical trial registration information-Treatment of Severe Childhood Aggression (The TOSCA Study); http://clinicaltrials.gov/; NCT00796302

  13. Cost effectiveness analysis comparing repetitive transcranial magnetic stimulation to antidepressant medications after a first treatment failure for major depressive disorder in newly diagnosed patients - A lifetime analysis.

    Science.gov (United States)

    Voigt, Jeffrey; Carpenter, Linda; Leuchter, Andrew

    2017-01-01

    Repetitive Transcranial Magnetic Stimulation (rTMS) commonly is used for the treatment of Major Depressive Disorder (MDD) after patients have failed to benefit from trials of multiple antidepressant medications. No analysis to date has examined the cost-effectiveness of rTMS used earlier in the course of treatment and over a patients' lifetime. We used lifetime Markov simulation modeling to compare the direct costs and quality adjusted life years (QALYs) of rTMS and medication therapy in patients with newly diagnosed MDD (ages 20-59) who had failed to benefit from one pharmacotherapy trial. Patients' life expectancies, rates of response and remission, and quality of life outcomes were derived from the literature, and treatment costs were based upon published Medicare reimbursement data. Baseline costs, aggregate per year quality of life assessments (QALYs), Monte Carlo simulation, tornado analysis, assessment of dominance, and one way sensitivity analysis were also performed. The discount rate applied was 3%. Lifetime direct treatment costs, and QALYs identified rTMS as the dominant therapy compared to antidepressant medications (i.e., lower costs with better outcomes) in all age ranges, with costs/improved QALYs ranging from $2,952/0.32 (older patients) to $11,140/0.43 (younger patients). One-way sensitivity analysis demonstrated that the model was most sensitive to the input variables of cost per rTMS session, monthly prescription drug cost, and the number of rTMS sessions per year. rTMS was identified as the dominant therapy compared to antidepressant medication trials over the life of the patient across the lifespan of adults with MDD, given current costs of treatment. These models support the use of rTMS after a single failed antidepressant medication trial versus further attempts at medication treatment in adults with MDD.

  14. Cost effectiveness analysis comparing repetitive transcranial magnetic stimulation to antidepressant medications after a first treatment failure for major depressive disorder in newly diagnosed patients - A lifetime analysis.

    Directory of Open Access Journals (Sweden)

    Jeffrey Voigt

    Full Text Available Repetitive Transcranial Magnetic Stimulation (rTMS commonly is used for the treatment of Major Depressive Disorder (MDD after patients have failed to benefit from trials of multiple antidepressant medications. No analysis to date has examined the cost-effectiveness of rTMS used earlier in the course of treatment and over a patients' lifetime.We used lifetime Markov simulation modeling to compare the direct costs and quality adjusted life years (QALYs of rTMS and medication therapy in patients with newly diagnosed MDD (ages 20-59 who had failed to benefit from one pharmacotherapy trial. Patients' life expectancies, rates of response and remission, and quality of life outcomes were derived from the literature, and treatment costs were based upon published Medicare reimbursement data. Baseline costs, aggregate per year quality of life assessments (QALYs, Monte Carlo simulation, tornado analysis, assessment of dominance, and one way sensitivity analysis were also performed. The discount rate applied was 3%.Lifetime direct treatment costs, and QALYs identified rTMS as the dominant therapy compared to antidepressant medications (i.e., lower costs with better outcomes in all age ranges, with costs/improved QALYs ranging from $2,952/0.32 (older patients to $11,140/0.43 (younger patients. One-way sensitivity analysis demonstrated that the model was most sensitive to the input variables of cost per rTMS session, monthly prescription drug cost, and the number of rTMS sessions per year.rTMS was identified as the dominant therapy compared to antidepressant medication trials over the life of the patient across the lifespan of adults with MDD, given current costs of treatment. These models support the use of rTMS after a single failed antidepressant medication trial versus further attempts at medication treatment in adults with MDD.

  15. Protection of workers during medical application of transcranial magnetic stimulation; Schutz der Beschaeftigten bei der medizinischen Anwendung transkranieller Magnetstimulation

    Energy Technology Data Exchange (ETDEWEB)

    Mischke, Marian [LAVG Brandenburg, Potsdam (Germany)

    2017-07-01

    Transcranial magnetic stimulation (TMS) is used in various applications in medicine. TMS is accompanied by relevant exposures by (extremely) low frequency magnetic fields. The applications can pose a threat to workers' health and safety at work through direct and indirect effects. Since the end of last year, the EMFV has been published to specify the obligations of the employer in association to ''Arbeitsschutzgesetz'' with regards to electromagnetic fields. Based on conventional types of equipment for the TMS, a possible procedure is presented for the employer to fulfill his duties.

  16. Maternal and Perinatal Outcomes among Eclamptic Patients ...

    African Journals Online (AJOL)

    HP

    1Department of Obstetrics and Gynaecology, Bugando Medical Centre, Mwanza, ... (10.5%), pulmonary oedema (10.5%), maternal stroke (8.8%), HELLP syndrome (50.9%), and Disseminated ..... health care services and medical attention.

  17. [Precautionary maternity leave in Tirol].

    Science.gov (United States)

    Ludescher, K; Baumgartner, E; Roner, A; Brezinka, C

    1998-01-01

    Under Austrian law, precautionary maternity leave is a decree issued by the district public health physician. It forbids a pregnant woman to work and mandates immediate maternity leave. Regular maternity leave for all women employed in all jobs begins at 32 weeks of gestation. Women who work in workplaces deemed dangerous and women with a history of obstetric problems such as premature or growth-retarded babies from previous pregnancies are regularly 'sent' into precautionary maternity leave. The public health physicians of Tirol's nine administrative districts were interviewed and supplied data on precautionary maternity leave from their districts. In 100 women who attended the clinic for pregnancies at risk of the Obstetrics/Gynecology Department of Innsbruck University Hospital and who had already obtained precautionary maternity leave, the medical/administrative procedure was studied in each case and correlated with pregnancy outcome. The town district of Innsbruck and the district that comprises the suburbs of the provincial capital had the highest rates of precautionary maternity leave. The town district of Innsbruck had a rate of 24.3% of all pregnant women (employed and not employed) in precautionary maternity leave in 1997, whereas the whole province of Tirol had 13.4%. More than 80% of decrees for precautionary maternity leave are issued by district public health physicians on the basis of written recommendations from gynecologists. One third of women who are sent into precautionary maternity leave are issued the decree prior to 12 weeks of gestation - mostly cases of multiple pregnancies and women with previous miscarriages. The present system of precautionary maternity leave appears to work in the sense that most working pregnant women with risk factors are correctly identified - with most errors on the side of caution. As the system also helps employers - the employee's pay is paid from the federal family support fund and state insurance once she is in

  18. Predicting acute side effects of stimulant medication in pediatric attention deficit/hyperactivity disorder: data from quantitative electroencephalography, event-related potentials, and a continuous-performance test

    Directory of Open Access Journals (Sweden)

    Ogrim G

    2013-09-01

    Full Text Available Geir Ogrim,1–3 Knut A Hestad,3,4 Jan Ferenc Brunner,3,5,6 Juri Kropotov3,7,8 1Neuropsychiatric Unit, Østfold Hospital Trust, Fredrikstad, Norway; 2National Resource Center for ADHD, Tourettes' Syndrome and Narcolepsy, Oslo, Norway; 3Institute of Psychology, Norwegian University of Science and Technology (NTNU, Trondheim, Norway; 4Division of Mental Health, Innlandet Hospital Trust, Brumunddal, Norway; 5Department of Physical Medicine and Rehabilitation, St Olav's Hospital, Trondheim, Norway; 6Department of Neuroscience, NTNU, Trondheim, Norway; 7Institute of the Human Brain, Russian Academy of Sciences, Saint Petersburg, Russia; 8Department of Neuropsychology, Andrzej Frycz Modrzewski Krakow University, Krakow, Poland Background: The aim of this study was to search for predictors of acute side effects of stimulant medication in pediatric attention deficit/hyperactivity disorder (ADHD, emphasizing variables from quantitative electroencephalography (QEEG, event-related potentials (ERPs, and behavior data from a visual continuous-performance test (VCPT. Methods: Seventy medication-naïve ADHD patients aged 7–16 years were tested with QEEG, including a go/no-go task condition (VCPT from which behavior data and ERPs were extracted, followed by a systematic trial on stimulant medication lasting at least 4 weeks. Based on data from rating scales and interviews, two psychologists who were blind to the QEEG/ERP test results independently rated the patients as having no or small side effects (n = 37 or troublesome side effects (n = 33. We determined if the side effects were related to sex, age, IQ, ADHD subtype, comorbidities, clinical outcome, and variables in QEEG, ERPs, and VCPT. Results: There was a moderate negative correlation between clinical outcome and side effects. Three variables were significantly associated with side effects in a multivariate logistic regression analysis. In the ERP independent component – contingent negative variation

  19. 32 CFR 728.71 - Ex-service maternity care.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 5 2010-07-01 2010-07-01 false Ex-service maternity care. 728.71 Section 728.71... FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES Other Persons § 728.71 Ex-service maternity... certified by medical authorities that the pregnancy existed prior to entry into service (EPTE), maternity...

  20. Reports of Perceived Adverse Events of Stimulant Medication on Cognition, Motivation, and Mood: Qualitative Investigation and the Generation of Items for the Medication and Cognition Rating Scale

    Science.gov (United States)

    Kovshoff, Hanna; Banaschewski, Tobias; Buitelaar, Jan K.; Carucci, Sara; Coghill, David; Danckaerts, Marina; Dittmann, Ralf W.; Falissard, Bruno; Grimshaw, Dina Gojkovic; Hollis, Chris; Inglis, Sarah; Konrad, Kerstin; Liddle, Elizabeth; McCarthy, Suzanne; Nagy, Peter; Thompson, Margaret; Wong, Ian C.K.; Zuddas, Alessandro

    2016-01-01

    Abstract Objective: There is no questionnaire to specifically monitor perceived adverse events of methylphenidate (MPH) on cognition, motivation, and mood. The current study therefore had two goals. First, to harvest accounts of such putative events from transcripts of interviews in samples enriched for such potential experiences. Second, to use the derived data to generate items for a new questionnaire that can be used for monitoring such events in medication trials or routine clinical care. Methods: Following a literature search aimed at identifying associations between MPH and cognition and/or motivation, a qualitative semistructured interview was designed to focus specifically on the domains of cognition (i.e., reasoning, depth/breadth of thinking, intellectual capacity, and creativity) and motivation (i.e., drive, effort, and attitudes toward rewards/incentives). Interviews were conducted with 45 participants drawn from the following four groups: (a) clinicians, child and adolescent psychiatrists, and pediatricians specializing in attention-deficit/hyperactivity disorder (ADHD) (n = 15); (2) teachers, with experience of teaching at least 10 medicated children with ADHD (n = 10); (3) parents of children with ADHD (n = 8) treated with MPH; and (4) adolescents/adults with ADHD (n = 12). Purposeful sampling was used to selectively recruit ADHD participants whose histories suggested a degree of vulnerability to MPH adverse events. Data were analyzed using a deductive approach to content analysis. Results: While we probed purposefully for cognitive and motivational adverse events, a third domain, related to mood, emerged from the reports. Therefore, three domains, each with a number of subdomains, were identified from the interview accounts: (i) Cognition (six subdomains; attention/concentration, changes in thinking, reduced creativity, sensory overload, memory, slower processing speed); (ii) motivation (four subdomains; loss of intrinsic motivation

  1. Reports of Perceived Adverse Events of Stimulant Medication on Cognition, Motivation, and Mood: Qualitative Investigation and the Generation of Items for the Medication and Cognition Rating Scale.

    Science.gov (United States)

    Kovshoff, Hanna; Banaschewski, Tobias; Buitelaar, Jan K; Carucci, Sara; Coghill, David; Danckaerts, Marina; Dittmann, Ralf W; Falissard, Bruno; Grimshaw, Dina Gojkovic; Hollis, Chris; Inglis, Sarah; Konrad, Kerstin; Liddle, Elizabeth; McCarthy, Suzanne; Nagy, Peter; Thompson, Margaret; Wong, Ian C K; Zuddas, Alessandro; Sonuga-Barke, Edmund J S

    2016-08-01

    There is no questionnaire to specifically monitor perceived adverse events of methylphenidate (MPH) on cognition, motivation, and mood. The current study therefore had two goals. First, to harvest accounts of such putative events from transcripts of interviews in samples enriched for such potential experiences. Second, to use the derived data to generate items for a new questionnaire that can be used for monitoring such events in medication trials or routine clinical care. Following a literature search aimed at identifying associations between MPH and cognition and/or motivation, a qualitative semistructured interview was designed to focus specifically on the domains of cognition (i.e., reasoning, depth/breadth of thinking, intellectual capacity, and creativity) and motivation (i.e., drive, effort, and attitudes toward rewards/incentives). Interviews were conducted with 45 participants drawn from the following four groups: (a) clinicians, child and adolescent psychiatrists, and pediatricians specializing in attention-deficit/hyperactivity disorder (ADHD) (n = 15); (2) teachers, with experience of teaching at least 10 medicated children with ADHD (n = 10); (3) parents of children with ADHD (n = 8) treated with MPH; and (4) adolescents/adults with ADHD (n = 12). Purposeful sampling was used to selectively recruit ADHD participants whose histories suggested a degree of vulnerability to MPH adverse events. Data were analyzed using a deductive approach to content analysis. While we probed purposefully for cognitive and motivational adverse events, a third domain, related to mood, emerged from the reports. Therefore, three domains, each with a number of subdomains, were identified from the interview accounts: (i) Cognition (six subdomains; attention/concentration, changes in thinking, reduced creativity, sensory overload, memory, slower processing speed); (ii) motivation (four subdomains; loss of intrinsic motivation for goal-directed activities, external

  2. Maternal antibiotic-induced early changes in microbial colonization selectively modulate colonic permeability and inducible heat shock proteins, and digesta concentrations of alkaline phosphatase and TLR-stimulants in swine offspring.

    Directory of Open Access Journals (Sweden)

    Marie-Edith Arnal

    Full Text Available Elevated intake of high energy diets is a risk factor for the development of metabolic diseases and obesity. High fat diets cause alterations in colonic microbiota composition and increase gut permeability to bacterial lipopolysaccharide, and subsequent low-grade chronic inflammation in mice. Chronic inflammatory bowel diseases are increasing worldwide and may involve alterations in microbiota-host dialog. Metabolic disorders appearing in later life are also suspected to reflect changes in early programming. However, how the latter affects the colon remains poorly studied. Here, we hypothesized that various components of colonic physiology, including permeability, ion exchange and protective inducible heat shock proteins (HSP are influenced in the short- and long-terms by early disturbances in microbial colonization. The hypothesis was tested in a swine model. Offspring were born to control mothers (n = 12 or mothers treated with the antibiotic (ATB amoxicillin around parturition (n = 11. Offspring were slaughtered between 14 and 42 days of age to study short-term effects. For long-term effects, young adult offspring from the same litters consumed a normal or a palm oil-enriched diet for 4 weeks between 140 and 169 days of age. ATB treatment transiently modified maternal fecal microbiota although the minor differences observed for offspring colonic microbiota were nonsignificant. In the short-term, consistently higher HSP27 and HSP70 levels and transiently increased horseradish peroxidase permeability in ATB offspring colon were observed. Importantly, long-term consequences included reduced colonic horseradish peroxidase permeability, and increased colonic digesta alkaline phosphatase (AP and TLR2- and TLR4-stimulant concentrations in rectal digesta in adult ATB offspring. Inducible HSP27 and HSP70 did not change. Interactions between early ATB treatment and later diet were noted for paracellular permeability and concentrations of colonic

  3. Maternal mortality ratio – trends in the vital registration data

    African Journals Online (AJOL)

    ORIGINAL ARTICLE. Tracking the level of ... based on good-quality medical certification of the cause of death, ... measurement of maternal mortality, Graham et al.2 argue that ..... the centrepiece of an accountability framework. A maternal ...

  4. Efficacy of Salvage Interferential Electrical Stimulation Therapy in Patients With Medication-Refractory Enuresis: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Hahn-Ey Lee

    2013-09-01

    Full Text Available Purpose In pediatric patients with enuresis, the protocol for salvage therapy in patients in whom first-line therapy was not successful has not yet been established. Interferential electrical stimulation (IF-ES therapy is advantageous because it is noninvasive and shows high compliance. We aimed to investigate the efficacy and safety of IF-ES therapy on pediatric enuresis in a pilot study. Methods We investigated 10 patients who underwent IF-ES therapy between August 2012 and March 2013 at our clinic. Patients with a history of previous treatment with desmopressin and anticholinergic agents for at least 3 months and those in whom alarm treatment previously failed or was refused by parents were eligible. Electrical current was given starting at approximately 20 mA and was increased until the patient complained of discomfort. Treatment was performed once a week, 20 minutes per treatment, 6 times per cycle. After each cycle, an interview was performed and voiding diaries were filled. The physician in charge evaluated improvement according to the International Children's Continence Society criteria. Results A final analysis was performed in 10 patients (5 male and 5 female patients in whom therapy for nocturnal enuresis had failed. Eight patients had nonmonosymptomatic enuresis and 2 had monosymptomatic enuresis. The mean age of the patients was 8.5±2.4 years, and the mean number of treatments was 10.6±3.6 times. A full response was observed in 1 patient (10%; a good response, in 1 patient (10%; a partial response, in 7 patients (70%; and no response, in 1 patient (10%. Conclusions Our study demonstrated that IF-ES therapy can be a promising treatment for the future, is safe, and can benefit from appropriate clinical trials in carefully selected groups. IF-ES therapy is expected to be a safe and effective treatment modality for children with enuresis.

  5. Can Medical Herbs Stimulate Regeneration or Neuroprotection and Treat Neuropathic Pain in Chemotherapy-Induced Peripheral Neuropathy?

    Directory of Open Access Journals (Sweden)

    Sven Schröder

    2013-01-01

    Full Text Available Chemotherapy-induced neuropathy (CIPN has a relevant impact on the quality of life of cancer patients. There are no curative conventional treatments, so further options have to be investigated. We conducted a systematic review in English and Chinese language databases to illuminate the role of medical herbs. 26 relevant studies on 5 single herbs, one extract, one receptor-agonist, and 8 combinations of herbs were identified focusing on the single herbs Acorus calamus rhizoma, Cannabis sativa fructus, Chamomilla matricaria, Ginkgo biloba, Salvia officinalis, Sweet bee venom, Fritillaria cirrhosae bulbus, and the herbal combinations Bu Yang Huan Wu, modified Bu Yang Huan Wu plus Liuwei Di Huang, modified Chai Hu Long Gu Mu Li Wan, Geranii herba plus Aconiti lateralis praeparata radix , Niu Che Sen Qi Wan (Goshajinkigan, Gui Zhi Jia Shu Fu Tang (Keishikajutsubuto, Huang Qi Wu Wu Tang (Ogikeishigomotsuto, and Shao Yao Gan Cao Tang (Shakuyakukanzoto. The knowledge of mechanism of action is still limited, the quality of clinical trials needs further improvement, and studies have not yielded enough evidence to establish a standard practice, but a lot of promising substances have been identified. While CIPN has multiple mechanisms of neuronal degeneration, a combination of herbs or substances might deal with multiple targets for the aim of neuroprotection or neuroregeneration in CIPN.

  6. Maternal hyperthyroidism after intrauterine insemination due to hypertrophic action of human chorionic gonadotropin: a case report.

    Science.gov (United States)

    Bakas, P; Tzouma, C; Creatsa, M; Boutas, I; Hassiakos, D

    2016-01-01

    To report a rare case of maternal hyperthyroidism after intrauterine insemination due to hypertrophic action of hCG. A 36-year-old woman after successful intrauterine insemination and triplet pregnancy, developed hyperthyroidism with resistance to medical treatment. All signs of hyperthyroidism resolved and the results of thyroid function tests returned to normal without any medication after embryo meiosis. De novo maternal hyperthyroidism may develop during pregnancy as a result of pathological stimulation of the thyroid gland from the high levels of hCG hormone that can be seen in multiple pregnancies. The risk of hyperthyroidism is related to the number of fetuses. Reversibility of symptomatology can be seen after fetal reduction of multiple pregnancies.

  7. Maternity leave in normal pregnancy.

    Science.gov (United States)

    Leduc, Dean

    2011-08-01

    To assist maternity care providers in recognizing and discussing health- and illness-related issues in pregnancy and their relationship to maternity benefits. Published literature was retrieved through searches of PubMed or Medline, CINAHL, and The Cochrane Library in 2009 using appropriate controlled vocabulary (e.g., maternity benefits) and key words (e.g., maternity, benefits, pregnancy). Results were restricted to systematic reviews, randomized controlled trials/controlled clinical trials, and observational studies. There were no date or language restrictions. Searches were updated on a regular basis and incorporated in the guideline to December 2009. Grey (unpublished) literature was identified through searching the web sites of health technology assessment and health technology assessment-related agencies, clinical practice guideline collections, clinical trial registries, and national and international medical specialty societies.

  8. THE INFLUENCE OF COMBINATION NON-MEDICAL TREATMENT INCLUDING FUNCTIONAL PROGRAMMED ELECTRICAL STIMULATION ON THE CLINICAL AND INSTRUMENTAL PARAMETERS IN PATIENTS WITH CEREBRAL PALSY WITH SPASTIC DIPLEGIA

    Directory of Open Access Journals (Sweden)

    V. V. Eliseev

    2015-01-01

    Full Text Available Background: Cerebral palsy is the leading cause of physical disability in pediatric  age. The search for new methods and improvement of old rehabil- itation techniques is ongoing, due to low efficacy of the latter. Aim: To assess the efficacy of a func- tional programmed electrical muscle stimulation as a part  of combination treatment of patients with cerebral palsy in the form of spastic diplegia. Materials and methods: We analyzed the results of treatment of 71 children with cerebral palsy and spastic diplegia, who had  been  randomized  into two groups  depending on the type of treatment. In  the  first group,  the  patients  (n = 38 received a course of functional programmed electric stim- ulation  in combination with  other  non-medical treatment  methods.  The  second   group   (n = 33 underwent a usual  course  of electrical  stimula- tion in combination with non-medical  treatment, similar to that  in the first group. The third group (control   included   41   children   without    cere- bral palsy. Clinical and  instrumental parameters were  assessed  in all study  participants. Results: After the course of combination treatment in the group  1, the  tonus  of m. gastrocnemius was de- creased significantly by 41%, that of the posterior group  of femur muscles by 43%, adductor group of femur muscles by 36%. In the group  2, the re- spective parameters decreased by 24, 21 and 21%. Muscle power  endurance was  increased  signifi- cantly in patients of both groups: that of long back extensors by 12.5 and 6.2 sec, of m. rectus abdomi- nis by 10.6 sec and 5.2 sec, of gluteal muscles by 9.3 and 4.6 sec, of m. quadriceps  by 19.8 and 7.2 sec, of m. anterior  tibialis by 12.1 and 4.6 sec, respec- tively. After the  treatment, the  active movement volume in the large joints of lower extremities  in the group 1 patients  improved as follows: by 15.6° in hip joints, by 11.1° in knee joints and by

  9. The impact of conduct disorder and stimulant medication on later substance use in an ethnically diverse sample of individuals with attention-deficit/hyperactivity disorder in childhood.

    Science.gov (United States)

    Harty, Seth C; Ivanov, Iliyan; Newcorn, Jeffrey H; Halperin, Jeffrey M

    2011-08-01

    To examine late adolescent substance use outcomes in relation to childhood conduct disorder (CD) and psychostimulant treatment in urban youth found to have attention-deficit/hyperactivity disorder (ADHD) in childhood. Ninety-seven adolescents, evaluated during childhood, were seen for follow-up on average 9.30 (SD = 1.65) years later along with a well-matched never-ADHD control group. Stimulant treatment history was coded: Never (n = 28), up to 1 year (n = 19), 1 to 5 years (n = 28), and greater than 5 years (n = 22). Substance use at outcome was coded dimensionally for severity (frequency × intensity) and categorically for substance use disorders (SUDs). Individuals with ADHD+CD in childhood had significantly higher rates of SUD and substance use severity than those with childhood ADHD and controls. The ADHD and control groups did not differ significantly. Among those with childhood ADHD, there were no significant differences in SUD status or substance use severity as a function of medication history. Within an ethnically diverse urban sample, the increased rate of substance use associated with ADHD was fully accounted for by the presence of CD. These results extend previous findings indicating little impact of psychostimulant treatment on later substance use to an ethnically diverse urban sample and to individuals who received treatment for up to 12 years.

  10. A novel MR-compatible sensor to assess active medical device safety: stimulation monitoring, rectified radio frequency pulses, and gradient-induced voltage measurements.

    Science.gov (United States)

    Barbier, Thérèse; Aissani, Sarra; Weber, Nicolas; Pasquier, Cédric; Felblinger, Jacques

    2018-03-30

    To evaluate the function of an active implantable medical device (AIMD) during magnetic resonance imaging (MRI) scans. The induced voltages caused by the switching of magnetic field gradients and rectified radio frequency (RF) pulse were measured, along with the AIMD stimulations. An MRI-compatible voltage probe with a bandwidth of 0-40 kHz was designed. Measurements were carried out both on the bench with an overvoltage protection circuit commonly used for AIMD and with a pacemaker during MRI scans on a 1.5 T (64 MHz) MR scanner. The sensor exhibits a measurement range of ± 15 V with an amplitude resolution of 7 mV and a temporal resolution of 10 µs. Rectification was measured on the bench with the overvoltage protection circuit. Linear proportionality was confirmed between the induced voltage and the magnetic field gradient slew rate. The pacemaker pacing was recorded successfully during MRI scans. The characteristics of this low-frequency voltage probe allow its use with extreme RF transmission power and magnetic field gradient positioning for MR safety test of AIMD during MRI scans.

  11. Maternal phenylketonuria

    Directory of Open Access Journals (Sweden)

    Kristina Štuikienė

    2013-04-01

    Full Text Available Phenylketonuria is a hereditary metabolic disorder inherited in an autosomal recessive pattern. Elevated phenylalanine levels in a pregnant woman with phenylketonuria result in phenylalanine embryopathy. Failure to follow special diets during gestation results in neonatal dysplasia. More favorable outcomes are observed when phenylalanine levels remain within normal ranges prior to conception, or at least when they reach normal levels by the 4th-10th weeks of gestation. We report the case of a newborn with maternal phenylketonuria.

  12. Variations in maternal care alter corticosterone and 17beta-estradiol levels, estrous cycle and folliculogenesis and stimulate the expression of estrogen receptors alpha and beta in the ovaries of UCh rats

    Directory of Open Access Journals (Sweden)

    Amorim João PA

    2011-12-01

    Full Text Available Abstract Background Variations in maternal care are associated with neonatal stress, hormonal disturbances and reproductive injuries during adulthood. However, the effects of these variations on sex hormones and steroid receptors during ovary development remain undetermined. This study aimed to investigate whether variations in maternal care are able to influence the hormonal profile, follicular dynamics and expression of AR, ER-alpha and ER-beta in the ovaries of UCh rat offspring. Methods Twenty-four adult UCh rats, aged 120 days, were randomly divided into two groups (UChA and UChB and mated. Maternal care was assessed from birth (day 0 to the 10th postnatal day (PND. In adulthood, twenty adult female rats (UChA and UChB offspring; n = 10/group, aged 120 days, were euthanized by decapitation during the morning estrus. Results UChA females (providing high maternal care more frequently displayed the behaviors of carrying pups, as well as licking/grooming and arched back nursing cares. Also, mothers providing high care had elevated corticosterone levels. Additionally, offspring receiving low maternal care showed the highest estrous cycle duration, increased corticosterone and 17beta-estradiol levels, overexpression of receptors ER-alpha and ER-beta, increased numbers of primordial, antral and mature follicles and accentuated granulosa cell proliferation. Conclusions Our study suggests that low maternal care alters corticosterone and 17beta-estradiol levels, disrupting the estrous cycle and folliculogenesis and differentially regulating the expression of ER-alpha and ER-beta in the ovaries of adult rats.

  13. Occipital nerve stimulation improves the quality of life in medically-intractable chronic cluster headache: Results of an observational prospective study.

    Science.gov (United States)

    Fontaine, Denys; Blond, Serge; Lucas, Christian; Regis, Jean; Donnet, Anne; Derrey, Stéphane; Guegan-Massardier, Evelyne; Jarraya, Bechir; Dang-Vu, Bich; Bourdain, Frederic; Valade, Dominique; Roos, Caroline; Creach, Christèle; Chabardes, Stéphan; Giraud, Pierric; Voirin, Jimmy; Bloch, Jocelyne; Rocca, Alda; Colnat-Coulbois, Sophie; Caire, Francois; Roger, Coralie; Romettino, Sylvie; Lanteri-Minet, Michel

    2017-10-01

    Background Occipital nerve stimulation (ONS) has been proposed to treat chronic medically-intractable cluster headache (iCCH) in small series of cases without evaluation of its functional and emotional impacts. Methods We report the multidimensional outcome of a large observational study of iCCH patients, treated by ONS within a nationwide multidisciplinary network ( https://clinicaltrials.gov NCT01842763), with a one-year follow-up. Prospective evaluation was performed before surgery, then three and 12 months after. Results One year after ONS, the attack frequency per week was decreased >30% in 64% and >50% in 59% of the 44 patients. Mean (Standard Deviation) weekly attack frequency decreased from 21.5 (16.3) to 10.7 (13.8) ( p = 0.0002). About 70% of the patients responded to ONS, 47.8% being excellent responders. Prophylactic treatments could be decreased in 40% of patients. Functional (HIT-6 and MIDAS scales) and emotional (HAD scale) impacts were significantly improved, as well as the health-related quality of life (EQ-5D). The mean (SD) EQ-5D visual analogic scale score increased from 35.2 (23.6) to 51.9 (25.7) ( p = 0.0037). Surgical minor complications were observed in 33% of the patients. Conclusion ONS significantly reduced the attack frequency per week, as well as the functional and emotional headache impacts in iCCH patients, and dramatically improved the health-related quality of life of responders.

  14. Processing of continuously provided punishment and reward in children with ADHD and the modulating effects of stimulant medication: an ERP study.

    Science.gov (United States)

    Groen, Yvonne; Tucha, Oliver; Wijers, Albertus A; Althaus, Monika

    2013-01-01

    Current models of ADHD suggest abnormal reward and punishment sensitivity, but the exact mechanisms are unclear. This study aims to investigate effects of continuous reward and punishment on the processing of performance feedback in children with ADHD and the modulating effects of stimulant medication. 15 Methylphenidate (Mph)-treated and 15 Mph-free children of the ADHD-combined type and 17 control children performed a selective attention task with three feedback conditions: no-feedback, gain and loss. Event Related Potentials (ERPs) time-locked to feedback and errors were computed. All groups performed more accurately with gain and loss than without feedback. Feedback-related ERPs demonstrated no group differences in the feedback P2, but an enhanced late positive potential (LPP) to feedback stimuli (both gains and losses) for Mph-free children with ADHD compared to controls. Feedback-related ERPs in Mph-treated children with ADHD were similar to controls. Correlational analyses in the ADHD groups revealed that the severity of inattention problems correlated negatively with the feedback P2 amplitude and positively with the LPP to losses and omitted gains. The early selective attention for rewarding and punishing feedback was relatively intact in children with ADHD, but the late feedback processing was deviant (increased feedback LPP). This may explain the often observed positive effects of continuous reinforcement on performance and behaviour in children with ADHD. However, these group findings cannot be generalised to all individuals with the ADHD, because the feedback-related ERPs were associated with the severity of the inattention problems. Children with ADHD-combined type with more inattention problems showed both deviant early attentional selection of feedback stimuli, and deviant late processing of non-reward and punishment.

  15. Processing of continuously provided punishment and reward in children with ADHD and the modulating effects of stimulant medication: an ERP study.

    Directory of Open Access Journals (Sweden)

    Yvonne Groen

    Full Text Available OBJECTIVES: Current models of ADHD suggest abnormal reward and punishment sensitivity, but the exact mechanisms are unclear. This study aims to investigate effects of continuous reward and punishment on the processing of performance feedback in children with ADHD and the modulating effects of stimulant medication. METHODS: 15 Methylphenidate (Mph-treated and 15 Mph-free children of the ADHD-combined type and 17 control children performed a selective attention task with three feedback conditions: no-feedback, gain and loss. Event Related Potentials (ERPs time-locked to feedback and errors were computed. RESULTS: All groups performed more accurately with gain and loss than without feedback. Feedback-related ERPs demonstrated no group differences in the feedback P2, but an enhanced late positive potential (LPP to feedback stimuli (both gains and losses for Mph-free children with ADHD compared to controls. Feedback-related ERPs in Mph-treated children with ADHD were similar to controls. Correlational analyses in the ADHD groups revealed that the severity of inattention problems correlated negatively with the feedback P2 amplitude and positively with the LPP to losses and omitted gains. CONCLUSIONS: The early selective attention for rewarding and punishing feedback was relatively intact in children with ADHD, but the late feedback processing was deviant (increased feedback LPP. This may explain the often observed positive effects of continuous reinforcement on performance and behaviour in children with ADHD. However, these group findings cannot be generalised to all individuals with the ADHD, because the feedback-related ERPs were associated with the severity of the inattention problems. Children with ADHD-combined type with more inattention problems showed both deviant early attentional selection of feedback stimuli, and deviant late processing of non-reward and punishment.

  16. Neonatal thyrotoxicosis caused by maternal autoimmune hyperthyroidism.

    Science.gov (United States)

    Correia, Miguel Fragata; Maria, Ana Teresa; Prado, Sara; Limbert, Catarina

    2015-03-06

    Neonatal immune hyperthyroidism is a rare but potentially fatal condition. It occurs in 1-5% of infants born to women with Graves' disease (GD). In most of the cases it is due to maternal antibodies transferred from the mother into the fetal compartment, stimulating the fetal thyroid by binding thyrotropin (thyroid-stimulating hormone, TSH) receptor. We present a case of neonatal thyrotoxicosis due to maternal GD detected at 25 days of age and discuss the potential pitfalls in the diagnosis. 2015 BMJ Publishing Group Ltd.

  17. Contraception in women with medical problems

    Science.gov (United States)

    Dhanjal, Mandish K

    2008-01-01

    Women with medical disease have a higher incidence of maternal mortality compared with healthy women, with cardiac disease now being the most common cause of maternal death in the UK. A handful of medical conditions exist where pregnancy is not recommended due to mortality rates approaching 50%. It is imperative that such women have the most reliable methods of contraception available. Contraceptive agents may themselves affect medical disease, or may interact with medications used by such women. There may be a range of contraceptive agents suitable for each medical condition. The contraceptive selected should be tailored to suit the individual. The following points should be considered when deciding on the most appropriate contraceptive agent: efficacy, thrombotic risk (oestrogen containing contraceptives), arterial risks (oestrogen containing contraceptives), infective risk (e.g. insertion of intrauterine device [IUD]), vagal stimulation (e.g. insertion of IUD, ESSURE®), bleeding risks with patients on anticoagulants, interaction with concomitant drugs, effects of anaesthesia and ease of use. This review aims to cover the different contraceptive agents available and the best ones to use for certain medical illnesses. PMID:27582790

  18. Maternal immunocompetence

    International Nuclear Information System (INIS)

    Harrison, M.R.

    1976-01-01

    The studies of distribution patterns of 51 Cr-labelled lymphocytes in pregnant mice were designed to explore the effect of pregnancy on the immunologic behaviour of the intact pregnant animal rather than on the isolated maternal lymphocyte. The distribution pattern of 51 Cr-labelled syngenic and semiallogenic lymphocytes was studied in intact primigravida mice, and there was no difference between interstrain and intrastrain pregnant mice, and there was no evidence of immunologically specific 'trapping' in the para-aortic lymph nodes draining the interstrain pregnant uterus. There is little evidence that the primigravida animal is even immunologically aware of the 'foreignness'of a semiallogenic fetus. (JIW)

  19. Contrast of Medical and Nonmedical Use of Stimulant Drugs, Basis for the Distinction, and Risk of Addiction: Comment on Smith and Farah (2011)

    Science.gov (United States)

    Swanson, James M.; Wigal, Timothy L.; Volkow, Nora D.

    2011-01-01

    Smith and Farah (2011) presented a scholarly review of critical areas related to their intriguing title "Are Prescription Stimulants 'Smart Pills'?" We contend that they accomplished the main goal of the article, to get the facts straight about possible cognitive enhancement via the nonmedical use of stimulant drugs by individuals without a…

  20. Prehospital maternity care in Norway.

    Science.gov (United States)

    Egenberg, Signe; Puntervoll, Stein Atle; Øian, Pål

    2011-11-29

    Out-of-hospital maternity care in Norway is randomly organised and not properly formalized. We wished to examine the extent, organisation and quality of this service. We obtained information from the Norwegian Medical Birth Registry on all unplanned out-of-hospital births in 2008. A questionnaire was sent to all maternity institutions, municipalities and emergency dispatch centres, with questions regarding the practical and formal organisation of the service using figures from 2008. 430 children, all above 22 weeks gestation, were born unplanned outside of hospitals in Norway in 2008. Of these, 194 were born unplanned at home, 189 while being transported and 47 in other locations (doctor's offices, infirmaries, unknown). Five out of 53 maternity institutions (9 %) confirmed they had a formal midwife service agreement for out-of-hospital births. 247 municipalities (79 %) claimed to have no such assistance. Of these, 33 are located at least 90 minutes away from the nearest maternity ward. Half of the emergency dispatch centres had no registration identifying formal agreements on assistance by midwives for out-of-hospital births. There is an urgent need to put in place formal agreements between the regional health authorities and the municipalities on out-of-hospital midwife services. A distance of 90 minutes' journey time to a maternity ward to fulfil the right to qualified assistance is not well-founded.

  1. Association between Maternal Smoking during Pregnancy and Low Birthweight: Effects by Maternal Age.

    Directory of Open Access Journals (Sweden)

    Wei Zheng

    Full Text Available Maternal smoking during pregnancy has been consistently related to low birthweight. However, older mothers, who are already at risk of giving birth to low birthweight infants, might be even more susceptible to the effects of maternal smoking. Therefore, this study aimed to examine the modified association between maternal smoking and low birthweight by maternal age.Data were obtained from a questionnaire survey of all mothers of children born between 2004 and 2010 in Okinawa, Japan who underwent medical check-ups at age 3 months. Variables assessed were maternal smoking during pregnancy, maternal age, gestational age, parity, birth year, and complications during pregnancy. Stratified analyses were performed using a logistic regression model.In total, 92641 participants provided complete information on all variables. Over the 7 years studied, the proportion of mothers smoking during pregnancy decreased from 10.6% to 5.0%, while the prevalence of low birthweight did not change remarkably (around 10%. Maternal smoking was significantly associated with low birthweight in all age groups. The strength of the association increased with maternal age, both in crude and adjusted models.Consistent with previous studies conducted in Western countries, this study demonstrates that maternal age has a modifying effect on the association between maternal smoking and birthweight. This finding suggests that specific education and health care programs for older smoking mothers are important to improve their foetal growth.

  2. Maternal Mortality – A Challenge?

    Directory of Open Access Journals (Sweden)

    Shital G. Sonone

    2013-01-01

    Full Text Available Background : The current maternal mortality rate (MMR in Maharashtra is 104/100000 live births, ranking 3rd in India. There is scope for reducing it as majority of the causes of MMR are preventable and curable. Aims and Objectives: To study the sociodemographic profile and causes of maternal deaths at Dr. V. M. Govt. Medical College, Solapur. Material and Methods: The study population included all deliveries i.e. women admitted in the hospital during pregnancy, child-birth or within 42 days of termination of pregnancy from any cause related to or aggravated due to pregnancy during the period of 2 years from 1st August 2009 to 31st July 2011. IPD case records and autopsy reports of all maternal deaths were taken and various variables were studied. The present study is prospective study of maternal mortality conducted in Dept. of Obstetrics and Gynaecology, Dr. V. M. Medical College Solapur. Cases were distributed ac-cording to their age, literacy rate, residence,socioeconomic status, ante-natal care, gestational age, gravida/parity, place of referral, pregnancy outcome, and place of delivery, perinatal outcome and etiological factors. This study also suggests the measures to reduce maternal mortality. Results: The total number of live births during the study period were 13,188 and total number of maternal deaths were 63 and MMR was 477 per 1, 00,000 live births. In the maternal deaths studied, 1/3rd of the women were illiterate, half of the women belonged to urban slum areas and of lower socioeconomic class.1/3rd of the deaths occurred in primigravida,within 24 hrs from admission, 58.73% of the patients were referred from outside. Out of that 86.49% of women were sent from private hospital and died in post partum period, having poor perinatal outcome. Haemorrhage (28.57% and hypertension (12.69% are two direct causes and severe anemia (33.33% is most common in direct cause of maternal death in our study.

  3. Maternal Obesity: Consequences and Prevention Strategies

    OpenAIRE

    Emre Yanikkerem; Selviye Mutlu

    2012-01-01

    Obesity is a medical condition in which excess body fat that it may have an adverse effect on health, leading to life expectancy and increased health problems. In keeping with the general international trend of rising prevalence of obesity, maternal obesity prevalence is rising. According to WHO, the prevalence of obesity in pregnancy ranges from 1.8 to 25.3%. Maternal obesity has been identified to be a risk factor for maternal and perinatal mortality. The aim of this article was reviewed in...

  4. Utilisation of maternal health care in western rural China under a new rural health insurance system (New Co-operative Medical System).

    Science.gov (United States)

    Long, Qian; Zhang, Tuohong; Xu, Ling; Tang, Shenglan; Hemminki, Elina

    2010-10-01

    To investigate factors influencing maternal health care utilisation in western rural China and its relation to income before (2002) and after (2007) introducing a new rural health insurance system (NCMS). Data from cross-sectional household-based health surveys carried out in ten western rural provinces of China in 2003 and 2008 were used in the study. The study population comprised women giving birth in 2002 or 2007, with 917 and 809 births, respectively. Correlations between outcomes and explanatory variables were studied by logistic regression models and a log-linear model. Between 2002 and 2007, having no any pre-natal visit decreased from 25% to 12% (difference 13%, 95% CI 10-17%); facility-based delivery increased from 45% to 80% (difference 35%, 95% CI 29-37%); and differences in using pre-natal and delivery care between the income groups narrowed. In a logistic regression analysis, women with lower education, from minority groups, or high parity were less likely to use pre-natal and delivery care in 2007. The expenditure for facility-based delivery increased over the period, but the out-of-pocket expenditure for delivery as a percentage of the annual household income decreased. In 2007, it was 14% in the low-income group. NCMS participation was found positively correlated with lower out-of-pocket expenditure for facility-based delivery (coefficient -1.14 P < 0.05) in 2007. Facility-based delivery greatly increased between 2002 and 2007, coinciding with the introduction of the NCMS. The rural poor were still facing substantial payment for facility-based delivery, although NCMS participation reduced the out-of-pocket expenditure on average. © 2010 Blackwell Publishing Ltd.

  5. Maternal care of undocumented pregnant women under the Fees Act (Medical) for Foreigners 1951. Perspectives of health and non-health actors

    OpenAIRE

    Loo, Pei Shan

    2017-01-01

    With the unprecedented international migration around the world, policies that restrict immigrants' health care access have become prevailing. In 2014, the amendment to The Fees Act (Medical) for Foreigners 1951 had further hindered the health care access of undocumented pregnant women. This qualitative study aimed to obtain perspectives of health and non-health actors regarding the implications of the amendment to the undocumented pregnant women. Ten semi-structured interviews were conducted...

  6. Radionuclides and maternal lactation

    International Nuclear Information System (INIS)

    Zamora, H.H.

    1989-01-01

    The increase in the number of nuclear medicine centers, both official and private in the country, as well as the increase in the number of patients, due to the effectiveness of their diagnostic and therapeutic procedures, brings out new situations that must be studied from the point of view of radioprotection. This work makes a revision in the medical literature about procedures with radioisotopes during the maternal nursing period. In general, it is recommended to stop nursing for 24 hours for 99mtc test, and to resume it after the draining of the milky content. This can be done in spite of the sensitivity of the target organ of the baby, because the dosage will be below permissible limits accepted by international agencies with respect to diagnostic test and I-131 treatment, and if continuing nursing is desired, it is recommended to use other diagnostic or therapeutic procedures before discontinuing the most important nutritional resource at this age

  7. The relationship between maternal self-esteem and maternal attachment in mothers of hospitalized premature infants.

    Science.gov (United States)

    Chen, C W; Conrad, B

    2001-09-01

    The purpose of this study was to examine the relationship between maternal self-esteem and maternal attachment in mothers of hospitalized premature infants. The research instruments administered included: a demographic sheet, the Maternal Self-Report Inventory (MSRI), Rosenberg Self-Esteem Scale, and Leifer's How I Feel About My Baby Now Scale. Thirty-two mothers whose premature infants were medically stable and hospitalized in the NICU were studied. Two hypotheses on the positive relationships between maternal self-esteem and maternal attachment, and global self-esteem and maternal attachment could not be tested by correlational analyses due to the inadequate internal consistency of the How I Feel About My Baby Now Scale. A significant correlation was found between maternal self-esteem and global self-esteem. Thus, maternal role influenced general self-concept in mothers. In addition, it was found that there were no significant correlations between the MSRI and demographic variables, such as: maternal age, marital status, income, and educational level. Another result indicated that increased global self-esteem was correlated (p attachment behaviors.

  8. growth stimulant

    African Journals Online (AJOL)

    Effects of timing and duration of supplementation of LIVFIT VET ® (growth stimulant) as substitute for fish meal on the growth performance, haematology and clinical enzymes concentration of growing pigs.

  9. Tuberculin-purified protein derivative-, MPT-64-, and ESAT-6-stimulated gamma interferon responses in medical students before and after Mycobacterium bovis BCG vaccination and in patients with tuberculosis

    DEFF Research Database (Denmark)

    Johnson, P D; Stuart, R L; Grayson, M L

    1999-01-01

    QuantiFERON-TB (QIFN) (CSL Limited) is a whole-blood assay for the recognition of infection with Mycobacterium tuberculosis. QIFN measures gamma interferon (IFN-gamma) production when purified protein derivatives (PPDs) of mycobacteria are incubated with venous blood samples. The specificity...... of QIFN in medical students before and after BCG immunization was assessed, and sensitivity in patients with tuberculosis was assessed. Antigens were PPD derived from M. tuberculosis and two M. tuberculosis-specific proteins, ESAT-6 and MPT-64. Of 60 medical students, all of whom had 0-mm tuberculin skin...... tests (TSTs) at study entry, 58 (97%) were initially classified as negative for M. tuberculosis infection by PPD QIFN. Five months after BCG immunization, 7 of 54 students (13%) had a TST result of >/=10 mm and 11 of 54 students (20%) tested positive by PPD QIFN. ESAT-6- and MPT-64-stimulated IFN...

  10. Goodbye, Mandatory Maternity Leaves

    Science.gov (United States)

    Nation's Schools, 1972

    1972-01-01

    In precedent-setting decrees, courts and federal and State authorities have branded compulsory maternity leaves either unconstitutional or illegal. School administrators are urged to prod boards of education to adopt more lenient maternity leave policies -- now. (Author)

  11. Maternal anxiety, maternal sensitivity, and attachment

    NARCIS (Netherlands)

    Stevenson-Hinde, Joan; Chicot, Rebecca; Shouldice, Anne; Hinde, Camilla A.

    2016-01-01

    Previous research has related maternal anxiety to insecurity of attachment. Here we ask whether different aspects of maternal sensitivity mediate this link. From a community sample of intact families with 1-3 children, mothers with 4.5-year-olds were selected for low, medium, or high anxiety

  12. Maternal anxiety, maternal sensitivity, and attachment

    NARCIS (Netherlands)

    Stevenson-Hinde, J.; Chicot, R.; Schouldice, A.; Hinde, C.A.

    2013-01-01

    Previous research has related maternal anxiety to insecurity of attachment. Here we ask whether different aspects of maternal sensitivity mediate this link. From a community sample of intact families with 1-3 children, mothers with 4.5-year-olds were selected for low, medium, or high anxiety levels

  13. EFFECTS OF ACOUSTIC STIMULATION ON BIOPHYSICAL PROFILE TESTING TIME

    Directory of Open Access Journals (Sweden)

    M. Pourissa

    2008-04-01

    Full Text Available Biophysical profile (BPP test is the most commonly used antenatal test of fetal well-being. Purpose of this study is determining the influence of acoustic stimulation (AS on BPP testing time. About 55 pregnant women at 35 to 42 weeks who referred to department of Obstetric & Gynecology at university of medical sciences, Tabriz, Iran, were selected randomly. We used abdominal ultrasound guidance to place buzzer like device with power of 110 dB at the skin surface of the maternal abdomen, close to the fetal head. BPP test performed and BPP mean testing time calculated before and after AS. Data compared and analyzed by paired t-test. The results showed that fetal AS reduces the overall mean testing time from 24 minutes to 5 minutes. This clinical application can be helpful in busy clinics when rapid assessment of fetal health is required.

  14. Maternity Protection at Work.

    Science.gov (United States)

    World of Work, 1998

    1998-01-01

    Discusses the need for maternity benefits for working women. Suggests that although most countries provide paid maternity leave by law, there is a gap between that law and practice. Includes a chart depicting maternity protection (length of leave, cash benefits, who pays) around the world. (JOW)

  15. Benefits and Limitations of Text Messages to Stimulate Higher Learning Among Community Providers: Participants' Views of an mHealth Intervention to Support Continuing Medical Education in Vietnam.

    Science.gov (United States)

    Sabin, Lora L; Larson Williams, Anna; Le, Bao Ngoc; Herman, Augusta R; Viet Nguyen, Ha; Albanese, Rebecca R; Xiong, Wenjun; Shobiye, Hezekiah Oa; Halim, Nafisa; Tran, Lien Thi Ngoc; McNabb, Marion; Hoang, Hai; Falconer, Ariel; Nguyen, Tam Thi Thanh; Gill, Christopher J

    2017-06-27

    A randomized controlled trial was conducted in 2015 to evaluate a mobile continuing medical education (mCME) intervention that provided daily text messages to community-based physicians' assistants (CBPAs) in Thai Nguyen Province, Vietnam. Although the intervention failed to improve medical knowledge over a 6-month period, a companion qualitative study provided insights on the views and experiences of intervention participants. We conducted focus group discussions (FGDs) and in-depth interviews (IDIs) among participants randomized to receive text messages containing either simple medical facts or quiz questions. Trained interviewers collected data immediately following the conclusion of the trial in December 2015. Using semi-structured question guides, respondents were queried on their views of the intervention, positive and negative, and perceived impacts of the intervention. During analysis, after learning that the intervention had failed to increase knowledge among participants, we also examined reasons for lack of improvement in medical knowledge. All analyses were performed in NVivo using a thematic approach. A total of 70 CBPAs engaged in one of 8 FGDs or an IDI. One-half were men; average age among all respondents was 40 years. Most (81%) practiced in rural settings and most (51%) focused on general medicine. The mean length of work experience was 3 years. All respondents made positive comments about the intervention; convenience, relevance, and quick feedback (quiz format) were praised. Downsides encompassed lack of depth of information, weak interaction, technology challenges, and challenging/irrelevant messages. Respondents described perceived impacts encompassing increased motivation, knowledge, collegial discussions, Internet use to search for more information, and clinical skills. Overall, they expressed a desire for the intervention to continue and recommended expansion to other medical professionals. Overreliance on the text messages, lack of

  16. No. 263-Maternity Leave in Normal Pregnancy.

    Science.gov (United States)

    Leduc, Dean

    2017-10-01

    To assist maternity care providers in recognizing and discussing health- and illness-related issues in pregnancy and their relationship to maternity benefits. Published literature was retrieved through searches of PubMed or Medline, CINAHL, and The Cochrane Library in 2009 using appropriate controlled vocabulary (e.g., maternity benefits) and key words (e.g., maternity, benefits, pregnancy). Results were restricted to systematic reviews, randomized controlled trials/controlled clinical trials, and observational studies. There were no date or language restrictions. Searches were updated on a regular basis and incorporated in the guideline to December 2009. Grey (unpublished) literature was identified through searching the web sites of health technology assessment and health technology assessment-related agencies, clinical practice guideline collections, clinical trial registries, and national and international medical specialty societies. Copyright © 2017. Published by Elsevier Inc.

  17. Influences of maternal overprotection.

    Science.gov (United States)

    Parker, G; Lipscombe, P

    1981-04-01

    While maternal overprotection appears associated with several neurotic and psychotic disorders, little is known about determinants of such a parental characteristic. Several hypotheses have been tested in a large nonclinical sample. Maternal and cultural factors seemed of greater relevance than characteristics in the child. Overprotective mothers gave evidence of marked maternal preoccupations before having children, of showing a capacity to be overprotective after the active stage of mothering, and of having personality characteristics of high anxiety, obsessionality and a need to control. Maternal overprotection appears associated with low, rather than with high maternal care. This has important primary prevention and treatment implications.

  18. Estimating Maternal Mortality Rate Using Sisterhood Methods in ...

    African Journals Online (AJOL)

    ... maternal and child morbidity and mortality, which could serve as a surveillance strategy to identify the magnitude of the problem and to mobilize resources to areas where the problems are most prominent for adequate control. KEY WORDS: Maternal Mortality Rate, Sisterhood Method. Highland Medical Research Journal ...

  19. The effects of maternal depression and maternal selective serotonin reuptake inhibitor exposure on the offspring

    Directory of Open Access Journals (Sweden)

    Jocelien DA Olivier

    2013-05-01

    Full Text Available It has been estimated that 20% of pregnant women suffer from depression and it is well documented that maternal depression can have long-lasting effects on the child. Currently, common treatment for maternal depression has been the selective serotonin reuptake inhibitor medications (SSRIs which are used by 2-3% of pregnant women in the Nordic countries and by up to 10% of pregnant women in the United States. Antidepressants cross the placenta and are transferred to the fetus, thus, the question arises as to whether children of women taking antidepressants are at risk for altered neurodevelopmental outcomes and, if so, whether the risks are due to SSRI medication exposure or to the underlying maternal depression. This review considers the effects of maternal depression and SSRI exposure on offspring development in both clinical and preclinical populations. As it is impossible in humans to study the effects of SSRIs without taking into account the possible underlying effects of maternal depression (healthy pregnant women do not take SSRIs, animal models are of great value. For example, rodents can be used to determine the effects of maternal depression and/or perinatal SSRI exposure on offspring outcomes. Unraveling the joint (or separate effects of maternal depression and SSRI exposure will provide more insights into the risks or benefits of SSRI exposure during gestation and will help women make informed decisions about using SSRIs during pregnancy.

  20. Associations between Maternal Hormonal Biomarkers and Maternal Mental and Physical Health of Very Low Birthweight Infants

    OpenAIRE

    Cho, June; Su, Xiaogang; Phillips, Vivien; Holditch-Davis, Diane

    2016-01-01

    The purpose of this study was to determine whether maternal mental and physical health is associated with maternal testosterone and cortisol levels, parenting of very low birth weight infants, physical exercise, and White vs non-White race. A total of 40 mothers of very low birth weight infants were recruited from a neonatal intensive care unit at a University Hospital in the Southeast United States. Data were collected through a review of medical records, standardized questionnaires, and bio...

  1. Reconfiguring Maternity Care?

    DEFF Research Database (Denmark)

    Johannsen, Nis

    This dissertation constitutes a reflection on two initiatives seeking to reconfigure maternity care. One initiative sought to digitalise maternity records and included a pilot run of an electronic maternity record in a Danish county. The other consisted of a collaboration between a maternity ward...... at a hospital and a group of researchers which included me. Both initiatives involved numerous seemingly different interests that were held together and related to reconfiguring maternity care. None of the initiatives can unequivocally be labelled a success, as neither managed to change maternity care, at least...... experimental designs are constructed. The consequences and the politics of the proposed changes are engaged with in laboratory manner through collaborative development of the designs and through exposing them to members of field of maternity care...

  2. KEMATIAN MATERNAL DI NUSA TENGGARA TIMUR

    Directory of Open Access Journals (Sweden)

    Emiliana Tjitra

    2012-09-01

    Full Text Available A prospective study was carried out in villages around health centers, which were distributed over 10 regencies in Timor island of East Nusa Tenggara province. All deaths occurring in 1986 were recorded and reported to the health centers. Each case was investigated by the health center doctor to identify the multiple causes of death as well as its related factors. Pregnancy and delivery histories of maternal deaths were analysed. In the study area, the maternal mortality ratio was found to be 1346 per 100,000 live births, and the maternal mortality rate was 101 per 100,000 women aged 15-49 years. The maternal mortality ratio, among women under 20 years of age, was 3390 per 100,000 live births; and 4545 per 100,000 live births among women aged 40 years and over. The predominant factor as a risk of maternal deaths was attributable to delivery assistance by non medical personnel, which was 71%. Maternal deaths attributable to the first parities was 40%, and to pregnancies without antenatal care was 20.1%}. The most prevalent disease causing maternal deaths were haemorrhage 46.2%}, postpartum infections 30.8% and retained placenta 30.8%. To reduce maternal mortality, the most important intervention is to provide qualified delivery assistants especially for the first parities, and the provision of accessible delivery centers for emergency cases in addition to provision of appropriate antenatal care for early detection of high risk pregnancies. Family planning programs will have to be more specified towards high risk groups, i.e women aged under 20 years or 35 years and over, as well as women of high parity. A similar study is recommended to be conducted throughout the other parts of East Nusa Tenggara islands in order to evaluate the general maternal health status of the province.

  3. Brain Stimulation Therapies

    Science.gov (United States)

    ... Magnetic Seizure Therapy Deep Brain Stimulation Additional Resources Brain Stimulation Therapies Overview Brain stimulation therapies can play ... for a shorter recovery time than ECT Deep Brain Stimulation Deep brain stimulation (DBS) was first developed ...

  4. The use of 10-kilohertz spinal cord stimulation in a cohort of patients with chronic neuropathic limb pain refractory to medical management.

    Science.gov (United States)

    Al-Kaisy, Adnan; Palmisani, Stefano; Smith, Tom; Harris, Stephany; Pang, David

    2015-01-01

    It is the purpose of this study to document our experience with the use of a 10-kHz high-frequency spinal cord stimulation (SCS) device for the relief of neuropathic pain of the upper and lower limbs. A retrospective chart review was performed of all patients treated with the 10-kHz high-frequency SCS system for neuropathic pain (upper or lower limb) refractory to conventional treatment. All patients underwent a trial with one or two eight-contact percutaneous leads using 50-Hz traditional stimulation. If ≥ 80% paresthesia coverage of the painful area with traditional SCS was obtained, high-frequency 10-kHz SCS was used. Patients who had a significant reduction in pain score (≥ 50%) at the end of the trial received a permanent implant and were then followed for up to six months. Outcome measures included a numeric rating scale for pain, the Brief Pain Inventory, health-related quality of life (EQ-5D), the Pain Catastrophizing Scale, and patient satisfaction. Fifteen patients completed a trial of high-frequency 10-kHz SCS. Eleven patients proceeded to permanent implantation. Ten of the 11 patients who proceeded to full implantation had significant reductions in all of the collected outcome variables at one, three, and six months. In this small cohort of patients, high-frequency 10-kHz SCS reduced pain and improved quality of life. However, before we can conclude that high-frequency 10-kHz SCS for neuropathic pain of the upper and lower extremities is efficacious, a large-scale multicenter observational study should be performed to corroborate our small retrospective study. © 2014 International Neuromodulation Society.

  5. Severe acute maternal morbidity and maternal death audit - a rapid ...

    African Journals Online (AJOL)

    Severe acute maternal morbidity and maternal death audit - a rapid diagnostic tool for evaluating maternal care. L Cochet, R.C. Pattinson, A.P. Macdonald. Abstract. Objective. To analyse severe acute maternal morbidity (SAMM) and maternal mortality in the Pretoria region over a 2-year period (2000 - 2001). Setting.

  6. Sectio på maternal request

    DEFF Research Database (Denmark)

    Forstholm, Malene Merete; Lidegaard, Ojvind

    2009-01-01

    An increasing number of women give birth by caesarean section (CS) in Denmark, some without any medical reasons for this procedure. This is called maternal request sectio (MRS). To analyse the development of MRS over a five-year period and investigate how parity, former birth complications...

  7. Maternal deaths in Denmark 2002-2006

    DEFF Research Database (Denmark)

    Bødker, Birgit; Hvidman, Lone; Weber, Tom

    2009-01-01

    OBJECTIVE: To describe a method for identification, classification and assessment of maternal deaths in Denmark and to identify substandard care. DESIGN: Register study and case audit based on data from the Registers of the Danish Medical Health Board, death certificates and hospital records. SET...

  8. Maternal Anaemia and Neonatal Outcomes

    Directory of Open Access Journals (Sweden)

    I.A. Deswanto

    2013-11-01

    Full Text Available This cross-sectional study aims to determine whether maternal anaemia would affect birth outcome – birth weight and length – of the baby and compare this with that of non-anaemicmothers. We used secondary data from Puskesmas Kecamatan Ciracas medical records. Alldelivery records from October – November 2012 were collected and analysed; samples weredivided into two group: Group 1 included anaemic pregnant women and Group 2 non-anaemicpregnant women. Inclusion criteria was all pregnant women 16 years and older and a singletonpregnancy with a complete medical record. All women with a past history of preterm delivery,obstetrical complications or any medical illness, except anaemia, were excluded from the study inorder to control for the confounding factors. Out of one hundred and one records, 79 non anaemicsubjects and 22 anaemic subjects, were included for the analysis. No significant difference wasfound in both groups in terms of baby’s birth weight and birth length.Keywords: maternity anaemia, birth weight, birth length

  9. Individual differences in maternal response to immune challenge predict offspring behavior: Contribution of environmental factors

    Science.gov (United States)

    Bronson, Stefanie L.; Ahlbrand, Rebecca; Horn, Paul S.; Kern, Joseph R.; Richtand, Neil M.

    2011-01-01

    Maternal infection during pregnancy elevates risk for schizophrenia and related disorders in offspring. Converging evidence suggests the maternal inflammatory response mediates the interaction between maternal infection, altered brain development, and behavioral outcome. The extent to which individual differences in the maternal response to immune challenge influence the development of these abnormalities is unknown. The present study investigated the impact of individual differences in maternal response to the viral mimic polyinosinic:polycytidylic acid (poly I:C) on offspring behavior. We observed significant variability in body weight alterations of pregnant rats induced by administration of poly I:C on gestational day 14. Furthermore, the presence or absence of maternal weight loss predicted MK-801 and amphetamine stimulated locomotor abnormalities in offspring. MK-801 stimulated locomotion was altered in offspring of all poly I:C treated dams; however, the presence or absence of maternal weight loss resulted in decreased and modestly increased locomotion, respectively. Adult offspring of poly I:C treated dams that lost weight exhibited significantly decreased amphetamine stimulated locomotion, while offspring of poly I:C treated dams without weight loss performed similarly to vehicle controls. Social isolation and increased maternal age predicted weight loss in response to poly I:C but not vehicle injection. In combination, these data identify environmental factors associated with the maternal response to immune challenge and functional outcome of offspring exposed to maternal immune activation. PMID:21255612

  10. Mothers of IVF and spontaneously conceived twins: a comparison of prenatal maternal expectations, coping resources and maternal stress.

    Science.gov (United States)

    Baor, Liora; Soskolne, Varda

    2010-06-01

    This study explores the differences in prenatal maternal expectations, coping resources and maternal stress between first time mothers of IVF twins and first time mothers of spontaneously conceived twins. The role of prenatal maternal expectations in the prediction of maternal stress was examined, as well as the mediating and moderating effect of coping resources on the association between pregnancy-type group and maternal stress. Mothers of twins from various regions in Israel were included in this prospective and cross-sectional study in which 88 mothers of IVF-conceived twins and 98 mothers of spontaneously conceived twins were interviewed twice. First, at 33-36 weeks of their pregnancy they completed a socio-demographic questionnaire and the maternal expectations questionnaire; then at 6 months after birth they completed a questionnaire regarding the delivery and medical condition of the infants, and their coping resources and maternal stress. Compared with mothers who conceived spontaneously, IVF mothers had more positive prenatal maternal expectations, but poorer coping resources and higher levels of maternal stress 6 months after birth. Maternal expectations had no predictive power regarding maternal stress, although the mother's coping resources were significantly related to maternal stress and mediated the association between pregnancy type and maternal stress. IVF-pregnant women bearing twins should be considered a high-risk group. Early identification of these mothers is essential for timely psychosocial interventions in order to enhance their resources and decrease maternal stress. Further longitudinal studies are required to determine causality in more ethnically-diverse mothers of twins.

  11. A First Standardized Swiss Electronic Maternity Record.

    Science.gov (United States)

    Murbach, Michel; Martin, Sabine; Denecke, Kerstin; Nüssli, Stephan

    2017-01-01

    During the nine months of pregnancy, women have to regularly visit several physicians for continuous monitoring of the health and development of the fetus and mother. Comprehensive examination results of different types are generated in this process; documentation and data transmission standards are still unavailable or not in use. Relevant information is collected in a paper-based maternity record carried by the pregnant women. To improve availability and transmission of data, we aim at developing a first prototype for an electronic maternity record for Switzerland. By analyzing the documentation workflow during pregnancy, we determined a maternity record data set. Further, we collected requirements towards a digital maternity record. As data exchange format, the Swiss specific exchange format SMEEX (swiss medical data exchange) was exploited. Feedback from 27 potential users was collected to identify further improvements. The relevant data is extracted from the primary care information system as SMEEX file, stored in a database and made available in a web and a mobile application, developed as prototypes of an electronic maternity record. The user confirmed the usefulness of the system and provided multiple suggestions for an extension. An electronical maternity record as developed in this work could be in future linked to the electronic patient record.

  12. [Family planning can reduce maternal mortality].

    Science.gov (United States)

    Potts, M

    1987-01-01

    Although the maternal mortality rate receives no newspaper headlines, the number of mothers dying throughout the world is equivalent to a full jumbo jet crashing every 5 hours. Population surveys carried out between 1981-83 by Family Health International indicated maternal mortality rates of 1.9/1000 live births in Menoufia, Egypt, and 7.2/1000 in Bali, Indonesia. 20-25% of all deaths in women aged 15-49 were directly related to pregnancy and delivery, compared to 1% in western countries where there is better prenatal care, medical assistance in almost all deliveries, and elimination of most high risk pregnancies through voluntary fertility control. Maternal mortality could be controlled by teaching traditional midwives to identify high risk patients at the beginning of their pregnancies and to refer them to appropriate health services. Maternal survival would also be improved if all women were in good health at the beginning of pregnancy. Families should be taught to seek medical care for the mother in cases of prolonged labor; many women arrive at hospitals beyond hope of recovery after hours or days of futile labor. Health policy makers should set new priorities. Sri Lanka, for example, has a lower per capita income than Pakistan, but also a lower maternal mortality rate because of better use of family planning services, more emphasis on prenatal care, and a tradition of care and attention on the part of the public health services.

  13. Maternal Pseudo-Bartter Syndrome Associated with Severe Perinatal Brain Injury.

    Science.gov (United States)

    Vora, Shrenik; Ibrahim, Thowfique; Rajadurai, Victor Samuel

    2017-09-15

    Maternal electrolyte imbalance is rarely reported as causative factor of severe perinatal brain injury. This case outlines a unique maternal and neonatal pseudo-Bartter syndrome presented with metabolic alkalosis and hypochloremia due to maternal severe vomiting. Neonatal MRI brain revealed extensive brain hemorrhages with porencephalic cysts. Subsequent investigation workup points towards maternal severe metabolic alkalosis as its cause. Careful medical attention should be paid to pregnant women with excessive vomiting to ensure a healthy outcome for both the mother and the baby.

  14. Wired for motherhood: induction of maternal care but not maternal aggression in virgin female CD1 mice.

    Science.gov (United States)

    Martín-Sánchez, Ana; Valera-Marín, Guillermo; Hernández-Martínez, Adoración; Lanuza, Enrique; Martínez-García, Fernando; Agustín-Pavón, Carmen

    2015-01-01

    Virgin adult female mice display nearly spontaneous maternal care towards foster pups after a short period of sensitization. This indicates that maternal care is triggered by sensory stimulation provided by the pups and that its onset is largely independent on the physiological events related to gestation, parturition and lactation. Conversely, the factors influencing maternal aggression are poorly understood. In this study, we sought to characterize two models of maternal sensitization in the outbred CD1 strain. To do so, a group of virgin females (godmothers) were exposed to continuous cohabitation with a lactating dam and their pups from the moment of parturition, whereas a second group (pup-sensitized females), were exposed 2 h daily to foster pups. Both groups were tested for maternal behavior on postnatal days 2-4. Godmothers expressed full maternal care from the first test. Also, they expressed higher levels of crouching than dams. Pup-sensitized females differed from dams in all measures of pup-directed behavior in the first test, and expressed full maternal care after two sessions of contact with pups. However, both protocols failed to induce maternal aggression toward a male intruder after full onset of pup-directed maternal behavior, even in the presence of pups. Our study confirms that adult female mice need a short sensitization period before the onset of maternal care. Further, it shows that pup-oriented and non-pup-oriented components of maternal behavior are under different physiological control. We conclude that the godmother model might be useful to study the physiological and neural bases of the maternal behavior repertoire.

  15. The role of sociodemographic factors in maternal psychological distress and mother-preterm infant interactions.

    Science.gov (United States)

    Gondwe, Kaboni W; White-Traut, Rosemary; Brandon, Debra; Pan, Wei; Holditch-Davis, Diane

    2017-12-01

    Preterm birth has been associated with greater psychological distress and less positive mother infant interactions than were experienced by mothers of full-term infants. Maternal and infant sociodemographic factors have also shown a strong association with psychological distress and the mother-infant relationship. However, findings on their effects over time are limited. In this longitudinal analysis, we explored the relationship of maternal and infant sociodemographic variables (maternal age, maternal education, marital status, being on social assistance, maternal race, infant birth weight, and infant gender) to maternal psychological distress (depressive, posttraumatic stress, anxiety, parenting stress symptoms, and maternal worry about child's health) through 12 months corrected age for prematurity, and on the home environment, and mother-infant interactions through 6 months corrected age for prematurity. We also explored differences related to maternal obstetrical characteristics (gestational age at birth, parity, mode of delivery, and multiple birth) and severity of infant conditions (Apgar scores, need for mechanical ventilation, and infant medical complications). Although the relationship of maternal and infant characteristics with these outcomes did not change over time, psychological distress differed based on marital status, maternal education, infant gender, and infant medical complications. Older mothers provided more a positive home environment. Mother-infant interactions differed by maternal age, being on public assistance, maternal race, infant gender, and infant medical complications. More longitudinal research is needed to better understand these effects over time in order to identify and support at-risk mothers. © 2017 Wiley Periodicals, Inc.

  16. Maternal Employment: 1979.

    Science.gov (United States)

    Hoffman, Lois Wladis

    1979-01-01

    Maternal employment is a part of modern family life, a response to changes such as smaller families and more efficient household management. Not only does maternal employment meet parents' needs, but it is a pattern better suited for socializing the child for the adult role s/he will occupy. (Author/GC)

  17. Neonatal Cuddliness and Maternal Handling Patterns in the First Month of Life.

    Science.gov (United States)

    Will, Jerrie Ann

    The effects of "cuddliness" on proximal and distal maternal stimulation and on maternal attachment were examined in 32 healthy mother/infant pairs. All mothers were black, inner-city, of low socioeconomic status, primaparous, bottle-feeding, and between 16 and 24 years of age. All also had adequate prenatal care, no complications, and…

  18. Maternal hypothyroxinemia and effects on cognitive functioning in childhood : How and why?

    NARCIS (Netherlands)

    Henrichs, J.; Ghassabian, A.; Peeters, R.P.; Tiemeier, H.W.

    2013-01-01

    Exposure to maternal hypothyroxinemia during pregnancy, which is characterized by low free T4 but normal thyroid-stimulating hormone (TSH) levels, can negatively affect the foetus. This review provides an overview of present findings concerning the association between maternal hypothyroxinemia

  19. Manipulative signals in family conflict? On the function of maternal yolk hormones in birds

    NARCIS (Netherlands)

    Muller, Wendt; Lessells, C(Kate). M.; Korsten, Peter; von Engelhardt, Nikolaus

    Maternal hormones in the yolk of birds' eggs have been a focus of attention in behavioral and evolutionary ecology stimulated by the pioneering work of Hubert Schwabl. Since then, knowledge of both the factors that influence maternal deposition patterns and their consequences for offspring

  20. Maternal sensitivity: a concept analysis.

    Science.gov (United States)

    Shin, Hyunjeong; Park, Young-Joo; Ryu, Hosihn; Seomun, Gyeong-Ae

    2008-11-01

    The aim of this paper is to report a concept analysis of maternal sensitivity. Maternal sensitivity is a broad concept encompassing a variety of interrelated affective and behavioural caregiving attributes. It is used interchangeably with the terms maternal responsiveness or maternal competency, with no consistency of use. There is a need to clarify the concept of maternal sensitivity for research and practice. A search was performed on the CINAHL and Ovid MEDLINE databases using 'maternal sensitivity', 'maternal responsiveness' and 'sensitive mothering' as key words. The searches yielded 54 records for the years 1981-2007. Rodgers' method of evolutionary concept analysis was used to analyse the material. Four critical attributes of maternal sensitivity were identified: (a) dynamic process involving maternal abilities; (b) reciprocal give-and-take with the infant; (c) contingency on the infant's behaviour and (d) quality of maternal behaviours. Maternal identity and infant's needs and cues are antecedents for these attributes. The consequences are infant's comfort, mother-infant attachment and infant development. In addition, three positive affecting factors (social support, maternal-foetal attachment and high self-esteem) and three negative affecting factors (maternal depression, maternal stress and maternal anxiety) were identified. A clear understanding of the concept of maternal sensitivity could be useful for developing ways to enhance maternal sensitivity and to maximize the developmental potential of infants. Knowledge of the attributes of maternal sensitivity identified in this concept analysis may be helpful for constructing measuring items or dimensions.

  1. Rebound effects with long-acting amphetamine or methylphenidate stimulant medication preparations among adolescent male drivers with attention-deficit/hyperactivity disorder.

    Science.gov (United States)

    Cox, Daniel J; Moore, Melissa; Burket, Roger; Merkel, R Lawrence; Mikami, Amori Yee; Kovatchev, Boris

    2008-02-01

    This study investigated whether OROS methylphenidate (OROS MPH, Concerta) or extended-release mixed amphetamine salts (se-AMPH ER, Adderall XR) were associated with worsening of driving performance, or drug rebound, relative to placebo 16-17 hours post-ingestion. Nineteen male adolescent drivers aged 17-19 with attention-deficit/hyperactivity disorder (ADHD) were compared on a virtual reality driving simulator and an on-road drive after taking 72 mg of OROS MPH, 30 mg of se-AMPH ER, or placebo. Medication was taken at 08:00 in a randomized, double-blind, placebo-controlled, crossover study. Participants drove a simulator at 17:00, 20:00, 23:00, and 01:00, and drove their own cars over a 16-mile road course at 24:00. The main outcome measures were composite scores of driving performance. Neither OROS MPH nor se-AMPH ER was associated with significant worsening of simulator performance relative to placebo 17 hours post-ingestion in group comparisons. However, inattentive on-road driving errors were significantly more common on se-AMPH ER relative to placebo at midnight (p = 0.04), suggesting possible rebound. During both late simulator and on-road testing, driving performance variance was approximately 300% greater during the se-AMPH ER compared to the OROS MPH condition.

  2. Maternal Death Reviews of a Tertiary Care Hospital

    Directory of Open Access Journals (Sweden)

    Indira Upadhyaya

    2014-03-01

    Full Text Available Introduction: All pregnant women are at risk of obstetrical complications which occurs during labour and delivary that lead to maternal death. Here to report a 10 year review of maternal mortality ratio in "Paropakar Maternity and Women's Hospital (PMWH" Thapathali Kathmandu, Nepal. Methods: Medical records of 66 maternal deaths were reviewed to study the likely cause of each death over the study period. Results: There were a total of 66 maternal deaths. While 192487 deliveries conducted over the 10 year period. The maternal mortality ratio (MMR was 356.64/100000 live birth. The highest MMR of 74.22/100,000 was observed in 2059 and lowest was 17.42/100,000 in 2068 B.S. Leading cause of MMR was remained hemorrhage accounting for 30.30% followed by eclampsia 24.24%. Sepsis, suspected cases of pulmonary embolism and amniotic fluid embolism each contributing 15.15%, 4.54% and 3.03% respectively. Where as anesthetic complication and abortion constiuates 6.06 % each equally for maternal death. The death noted in older women (30+year were 36.36%. Primipara accounted for more deaths (51.51%. Conclusions: The fall in maternal mortality rate has been observed except for year 2063 BS. Haemorrhage is the main contributing cause behind maternal mortality.

  3. Reducing Maternal Mortality by Strengthening Community Maternal ...

    African Journals Online (AJOL)

    AJRH Managing Editor

    translated from Hausa to English language. Using a pre-determined coding framework, coding and thematic analyses were carried out on the qualitative data collected from the baseline. LGA. Community. Estimated. Community. Population. Community maternal support systems established. Community savings. Emergency.

  4. Design of a light stimulator for fetal and neonatal magnetoencephalography

    International Nuclear Information System (INIS)

    Wilson, J D; Adams, A J; Murphy, P; Eswaran, H; Preissl, H

    2009-01-01

    The design, safety analysis and performance of a fetal visual stimulation system suitable for fetal and neonatal magnetoencephalography studies are presented. The issue of fetal, neonatal and maternal safety is considered and the maximum permissible exposure is computed for the maternal skin and the adult eye. The risk for neonatal eye exposure is examined. It is demonstrated that the fetus, neonate and mother are not at risk. (note)

  5. Direct maternal deaths in Norway 1976-1995

    DEFF Research Database (Denmark)

    Andersgaard, Alice Beate; Langhoff-Roos, J.; Oian, P.

    2008-01-01

    AIMS: To report direct maternal mortality ratio (MMR) in Norway between 1976 and 1995 including a description of the underlying complications in pregnancy, the causes of death and assessment of standard of care. METHODS: The maternal deaths were identified through the Cause of Death Registry......, Statistics Norway, and Medical Birth Registry of Norway. We requested copies of the hospital case records and the maternal death autopsies. The direct maternal deaths were classified on the basis underlying causes and assessed for substandard care according to the guidelines at the time of death...... and preventability provided optimal conditions and up to date guidelines. RESULTS: In the period 1976-1995 we identified 61 direct maternal deaths in Norway. The direct MMR was 5.5/100,000 births. Sufficient information was available for analysis in 51 of these cases. Six deaths occurred in early pregnancy. Among...

  6. Maternal mortality: a global overview.

    Science.gov (United States)

    Choolani, M; Ratnam, S S

    1995-02-01

    Reduction of maternal mortality in developing countries is possible through elimination of unsafe abortion, active management of labor, appropriate management of pregnancy complications, and availability of adequate facilities. Prevention and early recognition are key factors in preventing maternal deaths due to ruptured uteri. A well equipped hospital is the appropriate place for delivery of mothers with a history of previous cesarean sections, a grossly contracted pelvis, previous myomectomies, previous multiple births, and previous abnormal births or complications during delivery. Complicated procedures, use of oxytocins, and administration of anesthesia should be performed with experienced, trained medical personnel. Surveillance of and correction for anemia should occur during the course of the pregnancy. Infections can be controlled with tetanus toxoid immunization and use of chest X-rays. The health care system should be tiered with primary health care services located in suburbs and rural districts. Services should be situated to account for population distribution, extent of maternal mortality in the region, transportation facilities, and the nearest secondary hospital. Birthing homes with sanitary facilities are an option for rural districts. A two-way referral system should be established between the primary, secondary, and tertiary level hospitals. Audits should be conducted as a means of checking for needed improvements in the system. Planning that includes proper roads, transportation, and communication facilities is important. Funding can come in the form of money, materials, and manpower. Safe motherhood requires the commitment of local people and local governments. The first step in a safe motherhood program is creating awareness among the political and economic elite. Governments are encouraged to shift resources from the military to housing, transportation, communications, education, and health during peace-times. Local professional associations

  7. Maternal Mortality In Pakistan: Is There Any Metamorphosis Towards Betterment?

    Science.gov (United States)

    Nisar, Nusrat; Abbasi, Razia Mustafa; Chana, Shehla Raza; Rizwan, Noushaba; Badar, Razia

    2017-01-01

    Every year more than half million mother die due to pregnancy related preventable causes like haemorrhage, hypertensive disorders, sepsis, and obstructed labour and unsafe abortion. Among these deaths 99% occur in developing countries. The study was conducted to assess the maternal death rate and to analyse its trends over a period of 20 years in tertiary care hospital in Sindh Province Pakistan. A retrospective analysis of maternal mortality records were carried out for a period of 20 years from 1986-1995 and 2011-2015 at the Department of Obstetrics and gynaecology Liaquat University of Medical and Health Sciences Hyderabad Sindh Pakistan. The record retrieved was categorized into four 5 yearly periods 1986- 1990, 1991-995, 2006-2010 and 2011-2015 for comparison of trends. The cumulative maternal mortality ratio (MMR) was 1521.5 per 100,000 live births. The comparison of first 5 years' period (1986-1990) and last 5 years (2011-2015) showed downward trend in maternal mortality rate from 2368.6-1265.1. Direct causes of death have accounted for 2820 (84.78%) of total maternal death. Sepsis was the major cause of death for first 5 years accounted for 196(35.1%) of maternal death while in the last 5 years' eclampsia causes 284 (27.84%) of direct maternal deaths. The reduction in the maternal deaths has been very slow. The direct causes were still the main reasons for obstetrical deaths.

  8. Electrical stimulation in exercise training

    Science.gov (United States)

    Kroll, Walter

    1994-01-01

    Electrical stimulation has a long history of use in medicine dating back to 46 A.D. when the Roman physician Largus found the electrical discharge of torpedo fishes useful in the treatment of pain produced by headache and gout. A rival Greek physician, Dioscorides, discounted the value of the torpedo fish for headache relief but did recommend its use in the treatment of hemorrhoids. In 1745, the Leyden jar and various sized electrostatic generators were used to treat angina pectoris, epilepsy, hemiplegia, kidney stones, and sciatica. Benjamin Franklin used an electrical device to treat successfully a young woman suffering from convulsive fits. In the late 1800's battery powered hydroelectric baths were used to treat chronic inflammation of the uterus while electrified athletic supporters were advertised for the treatment of male problems. Fortunately, such an amusing early history of the simple beginnings of electrical stimulation did not prevent eventual development of a variety of useful therapeutic and rehabilitative applications of electrical stimulation. Over the centuries electrical stimulation has survived as a modality in the treatment of various medical disorders with its primary application being in the rehabilitation area. Recently, a surge of new interest in electrical stimulation has been kindled by the work of a Russian sport scientist who reported remarkable muscle strength and endurance improvements in elite athletes. Yakov Kots reported his research on electric stimulation and strength improvements in 1977 at a Canadian-Soviet Exchange Symposium held at Concordia University in Montreal. Since then an explosion of new studies has been seen in both sport science and in medicine. Based upon the reported works of Kots and the present surge of new investigations, one could be misled as to the origin of electrical stimulation as a technique to increase muscle strength. As a matter of fact, electric stimulation has been used as a technique to improve

  9. Rural maternity care.

    Science.gov (United States)

    Miller, Katherine J; Couchie, Carol; Ehman, William; Graves, Lisa; Grzybowski, Stefan; Medves, Jennifer

    2012-10-01

    To provide an overview of current information on issues in maternity care relevant to rural populations. Medline was searched for articles published in English from 1995 to 2012 about rural maternity care. Relevant publications and position papers from appropriate organizations were also reviewed. This information will help obstetrical care providers in rural areas to continue providing quality care for women in their communities. Recommendations 1. Women who reside in rural and remote communities in Canada should receive high-quality maternity care as close to home as possible. 2. The provision of rural maternity care must be collaborative, woman- and family-centred, culturally sensitive, and respectful. 3. Rural maternity care services should be supported through active policies aligned with these recommendations. 4. While local access to surgical and anaesthetic services is desirable, there is evidence that good outcomes can be sustained within an integrated perinatal care system without local access to operative delivery. There is evidence that the outcomes are better when women do not have to travel far from their communities. Access to an integrated perinatal care system should be provided for all women. 5. The social and emotional needs of rural women must be considered in service planning. Women who are required to leave their communities to give birth should be supported both financially and emotionally. 6. Innovative interprofessional models should be implemented as part of the solution for high-quality, collaborative, and integrated care for rural and remote women. 7. Registered nurses are essential to the provision of high-quality rural maternity care throughout pregnancy, birth, and the postpartum period. Maternity nursing skills should be recognized as a fundamental part of generalist rural nursing skills. 8. Remuneration for maternity care providers should reflect the unique challenges and increased professional responsibility faced by providers in

  10. Medical Toxicology and Public Health-Update on Research and Activities at the Centers for Disease Control and Prevention and the Agency for Toxic Substances and Disease Registry : Environmental Exposures among Arctic Populations: The Maternal Organics Monitoring Study in Alaska.

    Science.gov (United States)

    Anwar, Mehruba; Ridpath, Alison; Berner, James; Schier, Joshua G

    2016-09-01

    Evidence suggests that in-utero exposure to environmental chemicals, such as persistent organic pollutants (POPs), heavy metals, and radionuclides, that might bioaccumulate in the mother may increase a newborn's risk of adverse developmental, neurological, and immunologic effects. Chemical contamination of bodies of water and strong ocean currents worldwide can drive these chemicals from lower latitudes to Arctic waters where they accumulate in common traditional subsistence foods. In response to concerns of the people from Alaska of the effects of bio-accumulated chemicals on their children, the Maternal Organics Monitoring Study(MOMS) was developed. The objective of the study was to assess the risks and benefits associated with the population's subsistence diet. Data analysis of biological samples at the CDC's NCEH laboratory and maternal questionnaires is ongoing. Results will be provided to Alaska Native communities to help support public health actions and inform future interventions and research.

  11. Implantable electronic medical devices

    CERN Document Server

    Fitzpatrick, Dennis

    2014-01-01

    Implantable Electronic Medical Devices provides a thorough review of the application of implantable devices, illustrating the techniques currently being used together with overviews of the latest commercially available medical devices. This book provides an overview of the design of medical devices and is a reference on existing medical devices. The book groups devices with similar functionality into distinct chapters, looking at the latest design ideas and techniques in each area, including retinal implants, glucose biosensors, cochlear implants, pacemakers, electrical stimulation t

  12. Child Health, Maternal Marital and Socioeconomic Factors, and Maternal Health

    OpenAIRE

    Garbarski, Dana; Witt, Whitney P.

    2012-01-01

    While maternal socioeconomic status and health predict in part children’s future health and socioeconomic prospects, it is possible that the intergenerational association flows in the other direction such that child health affects maternal outcomes. Previous research demonstrates that poor child health increases the risk of adverse maternal physical and mental health outcomes. We hypothesize that poor child health may also increase the risk of poor maternal health outcomes through an interact...

  13. Somato stimulation and acupuncture therapy.

    Science.gov (United States)

    Zhao, Jing-Jun; Rong, Pei-Jing; Shi, Li; Ben, Hui; Zhu, Bing

    2016-05-01

    Acupuncture is an oldest somato stimulus medical technique. As the most representative peripheral nerve stimulation therapy, it has a complete system of theory and application and is applicable to a large population. This paper expounds the bionic origins of acupuncture and analyzes the physiological mechanism by which acupuncture works. For living creatures, functionally sound viscera and effective endurance of pain are essential for survival. This paper discusses the way in which acupuncture increases the pain threshold of living creatures and the underlying mechanism from the perspective of bionics. Acupuncture can also help to adjust visceral functions and works most effectively in facilitating the process of digestion and restraining visceral pain. This paper makes an in-depth overview of peripheral nerve stimulation therapy represented by acupuncture. We look forward to the revival of acupuncture, a long-standing somato stimulus medicine, in the modern medical systems.

  14. Maternal responsive-didactic caregiving in play interactions with 10-month-olds and cognitive development at 18 months

    OpenAIRE

    Mermelshtine, Roni; Barnes, Jacqueline

    2016-01-01

    Maternal responsive-didactic caregiving (RDC) and infant advanced object play were investigated in a sample of 400 mothers and their 10-month-old infants during video-recorded semi-structured play interactions. Three maternal behaviours: contingent response, cognitively stimulating language and autonomy promoting speech were coded and infant object play. Factor analysis confirmed the three maternal behaviours loaded onto one underlying factor, labelled RDC. Based on ecological and transaction...

  15. Maternal Mortality in a Nigerian Maternity Hospital | Olopade ...

    African Journals Online (AJOL)

    Despite recent focus on maternal mortality in Nigeria, its rates remain unacceptably high in Nigeria. A retrospective case-control study was carried out at Adeoyo Maternity Hospital, Ibadan between January 2003 and December 2004. This was to determine the maternal mortality ratio in a secondary health facility, to identify ...

  16. The effects of maternal haemoglobin as an indicator of maternal ...

    African Journals Online (AJOL)

    Background: Maternal measles antibodies (MMA) are actively transferred through the placenta from mother to foetus. A relationship could exist between MMA of mother-infant pairs and maternal nutritional indicator (haemoglobin). Objectives: This study reviewed the effects of maternal haemoglobin (Hb) on MMA of ...

  17. Maternal Responsive-Didactic Caregiving in Play Interactions with 10-Month-Olds and Cognitive Development at 18 Months

    Science.gov (United States)

    Mermelshtine, Roni; Barnes, Jacqueline

    2016-01-01

    Maternal responsive-didactic caregiving (RDC) and infant advanced object play were investigated in a sample of 400 mothers and their 10-month-old infants during video-recorded semi-structured play interactions. Three maternal behaviours: contingent response, cognitively stimulating language and autonomy-promoting speech were coded and infant…

  18. Thyroid Stimulating Hormone values from cord blood in neonates ...

    African Journals Online (AJOL)

    Objectives: To determine thyroid stimulating hormone (TSH) levels from cord blood in neonates and to establish the practice for possible application of congenital hypothyroidism screening in Ethiopia. Methods: TSH was measured from cord blood of 1207 consecutive new-borns in the maternal wards of St. Paul, Ghandi ...

  19. Associations between maternal hormonal biomarkers and maternal mental and physical health of very low birth weight infants

    Directory of Open Access Journals (Sweden)

    June Cho

    2016-12-01

    Full Text Available The purpose of this study was to determine whether maternal mental and physical health is associated with maternal testosterone and cortisol levels, parenting of very low birth weight infants, physical exercise, and White vs non-White race. A total of 40 mothers of very low birth weight infants were recruited from a neonatal intensive care unit at a University Hospital in the Southeast United States. Data were collected through a review of medical records, standardized questionnaires, and biochemical measurement. Maternal mental and physical health status using questionnaires as well as maternal testosterone and cortisol levels using an enzyme immunoassay were measured four times (birth, 40 weeks postmenstrual age [PMA], and 6 and 12 months [age of infant, corrected age]. General linear models showed that higher testosterone levels were associated with greater depressive symptoms, stress, and poorer physical health at 40 weeks PMA, and at 6 and 12 months. High cortisol levels were associated with greater anxiety at 40 weeks PMA; however, with better mental and physical health at 40 weeks PMA, and 6 and 12 months. Physical activity was associated with lower maternal perceived stress at 12 months. Maternal health did not differ by race, except anxiety, which was higher in White than non-White mothers after birth. As very low birth weight infants grew up, maternal physical health improved but mental health deteriorated. Testosterone and cortisol levels were found to be positively correlated in women but testosterone was more predictive of maternal mental and physical health than cortisol. Indeed testosterone consistently showed its associations with maternal health. Maternal stress might be improved through regular physical exercise.

  20. Maternal health Indicators Signal Optimism

    African Journals Online (AJOL)

    user

    Maternal health Indicators Signal Optimism. Abraham Haileamlak, MD, Professor of Pediatrics and Child Health. Maternal health is a major health priority for international agencies and the Ethiopian. Government. Many low income countries including. Ethiopia, made substantial improvements in maternal health achieving ...

  1. Maternal Sexuality and Breastfeeding

    Science.gov (United States)

    Bartlett, Alison

    2005-01-01

    In this paper I consider the ways in which lactation has been discussed as a form of maternal sexuality, and the implications this carries for our understanding of breastfeeding practices and sexuality. Drawing on knowledge constructed in the western world during the last half of the twentieth century, the paper identifies a shift between the…

  2. Maternity Leave in Taiwan

    Science.gov (United States)

    Feng, Joyce Yen; Han, Wen-Jui

    2010-01-01

    Using the first nationally representative birth cohort study in Taiwan, this paper examines the role that maternity leave policy in Taiwan plays in the timing of mothers returning to work after giving birth, as well as the extent to which this timing is linked to the amount of time mothers spend with their children and their use of breast milk…

  3. Maternity Leave Policies

    Science.gov (United States)

    Strang, Lucy; Broeks, Miriam

    2017-01-01

    Abstract Over recent years many European Union countries have made changes to the design of the maternity leave provision. These policy developments reflect calls for greater gender equality in the workforce and more equal share of childcare responsibilities. However, while research shows that long period of leave can have negative effects on women's labour market attachment and career advancements, early return to work can be seen as a factor preventing exclusive breastfeeding, and therefore, potentially having negative health impacts for babies. Indeed, the World Health Organisation recommends exclusive breastfeeding up to 6 months of age to provide babies with the nutrition for healthy growth and brain development, protection from life-threatening ailments, obesity and non-communicable diseases such as asthma and diabetes. Therefore, labour market demands on women may be at odds with the health benefits for children gained by longer periods of maternity leave. The aim of this article is to examine the relationship between leave provision and health benefits for children. We examine maternity and parental leave provision across European countries and its potential impact on the breastfeeding of very young babies (up to 6-months of age). We also consider economic factors of potential extension of maternity leave provision to 6 months, such as costs to businesses, effects on the female labour market attachment, and wider consequences (benefits and costs) for individuals, families, employers and the wider society. PMID:28983432

  4. Maternal periodontal disease is associated with oxidative stress during pregnancy.

    Science.gov (United States)

    Hickman, M Ashley; Boggess, Kim A; Moss, Kevin L; Beck, James D; Offenbacher, Steven

    2011-03-01

    We sought to determine if maternal periodontal disease is associated with oxidative stress as measured by serum 8-isoprostane. A secondary analysis was conducted using prospective data from the Oral Conditions and Pregnancy Study. Healthy women enrolled at periodontal disease status was categorized as healthy, mild, or moderate to severe by clinical criteria. Maternal serum was analyzed for 8-isoprostane using ultrasensitive enzyme-linked immunosorbent assay. Elevated 8-isoprostane level was defined as ≥ 75th percentile. Maternal factors associated with elevated 8-isoprostane were determined using chi-square or T test. Multivariable logistic regression was used to assess association between elevated 8-isoprostane and maternal factors. Seven hundred ninety-one women had complete data. Median (interquartile) 8-isoprostane serum level was 1806 (16 to 81,870) pg/dL. Using bivariate analysis, maternal age, race, marital status, utilization of public assistance, and mild or moderate to severe periodontal disease were associated with elevated serum 8-isoprostane. Using logistic regression, moderate to severe periodontal disease (adjusted odds ratio 2.9, 95% confidence interval: 1.7 to 5.0) remained significantly associated with an elevated serum 8-isoprostane level. Maternal periodontal disease is associated with oxidative stress during pregnancy. Further study is needed to determine the role of maternal oxidative stress in periodontal disease-associated adverse pregnancy outcomes. © Thieme Medical Publishers.

  5. Maternal correlates of maternal child feeding practices: a systematic review.

    Science.gov (United States)

    McPhie, Skye; Skouteris, Helen; Daniels, Lynne; Jansen, Elena

    2014-01-01

    Establishing healthy eating habits early in life is one important strategy to combat childhood obesity. Given that early maternal child feeding practices have been linked to child food intake and weight, identifying the maternal correlates of maternal child feeding practices is important in order to understand the determinants of childhood obesity; this was the overall aim of the current review. Academic databases were searched for studies examining the relationship between maternal child feeding practices and parenting, personal characteristics and psychopathology of mothers with preschoolers. Papers were limited to those published in English, between January 2000 and June 2012. Only studies with mothers of normally developing children between the ages of 2 and 6 years were included. There were no restrictions regarding the inclusion of maternal nationality or socioeconomic status (SES). Seventeen eligible studies were sourced. Information on the aim, sample, measures and findings of these was summarised into tables. The findings of this review support a relationship between maternal controlling parenting, general and eating psychopathology, and SES and maternal child feeding practices. The main methodological issues of the studies reviewed included inconsistency in measures of maternal variables across studies and cross-sectional designs. We conclude that the maternal correlates associated with maternal child feeding practices are complex, and the pathways by which maternal correlates impact these feeding practices require further investigation. © 2012 John Wiley & Sons Ltd.

  6. Article Commentary: Prenatal Substance Use: Exploring Assumptions of Maternal Unfitness

    Directory of Open Access Journals (Sweden)

    Mishka Terplan

    2015-01-01

    Full Text Available In spite of the growing knowledge and understanding of addiction as a chronic relapsing medical condition, individuals with substance use disorders (SUD continue to experience stigmatization. Pregnant women who use substances suffer additional stigma as their use has the potential to cause fetal harm, calling into question their maternal fitness and often leading to punitive responses. Punishing pregnant women denies the integral interconnectedness of the maternal-fetal dyad. Linking substance use with maternal unfitness is not supported by the balance of the scientific evidence regarding the actual harms associated with substance use during pregnancy. Such linkage adversely impacts maternal, child, and family health by deterring pregnant women from seeking both obstetrical care and SUD treatment. Pregnant women who use substances deserve compassion and care, not pariah-status and punishment.

  7. Unsafe Abortion- A Tragic Saga of Maternal Suffering

    Directory of Open Access Journals (Sweden)

    M C Regmi

    2010-03-01

    Full Text Available INTRODUCTION: Unsafe abortion is a significant cause of maternal morbidity and mortality in developing countries despite provision of adequate care and legalization of abortion. The aim of this study was to find out the contribution of unsafe abortion in maternal mortality and its other consequences. METHODS: A retrospective study was carried out in the Department of Obstetrics and Gynecology in BPKIHS between 2005 April to 2008 September analyzing all the unsafe abortion related admissions. RESULTS: There were 70 unsafe abortion patients. Majority of them (52.8% were of high grade. Most of them recovered but there were total 8maternal deaths. CONCLUSIONS: Unsafe abortion is still a significant medical and social problem even in post legalization era of this country. Keywords: abortion, legalization, maternal death, unsafe.

  8. A 2-center Comparative Study on Tonic Versus Burst Spinal Cord Stimulation: Amount of Responders and Amount of Pain Suppression

    NARCIS (Netherlands)

    Ridder, D.M.D.; Lenders, M.W.P.M.; de Vos, Cecilia Cecilia Clementine; Dijkstra-Scholten, C.R.N.; Wolters, R.R.N.; Vancamp, T.P.T.; Van Looy, P.R.N.; Van Havenbergh, T.M.D.; Vanneste, S.

    2015-01-01

    Introduction: Spinal cord stimulation is a safe and effective procedure applied for medically intractable neuropathic pain and failed back surgery syndrome. Recently, a novel stimulation paradigm was developed, called burst stimulation consisting of intermittent packets of closely spaced

  9. Maternal recall of birthweights of adult children: validation by hospital and well baby clinic records

    NARCIS (Netherlands)

    Lumey, L. H.; Stein, A. D.; Ravelli, A. C.

    1994-01-01

    Several studies have suggested that maternal recall of offspring birthweight compares well to data from birth certificates or medical records. However, these studies describe relatively short recall periods and pertain to populations where hospitalized childbirth is the norm. Accuracy of maternal

  10. Barriers to obstetric care among maternal near-misses | Soma-Pillay ...

    African Journals Online (AJOL)

    One hundred maternal near-misses were prospectively identified using the World Health Organization criteria. ... The above causes were also the most important factors causing delays for the leading causes of maternal near-misses – obstetric haemorrhage, hypertension/pre-eclampsia, and medical and surgical conditions.

  11. Pan African Medical Journal - Vol 23, No 1 (2016)

    African Journals Online (AJOL)

    Perceptions and uptake of health insurance for maternal care in rural Kenya: a .... Knowledge and awareness of medical doctors, medical students and nurses ..... Upper extremity deep vein thrombosis after elbow trauma: a case report of a ...

  12. Maternal nutrition and birth outcomes.

    Science.gov (United States)

    Abu-Saad, Kathleen; Fraser, Drora

    2010-01-01

    In this review, the authors summarize current knowledge on maternal nutritional requirements during pregnancy, with a focus on the nutrients that have been most commonly investigated in association with birth outcomes. Data sourcing and extraction included searches of the primary resources establishing maternal nutrient requirements during pregnancy (e.g., Dietary Reference Intakes), and searches of Medline for "maternal nutrition"/[specific nutrient of interest] and "birth/pregnancy outcomes," focusing mainly on the less extensively reviewed evidence from observational studies of maternal dietary intake and birth outcomes. The authors used a conceptual framework which took both primary and secondary factors (e.g., baseline maternal nutritional status, socioeconomic status of the study populations, timing and methods of assessing maternal nutritional variables) into account when interpreting study findings. The authors conclude that maternal nutrition is a modifiable risk factor of public health importance that can be integrated into efforts to prevent adverse birth outcomes, particularly among economically developing/low-income populations.

  13. Stimulants for the Control of Hedonic Appetite

    OpenAIRE

    Poulton, Alison S.; Hibbert, Emily J.; Champion, Bernard L.; Nanan, Ralph K. H.

    2016-01-01

    The focus of this paper is treatment of obesity in relation to the management of hedonic appetite. Obesity is a complex condition which may be potentiated by excessive reward seeking in combination with executive functioning deficits that impair cognitive control of behaviour. Stimulant medications address both reward deficiency and enhance motivation, as well as suppressing appetite. They have long been recognised to be effective for treating obesity. However, stimulants can be abused for th...

  14. Associations of Maternal and Infant Testosterone and Cortisol Levels With Maternal Depressive Symptoms and Infant Socioemotional Problems

    Science.gov (United States)

    Cho, June; Su, Xiaogang; Phillips, Vivien; Holditch-Davis, Diane

    2015-01-01

    This study examined the associations of testosterone and cortisol levels with maternal depressive symptoms and infant socioemotional (SE) problems that are influenced by infant gender. A total of 62 mothers and their very-low-birth weight (VLBW) infants were recruited from a neonatal intensive care unit at a tertiary medical center in the southeast United States. Data were collected at three time points (before 40 weeks’ postmenstrual age [PMA] and at 3 months and 6 months of age corrected for prematurity). Measures included infant medical record review, maternal interview, biochemical assays of salivary hormone levels in mother-VLBWinfant pairs, and standard questionnaires. Generalized estimating equations with separate analyses for boys and girls showed that maternal testosterone level was negatively associated with depressive symptoms in mothers of boys, whereas infant testosterone level was negatively associated with maternal report of infant SE problems in girls after controlling for characteristics of mothers and infants and number of days post birth of saliva collection. Not surprisingly, the SE problems were positively associated with a number of medical complications. Mothers with more depressive symptoms reported that their infants had more SE problems. Mothers with higher testosterone levels reported that girls, but not boys, had fewer SE problems. In summary, high levels of testosterone could have a protective role for maternal depressive symptoms and infant SE problems. Future research need to be directed toward clinical application of these preliminary results. PMID:25954021

  15. STUDY ON MATERNAL MORTALITY AND NEAR MISS CASE

    Directory of Open Access Journals (Sweden)

    Ritanjali Behera

    2017-12-01

    Full Text Available BACKGROUND Maternal mortality traditionally has been the indicator of maternal health. More recently the review of cases of near miss obstetric event is found to be useful to investigate maternal mortality. Cases of near miss are those, where a woman nearly died but survived a complication that occur during pregnancy or child birth. Aim and Objective 1. To analyse near miss cases and maternal deaths. 2. To determine maternal near miss indicator and to analyse the cause and contributing factors for both of them. MATERIALS AND METHODS This prospective observational study conducted in M.K.C.G. medical college, Berhampur from 1st October 2015 to 30th September 2017. All the cases of maternal deaths and near miss cases defined by WHO criteria are taken. Information regarding demographic profile and reproductive parameters are collected and results are analysed using percentage and proportion. RESULTS Out of 17977 deliveries 201 were near miss cases and 116 were maternal deaths. MMR was 681, near miss incidence 1.18, maternal death to near miss ratio was 1:1.73. Hypertensive disorder of pregnancy (37.4% was the leading cause followed by haemorrhage (17.4%. For near miss cases 101 cases fulfilled clinical criteria, 61 laboratory criteria and 131 cases management based criteria. CONCLUSION Hypertensive disorder of pregnancy and haemorrhage are the leading cause of maternal death and for near miss cases most common organ system involved was cardiovascular system. All the near miss cases should be interpreted as opportunities to improve the health care services.

  16. Maternal fever during labor--what does it mean?

    Science.gov (United States)

    Churgay, C A; Smith, M A; Blok, B

    1994-01-01

    Several studies have shown maternal fever to be associated with chorioamnionitis and neonatal sepsis if at least two of the following five criteria are also present: maternal tachycardia, purulent or foul-smelling amniotic fluid, fetal tachycardia, uterine tenderness, or maternal leukocytosis. Less is known about the risk of neonatal sepsis when the presence of maternal fever in labor is the only criterion. A retrospective medical record review searching for women who had a fever greater than 100.4 degrees F while in the active phase of labor during a 1-year period at the University of Michigan was undertaken to investigate the relation between isolated maternal fever in labor and neonatal sepsis. Eighty-two cases of maternal fever were found. Forty-six women met the clinical criteria for chorioamnionitis, and 6 of the 7 neonates with sepsis diagnosed were born to these mothers. There were no significant differences found in admission or intrapartum factors between women who did and did not meet clinical criteria for chorioamnionitis, and there was no association between these factors and neonatal sepsis. Epidural anesthesia was administered to 91 percent of these women and might be associated with maternal fever during labor. Using maternal clinical criteria for chorioamnionitis and a neonatal band cell-total neutrophil ratio of 0.2 or greater instead of the current system to determine the need for newborn antibiotic administration would improve the positive predictive value (12.5 percent versus 9.3 percent) and specificity (34.6 percent versus 16 percent) without compromising sensitivity (100 percent). All septic and probably septic newborns would be treated, and neonatal antibiotic administration would be reduced by 17 percent. The addition of the maternal clinical criteria for chorioamnionitis to the criteria already used for diagnosing and treating neonatal sepsis could prove useful in decisions regarding the selective administration of intrapartum antibiotics

  17. Maternal risk factors associated with low birth weight

    International Nuclear Information System (INIS)

    Khan, N.; Jamal, M.

    2003-01-01

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

  18. Good maternal nutrition

    DEFF Research Database (Denmark)

    Breda, Joao; Robertson, Aileen

    This publication has three parts: •a summary of the results of a systematic review of the most recent evidence on maternal nutrition, the prevention of obesity and noncommunicable diseases; •a review of existing recommendations for nutrition, physical activity and weight gain during pregnancy...... in European countries; and •lists of possible opportunities for action in European countries. The overview and exploration of the national recommendations for nutrition, physical activity and weight gain during pregnancy are based on the results of a survey in which 51 of the 53 Member States in the WHO....... These are opportunities to promote nutrition and health throughout the life-course, ensure optimal diet-related fetal development and reduce the impact of morbidity and risk factors for noncommunicable diseases by improving maternal nutrition....

  19. Effects of antenatal diet and physical activity on maternal and fetal outcomes

    DEFF Research Database (Denmark)

    Rogozińska, Ewelina; Marlin, Nadine; Jackson, Louise

    2017-01-01

    BACKGROUND: Diet- and physical activity-based interventions in pregnancy have the potential to alter maternal and child outcomes. OBJECTIVES: To assess whether or not the effects of diet and lifestyle interventions vary in subgroups of women, based on maternal body mass index (BMI), age, parity......, ethnicity, parity or underlying medical conditions for GWG, and composite maternal and fetal outcomes. Lifestyle interventions reduce Caesarean sections (OR 0.91, 95% CI 0.83 to 0.99), but not other individual maternal outcomes such as gestational diabetes mellitus (OR 0.89, 95% CI 0.72 to 1.10), pre...

  20. "So Either You Have a Foetal Monitor or You Have Your Waters Broken, Basically Is It?": Articulating Maternity Care Policy at a Midwives' Ante-Natal Clinic

    Science.gov (United States)

    O'Malley, Mary-Pat

    2010-01-01

    Maternity care in Ireland has been described as a "testament to the strength and influence of the medical profession" (Mc Kee 1986: 192). A review of maternity and gynaecology services in the Dublin area in 2004 revealed that "no participant...thought that the maternity services were women centred at the time" (Women's Health…

  1. [Severe neonatal hyperthyroidism which reveals a maternal Graves' disease].

    Science.gov (United States)

    Guérin, B; Vautier, V; Boin-Gay, V; Estrade, G; Choulot, J-J; Doireau, V

    2004-04-01

    Two of every thousand pregnancies are complicated by Graves' disease. Diagnosis is suggested by maternal disorders (tachycardia, exophthalmia, weight loss.) or fetal disorders (tachycardia, intra-uterine growth retardation, preterm birth.). Due to transfer into the fetal compartment of maternal antibodies which stimulate the fetal thyroid by binding to the thyroid thyrotropin (TSH) receptor, only 1% of children born to these mothers are described as having hyperthyroidism. Neonatal thyrotoxicosis disappears with clearance of the maternal antibodies; clinical signs usually disappear during the first four Months of life. The most frequent neonatal clinical signs of thyrotoxicosis are tachycardia, goiter, hyperexcitability, poor weight gain, hepatosplenomegaly, stare and eyelid retraction. Diagnosis is based on determination of the blood level of triiodothyronine (T3), thyroxine (T4) and TSH. To confirm the nature of hyperthyroidism, thyroid-stimulating immunoglobulins (TSI) should be assayed. The kinetics of TSI provides a guide for therapeutic adaptation and disappearance of TSI is a sign of recovery. Rare cases of familial non-autoimmune hyperthyroidism have been shown to be caused by germline mutation of the thyrotropin receptor. We report a case of severe neonatal hyperthyroidism which led to the diagnosis of maternal Graves' disease.

  2. Spinal cord stimulation

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/007560.htm Spinal cord stimulation To use the sharing features on this page, please enable JavaScript. Spinal cord stimulation is a treatment for pain that uses ...

  3. Feldspar, Infrared Stimulated Luminescence

    DEFF Research Database (Denmark)

    Jain, Mayank

    2014-01-01

    This entry primarily concerns the characteristics and the origins of infrared-stimulated luminescence in feldspars.......This entry primarily concerns the characteristics and the origins of infrared-stimulated luminescence in feldspars....

  4. Growth hormone stimulation test

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/003377.htm Growth hormone stimulation test To use the sharing features on this page, please enable JavaScript. The growth hormone (GH) stimulation test measures the ability of ...

  5. Maternally acquired runt disease.

    Science.gov (United States)

    Beer, A E; Billingham, R E

    1973-01-19

    Without altering the structural integrity of the placenta by irradiation or drugs, we have shown that it is possible to immunize females both adoptively and actively against the paternally inherited transplantation antigens of their fetuses. Such immunization causes a high incidence of runt disease among the litters. Although the putative chimeric status of the affected offspring has yet to be confirmed, the results of our experiments support the thesis that runt disease is caused by the activities of "unwanted" immigrant lymphocytes from the maternal circulation. Our results suggest that immunologically activated cells are more likely to cross the placenta than normal cells and that this greater mobility may not be related to the immunologic specificity of the activated cells. Two factors may have contributed to the apparent failure of numerous previous attempts to demonstrate the capacity of transplantation immunity to affect the well-being of a fetus or, more correctly, its placenta, in the way that might be expected of a homograft. (i) Investigators were preoccupied with obtaining a classic type of rejection, in utero, analogous to the rejection of an orthotopic skin homograft. The birth of consistently healthy-looking litters, interpreted as a failure of the experiment, convinced the investigators of the efficacy of nature's solution of the homograft problem and there was no reason for them to suspect its possible limitations. Observation of the litters for several weeks might have uncovered the phenomenon of maternally induced runt disease. (ii) Most investigators resorted to hyperimmunization of the mothers. This would have facilitated the synthesis of protective isoantibodies capable of interfering with the expression of the potentially harmful cellular immune response (6). Ever since the abnormalities of runt disease were first described they have repeatedly been compared to those observed in patients with certain lymphomas (17). Various theories have been

  6. Displays of paternal mouse pup retrieval following communicative interaction with maternal mates.

    Science.gov (United States)

    Liu, Hong-Xiang; Lopatina, Olga; Higashida, Chiharu; Fujimoto, Hiroko; Akther, Shirin; Inzhutova, Alena; Liang, Mingkun; Zhong, Jing; Tsuji, Takahiro; Yoshihara, Toru; Sumi, Kohei; Ishiyama, Mizuho; Ma, Wen-Jie; Ozaki, Mitsunori; Yagitani, Satoshi; Yokoyama, Shigeru; Mukaida, Naofumi; Sakurai, Takeshi; Hori, Osamu; Yoshioka, Katsuji; Hirao, Atsushi; Kato, Yukio; Ishihara, Katsuhiko; Kato, Ichiro; Okamoto, Hiroshi; Cherepanov, Stanislav M; Salmina, Alla B; Hirai, Hirokazu; Asano, Masahide; Brown, David A; Nagano, Isamu; Higashida, Haruhiro

    2013-01-01

    Compared with the knowledge of maternal care, much less is known about the factors required for paternal parental care. Here we report that new sires of laboratory mice, though not spontaneously parental, can be induced to show maternal-like parental care (pup retrieval) using signals from dams separated from their pups. During this interaction, the maternal mates emit 38-kHz ultrasonic vocalizations to their male partners, which are equivalent to vocalizations that occur following pheromone stimulation. Without these signals or in the absence of maternal mates, the sires do not retrieve their pups within 5 min. These results show that, in mice, the maternal parent communicates to the paternal parent to encourage pup care. This new paradigm may be useful in the analysis of the parental brain during paternal care induced by interactive communication.

  7. Impact of maternal mental health on maternal-child interaction in attendees in a community health clinic in Lagos, Nigeria

    OpenAIRE

    Motunrayo A Oyelohunnu; Yewande O Oshodi; Elizabeth A Campbell; Mercy Eigbike; Kofoworola A Odeyemi

    2016-01-01

    Background: Maternal mental health, in particular depression, has been found to negatively impact mother-child interaction, attachment, stimulation, growth, and many important aspects of development in the young child. These early deficits if sustained and unattended may have negative immediate and long-term consequences on the outcomes in the child. The study aimed to assess psychological distress and postpartum depression in mothers, and their relationship to the mother-child interaction. M...

  8. [Prenatal care and hospital maternal mortality in Tijuana, Baja California, Mexico].

    Science.gov (United States)

    Gonzaga-Soriano, María Rode; Zonana-Nacach, Abraham; Anzaldo-Campos, María Cecilia; Olazarán-Gutiérrez, Asbeidi

    2014-01-01

    To describe the prenatal care (PC) received in women with maternal hospital deaths from 2005 to 2011 in Tijuana, Baja California, Mexico. Were reviewed the medical chars and registrations of the maternal deaths by the local Committees of Maternal Mortality. There were 44 maternal hospital deaths. Thirty (68%) women assisted to PC appointments during pregnancy, the average number of PC visits was 3.8 and 18 (41%) had an adequate PC (≥ 5 visits). Six (14%) women didn't know they were pregnant; 19 (43%), 21 (48%) y 4 (9%) maternal deaths were due to direct, indirect obstetric cause or non-obstetric causes. Eighteen (18%), 2 (4 %) and 34 (77%) of the maternal deaths occurred during pregnancy, delivery or puerperium. It is necessary pregnancy women have an early, periodic and systematic PC to identify opportunely risk factors associated with pregnancy complications.

  9. Watching sexy displays improves hatching success and offspring growth through maternal allocation.

    Science.gov (United States)

    Loyau, Adeline; Lacroix, Frédéric

    2010-11-22

    Male attractiveness can have tremendous effects on the fitness of his offspring via good genes, but also via enhanced maternal allocation of resources. Yet the proximate mechanisms influencing differential maternal allocation in relation to male sexiness are poorly known. Here, we studied the importance of visual stimulation for maternal allocation in the Houbara bustard, a vulnerable bird species bred in captivity to support wild populations. Artificial insemination allowed controlling for potential confounding factors, such as a male's territory quality, social interactions or sperm quality/quantity, probably linked to mate attractiveness. We show that artificially inseminated females stimulated by highly displaying males increased their hatching success, owing to increased fertilization success. The females also increased the allocation of maternal androgens in their eggs, leading to an increase of circulating testosterone and growth rate in chicks. Hence, visual stimulation of the females can promote differential maternal allocation and favour offspring fitness. Our results further suggest that using artificial insemination for species conservation without appropriate stimulation of the breeding females probably has negative impacts on their breeding performance and therefore on population viability.

  10. Maternal health and survival in Pakistan: issues and options.

    Science.gov (United States)

    Khan, Yasir P; Bhutta, Shereen Z; Munim, Shama; Bhutta, Zulfiqar A

    2009-10-01

    Although its measurement may be difficult, the maternal mortality ratio (MMR) is a key indicator of maternal health globally. In Pakistan each year over five million women become pregnant, and of these 700,000 (15% of all pregnant women) are likely to experience some obstetrical and medical complications. An estimated 30,000 women die each year from pregnancy-related causes, and the most recent estimates indicate that the MMR is 276 per 100,000 births annually. In this review, we describe the status of maternal health and survival in Pakistan and place it in its wider context of key determinants. We draw attention to the economic and social vulnerability of pregnant women, and stress the importance of concomitant broader strategies, including poverty reduction and women's empowerment. Undernutrition for girls, early marriage, and high fertility rates coupled with unmet needs for contraception are important determinants of maternal ill health in Pakistan. Our review also examines factors influencing the under-utilization of maternal health services among Pakistani women, such as the lack of availability of skilled care providers and poor quality services. Notwithstanding these observations, there are evidence-based interventions available that, if implemented at scale, could make important contributions towards reducing the burden of maternal mortality in Pakistan.

  11. Adolescent mental health: Challenges with maternal noncompliance

    Directory of Open Access Journals (Sweden)

    Vicki A Nejtek

    2010-03-01

    Full Text Available Vicki A Nejtek, Sarah Hardy, Scott WinterUniversity of North Texas Health Science Center, Fort Worth, TX, USAAbstract: The leading cause of suicide ideation, attempts, and completion in adolescents is persistent and unresolved parental conflict. National statistics show extremely high rates of childhood neglect and abuse are perpetrated most often by single mothers. Psychiatric disorders arising from maternal–child dysfunction are well-documented. However, resources to prevent offspring victimization are lacking. Here, we report maternal neglect of a 15-year-old male brought to the psychiatric emergency room for suicidal ideation. An inpatient treatment plan including pharmacotherapy, family therapy and psychological testing was initiated. The patient’s mother failed to attend clinic appointments or family therapy sessions. Clinician attempts to engage the mother in the treatment plan was met with verbal assaults, aggression, and threatening behavior. The patient decompensated in relation to the mother’s actions. Child Protective Services were contacted and a follow-up assessment with the patient and mother is pending. Psychiatric treatment of the mother may be a necessary intervention and prevention regimen for both the adolescent and the mother. Without consistent Child Protective Services oversight, medical and psychosocial follow-up, the prognosis and quality of life for this adolescent is considered very poor. Stringent mental health law and institutional policies are needed to adequately intercede and protect adolescents with mental illness.Keywords: adolescent, suicide, maternal treatment noncompliance, maternal neglect

  12. Maternal health in Gujarat, India: a case study.

    Science.gov (United States)

    Mavalankar, Dileep V; Vora, Kranti S; Ramani, K V; Raman, Parvathy; Sharma, Bharati; Upadhyaya, Mudita

    2009-04-01

    Gujarat state of India has come a long way in improving the health indicators since independence, but progress in reducing maternal mortality has been slow and largely unmeasured or documented. This case study identified several challenges for reducing the maternal mortality ratio, including lack of the managerial capacity, shortage of skilled human resources, non-availability of blood in rural areas, and infrastructural and supply bottlenecks. The Gujarat Government has taken several initiatives to improve maternal health services, such as partnership with private obstetricians to provide delivery care to poor women, a relatively-short training of medical officers and nurses to provide emergency obstetric care (EmOC), and an improved emergency transport system. However, several challenges still remain. Recommendations are made for expanding the management capacity for maternal health, operationalization of health facilities, and ensuring EmOC on 24/7 (24 hours a day, seven days a week) basis by posting nurse-midwives and trained medical officers for skilled care, ensuring availability of blood, and improving the registration and auditing of all maternal deaths. However, all these interventions can only take place if there are substantially-increased political will and social awareness.

  13. Maternal cardiac metabolism in pregnancy

    Science.gov (United States)

    Liu, Laura X.; Arany, Zolt

    2014-01-01

    Pregnancy causes dramatic physiological changes in the expectant mother. The placenta, mostly foetal in origin, invades maternal uterine tissue early in pregnancy and unleashes a barrage of hormones and other factors. This foetal ‘invasion’ profoundly reprogrammes maternal physiology, affecting nearly every organ, including the heart and its metabolism. We briefly review here maternal systemic metabolic changes during pregnancy and cardiac metabolism in general. We then discuss changes in cardiac haemodynamic during pregnancy and review what is known about maternal cardiac metabolism during pregnancy. Lastly, we discuss cardiac diseases during pregnancy, including peripartum cardiomyopathy, and the potential contribution of aberrant cardiac metabolism to disease aetiology. PMID:24448314

  14. Pharmacotherapy for parents with attention-deficit hyperactivity disorder (ADHD): impact on maternal ADHD and parenting.

    Science.gov (United States)

    Chronis-Tuscano, Andrea; Stein, Mark A

    2012-09-01

    Given the high heritability of the disorder, attention-deficit hyperactivity disorder (ADHD) is common among parents of children with ADHD. Parental ADHD is associated with maladaptive parenting, negative parent-child interaction patterns and a diminished response to behavioural parent training. We describe our previous research demonstrating that stimulant medications for mothers with ADHD are associated with reductions in maternal ADHD symptoms. Although limited beneficial effects on self-reported parenting were also found in our study, the impact of ADHD medications on functional outcomes related to parenting and family interactions may not be sufficient for many families. Many questions remain with regard to how best to treat multiplex ADHD families in which a parent and child have ADHD. In particular, future studies are needed: (1) to evaluate how best to sequence pharmacotherapy, psychosocial treatment for adult ADHD and behavioural parenting interventions; (2) to determine the best approach to maintaining treatment effects over the long term for both parents and children; and (3) to identify individual predictors of treatment response.

  15. Embryo-maternal communication

    DEFF Research Database (Denmark)

    Østrup, Esben; Hyttel, Poul; Østrup, Olga

    2011-01-01

    Communication during early pregnancy is essential for successful reproduction. In this review we address the beginning of the communication between mother and developing embryo; including morphological and transcriptional changes in the endometrium as well as epigenetic regulation mechanisms dire...... directing the placentation. An increasing knowledge of the embryo-maternal communication might not only help to improve the fertility of our farm animals but also our understanding of human health and reproduction.......Communication during early pregnancy is essential for successful reproduction. In this review we address the beginning of the communication between mother and developing embryo; including morphological and transcriptional changes in the endometrium as well as epigenetic regulation mechanisms...

  16. Maternal obesity in Europe

    DEFF Research Database (Denmark)

    Devlieger, Roland; Benhalima, Katrien; Damm, Peter

    2016-01-01

    and offspring. These effects are often aggravated by the high incidence of abnormal glucose tolerance and excessive gestational weight gain found in this group. The main controversies around the management of the obese pregnant women are related to (1) the value of repeated weighing during pregnancy, (2......, the prevalence of maternal obesity varies from 7 to 25% and seems strongly related to social and educational inequalities. Obesity during pregnancy represents an important preventable risk factor for adverse pregnancy outcomes and is associated with negative long-term health outcomes for both mothers...

  17. Maternal ethanol ingestion: effect on maternal and neonatal glucose balance

    International Nuclear Information System (INIS)

    Witek-Janusek, L.

    1986-01-01

    Liver glycogen availability in the newborn is of major importance for the maintenance of postnatal blood glucose levels. This study examined the effect of maternal ethanol ingestion on maternal and neonatal glucose balance in the rate. Female rats were placed on 1) the Lieber-DeCarli liquid ethanol diet, 2) an isocaloric liquid pair-diet, or 3) an ad libitum rat chow diet at 3 wk before mating and throughout gestation. Blood and livers were obtained from dams and rat pups on gestational days 21 and 22. The pups were studied up to 6 h in the fasted state and up to 24 h in the fed state. Maternal ethanol ingestion significantly decreased litter size, birth weight, and growth. A significantly higher mortality during the early postnatal period was seen in the prenatal ethanol exposed pups. Ethanol significantly decreased fed maternal liver glycogen stores but not maternal plasma glucose levels. The newborn rats from ethanol ingesting dams also had significantly decreased liver glycogen stores. Despite mobilizing their available glycogen, these prenatal ethanol exposed pups became hypoglycemic by 6 h postnatal. This was more marked in the fasted pups. Ethanol did not affect maternal nor neonatal plasma insulin levels. Thus maternal ethanol ingestion reduces maternal and neonatal liver glycogen stores and leads to postnatal hypoglycemia in the newborn rat

  18. Maternal Depression, Maternal Expressed Emotion, and Youth Psychopathology

    Science.gov (United States)

    Tompson, Martha C.; Pierre, Claudette B.; Boger, Kathryn Dingman; McKowen, James W.; Chan, Priscilla T.; Freed, Rachel D.

    2010-01-01

    Across development, maternal depression has been found to be a risk factor for youth psychopathology generally and youth depression specifically. Maternal Expressed Emotion (EE) has been examined as a predictor of outcome among youth with depression. The present study explored the associations between youth psychopathology and two…

  19. The effects of maternal haemoglobin as an indicator of maternal ...

    African Journals Online (AJOL)

    EB

    relationship could exist between MMA of mother-infant pairs and maternal nutritional indicator (haemoglobin). Objectives: This study reviewed the effects of maternal haemoglobin (Hb) on MMA of mother-infant pairs at birth. Methods: One hundred and fifty three mother-infant pairs were enrolled in this study using the ...

  20. Brief Psychotherapy for Maternal Depression: Impact on Mothers and Children.

    Science.gov (United States)

    Swartz, Holly A; Cyranowski, Jill M; Cheng, Yu; Zuckoff, Allan; Brent, David A; Markowitz, John C; Martin, Stacy; Amole, Marlissa C; Ritchey, Fiona; Frank, Ellen

    2016-06-01

    Two-generation studies demonstrate that treating maternal depression benefits school-age children. Although mothers prefer psychotherapy to medication, little is known about how psychotherapy for maternal depression affects offspring, especially in very high-risk families in which both mothers and children concurrently meet syndromal criteria for psychiatric disorders. This trial evaluated the effects of 2 brief psychotherapies for maternal depression on very high-risk families. Mothers with major depressive disorder were randomly assigned to 9 sessions of either brief interpersonal psychotherapy for mothers (IPT-MOMS; n = 85) or brief supportive psychotherapy (BSP; n = 83). Independent assessors evaluated mothers and their children, ages 7 to 18 years, diagnosed with at least 1 internalizing disorder, every 3 months over the course of 1 year. Symptoms and functioning of mothers and children improved significantly over time, with no between-group differences. However, children of mothers assigned to BSP had more outpatient mental health visits and were more likely to receive antidepressant medication. Mothers reported greater satisfaction with IPT-MOMS than BSP. Improvement in mothers' depressive symptoms was associated with improvement in child functioning in time-lagged fashion, with children improving 3 to 6 months after mothers improved. Antidepressant medication use and number of mental health visits received by children did not affect outcomes. IPT-MOMS and BSP demonstrated comparable beneficial effects on maternal depression. Children's functioning improved following maternal improvement, independent of youths' treatment. Children of mothers randomized to IPT-MOMS, compared with BSP, achieved comparable outcomes despite less follow-up treatment. Observation of lagged association between maternal improvement and change in child functioning should influence treatment planning for families. Clinical trial registration information-Psychotherapy for Depressed

  1. Maternal Concern for Child Undereating.

    Science.gov (United States)

    Brown, Callie L; Pesch, Megan H; Perrin, Eliana M; Appugliese, Danielle P; Miller, Alison L; Rosenblum, Katherine; Lumeng, Julie C

    To describe features of maternal concern for her child undereating; examine maternal and child correlates of maternal concern for undereating; and determine whether maternal concern for undereating is associated with feeding practices. This was a cross-sectional analysis of an observational study with 286 mother-child dyads (mean child age, 71 months). Maternal concern for undereating was assessed using a semistructured interview. Mothers completed questionnaires to assess picky eating, food neophobia, and feeding practices. Feeding practices were further assessed using videotaped mealtime observations. Logistic regression was used to assess the association of maternal and child characteristics with maternal concern for undereating. Regression was used to assess the association of maternal concern for undereating with feeding practices, controlling for covariates. Over a third of mothers (36.5%) expressed concern that their child does not eat enough. Correlates of concern for undereating included child body mass index z-score (BMIz; odds ratio [OR] = 0.58; 95% confidence interval [CI], 0.43-0.77) and picky eating (OR = 2.41; 95% CI, 1.26-4.59). Maternal concern for undereating was associated with greater reported pressure to eat (relative risk [RR] = 1.97; 95% CI, 1.55-2.50), greater observed bribery (OR = 2.63; 95% CI, 1.50-4.60), and higher observed pressure (OR = 1.90; 95% CI, 1.08-3.36) during mealtimes. Mothers of children who are picky eaters and have a lower BMIz are more likely to be concerned that their children do not eat enough, and maternal concern for undereating is associated with pressuring and bribing children to eat. Pediatricians might address maternal concern for undereating by advising feeding practices that do not involve pressure and bribery, particularly among healthy weight children. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  2. Quality based social insurance coverage and payment of the application of a high cost medical therapy: the case of spinal cord stimulation for chronic non-oncologic pain in The Netherlands

    NARCIS (Netherlands)

    Beersen, Nicoline; Redekop, W. Ken; de Bruijn, J. H. Bart; Theuvenet, Peter J.; Berg, Marc; Klazinga, Niek S.

    2005-01-01

    This article describes a project in which a national continuous quality improvement system and a payment scheme were explicitly linked, while introducing an expensive treatment (Spinal Cord Stimulation (SCS)) in the social health insurance benefit package, in The Netherlands. By linking a national

  3. [Maternal deaths due to infectious cause, results from the French confidential enquiry into maternal deaths, 2010-2012].

    Science.gov (United States)

    Rigouzzo, A; Tessier, V; Zieleskiewicz, L

    2017-12-01

    Over the period 2010-2012, maternal mortality from infectious causes accounted for 5% of maternal deaths by direct causes and 16% of maternal deaths by indirect causes. Among the 22 deaths caused by infection occurred during this period, 6 deaths were attributed to direct causes from genital tract origin, confirming thus the decrease in direct maternal deaths by infection during the last ten years. On the contrary, indirect maternal deaths by infection, from extragenital origin, doubled during the same period, with 16 deaths in the last triennium, dominated by winter respiratory infections, particularly influenza: the 2009-2010 influenza A (H1N1) virus pandemic was the leading cause of indirect maternal mortality by infection during the studied period. The main infectious agents involved in maternal deaths from direct causes were Streptococcus A, Escherichia Coli and Clostridium perfringens: these bacterias were responsible for toxic shock syndrome, severe sepsis, secondary in some cases to cellulitis or necrotizing fasciitis. Of the 6 deaths due to direct infection, 4 were considered avoidable because of inadequate management: delayed or missed diagnosis, delayed or inadequate initiation of a specific medical and/or surgical treatment. Of the 16 indirect maternal deaths due to infection causes, the most often involved infectious agents were influenza A (H1N1) virus and Streptococcus pneumonia with induced purpura fulminans: the absence of influenza vaccination during pregnancy, delayed diagnosis and emergency initiation of a specific treatment, were the main contributory factors to these deaths and their avoidability in 70% of the cases analyzed. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  4. Effects of Stimulants on Height and Weight: A Review of the Literature

    Science.gov (United States)

    Faraone, Stephen V.; Biederman, Joseph; Morley, Christopher P.; Spencer, Thomas J.

    2008-01-01

    The article reviews existing literature on the effects of stimulant medications on the growth of children with attention-deficit/hyperactivity disorder. It concludes that treatment with stimulants in childhood results in moderate growth deficit in height and weight.

  5. Complete maternal and fetal recovery after prolonged cardiac arrest.

    Science.gov (United States)

    Selden, B S; Burke, T J

    1988-04-01

    A case of complete maternal and fetal recovery after prolonged cardiac arrest from massive lidocaine overdose is presented. A 27-year-old woman at 15 weeks gestation had a complete neurologic recovery after 22 minutes of CPR, including 19 minutes of electromechanical dissociation and asystole, with normal fetal heart function and fetal motion confirmed by ultrasound immediately after resuscitation. The patient delivered a healthy and neurologically normal infant at 40 weeks gestation. This is the longest cardiac arrest in early pregnancy reported in the medical literature with normal maternal and fetal outcome.

  6. Maternal depression predicts maternal use of corporal punishment in children with attention-deficit/hyperactivity disorder.

    Science.gov (United States)

    Shin, Dong-Won; Stein, Mark A

    2008-08-30

    We sought to determine if maternal depression contributed to the use of corporal punishment in children with attention-deficit/hyperactivity disorder (ADHD). The data were gathered through chart review of clinic-referred children with ADHD and their mothers who were evaluated at a psychiatric clinic located in a large academic medical center in Seoul, Korea. Daily records kept by parents and 13 items from the Physical Assault of the Parent-Child Conflict Tactics Scales (CTSPC) were used to assess corporal punishment. Ninety-one children with ADHD and their mothers were included in this study. Mothers who used corporal punishment showed significantly higher scores on the Beck Depression Inventory (t = -2.952, df = 89, p corporal punishment in ADHD children (Nagelkerke R2 = 0.102, p corporal punishment with children with ADHD. Assessment and management of the maternal depression should be an important focus of evaluation of children with ADHD.

  7. National level maternal health decisions

    NARCIS (Netherlands)

    Koduah, A.

    2016-01-01

    Maternal and neonatal deaths and morbidity still pose an enormous challenge for health authorities in Ghana, a lower middle income country. Despite massive investments in maternal and neonatal health and special attention through Millennium Development Goals (MDG) 4

  8. Maternal Involvement and Academic Achievement.

    Science.gov (United States)

    Lopez, Linda C.; Holmes, William M.

    The potential impact of several maternal involvement behaviors on teachers' ratings of children's academic skills was examined through statistical analyses. Data, based on mothers' responses to selected questions concerning maternal involvement and on teachers' ratings on the Classroom Behavior Inventory, were obtained for 115 kindergarten…

  9. Maternal Employment and Adolescent Development.

    Science.gov (United States)

    Montemayor, Raymond; Clayton, Mark D.

    1983-01-01

    The relationship between maternal employment and adolescent development is enormously complex, and no simple generalizations are possible. Many intervening variables alter the impact that maternal employment has on adolescent development. There is an urgent need to discover what impact this arrangement has on adolescent development. (CJ)

  10. Maternal scaffolding in a disadvantaged global context: The influence of working memory and cognitive capacities.

    Science.gov (United States)

    Obradović, Jelena; Portilla, Ximena A; Tirado-Strayer, Nicole; Siyal, Saima; Rasheed, Muneera A; Yousafzai, Aisha K

    2017-03-01

    The current study focuses on maternal cognitive capacities as determinants of parenting in a highly disadvantaged global context, where children's experiences at home are often the 1st and only opportunity for learning and intellectual growth. In a large sample of 1,291 biological mothers of preschool-aged children in rural Pakistan, we examined the unique association of maternal working memory skills (independent of related cognitive capacities) with cognitively stimulating parenting behaviors. Path analysis revealed that directly assessed working memory, short-term memory, and verbal intelligence independently predicted greater levels of observed maternal scaffolding behaviors. Mothers from poorer families demonstrated lower levels of working memory, short-term memory, and verbal intelligence. However, mothers' participation in an early childhood parenting intervention that ended 2 years prior to this study contributed to greater levels of working memory skills and verbal intelligence. Further, all 3 domains of maternal cognitive capacity mediated the effect of family economic resources on maternal scaffolding, and verbal intelligence also mediated the effect of early parenting intervention exposure on maternal scaffolding. The study demonstrates the unique relevance of maternal working memory for scaffolding behaviors that required continuously monitoring the child's engagement, providing assistance, and minimizing external distractions. These results highlight the importance of directly targeting maternal cognitive capacities in poor women with little or no formal education, using a 2-generation intervention approach that includes activities known to promote parental executive functioning and literacy. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  11. New dialogue for the way forward in maternal health: addressing market inefficiencies.

    Science.gov (United States)

    McCarthy, Katharine; Ramarao, Saumya; Taboada, Hannah

    2015-06-01

    Despite notable progress in Millennium Development Goal (MDG) five, to reduce maternal deaths three-quarters by 2015, deaths due to treatable conditions during pregnancy and childbirth continue to concentrate in the developing world. Expanding access to three effective and low-cost maternal health drugs can reduce preventable maternal deaths, if available to all women. However, current failures in markets for maternal health drugs limit access to lifesaving medicines among those most in need. In effort to stimulate renewed action planning in the post-MDG era, we present three case examples from other global health initiatives to illustrate how market shaping strategies can scale-up access to essential maternal health drugs. Such strategies include: sharing intelligence among suppliers and users to better approximate and address unmet need for maternal health drugs, introducing innovative financial strategies to catalyze otherwise unattractive markets for drug manufacturers, and employing market segmentation to create a viable and sustainable market. By building on lessons learned from other market shaping interventions and capitalizing on opportunities for renewed action planning and partnership, the maternal health field can utilize market dynamics to better ensure sustainable and equitable distribution of essential maternal health drugs to all women, including the most marginalized.

  12. Maternal Risk Factors for Neonatal Necrotizing Enterocolitis

    Science.gov (United States)

    March, Melissa I.; Gupta, Munish; Modest, Anna M.; Wu, Lily; Hacker, Michele R.; Martin, Camilia R.; Rana, Sarosh

    2015-01-01

    Objective This study aimed to investigate the relationship between maternal hypertensive disease and other risk factors and the neonatal development of necrotizing enterocolitis (NEC). Methods This was a retrospective case control study of infants with NEC from 2008 to 2012. The primary exposure of interest was maternal hypertensive disease, which has been hypothesized to put infants at risk for NEC. Other variables collected included demographics, pregnancy complications, medications, and neonatal hospital course. Data was abstracted from medical records. Results 28 cases of singleton neonates with NEC and 81 matched controls were identified and analyzed. There was no significant difference in the primary outcome. Fetuses with an antenatal diagnosis of growth restriction were more likely to develop NEC (p=0.008). Infants with NEC had lower median birth weight than infants without NEC (p=0.009). Infants with NEC had more late-onset sepsis (p=0.01) and mortality before discharge (p=0.001). Conclusions The factors identified by this case-control study that increased the risk of neonatal NEC included intrauterine growth restriction and lower neonatal birth weight. The primary exposure, hypertensive disease, did not show a significantly increased risk of neonatal NEC, however there was a nearly two-fold difference observed. Our study was underpowered to detect the observed difference. PMID:25162307

  13. Norwegian obstetricians' opinions about cesarean section on maternal request: should women pay themselves?

    Science.gov (United States)

    Fuglenes, Dorthe; Oian, Pål; Gyrd-Hansen, Dorte; Olsen, Jan Abel; Kristiansen, Ivar S

    2010-12-01

    to explore obstetricians' opinions on cesarean section (CS) on maternal request in the absence of a medical indication, and the potential to regulate CS on maternal request through financial incentives such as patient co-payment. cross-sectional study. Norway. a total of 507 obstetricians (response rate 71%). Questionnaire covering socio-demographic variables, professional experience and attitudes about CS on maternal request (such as willingness to perform, views on how CS on maternal request should be financed). obstetricians' opinions about CS on maternal request including funding and use of patient co-payments. clinical encounters with CS on maternal request were considered problematic from a clinical viewpoint by 62% of the respondents. While 35% considered the costs of CS on maternal request to be a public responsibility, 40% suggested use of co-payments ranging from €188- €7,500. Male obstetricians less frequently considered CS on maternal request problematic and were more likely to favor public funding than females. Female obstetricians favored use of co-payments more often than males (64% female vs. 37% male obstetricians, χ(2) = 23.94, p gender difference concerning obstetricians' responses to patient requested cesarean section. The results indicate that a substantial proportion of obstetricians welcome some form of constraint concerning cesarean section requests in the absence of a medical indication.

  14. Maternal iodine status and the thyroid function of pregnant mothers and their neonates in Jaffna District of Sri Lanka

    Directory of Open Access Journals (Sweden)

    Thirunavukkarasu Yoganathan

    2015-01-01

    Full Text Available Introduction: Iodine status of pregnant women and their newborns have not been studied in Jaffna District, Sri Lanka. This study was planned to assess the maternal iodine status and thyroid function at the third trimester of gestation and the thyrotrophin level of their neonate. Methods: Four hundred and seventy-seven pregnant women and their newborns were randomly selected among six Medical Officers of Health Divisions out of 12 in Jaffna District, Sri Lanka. Maternal thyroid stimulating hormone (TSH, free thyroxine (fT4, thyroglobulin (Tg, urinary iodine levels, and the neonatal thyrotrophin (nTSH level were assessed. Results: In this study, mean age, weight, height, and gestational age of the mothers were 28.95 (±5.46 years, 63.02 (±11.56 kg, 154.39 (±6.00 cm, and 39.33 (±1.37 weeks, respectively. Maternal median urinary iodine concentration (UIC was 140.0 μg/L (inter-quartile range 126.0–268.0 μg/L. Median values of the maternal serum TSH, fT4,and Tg were 1.9 mIU/L, 12.6 pmol/L, and 21.4 IU/L, respectively. Among the 477 newborns, 50.5% (n = 239 were males. Mean birth weight of newborn was 3.03 (±0.43 kg, while the mean length was 51.1 (±2.1 cm. Among the newborns, 18% (n = 86 had nTSH level > mIU/L and 37.7% (n = 180 within TSH level > mIU/L. nTSH level had positive but very weak correlations with maternal thyroid parameters, that is, UIC (r = 0.06, P = 0.13, fT4 (r = 0.01, P = 0.05, TSH (r = 0.09, P = 0.05, and Tg (r = 0.12, P = 0.03. Conclusion: On the basis of the World Health Organization criteria, the iodine status of pregnant women was inadequate in this region and also nTSH levels indicate moderate iodine deficiency during pregnancy. Therefore, the continuous education on adequate iodine intake during pregnancy and monitoring of iodine status are useful.

  15. The tripartite immune conflict in placentals and a hypothesis on fetal-->maternal microchimerism.

    Science.gov (United States)

    Apari, Péter; Rózsa, Lajos

    2009-01-01

    There is a two-way traffic of immune cells through the placenta; and fetal immune cells are often present in the maternal body even long after giving birth. We present an adaptationist theory to interpret fetal-->maternal microchimerism and the diverse set of concomitant medical phenomena. We handle fetal, maternal, and paternal adaptive interests separately and in interaction with one another. Fetuses may benefit from immunological information gathered by migrant cells in the maternal body, and also from improved maternal defence. However, they may be jeopardized by a selfish maternal usage of fetal-->maternal microchimerism - i.e., some mothers get pregnant only to improve their immune system and then to abort. The use of microchimeric cells by the maternal immune system may contribute to the adaptive benefits of female choosiness and polyandry. While fathers may enjoy an indirect benefit from enhanced fetal and maternal health, they also face the risk of wasting sexual efforts due to selfish pregnancies of cheating females. Paternal alleles acting via clones of microchimeric cells in the maternal body could launch an immunological attack against the non-kin sperm in the female genitalia, or against the non-kin fetus in the womb. Furthermore, an intraspecific version of Zahavi's Mafia Hypothesis could explain a potential interaction between the abortion of fetuses and a subsequent rise of an autoimmune disease. We suggest that males may be capable to provoke microchimerism-induced autoimmune-like diseases in the mother in revenge of selfish pregnancies. This hypothetic paternal threat could increase the maternal costs associated to selfish pregnancies. From a medical point of view, we propose new interpretations for autoimmune-like diseases, infertility, miscarriage, and also for the prevailing connections among them. Specifically, we argue that miscarriages may cause autoimmune diseases, a reversed causality as compared to the currently accepted one.

  16. Economic consequences of maternal illness in rural Bangladesh.

    Science.gov (United States)

    Powell-Jackson, Timothy; Hoque, Mohammad Enamul

    2012-07-01

    We use panel data on household consumption combined with information taken from the medical records of women who gave birth in health facilities to explore the economic consequences of maternal ill health, in the context of a rural population in Bangladesh. The findings suggest that there is a large reduction in household resources associated with maternal illness, driven almost entirely by spending on health care. In spite of this loss of resources, we find that households are able to fully insure consumption against maternal ill health, although confidence intervals are unable to rule out a small effect. Households in our study area are shown to have good access to informal credit (whether it be from local money lenders or family relatives), and this appears critical in helping to smooth consumption in response to these health shocks, at least in the short term. Copyright © 2011 John Wiley & Sons, Ltd.

  17. Unsafe abortion: a tragic saga of maternal suffering.

    Science.gov (United States)

    Regmi, M C; Rijal, P; Subedi, S S; Uprety, D; Budathoki, B; Agrawal, A

    2010-01-01

    Unsafe abortion is a significant cause of maternal morbidity and mortality in developing countries despite provision of adequate care and legalization of abortion. The aim of this study was to find out the contribution of unsafe abortion in maternal mortality and its other consequences. A retrospective study was carried out in the Department of Obstetrics and Gynecology in BPKIHS between 2005 April to 2008 September analyzing all the unsafe abortion related admissions. There were 70 unsafe abortion patients. Majority of them (52.8%) were of high grade. Most of them recovered but there were total 8 maternal deaths. Unsafe abortion is still a significant medical and social problem even in post legalization era of this country.

  18. Maternal employment, breastfeeding, and health: evidence from maternity leave mandates.

    Science.gov (United States)

    Baker, Michael; Milligan, Kevin

    2008-07-01

    Public health agencies around the world have renewed efforts to increase the incidence and duration of breastfeeding. Maternity leave mandates present an economic policy that could help achieve these goals. We study their efficacy, focusing on a significant increase in maternity leave mandates in Canada. We find very large increases in mothers' time away from work post-birth and in the attainment of critical breastfeeding duration thresholds. We also look for impacts of the reform on self-reported indicators of maternal and child health captured in our data. For most indicators we find no effect.

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

    Science.gov (United States)

    Ibanez, Gladys; Bernard, Jonathan Y.; Rondet, Claire; Peyre, Hugo; Forhan, Anne; Kaminski, Monique; Saurel-Cubizolles, Marie-Josèphe

    2015-01-01

    Introduction Studies have shown that depression or anxiety occur in 10–20% of pregnant women. These disorders are often undertreated and may affect mothers and children’s health. This study investigates the relation between antenatal maternal depression, anxiety and children’s early cognitive development among 1380 two-year-old children and 1227 three-year-old children. Methods In the French EDEN Mother-Child Cohort Study, language ability was assessed with the Communicative Development Inventory at 2 years of age and overall development with the Ages and Stages Questionnaire at 3 years of age. Multiple regressions and structural equation modeling were used to examine links between depression, anxiety during pregnancy and child cognitive development. Results We found strong significant associations between maternal antenatal anxiety and poorer children’s cognitive development at 2 and 3 years. Antenatal maternal depression was not associated with child development, except when antenatal maternal anxiety was also present. Both postnatal maternal depression and parental stimulation appeared to play mediating roles in the relation between antenatal maternal anxiety and children’s cognitive development. At 3 years, parental stimulation mediated 13.2% of the effect of antenatal maternal anxiety while postnatal maternal depression mediated 26.5%. Discussion The partial nature of these effects suggests that other mediators may play a role. Implications for theory and research on child development are discussed. PMID:26317609

  20. Labor stimulation with oxytocin: effects on obstetrical and neonatal outcomes

    Directory of Open Access Journals (Sweden)

    Pedro Hidalgo-Lopezosa

    Full Text Available Abstract Objective: to evaluate the effects of labor stimulation with oxytocin on maternal and neonatal outcomes. Method: descriptive and analytical study with 338 women who gave birth at a tertiary hospital. Obstetric and neonatal variables were measured and compared in women submitted and non-submitted to stimulation with oxytocin. Statistics were performed using Chi-square test, Fisher exact test, Student t-test; and crude Odds Ratio with 95% confidence interval were calculated. A p < 0.05 was considered statistically significant. Results: stimulation with oxytocin increases the rates of cesarean sections, epidural anesthesia and intrapartum maternal fever in primiparous and multiparous women. It has also been associated with low pH values of umbilical cord blood and with a shorter duration of the first stage of labor in primiparous women. However, it did not affect the rates of 3rd and 4th degree perineal lacerations, episiotomies, advanced neonatal resuscitation, 5-minute Apgar scores and meconium. Conclusion: stimulation with oxytocin should not be used systematically, but only in specific cases. These findings provide further evidence to health professionals and midwives on the use of oxytocin during labor. Under normal conditions, women should be informed of the possible effects of labor stimulation with oxytocin.

  1. Fortification of maternal milk

    Directory of Open Access Journals (Sweden)

    Cecilia Di Natale

    2013-06-01

    Full Text Available The beneficial effects of human milk (HM, well recognized for the term infant, extend to the feeding of premature infants, because their nutrition support must be designed to compensate for metabolic and gastrointestinal immaturity, immunologic compromise, and maternal psycosocial conditions. Studies show that preterm milk contains higher protein levels and more fat than term human milk. The American Academy of Pediatrics recommended that preterm neonates should receive sufficient nutrients to enable them to grow at a rate similar to that of fetuses of the same gestational age. There are no doubts about the fact that maternal milk is the best food for all neonates, but unfortified human breast milk may not meet the recommended nutritional needs of growing preterm infants. Human milk must therefore be supplemented (fortified with the nutrients in short supply. The objective of fortification is to increase the concentration of nutrients to such levels that at the customary feeding volumes infants receive amounts of all nutrients that meet the requirements. The are two different forms of fortification of human milk: standard and individualized. The new concepts and recommendations for optimization of human milk fortification is the “individualized fortification”. Actually, two methods have been proposed for individualization: the “targeted/tailored fortification” and the “adjustable fortification”. In summary, the use of fortified human milk produces adequate growth in premature infants and satisfies the specific nutritional requirements of these infants. The use of individualized fortification is recommended. Proceedings of the 9th International Workshop on Neonatology · Cagliari (Italy · October 23rd-26th, 2013 · Learned lessons, changing practice and cutting-edge research

  2. Association of postpartum maternal morbidities with children's mental, psychomotor and language development in rural Bangladesh.

    Science.gov (United States)

    Hamadani, J D; Tofail, F; Hilaly, A; Mehrin, F; Shiraji, S; Banu, S; Huda, S N

    2012-06-01

    Little is known from developing countries about the effects of maternal morbidities diagnosed in the postpartum period on children's development. The study aimed to document the relationships of such morbidities with care-giving practices by mothers, children's developmental milestones and their language, mental and psychomotor development. Maternal morbidities were identified through physical examination at 6-9 weeks postpartum (n=488). Maternal care-giving practices and postnatal depression were assessed also at 6-9 weeks postpartum. Children's milestones of development were measured at six months, and their mental (MDI) and psychomotor (PDI) development, language comprehension and expression, and quality of psychosocial stimulation at home were assessed at 12 months. Several approaches were used for identifying the relationships among different maternal morbidities, diagnosed by physicians, with children's development. After controlling for the potential confounders, maternal anaemia diagnosed postpartum showed a small but significantly negative effect on children's language expression while the effects on language comprehension did not reach the significance level (p=0.085). Children's development at 12 months was related to psychosocial stimulation at home, nutritional status, education of parents, socioeconomic status, and care-giving practices of mothers at six weeks of age. Only a few mothers experienced each specific morbidity, and with the exception of anaemia, the sample-size was insufficient to make a conclusion regarding each specific morbidity. Further research with a sufficient sample-size of individual morbidities is required to determine the association of postpartum maternal morbidities with children's development.

  3. Neuroendocrine Regulation of Maternal Behavior

    Science.gov (United States)

    Bridges, Robert S.

    2015-01-01

    The expression of maternal behavior in mammals is regulated by the developmental and experiential events over a female’s lifetime. In this review the relationships between the endocrine and neural systems that play key roles in these developmental and experiential that affect both the establishment and maintenance of maternal care are presented. The involvement of the hormones estrogen, progesterone, and lactogens are discussed in the context of ligand, receptor, and gene activity in rodents and to a lesser extent in higher mammals. The roles of neuroendocrine factors, including oxytocin, vasopressin, classical neurotransmitters, and other neural gene products that regulate aspects of maternal care are set forth, and the interactions of hormones with central nervous system mediators of maternal behavior are discussed. The impact of prior developmental factors, including epigenetic events, and maternal experience on subsequent maternal care are assessed over the course of the female’s lifespan. It is proposed that common neuroendocrine mechanisms underlie the regulation of maternal care in mammals. PMID:25500107

  4. Performance Enhancement by Brain Stimulation

    Directory of Open Access Journals (Sweden)

    Parisa Gazerani

    2017-09-01

    et al., 2017 has summarized that overall brain stimulation by some techniques including TMS and tDCS seem to speed up motor learning, and motor skills in sport activities. Considering that performance enhancement can be seen (Colzato et al., 2017, one would ask how and by which mechanism. Davis proposed that there would be two ways that brain stimulation could possibly improve sport performance (Davis, 2013. One way is to benefit from brain stimulation before performance to, for instance, reduce stress level or muscle tension or to enhance focus for a quicker action. The other way would be potential use during training for athletic performance that can eventually help athletes to learn motor skills better. Presented research results are mainly based on the experimental set up; therefore, it is important to identify whether physical and mental performance gains under experimental conditions would also be meaningful in a real world competition. To study actual gain by brain stimulation, future investigations must properly be designed, include placebo and control arms, remain blinded until after data analysis, and include objective assessments in addition to subjective outcomes. Time-course of beneficial effect in certain sport competition is not clear. It has been shown that repetitive applications of tDCS can increase the effects of stimulation (Nitsche and Paulus, 2011; but, it is not clear if this is the case for athletic performance. There is no evidence on side effects especially for long term use of these techniques. Overall, these techniques are considered non-invasive and safe (Rossi et al., 2009. Under medical application, it has been notified that some individuals are highly responders while others do not respond well. This might be the case for athletes. Additive or synergistic effects of these techniques together with other techniques or methods of performance enhancement have not yet been investigated either. Therefore, further studies are required to

  5. Maternal mortality in India: current status and strategies for reduction.

    Science.gov (United States)

    Prakash, A; Swain, S; Seth, A

    1991-12-01

    The causes (medical, reproductive factors, health care delivery system, and socioeconomic factors) of maternal mortality in India and strategies for reducing maternal mortality are presented. Maternal mortality rates (MMR) are very high in Asia and Africa compared with Northern Europe's 4/100,000 live births. An Indian hospital study found the MMR to be 4.21/1000 live births. 50-98% of maternal deaths are caused by direct obstetric causes (hemorrhage, infection, and hypertensive disorders, ruptured uterus, hepatitis, and anemia). 50% of maternal deaths due to sepsis are related to illegal induced abortion. MMR in India has not declined significantly in the past 15 years. Age, primi and grande multiparity, unplanned pregnancy, and related illegal abortion are the reproductive causes. In 1985 WHO reported that 63-80% of maternal deaths due to direct obstetric causes and 88-98% of all maternal deaths could probably have been prevented with proper handling. In India, coordination between levels in the delivery system and fragmentation of care account for the poor quality of maternal health care. Mass illiteracy is another cause. Effective strategies for reducing the MMR are 1) to place a high priority on maternal and child health (MCH) services and integrate vertical programs (e.g., family planning) related to MCH; 2) to give attention to care during labor and delivery, which is the most critical period for complications; 3) to provide community-based delivery huts which can provide a clean and safe delivery place close to home, and maternity waiting rooms in hospitals for high risk mothers; 4) to improve the quality of MCH care at the rural community level (proper history taking, palpation, blood pressure and fetal heart screening, risk factor screening, and referral); 5) to improve quality of care at the primary health care level (emergency care and proper referral); 6) to include in the postpartum program MCH and family planning services; 7) to examine the

  6. Are Prescription Stimulants "Smart Pills"? The Epidemiology and Cognitive Neuroscience of Prescription Stimulant Use by Normal Healthy Individuals

    Science.gov (United States)

    Smith, M. Elizabeth; Farah, Martha J.

    2011-01-01

    Use of prescription stimulants by normal healthy individuals to enhance cognition is said to be on the rise. Who is using these medications for cognitive enhancement, and how prevalent is this practice? Do prescription stimulants in fact enhance cognition for normal healthy people? We review the epidemiological and cognitive neuroscience…

  7. [Transcranial magnetic stimulation].

    Science.gov (United States)

    Tormos, J M; Catalá, M D; Pascual-Leone, A

    Transcranial magnetic stimulation (TMS) permits stimulation of the cerebral cortex in humans without requiring open access to the brain and is one of the newest tools available in neuroscience. There are two main types of application: single-pulse TMS and repetitive TMS. The magnetic stimulator is composed of a series of capacitors that store the voltage necessary to generate a stimulus of the sufficient intensity of generate an electric field in the stimulation coil. The safety of TMS is supported by the considerable experience derived from studies involving electrical stimulation of the cortex in animals and humans, and also specific studies on the safety of TMS in humans. In this article we review historical and technical aspects of TMS, describe its adverse effects and how to avoid them, summarize the applications of TMS in the investigation of different cerebral functions, and discuss the possibility of using TMS for the treatment of neuropsychiatric disorders.

  8. Placental morphology at different maternal hemoglobin levels: a histopathological study

    International Nuclear Information System (INIS)

    Kiran, N.; Zubair, A.; Malik, T.M.

    2015-01-01

    To evaluate the histopathological parameters of the placenta like weight, infarct and syncytial knots, at different maternal hemoglobin levels, in both qualitative and quantitative manner. Study design: Descriptive study Place and Duration of Study: Army Medical College, National University of Sciences and Technology in collaboration with Department of Obstetrics and Gynecology, Military Hospital, Rawalpindi, Pakistan, from December 2011 to November 2012. Patients and Methods: A total of 75 placentas were included, that were collected from full term mothers at the time of childbirth. Placental weight was taken without umbilical cord and gross placental infarcts were noted. Samples of placental tissue were taken and stained by haematoxylin and eosin (H and E). Microscopic study was done to evaluate placental infarcts and syncytial knots. Results: Mean placental weight at normal and low maternal hemoglobin was 581.67 ± 83.97g and 482.58 ± 104.74g respectively. Gross placental infarcts were found in all cases having low maternal hemoglobin concentration (60% cases). Syncytial knots were found in all placentas but they were considerably more at decreasing levels of maternal hemoglobin (19.79 ± 5.22). Conclusion: The present study showed decrease in placental weight, increase in placental infarcts and syncytial knot hyperplasia at low maternal hemoglobin concentration, displaying adaptive alterations. (author)

  9. Prenatal Maternal Smoking and Tourette Syndrome: A Nationwide Register Study.

    Science.gov (United States)

    Leivonen, Susanna; Chudal, Roshan; Joelsson, Petteri; Ekblad, Mikael; Suominen, Auli; Brown, Alan S; Gissler, Mika; Voutilainen, Arja; Sourander, Andre

    2016-02-01

    This is the first nationwide register-based study to examine the relationship between prenatal maternal smoking and Tourette syndrome. A total of 767 children diagnosed with Tourette syndrome were identified from the Finnish Hospital Discharge Register. Each case was matched to four controls. Information on maternal smoking during pregnancy was obtained from the Finnish Medical Birth Register. Conditional logistic regression models were used for statistical analyses. Prenatal maternal smoking was associated with Tourette syndrome when comorbid with ADHD (OR 4.0, 95 % CI 1.2-13.5, p = 0.027 for exposure during first trimester, OR 1.7, 95 % CI, 1.05-2.7, p = 0.031 for exposure for the whole pregnancy). There was no association between maternal smoking during pregnancy and Tourette syndrome without comorbid ADHD (OR 0.5, 95 % CI 0.2-1.3, p = 0.166, OR 0.9, 95 % CI 0.7-1.3, p = 0.567). Further research is needed to elucidate the mechanisms behind the association between prenatal maternal smoking and Tourette syndrome with comorbid ADHD.

  10. PPO.02 Severe maternal morbidity in Ireland

    NARCIS (Netherlands)

    Manning, E.; Lutomski, J.E.; O'Connor, L.; Corcoran, P.; Greene, R.

    2014-01-01

    OBJECTIVE: To assess the incidence of severe maternal morbidity (SMM) and examine associated factors in Ireland. METHODS: In 2011, 67,806 maternities were reported from 19 maternity units, representing 93% of maternities in Ireland. SMM was classified as the presence of one or more of 15 categories

  11. Regional differences in Dutch maternal mortality

    NARCIS (Netherlands)

    de Graaf, J.P.; Schutte, J.M.; Poeran, J.J.; van Roosmalen, J.; Bonsel, G.J.; Steegers, E.A.P.

    2012-01-01

    Objective To study regional differences in maternal mortality in the Netherlands. Design Confidential inquiry into the causes of maternal mortality. Setting Nationwide. Population A total of 3 108 235 live births and 337 maternal deaths. Methods Data analysis of all maternal deaths in the period

  12. Rise in maternal mortality in the Netherlands

    NARCIS (Netherlands)

    Schutte, J. M.; Steegers, E. A. P.; Schuitemaker, N. W. E.; Santema, J. G.; de Boer, K.; Pel, M.; Vermeulen, G.; Visser, W.; van Roosmalen, J.

    2010-01-01

    To assess causes, trends and substandard care factors in maternal mortality in the Netherlands. Design Confidential enquiry into the causes of maternal mortality. Nationwide in the Netherlands. 2,557,208 live births. Data analysis of all maternal deaths in the period 1993-2005. Maternal mortality.

  13. Obstetric transition in the World Health Organization Multicountry Survey on Maternal and Newborn Health: exploring pathways for maternal mortality reduction

    Directory of Open Access Journals (Sweden)

    Solange da Cruz Chaves

    2015-05-01

    Full Text Available OBJECTIVE: To test whether the proposed features of the Obstetric Transition Model-a theoretical framework that may explain gradual changes that countries experience as they eliminate avoidable maternal mortality-are observed in a large, multicountry, maternal and perinatal health database; and to discuss the dynamic process of maternal mortality reduction using this model as a theoretical framework. METHODS: This was a secondary analysis of a cross-sectional study by the World Health Organization that collected information on more than 300 000 women who delivered in 359 health facilities in 29 countries in Africa, Asia, Latin America, and the Middle East, during a 2-4-month period in 2010-2011. The ratios of Potentially Life-Threatening Conditions, Severe Maternal Outcomes, Maternal Near Miss, and Maternal Death were estimated and stratified by stages of obstetric transition. The characteristics of each stage are defined. RESULTS: Data from 314 623 women showed that female fertility, indirectly estimated by parity, was higher in countries at a lower obstetric transition stage, ranging from a mean of 3 children in Stage II to 1.8 children in Stage IV. Medicalization increased with obstetric transition stage. In Stage IV, women had 2.4 times the cesarean deliveries (15.3% in Stage II and 36.7% in Stage IV and 2.6 times the labor inductions (7.1% in Stage II and 18.8% in Stage IV as women in Stage II. The mean age of primiparous women also increased with stage. The occurrence of uterine rupture had a decreasing trend, dropping by 5.2 times, from 178 to 34 cases per 100 000 live births, as a country transitioned from Stage II to IV. CONCLUSIONS: This analysis supports the concept of obstetric transition using multicountry data. The Obstetric Transition Model could provide justification for customizing strategies for reducing maternal mortality according to a country's stage in the obstetric transition.

  14. Regulatory T cells, maternal-foetal immune tolerance and recurrent miscarriage: new therapeutic challenging opportunities.

    Science.gov (United States)

    Alijotas-Reig, Jaume; Melnychuk, Taisiia; Gris, Josep Maria

    2015-03-15

    Because maternal alloreactive lymphocytes are not depleted during pregnancy, local and/or systemic mechanisms have to play a key role in altering the maternal immune response. Peripheral T regulatory cells (pTregs) at the maternal-foetal interface are necessary in situ to prevent early abortion, but only those pTregs that have been previously exposed to paternal alloantigens. It has been showed that pregnancy selectively stimulates the accumulation of maternal Foxp3(+)CD4(+)CD25(+) (Foxp3Tregs) cells with foetal specificity. Interestingly, after delivery, foetal-specific pTregs persist at elevated levels, maintain tolerance to pre-existing foetal antigen, and rapidly re-accumulate during subsequent pregnancy. pTreg up-regulation could be hypothesized as a possible future therapeutic strategy in humans. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  15. Music acupuncture stimulation method.

    Science.gov (United States)

    Brătilă, F; Moldovan, C

    2007-01-01

    Harmonic Medicine is the model using the theory that the body rhythms synchronize to an outer rhythm applied for therapeutic purpose, can restores the energy balance in acupuncture channels and organs and the condition of well-being. The purpose of this scientific work was to demonstrate the role played by harmonic sounds in the stimulation of the Lung (LU) Meridian (Shoutaiyin Feijing) and of the Kidney (KI) Meridian (Zushaoyin Shenjing). It was used an original method that included: measurement and electronic sound stimulation of the Meridian Entry Point, measurement of Meridian Exit Point, computer data processing, bio feed-back adjustment of the music stimulation parameters. After data processing, it was found that the sound stimulation of the Lung Meridian Frequency is optimal between 122 Hz and 128 Hz, with an average of 124 Hz (87% of the subjects) and for Kidney Meridian from 118 Hz to 121 Hz, with an average of 120 Hz (67% of the subjects). The acupuncture stimulation was more intense for female subjects (> 7%) than for the male ones. We preliminarily consider that an informational resonance phenomenon can be developed between the acupuncture music stimulation frequency and the cellular dipole frequency, being a really "resonant frequency signature" of an acupoint. The harmonic generation and the electronic excitation or low-excitation status of an acupuncture point may be considered as a resonance mechanism. By this kind of acupunctural stimulation, a symphony may act and play a healer role.

  16. Effects of Maternal Behavior Induction and Pup Exposure on Neurogenesis in Adult, Virgin Female Rats

    Science.gov (United States)

    Furuta, Miyako; Bridges, Robert S.

    2009-01-01

    The states of pregnancy and lactation bring about a range of physiological and behavioral changes in the adult mammal that prepare the mother to care for her young. Cell proliferation increases in the subventricular zone (SVZ) of the female rodent brain during both pregnancy and lactation when compared to that in cycling, diestrous females. In the present study, the effects of maternal behavior induction and pup exposure on neurogenesis in nulliparous rats were examined in order to determine whether maternal behavior itself, independent of pregnancy and lactation, might affect neurogenesis. Adult, nulliparous, Sprague-Dawley, female rats were exposed daily to foster young in order to induce maternal behavior. Following the induction of maternal behavior each maternal subject plus females that were exposed to pups for a comparable number of test days, but did not display maternal behavior, and subjects that had received no pup exposure were injected with bromodeoxyuridine (BrdU, 90 mg/kg, i.v.). Brain sections were double-labeled for BrdU and the neural marker, NeuN, to examine the proliferating cell population. Increases in the number of double-labeled cells were found in the maternal virgin brain when compared with the number of double-labeled cells present in non-maternal, pup-exposed nulliparous rats and in females not exposed to young. No changes were evident in the dentate gyrus of the hippocampus as a function of maternal behavior. These data indicate that in nulliparous female rats maternal behavior itself is associated with the stimulation of neurogenesis in the SVZ. PMID:19712726

  17. Hepatitis E and Maternal Deaths

    Centers for Disease Control (CDC) Podcasts

    Dr. Alain Labrique, assistant professor in the Department of International Health and Department of Epidemiology at the Bloomberg School of Public Health, gives us his perspective on hepatitis E and maternal deaths.

  18. Maternal Employment and Childhood Obesity

    DEFF Research Database (Denmark)

    Gwozdz, Wencke; Sousa-Poza, Alfonso; Reisch, Lucia

    2013-01-01

    The substantial increase in female employment rates in Europe over the past two decades has often been linked in political and public rhetoric to negative effects on child development, including obesity. We analyse this association between maternal employment and childhood obesity using rich...... on obesity's main drivers: calorie intake and physical activity. Our analysis provides little evidence for any association between maternal employment and childhood obesity, diet or physical activity....

  19. Maternal Employment and Childhood Obesity

    DEFF Research Database (Denmark)

    Gwozdz, Wencke; Sousa-Poza, Alfonso; Reisch, Lucia

    The substantial increase in female employment rates in Europe over the past two decades has often been linked in political and public rhetoric to negative effects on child development, including obesity. We analyse this association between maternal employment and childhood obesity using rich...... on obesity's main drivers: calorie intake and physical activity. Our analysis provides little evidence for any association between maternal employment and childhood obesity, diet or physical activity....

  20. Maternal complications and perinatal mortality: findings of the World Health Organization Multicountry Survey on Maternal and Newborn Health.

    Science.gov (United States)

    Vogel, J P; Souza, J P; Mori, R; Morisaki, N; Lumbiganon, P; Laopaiboon, M; Ortiz-Panozo, E; Hernandez, B; Pérez-Cuevas, R; Roy, M; Mittal, S; Cecatti, J G; Tunçalp, Ö; Gülmezoglu, A M

    2014-03-01

    We aimed to determine the prevalence and risks of late fetal deaths (LFDs) and early neonatal deaths (ENDs) in women with medical and obstetric complications. Secondary analysis of the WHO Multicountry Survey on Maternal and Newborn Health (WHOMCS). A total of 359 participating facilities in 29 countries. A total of 308 392 singleton deliveries. We reported on perinatal indicators and determined risks of perinatal death in the presence of severe maternal complications (haemorrhagic, infectious, and hypertensive disorders, and other medical conditions). Fresh and macerated LFDs (defined as stillbirths ≥ 1000 g and/or ≥28 weeks of gestation) and ENDs. The LFD rate was 17.7 per 1000 births; 64.8% were fresh stillbirths. The END rate was 8.4 per 1000 liveborns; 67.1% occurred by day 3 of life. Maternal complications were present in 22.9, 27.7, and 21.2% [corrected] of macerated LFDs, fresh LFDs, and ENDs, respectively. The risks of all three perinatal mortality outcomes were significantly increased with placental abruption, ruptured uterus, systemic infections/sepsis, pre-eclampsia, eclampsia, and severe anaemia. Preventing intrapartum-related perinatal deaths requires a comprehensive approach to quality intrapartum care, beyond the provision of caesarean section. Early identification and management of women with complications could improve maternal and perinatal outcomes. © 2014 RCOG The World Health Organization retains copyright and all other rights in the manuscript of this article as submitted for publication.

  1. Spinal cord stimulation for neuropathic pain: current perspectives.

    Science.gov (United States)

    Wolter, Tilman

    2014-01-01

    Neuropathic pain constitutes a significant portion of chronic pain. Patients with neuropathic pain are usually more heavily burdened than patients with nociceptive pain. They suffer more often from insomnia, anxiety, and depression. Moreover, analgesic medication often has an insufficient effect on neuropathic pain. Spinal cord stimulation constitutes a therapy alternative that, to date, remains underused. In the last 10 to 15 years, it has undergone constant technical advancement. This review gives an overview of the present practice of spinal cord stimulation for chronic neuropathic pain and current developments such as high-frequency stimulation and peripheral nerve field stimulation.

  2. Review: Fetal-maternal communication via extracellular vesicles - Implications for complications of pregnancies.

    Science.gov (United States)

    Adam, Stefanie; Elfeky, Omar; Kinhal, Vyjayanthi; Dutta, Suchismita; Lai, Andrew; Jayabalan, Nanthini; Nuzhat, Zarin; Palma, Carlos; Rice, Gregory E; Salomon, Carlos

    2017-06-01

    The maternal physiology experiences numerous changes during pregnancy which are essential in controlling and maintaining maternal metabolic adaptations and fetal development. The human placenta is an organ that serves as the primary interface between the maternal and fetal circulation, thereby supplying the fetus with nutrients, blood and oxygen through the umbilical cord. During gestation, the placenta continuously releases several molecules into maternal circulation, including hormones, proteins, RNA and DNA. Interestingly, the presence of extracellular vesicles (EVs) of placental origin has been identified in maternal circulation across gestation. EVs can be categorised according to their size and/or origin into microvesicles (∼150-1000 nm) and exosomes (∼40-120 nm). Microvesicles are released by budding from the plasmatic membrane, whereas exosome release is by fusion of multivesicular bodies with the plasmatic membrane. Exosomes released from placental cells have been found to be regulated by oxygen tension and glucose concentration. Furthermore, maternal exosomes have the ability to stimulate cytokine release from endothelial cells. In this review, we will discuss the role of EVs during fetal-maternal communication during gestation with a special emphasis on exosomes. Copyright © 2016. Published by Elsevier Ltd.

  3. Paradoxes of maternal mourning.

    Science.gov (United States)

    Brice, C W

    1991-02-01

    It has been customary to conceptualize mourning as a phasic or stage phenomenon (Lindemann 1944; Parkes 1972; Bowlby 1980; Knapp 1986). Such a conceptualization has proved to be of tremendous didactic value, especially in terms of succinctly organizing and communicating the major affects, behaviors, and reactions of mourning. It is, however, my belief, based upon clinical experience with many forms of bereavement, that the phenomenon of mourning is not comprised of clearly delineated stages and phases. I have come to conceptualize the phenomenon of mourning the death of a loved person as involving the bereaved's struggle with a series of more or less unresolvable paradoxes rather than as a progression through stages that possess relatively distinct and predictable beginning and ending points. The specific paradoxes encountered by a bereaved person differ, of course, in accordance with the relationship that was lost (mother, father, spouse, child, or sibling), the developmental stage of the bereaved (childhood, adolescence, adulthood, or maturity), the type of death (sudden or prolonged), and the cause of death (illness, murder, suicide, or accident). In this paper, I will address those paradoxes that seem specific to maternal mourning - that is, to mothers who are mourning the death of a child.

  4. Concordance between maternal recall of birth complications and data from obstetrical records.

    Science.gov (United States)

    Keenan, Kate; Hipwell, Alison; McAloon, Rose; Hoffmann, Amy; Mohanty, Arpita; Magee, Kelsey

    2017-02-01

    Prenatal complications are associated with poor outcomes in the offspring. Access to medical records is limited in the United States and investigators often rely on maternal report of prenatal complications. We tested concordance between maternal recall and birth records in a community-based sample of mothers participating in a longitudinal study in order to determine the accuracy of maternal recall of perinatal complications. Participants were 151 biological mothers, who were interviewed about gestational age at birth, birthweight, and the most commonly occurring birth complications: nuchal cord and meconium aspiration when the female child was on average 6years old, and for whom birth records were obtained. Concordance between reports was assessed using one-way random intra-class coefficients for continuous measures and kappa coefficients for dichotomous outcomes. Associations between maternal demographic and psychological factors and discrepancies also were tested. Concordance was excellent for continuously measured birthweight (ICC=0.85, pbirth record and absence according to maternal recall. Receipt of public assistance was associated with a decrease in discrepancy in report of nuchal cord. Concordance between maternal retrospective report and medical birth records varies across different types of perinatal events. There was little evidence that demographic or psychological factors increased the risk of discrepancies. Maternal recall based on continuous measures of perinatal factors may yield more valid data than dichotomous outcomes. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  5. Adolescent mental health: Challenges with maternal noncompliance.

    Science.gov (United States)

    Nejtek, Vicki A; Hardy, Sarah; Winter, Scott

    2010-04-07

    The leading cause of suicide ideation, attempts, and completion in adolescents is persistent and unresolved parental conflict. National statistics show extremely high rates of childhood neglect and abuse are perpetrated most often by single mothers. Psychiatric disorders arising from maternal-child dysfunction are well-documented. However, resources to prevent offspring victimization are lacking. Here, we report maternal neglect of a 15-year-old male brought to the psychiatric emergency room for suicidal ideation. An inpatient treatment plan including pharmacotherapy, family therapy and psychological testing was initiated. The patient's mother failed to attend clinic appointments or family therapy sessions. Clinician attempts to engage the mother in the treatment plan was met with verbal assaults, aggression, and threatening behavior. The patient decompensated in relation to the mother's actions. Child Protective Services were contacted and a follow-up assessment with the patient and mother is pending. Psychiatric treatment of the mother may be a necessary intervention and prevention regimen for both the adolescent and the mother. Without consistent Child Protective Services oversight, medical and psychosocial follow-up, the prognosis and quality of life for this adolescent is considered very poor. Stringent mental health law and institutional policies are needed to adequately intercede and protect adolescents with mental illness.

  6. Maternal age during pregnancy is associated with third trimester blood pressure level: the generation R study.

    Science.gov (United States)

    Gaillard, Romy; Bakker, Rachel; Steegers, Eric A P; Hofman, Albert; Jaddoe, Vincent W V

    2011-09-01

    We hypothesized that hemodynamic adaptations related to pregnancy and ageing might be associated with differences in blood pressure levels during pregnancy between younger and older women. This might partly explain the increased risk of gestational hypertensive disorders with advanced maternal age. We examined the associations of maternal age with systolic and diastolic blood pressure in each trimester of pregnancy and the risks of gestational hypertensive disorders. The study was conducted among 8,623 women participating in a population-based prospective cohort study from early pregnancy onwards. Age was assessed at enrolment. Blood pressure was measured in each trimester. Information about gestational hypertensive disorders was available from medical records. In second and third trimester, older maternal age was associated with lower systolic blood pressure (-0.9 mm Hg (95% confidence interval: -1.4, -0.3) and -0.6 mm Hg (95% confidence interval: -1.1, -0.02) per additional 10 maternal years, respectively). Older maternal age was associated with higher third trimester diastolic blood pressure (0.5 mm Hg (95% confidence interval: 0.04, 0.9) per additional 10 maternal years). Maternal age was associated with pregnancy-induced hypertension among overweight and obese women. Older maternal age is associated with lower second and third trimester systolic blood pressure, but higher third trimester diastolic blood pressure. These blood pressure differences seem to be small and within the physiological range. Maternal age is not consistently associated with the risks of gestational hypertensive disorders. Maternal body mass index might influence the association between maternal age and the risk of pregnancy-induced hypertension.

  7. Effect of maternal age on the risk of preterm birth: A large cohort study.

    Science.gov (United States)

    Fuchs, Florent; Monet, Barbara; Ducruet, Thierry; Chaillet, Nils; Audibert, Francois

    2018-01-01

    Maternal age at pregnancy is increasing worldwide as well as preterm birth. However, the association between prematurity and advanced maternal age remains controversial. To evaluate the impact of maternal age on the occurrence of preterm birth after controlling for multiple known confounders in a large birth cohort. Retrospective cohort study using data from the QUARISMA study, a large Canadian randomized controlled trial, which collected data from 184,000 births in 32 hospitals. Inclusion criteria were maternal age over 20 years. Exclusion criteria were multiple pregnancy, fetal malformation and intra-uterine fetal death. Five maternal age categories were defined and compared for maternal characteristics, gestational and obstetric complications, and risk factors for prematurity. Risk factors for preterm birth births were included in the study. Chronic hypertension, assisted reproduction techniques, pre-gestational diabetes, invasive procedure in pregnancy, gestational diabetes and placenta praevia were linearly associated with increasing maternal age whereas hypertensive disorders of pregnancy followed a "U" shaped distribution according to maternal age. Crude rates of preterm birth before 37 weeks followed a "U" shaped curve with a nadir at 5.7% for the group of 30-34 years. In multivariate analysis, the adjusted odds ratio (aOR) of prematurity stratified by age group followed a "U" shaped distribution with an aOR of 1.08 (95%CI; 1.01-1.15) for 20-24 years, and 1.20 (95% CI; 1.06-1.36) for 40 years and older. Confounders found to have the greatest impact were placenta praevia, hypertensive complications, and maternal medical history. Even after adjustment for confounders, advanced maternal age (40 years and over) was associated with preterm birth. A maternal age of 30-34 years was associated with the lowest risk of prematurity.

  8. Maternal Mortality Ratio and Causes of Death in IRI Between 2009 and 2012

    Directory of Open Access Journals (Sweden)

    Marzieh Vahiddastjerdy

    2016-12-01

    Full Text Available Objective: The Maternal Mortality Ratio is an important health indicator. We presented the distribution and causes of maternal mortality in Islamic Republic of Iran.Materials and methods: After provision of an electronic Registry system for date entry, a descriptive-retrospective data collection had been performed for all maternal Deaths in March 2009- March 2012. All maternal deaths and their demographic characteristic were identified by using medical registries, death certificates, and relevant codes according to International Classification of Diseases (ICD-9 during pregnancy, labor, and 42 days after parturition.Results: During 3 years, there were 5094317 deliveries and 941 maternal deaths (MMR of 18.5 per 1000000 live births. We had access to pertained data of 896 cases (95.2% for review in our study. Of 896 reported deaths, 549 were classified as direct, 302 as indirect and 45 as unknown. Hemorrhage was the most common cause of maternal mortality, followed by Preeclampsia, Eclampsia and sepsis. Among all indirect causes, cardio -vascular diseases were responsible for 10% of maternal deaths, followed by thromboembolism, HTN and renal diseases.Conclusion: Although maternal mortality ratio in IRI could be comparable with the developed countries but its pattern is following developing countries and with this study we had provided reliable data for other prospective studies.

  9. Mothers of IVF twins: the mediating role of employment and social coping resources in maternal stress.

    Science.gov (United States)

    Baor, Liora; Soskolne, Varda

    2012-01-01

    Twin pregnancies and births resulting from assisted reproductive technologies have been associated with adverse perinatal outcomes and maternal health complications leading to psychologically complex parenting. In the current study the authors assess the prevalence of clinical levels of maternal stress among mothers of twins resulting from in vitro fertilization and examine the association of social coping resources with three maternal stress sub-scales. During the years 2003-2005, 88 primiparous Israeli mothers of in vitro fertilization-conceived twins provided socio-demographic data during their third trimester of pregnancy, and at 6 months after birth provided data on delivery and medical condition of infants, coping resources (social support and marital quality), and a maternal stress scale. Forty-one percent of the mothers reached a clinically significant level of maternal stress. Social support and maternal employment were the most significant variables associated with experience of the stress in the early stages of adaptation to mothering in vitro fertilization twins. Primiparous mothers of in vitro fertilization twins are vulnerable to maternal stress in early stages of adaptation to the maternal role, some of whom reach clinical levels that may require professional interventions. Unemployed mothers with low social support were the most susceptible to the deleterious effects of in vitro fertilization treatment.

  10. Maternal Childhood Maltreatment History and Child Mental Health: Mechanisms in Intergenerational Effects.

    Science.gov (United States)

    Bosquet Enlow, Michelle; Englund, Michelle M; Egeland, Byron

    2016-04-12

    The objectives of this study were to examine whether a maternal history of maltreatment in childhood has a detrimental impact on young children's mental health and to test theoretically and empirically informed pathways by which maternal history may influence child mental health. Mother-child dyads (N = 187) were evaluated between birth and 64 months of age via home and laboratory observations, medical and child protection record reviews, and maternal interviews to assess maternal history of childhood maltreatment and microsystem and exosystem measures of the caregiving context, including child maltreatment, maternal caregiving quality, stress exposures, and social support. When the children were 7 years of age, mothers and teachers reported on child emotional and behavioral problems. Analyses examined whether the caregiving context variables linked maternal maltreatment history with child emotional and behavioral problems, controlling for child sex (54% male), race/ethnicity (63% White), and family sociodemographic risk at birth. Maltreated mothers experienced greater stress and diminished social support, and their children were more likely to be maltreated across early childhood. By age 7, children of maltreated mothers were at increased risk for clinically significant emotional and behavioral problems. A path analysis model showed mediation of the effects of maternal childhood maltreatment history on child symptoms, with specific effects significant for child maltreatment. Interventions that reduce child maltreatment risk and stress exposures and increase family social support may prevent deleterious effects of maternal childhood maltreatment history on child mental health.

  11. The Impact of Paternal and Maternal Smoking on Semen Quality of Adolescent Men.

    Science.gov (United States)

    Axelsson, Jonatan; Rylander, Lars; Rignell-Hydbom, Anna; Silfver, Karl Ågren; Stenqvist, Amelie; Giwercman, Aleksander

    2013-01-01

    Maternal smoking during pregnancy has been reported to negatively impact sperm counts of the sons. Sufficient data on the effect of paternal smoking is lacking. We wished to elucidate the impact of maternal and paternal smoking during pregnancy and current own smoking on reproductive function of the male offspring. Semen parameters including sperm DNA integrity were analyzed in 295 adolescents from the general population close to Malmö, Sweden, recruited for the study during 2008-2010. Information on maternal smoking was obtained from the Swedish Medical Birth Register, and regarding own and paternal smoking from questionnaires. The impacts of maternal, paternal and own smoking were evaluated in a multivariate regression model and by use of models including interaction terms. Totally, three exposures and five outcomes were evaluated. In maternally unexposed men, paternal smoking was associated with 46% lower total sperm count (95%CI: 21%, 64%) in maternally unexposed men. Both paternal and maternal smoking were associated with a lower sperm concentration (mean differences: 35%; 95%CI: 8.1%, 55% and 36%; 95%CI: 3.9%, 57%, respectively) if the other parent was a non-smoker. No statistically significant impact of own smoking on semen parameters was seen. Prenatal both maternal and paternal smoking were separately associated with some decrease in sperm count in men of whom the other parent was not reported to smoke.

  12. The Impact of Paternal and Maternal Smoking on Semen Quality of Adolescent Men.

    Directory of Open Access Journals (Sweden)

    Jonatan Axelsson

    Full Text Available Maternal smoking during pregnancy has been reported to negatively impact sperm counts of the sons. Sufficient data on the effect of paternal smoking is lacking.We wished to elucidate the impact of maternal and paternal smoking during pregnancy and current own smoking on reproductive function of the male offspring.Semen parameters including sperm DNA integrity were analyzed in 295 adolescents from the general population close to Malmö, Sweden, recruited for the study during 2008-2010. Information on maternal smoking was obtained from the Swedish Medical Birth Register, and regarding own and paternal smoking from questionnaires. The impacts of maternal, paternal and own smoking were evaluated in a multivariate regression model and by use of models including interaction terms. Totally, three exposures and five outcomes were evaluated.In maternally unexposed men, paternal smoking was associated with 46% lower total sperm count (95%CI: 21%, 64% in maternally unexposed men. Both paternal and maternal smoking were associated with a lower sperm concentration (mean differences: 35%; 95%CI: 8.1%, 55% and 36%; 95%CI: 3.9%, 57%, respectively if the other parent was a non-smoker. No statistically significant impact of own smoking on semen parameters was seen.Prenatal both maternal and paternal smoking were separately associated with some decrease in sperm count in men of whom the other parent was not reported to smoke.

  13. Maternal scaffolding behavior: links with parenting style and maternal education.

    Science.gov (United States)

    Carr, Amanda; Pike, Alison

    2012-03-01

    The purpose of this study was to specify the relationship between positive and harsh parenting and maternal scaffolding behavior. A 2nd aim was to disentangle the effects of maternal education and parenting quality, and a 3rd aim was to test whether parenting quality mediated the association between maternal education and scaffolding practices. We examined associations between positive and harsh parenting practices and contingent and noncontingent tutoring strategies. Ninety-six mother-child dyads (49 boys, 47 girls) from working- and middle-class English families participated. Mothers reported on parenting quality at Time 1 when children were 5 years old and again approximately 5 years later at Time 2. Mother-child pairs were observed working together on a block design task at Time 2, and interactions were coded for contingent (contingent shifting) and noncontingent (fixed failure feedback) dimensions of maternal scaffolding behavior. Positive and harsh parenting accounted for variance in contingent behavior over and above maternal education, whereas only harsh parenting accounted for unique variance in noncontingent scaffolding practices. Our findings provide new evidence for a more differentiated model of the relation between general parenting quality and specific scaffolding behaviors. PsycINFO Database Record (c) 2012 APA, all rights reserved.

  14. Analysis of preventability of hypertensive disorder in pregnancy-related maternal death using the nationwide registration system of maternal deaths in Japan.

    Science.gov (United States)

    Katsuragi, Shinji; Tanaka, Hiroaki; Hasegawa, Junichi; Nakamura, Masamitsu; Kanayama, Naohiro; Nakata, Masahiko; Murakoshi, Takeshi; Yoshimatsu, Jun; Osato, Kazuhiro; Tanaka, Kayo; Sekizawa, Akihiko; Ishiwata, Isamu; Ikeda, Tomoaki

    2018-04-26

    Hypertensive disorder of pregnancy (HDP) is a major cause of maternal death. The goal of this study was to investigate factors associated with maternal death due to HDP. HDP-related maternal deaths in Japan reported to the Committee of the Ministry of Health, Labor and Welfare from 2010 to 2015 were examined. Out of 47 cases of HDP, 30 were identified as the major cause of maternal death. The median maternal age was 34 years (range 24-45) and the mortality in women aged ≥40 years was seven times higher that than in women aged deaths in Japan. Mothers aged ≥40 years are most at risk for HDP-related maternal death. Major concerns for preventabilities were late hospitalization, maternal transportation, and termination of pregnancy for term or near-term HDP. Regular vital checks and prompt lowering of BP were lacked during labor in most cases. HELLP syndrome should be managed at a general hospital with sufficient medical resources.

  15. Gaining Insight into the Prevention of Maternal Death Using Narrative Analysis: An Experience from Kerman, Iran

    Directory of Open Access Journals (Sweden)

    Rana Eftekhar-Vaghefi

    2013-11-01

    Full Text Available Reduction in maternal mortality requires an in-depth knowledge of the causes of death. This study was conducted to explore the circumstances and events leading to maternal mortality through a holistic approach. Using narrative text analysis, all documents related to maternal deaths occurred from 2007 to 2011 in Kerman province/Iran were reviewed thoroughly by an expert panel. A 93-item chart abstraction instrument was developed according to the expert panel and literature. The instrument consisted of demographic and pregnancy related variables, underlying and contributing causes of death, and type of delays regarding public health aspects, medical and system performance issues. A total of 64 maternal deaths were examined. One third of deaths occurred in women less than 18 or higher than 35 years. Nearly 95% of them lived in a low or mid socioeconomic status. In half of the cases, inappropriate or nonuse of contraceptives was seen. Delay in the provision of any adequate treatment after arrival at the health facility was seen in 59% of cases. The most common medical causes of death were preeclampsia/eclampsia (15.6%, postpartum hemorrhage (12.5% and deep phlebothrombosis (10.9%, respectively. Negligence was accounted for 95% of maternal deaths. To overcome the root causes of maternal death, more emphasis should be devoted to system failures and patient safety rather than the underlying causes of death and medical issues solely.

  16. Maternal Mortality Risk Factors in Dr. Hasan Sadikin General Hospital, Bandung in 2009−2013

    Directory of Open Access Journals (Sweden)

    Shely Karma Astuti

    2017-09-01

    Full Text Available Objective: To discover the factors affecting the occurrence of maternal deaths. The high maternal mortality rate (MMR in Indonesia is still a common problem which needs urgent solution. Methods: This is an analytic observational, cross-sectional study using a case control approach Fifty two cases were selected as cases, another 52 were selected as control. The sampling was performed by simple random sampling. The instruments used in this study were the medical records of mothers who gave birth in Dr. Hasan Sadikin General Hospital Bandung from 1 January 2009–31 December 2013. Data analysis was performed using chi-square test. Results: In this study, the results showed that the risk factors contributing to maternal deaths were pregnancy complication (p<0.001, delivery complication (p<0.001, puerpural complication (p=0.022, age (p=0.030, parity (p=0.427, prior medical history (p<0.001, antenatal care (p=0.007, maternal education (p=0.527, and area of residence (p=0.049. Conclusions: The risk factors that contribute to maternal deaths include pregnancy complication, delivery complication, puerpural complication, maternal age, prior medical history, antenatal care, and area of residence.

  17. Thyroid-Stimulating Hormone Receptor Antibodies in Pregnancy: Clinical Relevance

    Science.gov (United States)

    Bucci, Ines; Giuliani, Cesidio; Napolitano, Giorgio

    2017-01-01

    Graves’ disease is the most common cause of thyrotoxicosis in women of childbearing age. Approximately 1% of pregnant women been treated before, or are being treated during pregnancy for Graves’ hyperthyroidism. In pregnancy, as in not pregnant state, thyroid-stimulating hormone (TSH) receptor (TSHR) antibodies (TRAbs) are the pathogenetic hallmark of Graves’ disease. TRAbs are heterogeneous for molecular and functional properties and are subdivided into activating (TSAbs), blocking (TBAbs), or neutral (N-TRAbs) depending on their effect on TSHR. The typical clinical features of Graves’ disease (goiter, hyperthyroidism, ophthalmopathy, dermopathy) occur when TSAbs predominate. Graves’ disease shows some peculiarities in pregnancy. The TRAbs disturb the maternal as well as the fetal thyroid function given their ability to cross the placental barrier. The pregnancy-related immunosuppression reduces the levels of TRAbs in most cases although they persist in women with active disease as well as in women who received definitive therapy (radioiodine or surgery) before pregnancy. Changes of functional properties from stimulating to blocking the TSHR could occur during gestation. Drug therapy is the treatment of choice for hyperthyroidism during gestation. Antithyroid drugs also cross the placenta and therefore decrease both the maternal and the fetal thyroid hormone production. The management of Graves’ disease in pregnancy should be aimed at maintaining euthyroidism in the mother as well as in the fetus. Maternal and fetal thyroid dysfunction (hyperthyroidism as well as hypothyroidism) are in fact associated with several morbidities. Monitoring of the maternal thyroid function, TRAbs measurement, and fetal surveillance are the mainstay for the management of Graves’ disease in pregnancy. This review summarizes the biochemical, immunological, and therapeutic aspects of Graves’ disease in pregnancy focusing on the role of the TRAbs in maternal and fetal

  18. Thyroid-Stimulating Hormone Receptor Antibodies in Pregnancy: Clinical Relevance

    Directory of Open Access Journals (Sweden)

    Ines Bucci

    2017-06-01

    Full Text Available Graves’ disease is the most common cause of thyrotoxicosis in women of childbearing age. Approximately 1% of pregnant women been treated before, or are being treated during pregnancy for Graves’ hyperthyroidism. In pregnancy, as in not pregnant state, thyroid-stimulating hormone (TSH receptor (TSHR antibodies (TRAbs are the pathogenetic hallmark of Graves’ disease. TRAbs are heterogeneous for molecular and functional properties and are subdivided into activating (TSAbs, blocking (TBAbs, or neutral (N-TRAbs depending on their effect on TSHR. The typical clinical features of Graves’ disease (goiter, hyperthyroidism, ophthalmopathy, dermopathy occur when TSAbs predominate. Graves’ disease shows some peculiarities in pregnancy. The TRAbs disturb the maternal as well as the fetal thyroid function given their ability to cross the placental barrier. The pregnancy-related immunosuppression reduces the levels of TRAbs in most cases although they persist in women with active disease as well as in women who received definitive therapy (radioiodine or surgery before pregnancy. Changes of functional properties from stimulating to blocking the TSHR could occur during gestation. Drug therapy is the treatment of choice for hyperthyroidism during gestation. Antithyroid drugs also cross the placenta and therefore decrease both the maternal and the fetal thyroid hormone production. The management of Graves’ disease in pregnancy should be aimed at maintaining euthyroidism in the mother as well as in the fetus. Maternal and fetal thyroid dysfunction (hyperthyroidism as well as hypothyroidism are in fact associated with several morbidities. Monitoring of the maternal thyroid function, TRAbs measurement, and fetal surveillance are the mainstay for the management of Graves’ disease in pregnancy. This review summarizes the biochemical, immunological, and therapeutic aspects of Graves’ disease in pregnancy focusing on the role of the TRAbs in maternal and

  19. Magnetic fields in noninvasive brain stimulation.

    Science.gov (United States)

    Vidal-Dourado, Marcos; Conforto, Adriana Bastos; Caboclo, Luis Otávio Sales Ferreira; Scaff, Milberto; Guilhoto, Laura Maria de Figueiredo Ferreira; Yacubian, Elza Márcia Targas

    2014-04-01

    The idea that magnetic fields could be used therapeutically arose 2000 years ago. These therapeutic possibilities were expanded after the discovery of electromagnetic induction by the Englishman Michael Faraday and the American Joseph Henry. In 1896, Arsène d'Arsonval reported his experience with noninvasive brain magnetic stimulation to the scientific French community. In the second half of the 20th century, changing magnetic fields emerged as a noninvasive tool to study the nervous system and to modulate neural function. In 1985, Barker, Jalinous, and Freeston presented transcranial magnetic stimulation, a relatively focal and painless technique. Transcranial magnetic stimulation has been proposed as a clinical neurophysiology tool and as a potential adjuvant treatment for psychiatric and neurologic conditions. This article aims to contextualize the progress of use of magnetic fields in the history of neuroscience and medical sciences, until 1985.

  20. Pathways of translation: deep brain stimulation.

    Science.gov (United States)

    Gionfriddo, Michael R; Greenberg, Alexandra J; Wahegaonkar, Abhijeet L; Lee, Kendall H

    2013-12-01

    Electrical stimulation of the brain has a 2000 year history. Deep brain stimulation (DBS), one form of neurostimulation, is a functional neurosurgical approach in which a high-frequency electrical current stimulates targeted brain structures for therapeutic benefit. It is an effective treatment for certain neuropathologic movement disorders and an emerging therapy for psychiatric conditions and epilepsy. Its translational journey did not follow the typical bench-to-bedside path, but rather reversed the process. The shift from ancient and medieval folkloric remedy to accepted medical practice began with independent discoveries about electricity during the 19th century and was fostered by technological advances of the 20th. In this paper, we review that journey and discuss how the quest to expand its applications and improve outcomes is taking DBS from the bedside back to the bench. © 2013 Wiley Periodicals, Inc.

  1. MATERNAL AND PERINATAL OUTCOME IN ABRUPTIO PLACENTA

    Directory of Open Access Journals (Sweden)

    Prabha Janakiram

    2017-08-01

    Full Text Available BACKGROUND Antepartum Haemorrhage (APH is the leading cause of vaginal bleeding. It is also the important cause of maternal morbidity as well as perinatal morbidity. APH is defined as bleeding per vagina occurring after 28 weeks of gestation and before the birth of the baby. Among APH, abruptio placenta and placenta previa are the leading cause that endanger the life of the mother and a great risk to high unfavourable perinatal outcome. Placental abruption is the bleeding from the premature separation of the normally implanted placenta after 20 weeks of gestations and prior to the birth of the foetus/foetuses. It is the major contribution of obstetric haemorrhage and complicates 0.8 to 1% of pregnancies worldwide. Placental abruption is the premature separation of implanted placenta before the delivery of foetus/foetuses. The aim of the study is to analyse the risk factors associated with abruption and hence methods can be formulated to prevent maternal mortality and morbidity. MATERIALS AND METHODS The present study is a retrospective study and was done in the Department of Obstetrics and Gynaecology from July to December, 2016, for a period of 6 months in the year 2016 at Government K.A.P.V. Medical College, Trichy, South India. RESULTS The total number of abruption placenta cases reported during the study period- June 2016 to November 2016 were 40. The total number of livebirth during same period was 5,348. The stillbirth rate was 42.5% and neonatal death rate was 22.5%. Clinical information were collected, maternal age, parity, gestational age at parity, prior history of abruption, clinical presentation like pain, bleeding, type of abruption like concealed or revealed amount of retroplacental clots and its size and degree of abruption associated with hypertensive disorders, mode of delivery, abruption-delivery interval, maternal complications, requirement of blood transfusions and immediate neonatal outcome. The results of studies were

  2. Maternal thyroid function and child educational attainment: prospective cohort study.

    Science.gov (United States)

    Nelson, Scott M; Haig, Caroline; McConnachie, Alex; Sattar, Naveed; Ring, Susan M; Smith, George D; Lawlor, Debbie A; Lindsay, Robert S

    2018-02-20

    To determine if first trimester maternal thyroid dysfunction is a critical determinant of child scholastic performance and overall educational attainment. Prospective cohort study. Avon Longitudinal Study of Parents and Children cohort in the UK. 4615 mother-child pairs with an available first trimester sample (median 10 weeks gestation, interquartile range 8-12). Free thyroxine, thyroid stimulating hormone, and thyroid peroxidase antibodies assessed as continuous measures and the seven clinical categories of maternal thyroid function. Five age-specific national curriculum assessments in 3580 children at entry stage assessment at 54 months, increasing up to 4461 children at their final school assessment at age 15. No strong evidence of clinically meaningful associations of first trimester free thyroxine and thyroid stimulating hormone levels with entry stage assessment score or Standard Assessment Test scores at any of the key stages was found. Associations of maternal free thyroxine or thyroid stimulating hormone with the total number of General Certificates of Secondary Education (GCSEs) passed (range 0-16) were all close to the null: free thyroxine, rate ratio per pmol/L 1.00 (95% confidence interval 1.00 to 1.01); and thyroid stimulating hormone, rate ratio 0.98 (0.94 to 1.02). No important relationship was observed when more detailed capped scores of GCSEs allowing for both the number and grade of pass or when language, mathematics, and science performance were examined individually or when all educational assessments undertaken by an individual from school entry to leaving were considered. 200 (4.3%) mothers were newly identified as having hypothyroidism or subclinical hypothyroidism and 97 (2.1%) subclinical hyperthyroidism or hyperthyroidism. Children of mothers with thyroid dysfunction attained an equivalent number of GCSEs and equivalent grades as children of mothers with euthyroidism. Maternal thyroid dysfunction in early pregnancy does not have a

  3. Maternal and fetal outcome in grand multipara

    International Nuclear Information System (INIS)

    Qamar, A.; Qamar, S.

    2015-01-01

    Study Design: Case control study. Place and Duration of Study: Gynecology and Obstetric Unit-I of the Jinnah Post Graduate and Medical Centre Karachi, from February 2009 to January 2010. Patients and Methods: One hundred (100) patients of grand multipara (GMP), (parity = 5) and 100 patients of multipara (MP) (parity 2-4) were included in the study. Pregnant women with known medical conditions including essential hypertension, diabetes mellitus, epilepsy, primigravidas, women with previous caesarean section and twin pregnancies were excluded. Patients were admitted through antenatal clinic and emergency. A detailed history was taken and a physical examination was done with special emphasis on obstetrical examination. Investigations like blood CP, Urine D/R, blood grouping and sonogram were done. During labour, mother and neonates were managed according to ward protocols. Maternal and fetal outcomes were compared among GMPs and MPs. Results: A high frequency of anaemia (81% vs 20%), pregnancy induced hypertension (45%, vs. 26%) and gestational diabetes (9%, vs1%) were seen in GMP as compared to MP group. Frequency of malpresentations (26% vs 15%), postpartum hemorrhage (15%, vs 10%) and intrauterine deaths (26%, vs 13%) were higher in GMP group along with a high caesarean delivery rate (GMP 21%, MP 14%). A higher maternal mortality (GMP 4%, MP 1%) and low APGAR score (GMP 12%, MP 4%) were observed among babies born to grand multipara group. Conclusion: Grand multiparity is associated with adverse outcome for both mother and fetus. Effort should be directed to reduce high parity in the community through effective family planning initiatives. Specialized antenatal and obstetrical care facilities should be available. (author)

  4. Effects of prenatal music stimulation on state/trait anxiety in full-term pregnancy and its influence on childbirth: a randomized controlled trial.

    Science.gov (United States)

    García González, J; Ventura Miranda, M I; Requena Mullor, M; Parron Carreño, T; Alarcón Rodriguez, R

    2018-04-01

    Many researchers have pointed out the strong relationship between maternal psychological well-being and fetal welfare during pregnancy. The impact of music interventions during pregnancy should be examined in depth, as they could have an impact on stress reduction, not only during pregnancy but also during the course of delivery, and furthermore induce fetal awareness. This study aimed to investigate the effect of music on maternal anxiety, before and after a non-stress test (NST), and the effect of music on the birthing process. The four hundred and nine pregnant women coming for routine prenatal care were randomized in the third trimester to receive either music (n = 204) or no music (n = 205) stimulation during an NST. The primary outcome was considered as the maternal state anxiety score before and after the NST, and the secondary outcome was the birthing process. Before their NST, full-term pregnant women who had received music intervention were found to have a similar state-trait anxiety score to those from the control group, with 38.10 ± 8.8 and 38.08 ± 8.2, respectively (p = .97). After the NST, the mean state-trait anxiety score of each group was recorded, with results of 30.58 ± 13.2 for those with music intervention, and 43.11 ± 15.0 for those without music intervention (p < .001). In the control group, the NST was followed by a statistically significant increase in the state-trait anxiety score (38.08 ± 8.2 versus 43.11 ± 15.0, p < .001). However, listening to music during the NST resulted in a statistically significant decrease in the state-trait anxiety score of the study group (38.10 ± 8.8 versus 30.58 ± 13.2, OR = 0.87, p < .001). Furthermore, the first stage of labor was shorter in women who received music stimulation (OR = 0.92, p < .004). They also presented a more natural delivery beginning (spontaneous) and less medication (stimulated and induced) than those who were

  5. Theta Burst Transcranial Magnetic Stimulation for Auditory Verbal Hallucinations : Negative Findings From a Double-Blind-Randomized Trial

    NARCIS (Netherlands)

    Koops, Sanne; van Dellen, Edwin; Schutte, Maya J L; Nieuwdorp, Wendy; Neggers, Sebastiaan F W; Sommer, Iris E C

    BACKGROUND: Auditory verbal hallucinations (AVH) in schizophrenia are resistant to antipsychotic medication in approximately 25% of patients. Treatment with repetitive transcranial magnetic stimulation (rTMS) for refractory AVH has shown varying results. A stimulation protocol using continuous theta

  6. Review: Adiponectin – The Missing Link between Maternal Adiposity, Placental Transport and Fetal Growth?

    Science.gov (United States)

    Aye, Irving L. M. H.; Powell, Theresa L.; Jansson, Thomas

    2012-01-01

    Adiponectin has well-established insulin-sensitizing effects in non-pregnant individuals. Pregnant women who are obese or have gestational diabetes typically have low circulating levels of adiponectin, which is associated with increased fetal growth. Lean women, on the other hand, have high circulating levels of adiponectin. As a result, maternal serum adiponectin is inversely correlated to fetal growth across the full range of birth weights, suggesting that maternal adiponectin may limit fetal growth. In the mother, adiponectin is predicted to promote insulin sensitivity and stimulate glucose uptake in maternal skeletal muscle thereby reducing nutrient availability for placental transfer. Adiponectin prevents insulin-stimulated amino acid uptake in cultured primary human trophoblast cells by modulating insulin receptor substrate phosphorylation. Furthermore, chronic administration of adiponectin to pregnant mice inhibits placental insulin and mammalian target of rapamycin complex 1 (mTORC1) signaling, down-regulates the activity and expression of key placental nutrient transporters and decreases fetal growth. Preliminary findings indicate that adiponectin binds to the adiponectin receptor-2 on the trophoblast cell and activates p38 MAPK and PPAR-α, which inhibits the insulin/IGF-1 signaling pathway. In contrast to maternal adiponectin, recent reports suggest that fetal adiponectin may promote expansion of adipose tissue and stimulate fetal growth. Regulation of placental function by adiponectin constitutes a novel physiological mechanism by which the endocrine functions of maternal adipose tissue influence fetal growth. These findings may help us better understand the factors determining birth weight in normal pregnancies and in pregnancy complications associated with altered maternal adiponectin levels such as obesity and gestational diabetes. PMID:23245987

  7. Stimulants for the control of hedonic appetite

    Directory of Open Access Journals (Sweden)

    Alison Sally Poulton

    2016-04-01

    Full Text Available The focus of this paper is treatment of obesity in relation to the management of hedonic appetite. Obesity is a complex condition which may be potentiated by excessive reward seeking in combination with executive functioning deficits that impair cognitive control of behaviour. Stimulant medications address both reward deficiency and enhance motivation, as well as suppressing appetite. They have long been recognised to be effective for treating obesity. However, stimulants can be abused for their euphoric effect. They induce euphoria via the same neural pathway that underlies their therapeutic effect in obesity. For this reason they have generally not been endorsed for use in obesity. Among the stimulants, only phentermine (either alone or in combination with topiramate and bupropion (which has stimulant-like properties and is used in combination with naltrexone, are approved by the United States Food and Drug Administration (FDA for obesity, although dexamphetamine and methylpenidate are approved and widely used for treating attention deficit hyperactivity disorder (ADHD in adults and children. Experience gained over many years in the treatment of ADHD demonstrates that with careful dose titration, stimulants can be used safely. In obesity, improvement in mood and executive functioning could assist with the lifestyle changes necessary for weight control, acting synergistically with appetite suppression. The obesity crisis has reached the stage that strong consideration should be given to adequate utilisation of this effective and inexpensive class of drug.

  8. Reverse innovation in maternal health.

    Science.gov (United States)

    Firoz, Tabassum; Makanga, Prestige Tatenda; Nathan, Hannah L; Payne, Beth; Magee, Laura A

    2017-09-01

    Reverse innovation, defined as the flow of ideas from low- to high-income settings, is gaining traction in healthcare. With an increasing focus on value, investing in low-cost but effective and innovative solutions can be of mutual benefit to both high- and low-income countries. Reverse innovation has a role in addressing maternal health challenges in high-income countries by harnessing these innovative solutions for vulnerable populations especially in rural and remote regions. In this paper, we present three examples of 'reverse innovation' for maternal health: a low-cost, easy-to-use blood pressure device (CRADLE), a diagnostic algorithm (mini PIERS) and accompanying mobile app (PIERS on the Move), and a novel method for mapping maternal outcomes (MOM).

  9. Classification differences and maternal mortality

    DEFF Research Database (Denmark)

    Salanave, B; Bouvier-Colle, M H; Varnoux, N

    1999-01-01

    OBJECTIVES: To compare the ways maternal deaths are classified in national statistical offices in Europe and to evaluate the ways classification affects published rates. METHODS: Data on pregnancy-associated deaths were collected in 13 European countries. Cases were classified by a European panel....... This change was substantial in three countries (P statistical offices appeared to attribute fewer deaths to obstetric causes. In the other countries, no differences were detected. According to official published data, the aggregated maternal mortality rate for participating countries was 7.7 per...... of experts into obstetric or non-obstetric causes. An ICD-9 code (International Classification of Diseases) was attributed to each case. These were compared to the codes given in each country. Correction indices were calculated, giving new estimates of maternal mortality rates. SUBJECTS: There were...

  10. Maternal employment and birth outcomes

    DEFF Research Database (Denmark)

    Wüst, Miriam

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

  11. Antenatal management of recurrent fetal goitrous hyperthyroidism associated with fetal cardiac failure in a pregnant woman with persistent high levels of thyroid-stimulating hormone receptor antibody after ablative therapy.

    Science.gov (United States)

    Matsumoto, Tadashi; Miyakoshi, Kei; Saisho, Yoshifumi; Ishii, Tomohiro; Ikenoue, Satoru; Kasuga, Yoshifumi; Kadohira, Ikuko; Sato, Seiji; Momotani, Naoko; Minegishi, Kazuhiro; Yoshimura, Yasunori

    2013-01-01

    High titer of maternal thyroid-stimulating hormone receptor antibody (TRAb) in patients with Graves' disease could cause fetal hyperthyroidism during pregnancy. Clinical features of fetal hyperthyroidism include tachycardia, goiter, growth restriction, advanced bone maturation, cardiomegaly, and fetal death. The recognition and treatment of fetal hyperthyroidism are believed to be important to optimize growth and intellectual development in affected fetuses. We herein report a case of fetal treatment in two successive siblings showing in utero hyperthyroid status in a woman with a history of ablative treatment for Graves' disease. The fetuses were considered in hyperthyroid status based on high levels of maternal TRAb, a goiter, and persistent tachycardia. In particular, cardiac failure was observed in the second fetus. With intrauterine treatment using potassium iodine and propylthiouracil, fetal cardiac function improved. A high level of TRAb was detected in the both neonates. To the best of our knowledge, this is the first report on the changes of fetal cardiac function in response to fetal treatment in two siblings showing in utero hyperthyroid status. This case report illustrates the impact of prenatal medication via the maternal circulation for fetal hyperthyroidism and cardiac failure.

  12. Maternity Care in Russia: Issues, Achievements, and Potential.

    Science.gov (United States)

    Shuvalova, Marina P; Yarotskaya, Ekaterina L; Pismenskaya, Tatiana V; Dolgushina, Nataliya V; Baibarina, Elena N; Sukhikh, Gennady T

    2015-10-01

    In this review, we provide basic facts about maternity care services within the health care system in Russia. We give a short overview of such key aspects as the demographic situation, reproductive behaviour, regulatory framework for providing health care for women and children, maternal and perinatal mortality, and the availability of medical personnel. In 2012, Russia began registration of births in accordance with the WHO recommendations (births with weight ≥ 500 g at ≥ 22 weeks' gestation). Introduction of this new registration system increased the completeness and quality of the collected information and expanded possibilities for future international comparative assessments. A three-level system of specialized medical care has been introduced in Russia for women and newborns during pregnancy, childbirth, and the postpartum period. In 2014, the system included 1942 state (public) maternity hospitals providing 20 obstetric beds per 10 000 women aged 15 to 49 years. More than 100 perinatal centres (level III) are currently functioning in the country, with 32 new perinatal centres planned to open by 2016. The total number of obstetrician-gynaecologists in Russia is approximately 44 000, providing a ratio of 5.7 specialists per 10 000 women. The total number of midwives is 62 000, providing a ratio of 8.1 midwives per 10 000 women. In recent years we have succeeded in optimizing the maternity care system by increasing its accessibility and quality. This was achieved through qualitative and quantitative progress in the training of neonatologists, the development of intensive care technologies and neonatal critical care, capacity building of medical-genetic services and counselling, prenatal diagnosis, and the standardization of health care with data collection.

  13. New York Canyon Stimulation

    Energy Technology Data Exchange (ETDEWEB)

    Raemy, Bernard

    2012-06-21

    The New York Canyon Stimulation Project was to demonstrate the commercial application of Enhanced Geothermal System techniques in Buena Vista Valley area of Pershing County, Nevada. From October 2009 to early 2012, TGP Development Company aggressively implemented Phase I of Pre-Stimulation and Site/Wellbore readiness. This included: geological studies; water studies and analyses and procurement of initial permits for drilling. Oversubscription of water rights and lack of water needed for implementation of EGS were identified and remained primary obstacles. Despite extended efforts to find alternative solutions, the water supply circumstances could not be overcome and led TGP to determine a "No Go" decision and initiate project termination in April 2012.

  14. Pregnancy Complications Associated With Maternal Hypothyroidism: A Systematic Review.

    Science.gov (United States)

    Shinohara, Danielle Rosani; Santos, Thais da Silva; de Carvalho, Hayalla Corrêa; Lopes, Laíza Cristina Bahls; Günther, Luciene Setsuko Akimoto; Aristides, Sandra Mara Alessi; Teixeira, Jorge Juarez Vieira; Demarchi, Izabel Galhardo

    2018-04-01

    Hypothyroidism is one of the most prevalent diseases in pregnancy, but there is no consensus about its management in pregnant women. In this systematic review, we evaluated the association between pregnancy complications and treated or untreated maternal hypothyroidism. PubMed and reference lists were searched for the Medical Subject Headings terms "pregnancy complications" and "hypothyroidism." The eligibility criteria for inclusion in the study were an original study published between 2002 and 2013. Six reviewers independently selected the studies, and 3 extracted the data. Two reviewers assessed the risk of bias and quality of the studies. Eighteen studies were included in the systematic review. The most prevalent complications associated with maternal hypothyroidism were abortion, intrauterine fetal death, preterm delivery, and preeclampsia. The pregnancy outcome depended on the treatment that was received by the patient. Strong evidence indicates that maternal hypothyroidism is associated with maternal-fetal complications, but no consensus was found among the studies reviewed herein. The dose of levothyroxine that is required to maintain euthyroidism is still questioned, but studies have suggested that levothyroxine should be adjusted according to the gestational period and laboratory profile.

  15. Maternal and fetal hormonal profiles of anemic pregnant women of Eastern Sudan

    International Nuclear Information System (INIS)

    Mohammed, E. Y. A.

    2010-12-01

    Anaemia is defined as reduction in circulating hemoglobin mass below the critical level expected for age and sex. Anaemia affects almost two- thirds of pregnant women in developing countries, it is associated with poor maternal and prenatal outcomes. Anaemia during pregnancy through many endocrine alterations-may influence the maternal and fetal environment. To investigate the anthropometric, biochemical and hormonal profiles in paired maternal and cord blood samples and to compare between the two groups, anaemic (n=68) and non-anaemic groups (n=57), in order to study the endocrine effects of anaemia during pregnancy in the mothers and their neonates. This cross sectional study was conducted in Gadarif hospital, Eastern Sudan. Women were classified into two groups based on the WHO classification of anaemia: Group 1(normal control-no anaemia Hb>11.0 g/dl) Group 2 anaemic, (Hb 11g/dl). There was no significant difference in the fetal anthropometrics parameters (weight, length and placental weight) between the anaemic (Hb 11g/dl). Maternal prolactin was significantly higher in anaemic group when compared with non anaemic group with p-value =.002. Cord serum albumin was significantly higher in anaemic group compared with non anaemic group with p-value=.04. Cord serum ferritin was significantly higher in anaemic group compared with non anemic group with p-value<.001. There was no significant difference was observed in the other maternal parameters (total protein, growth hormone, cortisol, insulin, thyroid stimulating hormone, total thyroxin and triiodo thyroxine). There was no significant difference was observed in the other fetal parameters (total protein, growth hormone, cortisol, insulin, thyroid stimulating hormone, total thyroxin and triiodo thyroxine). In this study there were some maternal and fetal endocrine modulations due to anaemia during pregnancy as indicated by the high levels of maternal prolactin in blood of the anemic women group and also the high

  16. Maternal Depression and Youth Internalizing and Externalizing Symptomatology: Severity and Chronicity of Past Maternal Depression and Current Maternal Depressive Symptoms

    Science.gov (United States)

    O’Connor, Erin E.; Langer, David A.; Tompson, Martha C.

    2017-01-01

    Maternal depression is a well-documented risk factor for youth depression, and taking into account its severity and chronicity may provide important insight into the degree of risk conferred. This study explored the degree to which the severity/chronicity of maternal depression history explained variance in youth internalizing and externalizing symptoms above and beyond current maternal depressive symptoms among 171 youth (58% male) ages 8 to 12 over a span of three years. Severity and chronicity of past maternal depression and current maternal depressive symptoms were examined as predictors of parent-reported youth internalizing and externalizing symptomatology, as well as youth self-reported depressive symptoms. Severity and chronicity of past maternal depression did not account for additional variance in youth internalizing and externalizing symptoms at Time 1 beyond what was accounted for by maternal depressive symptoms at Time 1. Longitudinal growth curve modeling indicated that prior severity/chronicity of maternal depression predicted levels of youth internalizing and externalizing symptoms at each time point when controlling for current maternal depressive symptoms at each time point. Chronicity of maternal depression, apart from severity, also predicted rate of change in youth externalizing symptoms over time. These findings highlight the importance of screening and assessing for current maternal depressive symptoms, as well as the nature of past depressive episodes. Possible mechanisms underlying the association between severity/chronicity of maternal depression and youth outcomes, such as residual effects from depressive history on mother–child interactions, are discussed. PMID:27401880

  17. State of the science: does the theory of maternal role attainment apply to African American motherhood?

    Science.gov (United States)

    Fouquier, Katherine Ferrell

    2013-01-01

    This article reviews the current state of knowledge of the theory of maternal role attainment (MRA) and its relevance in describing African American motherhood. EBSCOhost Research Databases that included PubMed, CINAHL plus, MEDLINE, PsycINFO, SCOPUS, and Web of Science were searched for journal articles that examined maternal identity and MRA. Keyword searches included maternal identity, maternal role attainment, becoming a mother, prenatal attachment, maternal-fetal attachment, and maternal-infant attachment. Inclusion criteria for this review were published journal articles of studies conducted in the United States, with a clear delineation of the theoretical framework of MRA. Journal articles that measured MRA among women with depression or medically fragile infants were excluded. Two hundred and twelve studies were reviewed; 25 studies, published between 1975 and 2007, met the inclusion criteria. Nine articles described the theory of MRA, 11 articles measured variables thought to influence MRA, and 6 articles described maternal-fetal attachment, a construct of MRA. Studies were reviewed, categorized, and analyzed to determine current knowledge of how the theory of MRA describes African American motherhood. Categories included studies describing the theoretical framework of maternal identity and MRA, studies measuring key variables thought to impact MRA, and studies measuring maternal-fetal attachment and maternal-infant attachment. The studies were limited by homogenous samples of upper-middle-class white women and low-income, single, African American adolescents. Study results of MRA cannot be generalized to African American women. Further research is essential to identify attributes influencing MRA, specifically among larger samples of African American women with demographics similar to that of the white populations that have been included in studies thus far. © 2013 by the American College of Nurse-Midwives.

  18. Birthing Centers and Hospital Maternity Services

    Science.gov (United States)

    ... Educators Search English Español Birthing Centers and Hospital Maternity Services KidsHealth / For Parents / Birthing Centers and Hospital Maternity Services What's in this article? Giving Birth at ...

  19. Maternal death and near miss measurement

    African Journals Online (AJOL)

    ABEOLUGBENGAS

    2008-05-26

    May 26, 2008 ... Maternal health services need to be accountable more than ever ... of maternal death and near miss audit, surveillance and review is ..... (d) A fundamental principle of these ..... quality assurance in obstetrics in Nigeria - a.

  20. Maternal postpartum distress and childhood overweight

    DEFF Research Database (Denmark)

    Adeltoft, Teresa Ajslev; Andersen, Camilla S; Ingstrup, Katja Glejsted

    2010-01-01

    We investigated associations between maternal postpartum distress covering anxiety, depression and stress and childhood overweight.......We investigated associations between maternal postpartum distress covering anxiety, depression and stress and childhood overweight....

  1. Negotiating Rights : Building Coalitions for Improving Maternal ...

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

    Negotiating Rights : Building Coalitions for Improving Maternal Health Services ... the state of maternal health in the country reflects poorly on public health priorities. ... A number of international agencies and civil society organizations are ...

  2. Maternity waiting homes: A panacea for maternal/neonatal ...

    African Journals Online (AJOL)

    women to inadequately equipped delivery settings 4,5. Eritrea has made some ... Maternity waiting homes were introduced in Eritrea in 2007 as a strategy to mitigate .... 24(4):472-8. 5. Chandramohan D, Cutts F, Millard P The effect of stay in.

  3. Effect of sevoflurane on neuronal activity during deep brain stimulation surgery for epilepsy: A case report

    OpenAIRE

    Michaël J. Bos, MD; Linda Ackermans, MD, PhD; Frédéric L.W.V.J. Schaper, MD; Rob P.W. Rouhl, MD, PhD; Vivianne H.J.M. van Kranen-Mastenbroek, MD, PhD; Wolfgang F. Buhre, MD, PhD; Marcus L.F. Janssen, MD, PhD

    2018-01-01

    Deep brain stimulation of the anterior nucleus of the thalamus is an effective treatment for patients with refractory epilepsy who do not respond sufficiently to medical therapy. Optimal therapeutic effects of deep brain stimulation probably depend on accurate positioning of the stimulating electrodes. Microelectrode recordings show bursty firing neurons in the anterior nucleus of the thalamus region, which confirms the anatomical target determined by the surgeon. Deep brain stimulation elect...

  4. Effects of maternal confidence and competence on maternal parenting stress in newborn care.

    Science.gov (United States)

    Liu, Chien-Chi; Chen, Yueh-Chih; Yeh, Yen-Po; Hsieh, Yeu-Sheng

    2012-04-01

    This paper is a report of a correlational study of the relations of maternal confidence and maternal competence to maternal parenting stress during newborn care. Maternal role development is a cognitive and social process influenced by cultural and family contexts and mother and child characteristics. Most knowledge about maternal role development comes from western society. However, perceptions of the maternal role in contemporary Taiwanese society may be affected by contextual and environmental factors. A prospective correlational design was used to recruit 372 postpartum Taiwanese women and their infants from well-child clinics at 16 health centres in central Taiwan. Inclusion criteria for mothers were gestational age >37 weeks, ≥18 years old, and healthy, with infants maternal confidence, maternal competence and self-perceived maternal parenting stress. After controlling for maternal parity and infant temperament, high maternal confidence and competence were associated with low maternal parenting stress. Maternal confidence influenced maternal parenting stress both directly and indirectly via maternal competence. To assist postpartum women in infant care programmes achieve positive outcomes, nurses should evaluate and bolster mothers' belief in their own abilities. Likewise, nurses should not only consider mothers' infant care skills, but also mothers' parity and infant temperament. Finally, it is crucial for nurses and researchers to recognize that infant care programmes should be tailored to mothers' specific maternal characteristics. © 2011 The Authors. Journal of Advanced Nursing © 2011 Blackwell Publishing Ltd.

  5. Maternal mortality and severe maternal morbidity from acute fatty liver of pregnancy in the Netherlands

    NARCIS (Netherlands)

    Dekker, Ruth R.; Schutte, Joke M.; Stekelenburg, Jelle; Zwart, Joost J.; van Roosmalen, Jos

    Objective: To assess maternal death and severe maternal morbidity from acute fatty liver of pregnancy (AFLP) in the Netherlands. Study design: A retrospective study of all cases of maternal mortality in the Netherlands between 1983 and 2006 and all cases of severe maternal morbidity in the

  6. Maternal drug use: evaluation of risks to breast-fed infants.

    Science.gov (United States)

    Kirksey, A; Groziak, S M

    1984-01-01

    This paper, based on a review of the literature, evaluates the risks to infants of maternal drug use during lactation. The potential harm of a particular drug to the breastfed infant is related both to the complex mechanism of milk synthesis and secretion and the mode of passage of the drug from plasma into milk. The 1st part of the paper discusses mammary cell and milk synthesis, milk secretion and composition, the mode of passage of drugs into milk, and factors influencing drug concentrations in milk. Drug concentrations in milk are dependent on 6 major factors: drug dosage, proportion bound in plasma, molecular weight, lipid solubility, degree of ionization, and pH difference between plasma and milk. Drugs that are weak acids are ionized to a greater extent and are more protein-bound than weak alkaline drugs. The 2nd part of the paper evaluates the risks to breastfed infants of selected pharmacons. Some categories of drugs that contain pharmacons that should be limited or avoided by nursing mothers are alkylating agents, analgesics and anti-inflammatory agents, anticoagulants, anticonvulsants, anti-infective agents, central nervous system stimulants, hormones, laxatives, minerals, provitamins, psychotherapeutic agents, thyroid affecting agents, and vitamins. The following precautions are suggested to minimize the risks of potentially harmful pharmacons: 1) all unnecessary medications should be avoided by nrusing mothers; 2) if medication is necessary during lactation, drug dosage should be controlled and the infant should be monitored for adverse symptoms; 3) drugs should be administered shortly after breastfeeding and the interval prolonged before the next feeding; and 4) if the infant must be fed soon after a potentially harmful drug has been taken by the mother, bottle feeding is recommended.

  7. Problems of contemporary maternity: psychological aspect

    Directory of Open Access Journals (Sweden)

    I. V. Puz

    2013-08-01

    Full Text Available This article deals with the problems of modern motherhood and studies the phenomenon of deviant maternal behavior. Based on the literature, present study analyzes such forms of violation of maternal behavior as mother's refusal from a baby; mother's cruel treatment of a baby; frequent abortions; maternity in the early reproductive age; conscious maternity postponement for a later reproductive age. Also the factors that contribute to various manifestations of deviant motherhood are described.

  8. [Maternal and perinatal health].

    Science.gov (United States)

    1991-01-01

    After a year-long diagnosis of Chile's health situation, the Ministry of Health in 1991 formulated a new maternal-child health program designed to assure that all pregnancies would be desired and would occur under optimal conditions. Orientation for responsible parenthood will be an important part of the process. Other objectives include reducing the incidence of adolescent pregnancy and of sexually transmitted diseases. The pregnancy rate for young women 15-19 changed very little in Chile between 1952-82, because of the lack of sex education and family planning services. Family planning programs designed especially for adolescents would help to combat unwanted pregnancies and could offer the methods most suitable for young women. The well-known longitudinal study in Czechoslovakia which followed the development of children whose mothers were denied legal abortions in the 1960s showed the children to be at increased risk of unsatisfactory social adjustment in later life and suggested some consequences of unwanted pregnancy. A study of unwanted pregnancy in Chile was initiated in 4 prenatal care centers in a working class area of Santiago in 1984. 2485 women in the 6th or 7th month of pregnancy were classified according to their existing family sizes. Only 33.1% of the women desired the pregnancy at that time and 38.4% desired it but at a later time. 28.5% did not desire it at all. Women who did not desire the pregnancy waited significantly longer to obtain prenatal care than women who desired it. Age, economic problems, being single, family conflicts, already having the desired number of children, and short intervals since the most recent birth were associated with not desiring the current pregnancy. Of the 1663 women who did not desire the pregnancy, only 13.1% of those single, 35.8% of those in union, and 44.0% of those married used a contraceptive method. 2133 of the mothers were interviewed 6 months and 1977 12 months after delivery. Birth weights did not vary

  9. Maternal enrichment affects prenatal hippocampal proliferation and open-field behaviors in female offspring mice.

    Science.gov (United States)

    Maruoka, Takashi; Kodomari, Ikuko; Yamauchi, Rena; Wada, Etsuko; Wada, Keiji

    2009-04-17

    The maternal environment is thought to be important for fetal brain development. However, the effects of maternal environment are not fully understood. Here, we investigated whether enrichment of the maternal environment can influence prenatal brain development and postnatal behaviors in mice. An enriched environment is a housing condition with several objects such as a running wheel, tube and ladder, which are thought to increase sensory, cognitive and motor stimulation in rodents compared with standard housing conditions. First, we measured the number of BrdU-positive cells in the hippocampal dentate gyrus of fetuses from pregnant dams housed in an enriched environment. Our results revealed that maternal enrichment influences cell proliferation in the hippocampus of female, but not male, fetuses. Second, we used the open-field test to investigate postnatal behaviors in the offspring of dams housed in the enriched environment during pregnancy. We found that maternal enrichment significantly affects the locomotor activity and time spent in the center of the open-field in female, but not male, offspring. These results indicate that maternal enrichment influences prenatal brain development and postnatal behaviors in female offspring.

  10. IDEA: Stimulating Oral Production.

    Science.gov (United States)

    Easley, Jacob J.

    1995-01-01

    Presents daily activities that facilitate complete sentence response, promote oral production, and aid the learning of vocabulary in foreign-language classes. Because speech is the primary form of communication in the foreign-language classroom, it is important to stimulate students to converse as soon as possible. (Author/CK)

  11. stimulated BV2 Microglial

    African Journals Online (AJOL)

    2012-03-26

    Mar 26, 2012 ... 2), in LPS-stimulated BV2 microglial cells. The level of NO production was analyzed using Griess reaction. The release of PGE2 was determined using sandwich enzyme-linked immunosorbent assay. The DNA-binding activity of nuclear factor-κB (NF-κB) was measured by electrophoretic mobility shift assay ...

  12. Brain stimulation in migraine.

    Science.gov (United States)

    Brighina, Filippo; Cosentino, Giuseppe; Fierro, Brigida

    2013-01-01

    Migraine is a very prevalent disease with great individual disability and socioeconomic burden. Despite intensive research effort in recent years, the etiopathogenesis of the disease remains to be elucidated. Recently, much importance has been given to mechanisms underlying the cortical excitability that has been suggested to be dysfunctional in migraine. In recent years, noninvasive brain stimulation techniques based on magnetic fields (transcranial magnetic stimulation, TMS) and on direct electrical currents (transcranial direct current stimulation, tDCS) have been shown to be safe and effective tools to explore the issue of cortical excitability, activation, and plasticity in migraine. Moreover, TMS, repetitive TMS (rTMS), and tDCS, thanks to their ability to interfere with and/or modulate cortical activity inducing plastic, persistent effects, have been also explored as potential therapeutic approaches, opening an interesting perspective for noninvasive neurostimulation for both symptomatic and preventive treatment of migraine and other types of headache. In this chapter we critically review evidence regarding the role of noninvasive brain stimulation in the pathophysiology and treatment of migraine, delineating the advantages and limits of these techniques together with potential development and future application. © 2013 Elsevier B.V. All rights reserved.

  13. Maternal inflammation during pregnancy and childhood adiposity

    NARCIS (Netherlands)

    R. Gaillard (Romy); S.L. Rifas-Shiman (Sheryl); W. Perng (Wei); E. Oken (Emily); M.W. Gillman (Matthew W.)

    2016-01-01

    textabstractObjective: Maternal pre-pregnancy obesity is associated with offspring obesity. Underlying mechanisms may involve a maternal obesity-mediated proinflammatory state during pregnancy. Maternal C-reactive protein (CRP) level during pregnancy is a biomarker of low-grade systemic

  14. Epidemiology of Maternal Mortality in Malawi

    African Journals Online (AJOL)

    live births. Causes and determinants of maternal mortal- ity. Global causes of maternal mortality. Across the globe the causes of maternal deaths are strik- ..... at home”. Findings from Thyolo, Mangochi and Chik- wawa were similar". Perceived qua/ity of care. Like anywhere in the world, the perceived quality of care in ...

  15. Prenatal Maternal Stress Programs Infant Stress Regulation

    Science.gov (United States)

    Davis, Elysia Poggi; Glynn, Laura M.; Waffarn, Feizal; Sandman, Curt A.

    2011-01-01

    Objective: Prenatal exposure to inappropriate levels of glucocorticoids (GCs) and maternal stress are putative mechanisms for the fetal programming of later health outcomes. The current investigation examined the influence of prenatal maternal cortisol and maternal psychosocial stress on infant physiological and behavioral responses to stress.…

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

    Science.gov (United States)

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

    1991-12-01

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

  17. Maternal exposure to the holocaust and health complaints in offspring.

    Science.gov (United States)

    Flory, Janine D; Bierer, Linda M; Yehuda, Rachel

    2011-01-01

    Although the link between chronic stress and the development of cardiovascular and metabolic diseases of adulthood has been known for some time, there is growing recognition that early environmental influences may result in developmental programming via epigenetic mechanisms, thereby affecting the developmental trajectory of disease progression. Previous studies support the idea that offspring of Holocaust survivors may have been subjected to early developmental programming. We evaluated the relationship between parental exposure to the Holocaust and self-reported health ratings and disorders made by their adult offspring (i.e., second generation Holocaust survivors). A total of 137 subjects were evaluated. Regression analyses demonstrated that maternal but not paternal exposure to the Holocaust was related to poorer subjective impressions of emotional and physical health. This relationship was diminished when the offspring's own level of trait anxiety was considered. Offspring with maternal, but not paternal, Holocaust exposure also reported greater use of psychotropic and other medications, including medications for the treatment of hypertension and lipid disorders. The mechanism linking these health outcomes and maternal exposure deserves further investigation, including the possibility that fetal or early developmental programming is involved.

  18. Plotting Maternity in Three Persons

    Science.gov (United States)

    Kinser, Amber E.

    2012-01-01

    This performance text examines complexities of personal and maternal identity in family life. Speaking in first, second, and third person voices, the author offers autoethnographic accounts of the tensions between separateness and connectedness, normative and subjective motherhood, and novice and seasoned perspectives. The piece functions as a…

  19. Intergenerational Attitudes toward Maternal Employment.

    Science.gov (United States)

    Heaven, Catherine P.; McCluskey-Fawcett, Kathleen

    Intergenerational attitudes toward child care were examined among college-age students and their parents through the use of questionnaires, the Beliefs About the Consequences of Maternal Employment Scale (BACMEC), and the Bias in Attitudes toward Women Scale (BIAS). Findings indicated that traditional attitudes were more prevalent in males of both…

  20. Multigenerational effects of maternal undernutrition

    Science.gov (United States)

    Einstein, Francine H.

    2014-01-01

    Intrauterine exposure to reduced nutrient availability can have major effects in determining susceptibility to chronic disease later in life. Martínez et al. (2014) demonstrate multigenerational effects of poor maternal nutrition and evidence of germ-line transmission through alterations in DNA methylation. PMID:24896533

  1. Refusal of recommended maternity care: Time to make a pact with women?

    Science.gov (United States)

    Jenkinson, Bec; Kruske, Sue; Kildea, Sue

    2018-03-28

    The right to refuse medical treatment can be contentious in maternity care. Professional guidance for midwives and obstetricians emphasises informed consent and respect for patient autonomy, but there is little guidance available to clinicians about the appropriate clinical responses when women decline recommended care. We propose a comprehensive, woman-centred, systems-level framework for documentation and communication with the goal of supporting women, clinicians and health services in situations of maternal refusal. We term this the Personalised Alternative Care and Treatment framework. The Personalised Alternative Care and Treatment framework addresses Australian policy, practice, education and professional issues to underpin woman-centred care in the context of maternal refusal. It embeds Respectful Maternity Care in system-level maternity care policy; highlights the woman's role as decision maker about her maternity care; documents information exchanged with women; creates a 'living' plan that respects the woman's birth intentions and can be reviewed as circumstances change; enables communication between clinicians; permits flexible initiation pathways; provides for professional education for clinicians, and incorporates a mediation role to act as a failsafe. The Personalised Alternative Care and Treatment framework has the potential to meet the needs of women, clinicians and health services when pregnant women decline recommended maternity care. Copyright © 2018. Published by Elsevier Ltd.

  2. Autistic spectrum disorder, epilepsy, and vagus nerve stimulation.

    Science.gov (United States)

    Hull, Mariam Mettry; Madhavan, Deepak; Zaroff, Charles M

    2015-08-01

    In individuals with a comorbid autistic spectrum disorder and medically refractory epilepsy, vagus nerve stimulation may offer the potential of seizure control and a positive behavioral side effect profile. We aimed to examine the behavioral side effect profile using longitudinal and quantitative data and review the potential mechanisms behind behavioral changes. We present a case report of a 10-year-old boy with autistic spectrum disorder and epilepsy, who underwent vagus nerve stimulation subsequent to unsuccessful treatment with antiepileptic medication. Following vagus nerve stimulation implantation, initial, if temporary, improvement was observed in seizure control. Modest improvements were also observed in behavior and development, improvements which were observed independent of seizure control. Vagus nerve stimulation in autistic spectrum disorder is associated with modest behavioral improvement, with unidentified etiology, although several candidates for this improvement are evident.

  3. Vagus nerve stimulation and stereotactic radiosurgery

    International Nuclear Information System (INIS)

    Kawai, Kensuke

    2005-01-01

    Vagus nerve stimulation and stereotactic radiosurgery represent novel and less invasive therapeutics for medically intractable epilepsy. Chronic stimulation of the left vagus nerve with implanted generator and electrodes inhibits seizure susceptibility of the cerebral cortices. While the underlying mechanisms of the effect remains to be further elucidated, the efficacy and safety of vagus nerve stimulation have been established by randomized clinical trials in the United States and European countries. It has been widely accepted as a treatment option for patients with medically intractable epilepsy and for whom brain surgery is not indicated. The primary indication of vagus nerve stimulation in the clinical trials was localization-related epilepsy in adult patients but efficacy in a wide range of patient groups such as generalized epilepsy and children has been reported. Improvements in daytime alertness, mood, higher cognitive functions and overall quality of life have been reported other than the effect on epileptic seizures. Since the devices are not approved for clinical use in Japan by the Health, Labor and Welfare Ministry, there exist barriers to provide this treatment to patients at present. Stereotactic radiosurgery has been used for temporal lobe epilepsy and hypothalamic hamartoma, but it is still controversial whether the therapy is more effective and less invasive than brain surgery. Promising results of gamma knife radiosurgery for medically intractable temporal lobe epilepsy with unilateral hippocampal sclerosis have been reported essentially from one French center. Results from others were not as favorable. There seems to be an unignorable risk of brain edema and radiation necrosis when the delivered dose over the medial temporal structures is high enough to abolish epileptic seizures. A randomized clinical trial comparing different marginal doses is ongoing in the United States. Clinical trials like this, technical advancement and standardization

  4. Evaluating medical and systemic factors related to maternal ...

    African Journals Online (AJOL)

    lawupt

    complicates the situation in Tanzania as the poorest pregnant women are half as likely as the ... neonatal mortality in response to high death rates and United Nations and ... birth rate is 4.6% with the majority of women delivering at home as is ...

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

    Science.gov (United States)

    Rossin, Maya

    2011-03-01

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

  6. Systems for deep brain stimulation: review of technical features.

    Science.gov (United States)

    Amon, A; Alesch, F

    2017-09-01

    The use of deep brain stimulation (DBS) is an important treatment option for movement disorders and other medical conditions. Today, three major manufacturers provide implantable systems for DBS. Although the underlying principle is basically the same for all available systems, the differences in the technical features vary considerably. This article outlines aspects regarding the technical features of DBS systems. The differences between voltage and current sources are addressed and their effect on stimulation is shown. To maintain clinical benefit and minimize side effects the stimulation field has to be adapted to the requirements of the patient. Shaping of the stimulation field can be achieved by the electrode design and polarity configuration. Furthermore, the electric signal consisting of stimulation rate, stimulation amplitude and pulse width affect the stimulation field. Interleaving stimulation is an additional concept, which permits improved treatment outcomes. Therefore, the electrode design, the polarity, the electric signal, and the concept of interleaving stimulation are presented. The investigated systems can be also categorized as rechargeable and non-rechargeable, which is briefly discussed. Options for interconnecting different system components from various manufacturers are presented. The present paper summarizes the technical features and their combination possibilities, which can have a major impact on the therapeutic effect.

  7. Effect of massage stimulation on weight gain in full term infants

    Directory of Open Access Journals (Sweden)

    Nyoman Nursari Dewi

    2011-08-01

    Full Text Available Background Massage is a tactile/kinesthetic stimulation with biochemical and physiological effects on the body. Newborn infant massage stimulation given by mothers may promote maternal-infant bonding and attachment, enhance infant weight gain and stimulate the production of breast milk. There have been few studies on the effect of massage stimulation on weight gain in full term infants, and this topic remains controversial. Objective To examine the effect of massage stimulation on weight gain in full term infants. Methods This quasi-experimental study was held in Sanglah Hospital and Bunda Setia Maternity Clinic. Massage stimulation was performed by mothers once daily for a four week period. Massage stimulation was given to 30 full term infants and their weight gain was compared to 31 control infants who did not receive massages. Results There were no differences in subject characteristics between the massage and control groups. Median weight gain in the massage group was 1230 grams, while that in the control group was 830 grams (P=0.028. Conclusion Weight gain in full term infants in the massage group was significantly greater than that in the control group after 4 weeks.

  8. Appetite stimulants for people with cystic fibrosis.

    Science.gov (United States)

    Chinuck, Ruth; Dewar, Jane; Baldwin, David R; Hendron, Elizabeth

    2014-07-27

    , this is based upon moderate quality data from a small number of trials and so this therapy cannot be conclusively recommended based upon the findings in the review. Clinicians need to be aware of the potential adverse effects of appetite stimulants and actively monitor any patients prescribed these medications accordingly.Research is needed to determine meaningful surrogate measures for appetite and define what constitutes quality weight gain. Future trials of appetite stimulants should use a validated measure of symptoms including a disease-specific instrument for measuring poor appetite. This review highlights the need for multicentred, adequately powered and well-designed trials to evaluate agents to safely increase appetite in people with cystic fibrosis and to establish the optimal mode of treatment.

  9. Differential ethnic associations between maternal flexibility and play sophistication in toddlers born very low birth weight

    Science.gov (United States)

    Erickson, Sarah J.; Montague, Erica Q.; Maclean, Peggy C.; Bancroft, Mary E.; Lowe, Jean R.

    2013-01-01

    Children born very low birth weight (development of self-regulation and effective functional skills, and play serves as an important avenue of early intervention. The current study investigated associations between maternal flexibility and toddler play sophistication in Caucasian, Spanish speaking Hispanic, English speaking Hispanic, and Native American toddlers (18-22 months adjusted age) in a cross-sectional cohort of 73 toddlers born VLBW and their mothers. We found that the association between maternal flexibility and toddler play sophistication differed by ethnicity (F(3,65) = 3.34, p = .02). In particular, Spanish speaking Hispanic dyads evidenced a significant positive association between maternal flexibility and play sophistication of medium effect size. Results for Native Americans were parallel to those of Spanish speaking Hispanic dyads: the relationship between flexibility and play sophistication was positive and of small-medium effect size. Findings indicate that for Caucasians and English speaking Hispanics, flexibility evidenced a non-significant (negative and small effect size) association with toddler play sophistication. Significant follow-up contrasts revealed that the associations for Caucasian and English speaking Hispanic dyads were significantly different from those of the other two ethnic groups. Results remained unchanged after adjusting for the amount of maternal language, an index of maternal engagement and stimulation; and after adjusting for birth weight, gestational age, gender, test age, cognitive ability, as well maternal age, education, and income. Our results provide preliminary evidence that ethnicity and acculturation may mediate the association between maternal interactive behavior such as flexibility and toddler developmental outcomes, as indexed by play sophistication. Addressing these association differences is particularly important in children born VLBW because interventions targeting parent interaction strategies such as

  10. Maternal health phone line: saving women in papua new Guinea.

    Science.gov (United States)

    Watson, Amanda H A; Sabumei, Gaius; Mola, Glen; Iedema, Rick

    2015-04-27

    This paper presents the findings of a research project which has involved the establishment of a maternal health phone line in Milne Bay Province of Papua New Guinea (PNG). Mobile phones and landline phones are key information and communication technologies (ICTs). This research study uses the "ICTs for healthcare development" model to ascertain benefits and barriers to the successful implementation of the Childbirth Emergency Phone. PNG has a very high maternal mortality rate. The "three stages of delay" typology was developed by Thaddeus and Maine to determine factors that might delay provision of appropriate medical treatment and hence increase risk of maternal death. The "three stages of delay" typology has been utilised in various developing countries and also in the present study. Research undertaken has involved semi-structured interviews with health workers, both in rural settings and in the labour ward in Alotau. Additional data has been gathered through focus groups with health workers, analysis of notes made during phone calls, interviews with women and community leaders, observations and field visits. One hundred percent of interviewees (n = 42) said the project helped to solve communication barriers between rural health workers and Alotau Provincial Hospital. Specific examples in which the phone line has helped to create positive health outcomes will be outlined in the paper, drawn from research interviews. The Childbirth Emergency Phone project has shown itself to play a critical role in enabling healthcare workers to address life-threatening childbirth complications. The project shows potential for rollout across PNG; potentially reducing maternal morbidity and maternal mortality rates by overcoming communication challenges.

  11. Maternal Health Phone Line: Saving Women in Papua New Guinea

    Directory of Open Access Journals (Sweden)

    Amanda H.A. Watson

    2015-04-01

    Full Text Available This paper presents the findings of a research project which has involved the establishment of a maternal health phone line in Milne Bay Province of Papua New Guinea (PNG. Mobile phones and landline phones are key information and communication technologies (ICTs. This research study uses the “ICTs for healthcare development” model to ascertain benefits and barriers to the successful implementation of the Childbirth Emergency Phone. PNG has a very high maternal mortality rate. The “three stages of delay” typology was developed by Thaddeus and Maine to determine factors that might delay provision of appropriate medical treatment and hence increase risk of maternal death. The “three stages of delay” typology has been utilised in various developing countries and also in the present study. Research undertaken has involved semi-structured interviews with health workers, both in rural settings and in the labour ward in Alotau. Additional data has been gathered through focus groups with health workers, analysis of notes made during phone calls, interviews with women and community leaders, observations and field visits. One hundred percent of interviewees (n = 42 said the project helped to solve communication barriers between rural health workers and Alotau Provincial Hospital. Specific examples in which the phone line has helped to create positive health outcomes will be outlined in the paper, drawn from research interviews. The Childbirth Emergency Phone project has shown itself to play a critical role in enabling healthcare workers to address life-threatening childbirth complications. The project shows potential for rollout across PNG; potentially reducing maternal morbidity and maternal mortality rates by overcoming communication challenges.

  12. Maternal Health Phone Line: Saving Women in Papua New Guinea

    Science.gov (United States)

    Watson, Amanda H.A.; Sabumei, Gaius; Mola, Glen; Iedema, Rick

    2015-01-01

    This paper presents the findings of a research project which has involved the establishment of a maternal health phone line in Milne Bay Province of Papua New Guinea (PNG). Mobile phones and landline phones are key information and communication technologies (ICTs). This research study uses the “ICTs for healthcare development” model to ascertain benefits and barriers to the successful implementation of the Childbirth Emergency Phone. PNG has a very high maternal mortality rate. The “three stages of delay” typology was developed by Thaddeus and Maine to determine factors that might delay provision of appropriate medical treatment and hence increase risk of maternal death. The “three stages of delay” typology has been utilised in various developing countries and also in the present study. Research undertaken has involved semi-structured interviews with health workers, both in rural settings and in the labour ward in Alotau. Additional data has been gathered through focus groups with health workers, analysis of notes made during phone calls, interviews with women and community leaders, observations and field visits. One hundred percent of interviewees (n = 42) said the project helped to solve communication barriers between rural health workers and Alotau Provincial Hospital. Specific examples in which the phone line has helped to create positive health outcomes will be outlined in the paper, drawn from research interviews. The Childbirth Emergency Phone project has shown itself to play a critical role in enabling healthcare workers to address life-threatening childbirth complications. The project shows potential for rollout across PNG; potentially reducing maternal morbidity and maternal mortality rates by overcoming communication challenges. PMID:25923199

  13. Maternal Super Obesity and Neonatal Morbidity after Term Cesarean Delivery.

    Science.gov (United States)

    Smid, Marcela C; Vladutiu, Catherine J; Dotters-Katz, Sarah K; Manuck, Tracy A; Boggess, Kim A; Stamilio, David M

    2016-10-01

    Objective To estimate the association between maternal super obesity (body mass index [BMI] ≥ 50 kg/m(2)) and neonatal morbidity among neonates born via cesarean delivery (CD). Methods Retrospective cohort of singleton neonates delivered via CD ≥ 37 weeks in the Maternal-Fetal Medicine Unit Cesarean Registry. Maternal BMI at delivery was stratified as 18.5 to 29.9 kg/m(2), 30 to 39.9 kg/m(2), 40 to 49.9 kg/m(2), and ≥ 50 kg/m(2). Primary outcomes included acute (5-minute Apgar score neonatal injury, and/or transient tachypnea of the newborn) and severe (grade 3 or 4 intraventricular hemorrhage, necrotizing enterocolitis, seizure, respiratory distress syndrome, hypoxic ischemic encephalopathy, meconium aspiration, ventilator support ≥ 2 days, sepsis and/or neonatal death) neonatal morbidity. Odds of neonatal morbidity were estimated for each BMI category adjusting for clinical and operative characteristics. Results Of 41,262 maternal-neonatal dyads, 36% of women were nonobese, 49% had BMI of 30 to 39.9 kg/m(2), 12% had BMI of 40 to 49.9 kg/m(2), and 3% were super obese. Compared with nonobese women, super obese women had twofold odds of acute (5 vs. 10%; adjusted odds ratio [aOR]: 1.81, 95% confidence interval [CI]: 1.59-2.73) and severe (3 vs. 6%; aOR: 2.08; 95% CI: 1.59-2.73) neonatal morbidity. Conclusion Among term infants delivered via CD, maternal super obesity is associated with increased risk of neonatal morbidity. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  14. Hyperammonemia: A Report of Maternal Biliary Cirrhosis and Neonatal Outcome

    Directory of Open Access Journals (Sweden)

    Deana J. Hussamy

    2013-01-01

    Full Text Available Although uncommon during pregnancy, cirrhosis results in multiple medical complications impacting both mother and fetus. Previous reports suggest liver dysfunction in pregnancy causes accumulation of neurotoxins within the maternal compartment that increases neonatal morbidity through placental transfer. We present a case of a 36-year-old G2P1 female with history of biliary cirrhosis presenting at 32-weeks' gestation with hepatic congestion progressing to hepatic encephalopathy prompting delivery. Umbilical cord sampling and postnatal infant testing demonstrated elevated ammonia levels which resolved by 12 hours of life without intervention. At discharge, the infant did not demonstrate evidence of neurologic deficit. We conclude that acute maternal hepatic encephalopathy and hyperammonemia due to chronic liver disease do not portend adverse neonatal outcomes, notably encephalopathy.

  15. Distribution of causes of maternal mortality during delivery and post-partum: results of an African multicentre hospital-based study.

    Science.gov (United States)

    Thonneau, Patrick F; Matsudai, Tomohiro; Alihonou, Eusèbe; De Souza, Jose; Faye, Ousseynou; Moreau, Jean-Charles; Djanhan, Yao; Welffens-Ekra, Christiane; Goyaux, Nathalie

    2004-06-15

    To assess the maternal mortality ratio in maternity units of reference hospitals in large west African cities, and to describe the distribution of complications and causes of maternal deaths. Prospective descriptive study in twelve reference maternities located in three African countries (Benin, Ivory Coast, Senegal). Data (clinical findings at hospital entry, medical history, complications, type of surgery, vital status of the women at discharge) were collected from obstetrical and surgical files and from admission hospital registers. All cases of maternal deaths were systematically reviewed by African and European staff. Of a total of 10,515 women, 1495 presented a major obstetric complication with dystocia or inappropriate management of the labour phase as the leading cause. Eighty-five maternal deaths were reported, giving a global hospital-based maternal mortality ratio of 800/100,000. Hypertensive disorders were involved in 25/85 cases (29%) and post-partum haemorrhage in 13/85 cases (15%). Relatively few cases (14) of major sepsis were reported, leading to three maternal deaths. The results of this multicentre study confirm the high rates of maternal mortality in maternity units of reference hospitals in large African cities, and in addition to dystocia the contribution of hypertensive disorders and post-partum haemorrhage to maternal deaths.

  16. Spinal cord stimulation for neuropathic pain: current perspectives

    Directory of Open Access Journals (Sweden)

    Wolter T

    2014-11-01

    Full Text Available Tilman Wolter Interdisciplinary Pain Centre, University Hospital Freiburg, Freiburg, Germany Abstract: Neuropathic pain constitutes a significant portion of chronic pain. Patients with neuropathic pain are usually more heavily burdened than patients with nociceptive pain. They suffer more often from insomnia, anxiety, and depression. Moreover, analgesic medication often has an insufficient effect on neuropathic pain. Spinal cord stimulation constitutes a therapy alternative that, to date, remains underused. In the last 10 to 15 years, it has undergone constant technical advancement. This review gives an overview of the present practice of spinal cord stimulation for chronic neuropathic pain and current developments such as high-frequency stimulation and peripheral nerve field stimulation. Keywords: spinal cord stimulation, neuropathic pain, neurostimulation

  17. [Transcranial magnetic stimulation and motor cortex stimulation in neuropathic pain].

    Science.gov (United States)

    Mylius, V; Ayache, S S; Teepker, M; Kappus, C; Kolodziej, M; Rosenow, F; Nimsky, C; Oertel, W H; Lefaucheur, J P

    2012-12-01

    Non-invasive and invasive cortical stimulation allows the modulation of therapy-refractory neuropathic pain. High-frequency repetitive transcranial magnetic stimulation (rTMS) of the contralateral motor cortex yields therapeutic effects at short-term and predicts the benefits of epidural motor cortex stimulation (MCS). The present article summarizes the findings on application, mechanisms and therapeutic effects of cortical stimulation in neuropathic pain.

  18. Radiation sterilization of medical products

    International Nuclear Information System (INIS)

    Khurshid, S.J.; Hussain, A.M.

    1989-01-01

    Radiation sterilization is the best method of sterilization, essentially for single use medical and surgical products. Pakistan has established a commercial gamma irradiation plant for this purpose. This article overviews the advantages and benefits of radiation sterilization to stimulate the interest of industrialists and the users in this technology. This technology can give a better medical care in the country and the growing demand can only be met by bulk sterilization. The radiation sterilized medical products can also compete well with the products sterilized by other methods in the international market, gamma sterilization is accepted internationally and if adopted it can boost our export of medical products. (author)

  19. Addressing maternal deaths due to violence: the Illinois experience.

    Science.gov (United States)

    Koch, Abigail R; Geller, Stacie E

    2017-11-01

    Homicide, suicide, and substance abuse accounted for nearly one fourth of all pregnancy-associated deaths in Illinois from 2002 through 2013. Maternal mortality review in Illinois has been primarily focused on obstetric and medical causes and little is known about the circumstances surrounding deaths due to homicide, suicide, and substance abuse, if they are pregnancy related, and if the deaths are potentially preventable. To address this issue, we implemented a process to form a second statewide maternal mortality review committee for deaths due to violence in late 2014. We convened a stakeholder group to accomplish 3 tasks: (1) identify appropriate committee members; (2) identify potential types and sources of information that would be required for a meaningful review of violent maternal deaths; and (3) revise the Maternal Mortality Review Form. Because homicide, suicide, and substance abuse are closely linked to the social determinants of health, the review committee needed to have a broad membership with expertise in areas not required for obstetric maternal mortality review, including social service and community organizations. Identifying additional sources of information is critical; the state Violent Death Reporting System, case management data, and police and autopsy reports provide contextual information that cannot be found in medical records. The stakeholder group revised the Maternal Mortality Review Form to collect information relevant to violent maternal deaths, including screening history and psychosocial history. The form guides the maternal mortality review committee for deaths due to violence to identify potentially preventable factors relating to the woman, her family, systems of care, the community, the legal system, and the institutional environment. The committee has identified potential opportunities to decrease preventable death requiring cooperation with social service agencies and the criminal justice system in addition to the physical

  20. Rapid Survey For Measuring The Level And Causes Of Maternal Mortality

    Directory of Open Access Journals (Sweden)

    Kumar Rajesh

    1997-01-01

    Full Text Available Research question: What is the extent of problem of maternal mortality in a given population? Objective: 1. To evolve a rapid survey methodology aimed at measuring maternal mortality ratio. 2. To find out the probable medical causes of maternal deaths and behavioural factors associated with them. Study Design: cross- sectional. Setting: Urban and rural areas of district Mohindergarh, Haryana. Participants: Members of families in which a maternal death had taken place in last 12 months. Sample size: All 275 deaths among women 15-44 years occurring in the district from 1st April 95 to 31st March 96. Study variables: Age, gravida, parity, literacy, caste, land holding, health care facilities, distance from health centers, mode of conveyance. Statistical Analysis: Rates and ratios. Results: Maternal mortality ratio was estimated to be 275 per 100,000 live births (298 rural and 82 urban. Major causes of death were â€" sepsis(30%, haemorrhage (21%, abortion(5%, eclampsia (3% and obstructed labour(3%. Twenty-nine causes of deaths occurred at home and 26% on way to hospital. Out of 59(93.7% cases who could avail medical consultation, 61% arranged it within five hours after onset of symptoms, and 78% availed two, 21% three, and 11% four consulations. The survey was completed in three months at a cost of Rs. 54,000. Recommendations: Such rapid surveys should be carried out periodically (every 4-5 years to monitor the progress in maternal health. Staff of heath deptt. Should be involved in carrying out these surveys. This will not only help in reducing cost of the survey but information about specific problems of maternal mortality in the area can be utilized by health staff for taking appropriate action to improve maternal health care.

  1. Associations of maternal o,p'-DDT and p,p'-DDE levels with birth outcomes in a Bolivian cohort

    DEFF Research Database (Denmark)

    Arrebola, Juan P.; Cuellar, Miriam; Bonde, Jens Peter

    2016-01-01

    This study examined the potential association of maternal serum levels of o,p'-DDT and p,p'-DDE with gestation time and with anthropometric measurements and thyroid-stimulating hormone (TSH) levels of newborns in a Bolivian birth cohort. Two hundred mothers were consecutively recruited between Ja...

  2. Household Size and Water Availability as Demographic Predictors of Maternal and Child Mortality in Delta State: Implications for Health Education

    Science.gov (United States)

    Ogbe, Joseph O.

    2010-01-01

    The purpose of this study was to stimulate action to address and identify maternal, child and community needs towards the improvement in health of pregnant women, children and communities. Four null hypotheses were generated from the research questions while multiple regression analysis was used to analyse the data. The study found that household…

  3. Maternal Characteristics Predicting Young Girls’ Disruptive Behavior

    Science.gov (United States)

    van der Molen, Elsa; Hipwell, Alison E.; Vermeiren, Robert; Loeber, Rolf

    2011-01-01

    Little is known about the relative predictive utility of maternal characteristics and parenting skills on the development of girls’ disruptive behavior. The current study used five waves of parent and child-report data from the ongoing Pittsburgh Girls Study to examine these relationships in a sample of 1,942 girls from age 7 to 12 years. Multivariate Generalized Estimating Equation (GEE) analyses indicated that European American race, mother’s prenatal nicotine use, maternal depression, maternal conduct problems prior to age 15, and low maternal warmth explained unique variance. Maladaptive parenting partly mediated the effects of maternal depression and maternal conduct problems. Both current and early maternal risk factors have an impact on young girls’ disruptive behavior, providing support for the timing and focus of the prevention of girls’ disruptive behavior. PMID:21391016

  4. Words in Maternity Wards: An Aproximation to Perinatal Psychology

    Directory of Open Access Journals (Sweden)

    Alicia Oiberman

    2016-02-01

    Full Text Available The acknowledgment that just born babies interact with human and physical contexts originated changes in behaviors of health teems working in maternity wards settings. Concepts such as initial interactions, attachment, dyads, maternal vulnerability, behavioral competences of the just born babies and their applications to perinatal psychology, marked a transformation in different professionals involved in birth’s approaches. From one side, it can be said that medicalization of the birth act in Western societies had allowed to minimize risk factors. But this progress had been carried out without taking into account emotional expressions. The introduction of psychological interventions in neonatal periods is a new field of knowledge. History shows that in different periods and cultures there were amulets, potions and other elements associated with magic that were used to swear baby or mother’s death risk during childbirth. All these practices were taken the place of words, in a hard emotional moment: parturition. It was necessary to walk a long and difficult road for Perinatal Psycholy to recuperate the ancient place of old good women and incorporate words in maternity wards, knowing that the main scenery is first occupied by the mother’s body and then by the baby. Our daily job in a maternity ward, working together with pediatricians and neonatologists, allowed us to verify that words come out when psychologists themselves “include their body” as well as do mothers, babies and the medical teem. Words contribute to facilitate emotional expressions related to motherhood and place the baby in the family history, making able his or her “psychological birth”. 

  5. Grating stimulated echo

    International Nuclear Information System (INIS)

    Dubetsky, B.; Berman, P.R.; Sleator, T.

    1992-01-01

    A theory of a grating simulated echo (GTE) is developed. The GSE involves the sequential excitation of atoms by two counterpropagating traveling waves, a standing wave, and a third traveling wave. It is shown that the echo signal is very sensitive to small changes in atomic velocity, much more sensitive than the normal stimulated echo. Use of the GSE as a collisional probe or accelerometer is discussed

  6. Thyroid Stimulating Hormone Receptor

    Directory of Open Access Journals (Sweden)

    Murat Tuncel

    2017-02-01

    Full Text Available Thyroid stimulating hormone receptor (TSHR plays a pivotal role in thyroid hormone metabolism. It is a major controller of thyroid cell function and growth. Mutations in TSHR may lead to several thyroid diseases, most commonly hyperthyroidism. Although its genetic and epigenetic alterations do not directly lead to carcinogenesis, it has a crucial role in tumor growth, which is initiated by several oncogenes. This article will provide a brief review of TSHR and related diseases.

  7. Cranial electrotherapy stimulation for treatment of anxiety, depression, and insomnia.

    Science.gov (United States)

    Kirsch, Daniel L; Nichols, Francine

    2013-03-01

    Cranial electrotherapy stimulation is a prescriptive medical device that delivers a mild form of electrical stimulation to the brain for the treatment of anxiety, depression, and insomnia. It is supported by more than 40 years of research demonstrating its effectiveness in several mechanistic studies and greater than 100 clinical studies. Adverse effects are rare (<1%), mild, and self-limiting, consisting mainly of skin irritation under the electrodes and headaches. Often used as a stand-alone therapy, because results are usually seen from the first treatment, cranial electrotherapy stimulation may also be used as an adjunctive therapy. Copyright © 2013 Elsevier Inc. All rights reserved.

  8. Biomagnetics and bioimaging for medical applications

    Energy Technology Data Exchange (ETDEWEB)

    Ueno, Shoogo [Department of Biomedical Engineering, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033 (Japan)]. E-mail: ueno@medes.m.u-tokyo.ac.jp; Sekino, Masaki [Department of Biomedical Engineering, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033 (Japan)

    2006-09-15

    This paper reviews medical applications of the recently developed techniques in biomagnetics and bioimaging such as transcranial magnetic stimulation, magnetoencephalography, magnetic resonance imaging, cancer therapy based on magnetic stimulation, and magnetic control of cell orientation and cell growth. These techniques are leading medicine and biology into a new horizon through the novel applications of magnetism.

  9. Biomagnetics and bioimaging for medical applications

    International Nuclear Information System (INIS)

    Ueno, Shoogo; Sekino, Masaki

    2006-01-01

    This paper reviews medical applications of the recently developed techniques in biomagnetics and bioimaging such as transcranial magnetic stimulation, magnetoencephalography, magnetic resonance imaging, cancer therapy based on magnetic stimulation, and magnetic control of cell orientation and cell growth. These techniques are leading medicine and biology into a new horizon through the novel applications of magnetism

  10. THE AVAILABILITY AND PORTRAYAL OF STIMULANTS OVER THE INTERNET

    Science.gov (United States)

    Schepis, Ty S.; Marlowe, Douglas B.; Forman, Robert F.

    2008-01-01

    Purpose To quantify the online availability and portrayal of amphetamine-class prescription stimulants with a focus on those medications commonly prescribed to and abused by adolescents. Methods The Google™ search engine was used in searches to assess the frequency of websites offering to sell controlled stimulants (retail sites) or websites that directly linked to retail sites (portal sites). Also, separate searches evaluated the portrayal of controlled prescription stimulants by the initial 20 websites returned by Google™. Retail and portal website frequency was collected for each search. For searches measuring the portrayal of stimulants, webpages were categorized as pro-abuse, anti-abuse, neutral or other, based on set criteria. Results Sites offering to sell stimulants without a prescription were found for nearly all search terms. Across all searches, the Schedule III stimulants indicated for the treatment of obesity returned more sites offering to sell stimulants without a prescription than Schedule II stimulants indicated for the treatment of ADHD. Internet site portrayal of each stimulant varied. However, sites that contained “methamphetamine” often included anti-abuse information. Discussion The apparent availability of stimulants over the Internet without a prescription indicates the potential for a significant public health problem. The extent to which teens are obtaining these drugs via the Internet remains unclear, but clinicians must be aware of the potential for abuse, concomitant prescription use issues, illicit sources, and diversion of these highly addictive medications. Education of consumers and physicians as well as further governmental interventions is needed to limit the potential scope of this problem. PMID:18407040

  11. The evolution of multivariate maternal effects.

    Directory of Open Access Journals (Sweden)

    Bram Kuijper

    2014-04-01

    Full Text Available There is a growing interest in predicting the social and ecological contexts that favor the evolution of maternal effects. Most predictions focus, however, on maternal effects that affect only a single character, whereas the evolution of maternal effects is poorly understood in the presence of suites of interacting traits. To overcome this, we simulate the evolution of multivariate maternal effects (captured by the matrix M in a fluctuating environment. We find that the rate of environmental fluctuations has a substantial effect on the properties of M: in slowly changing environments, offspring are selected to have a multivariate phenotype roughly similar to the maternal phenotype, so that M is characterized by positive dominant eigenvalues; by contrast, rapidly changing environments favor Ms with dominant eigenvalues that are negative, as offspring favor a phenotype which substantially differs from the maternal phenotype. Moreover, when fluctuating selection on one maternal character is temporally delayed relative to selection on other traits, we find a striking pattern of cross-trait maternal effects in which maternal characters influence not only the same character in offspring, but also other offspring characters. Additionally, when selection on one character contains more stochastic noise relative to selection on other traits, large cross-trait maternal effects evolve from those maternal traits that experience the smallest amounts of noise. The presence of these cross-trait maternal effects shows that individual maternal effects cannot be studied in isolation, and that their study in a multivariate context may provide important insights about the nature of past selection. Our results call for more studies that measure multivariate maternal effects in wild populations.

  12. The evolution of multivariate maternal effects.

    Science.gov (United States)

    Kuijper, Bram; Johnstone, Rufus A; Townley, Stuart

    2014-04-01

    There is a growing interest in predicting the social and ecological contexts that favor the evolution of maternal effects. Most predictions focus, however, on maternal effects that affect only a single character, whereas the evolution of maternal effects is poorly understood in the presence of suites of interacting traits. To overcome this, we simulate the evolution of multivariate maternal effects (captured by the matrix M) in a fluctuating environment. We find that the rate of environmental fluctuations has a substantial effect on the properties of M: in slowly changing environments, offspring are selected to have a multivariate phenotype roughly similar to the maternal phenotype, so that M is characterized by positive dominant eigenvalues; by contrast, rapidly changing environments favor Ms with dominant eigenvalues that are negative, as offspring favor a phenotype which substantially differs from the maternal phenotype. Moreover, when fluctuating selection on one maternal character is temporally delayed relative to selection on other traits, we find a striking pattern of cross-trait maternal effects in which maternal characters influence not only the same character in offspring, but also other offspring characters. Additionally, when selection on one character contains more stochastic noise relative to selection on other traits, large cross-trait maternal effects evolve from those maternal traits that experience the smallest amounts of noise. The presence of these cross-trait maternal effects shows that individual maternal effects cannot be studied in isolation, and that their study in a multivariate context may provide important insights about the nature of past selection. Our results call for more studies that measure multivariate maternal effects in wild populations.

  13. An Investigation into the Use of Stimulant Therapy during Pregnancy

    Directory of Open Access Journals (Sweden)

    Natalie Shields

    2012-01-01

    Full Text Available Introduction. A lack of documentation of stimulant use during pregnancy means that doctors have difficulty advising narcoleptic and hypersomnolent patients. Objectives. To investigate the use of stimulant therapy in narcoleptic and hypersomnolent patients during pregnancy. Method. A search of clinic letters at a tertiary sleep clinic identified women who became pregnant whilst receiving stimulant therapy between 01/09/1999 and 18/11/2010. Fifteen patients were included in a telephone survey. Results. There were 20 pregnancies. The reported advice received with regards to stimulant use was variable. In 7 pregnancies, medication was stopped preconceptually: 1 had a cleft palate and an extra digit 6 had good foetal outcomes. In 8 pregnancies, medication was stopped postconceptually: 1 had autism and attention-deficit hyperactivity disorder; 7 had good foetal outcomes. In 5 pregnancies, medication was continued throughout pregnancy: 2 ended in miscarriage; 1 was ectopic; 2 had good foetal outcomes. The most common symptom experienced was debilitating hypersomnolence. Conclusion. There are no standardised guidelines for use of stimulants during pregnancy. Women have significant symptoms during pregnancy for which there is an unmet clinical need. More research is needed into whether medication can be safely continued during pregnancy, and if not, when it should be discontinued. Better standardized advice should be made available.

  14. Predicting students' intention to use stimulants for academic performance enhancement.

    Science.gov (United States)

    Ponnet, Koen; Wouters, Edwin; Walrave, Michel; Heirman, Wannes; Van Hal, Guido

    2015-02-01

    The non-medical use of stimulants for academic performance enhancement is becoming a more common practice among college and university students. The objective of this study is to gain a better understanding of students' intention to use stimulant medication for the purpose of enhancing their academic performance. Based on an extended model of Ajzen's theory of planned behavior, we examined the predictive value of attitude, subjective norm, perceived behavioral control, psychological distress, procrastination, substance use, and alcohol use on students' intention to use stimulants to improve their academic performance. The sample consisted of 3,589 Flemish university and college students (mean age: 21.59, SD: 4.09), who participated anonymously in an online survey conducted in March and April 2013. Structural equation modeling was used to investigate the relationships among the study variables. Our results indicate that subjective norm is the strongest predictor of students' intention to use stimulant medication, followed by attitude and perceived behavioral control. To a lesser extent, procrastinating tendencies, psychological distress, and substance abuse contribute to students' intention. Conclusions/ Importance: Based on these findings, we provide several recommendations on how to curtail students' intention to use stimulant medication for the purpose of improving their academic performance. In addition, we urge researchers to identify other psychological variables that might be related to students' intention.

  15. Impact of maternal mental health on maternal-child interaction in attendees in a community health clinic in Lagos, Nigeria

    Directory of Open Access Journals (Sweden)

    Motunrayo A Oyelohunnu

    2016-01-01

    Full Text Available Background: Maternal mental health, in particular depression, has been found to negatively impact mother-child interaction, attachment, stimulation, growth, and many important aspects of development in the young child. These early deficits if sustained and unattended may have negative immediate and long-term consequences on the outcomes in the child. The study aimed to assess psychological distress and postpartum depression in mothers, and their relationship to the mother-child interaction. Methodology: This is a descriptive clinic-based study. Eligible and consenting mothers are attending the child immunization clinic in the Lagos University Teaching Hospital, Lagos, Nigeria participated. Consecutive mothers completed the interview questionnaires independently while those who were not literate had the questionnaires administered by trained interviewers. Instruments used were a sociodemographic proforma, the General Health Questionnaire-12, Mother and Infant Attachment Scale (MIAS, and the Zung Depression Scale. Results: In total, ninety-eight women were enrolled, 66.3% were aged between 26 and 35 years, and mean age of 30.9 years (±5.1 standard deviation. Most were aged between 26 and 35 years (66.3%. Over 90% had at secondary school education or more. Over a 10 th (13.3% was unemployed and 96% married. The children were aged between 6 weeks and 1 year, males (63.1%, and females (46.9%, and the majority were born by spontaneous vaginal delivery (82.7%. A 10 th (10.2% of the women had probable psychiatric morbidity, 14.3% had scores suggestive of postpartum depression, and 18 (16.3% scored below average attachment in interaction with their children on the MIAS. There was an association found between reduced maternal-child attachment interaction and maternal depression (P ≤ 0.05. Conclusions: Emotional disorders, such as depression, in mothers can be associated reduced maternal-child interaction. It is important that integrated mental health

  16. Novel transcranial magnetic stimulation coil for mice

    Science.gov (United States)

    March, Stephen; Stark, Spencer; Crowther, Lawrence; Hadimani, Ravi; Jiles, David

    2014-03-01

    Transcranial magnetic stimulation (TMS) shows potential for non-invasive treatment of various neurological disorders. Significant work has been performed on the design of coils used for TMS on human subjects but few reports have been made on the design of coils for use on the brains of animals such as mice. This work is needed as TMS studies utilizing mice can allow rapid preclinical development of TMS for human disorders but the coil designs developed for use on humans are inadequate for optimal stimulation of the much smaller mouse brain. A novel TMS coil has been developed with the goal of inducing strong and focused electric fields for the stimulation of small animals such as mice. Calculations of induced electric fields were performed utilizing an MRI derived inhomogeneous model of an adult male mouse. Mechanical and thermal analysis of this new TMS helmet-coil design have also been performed at anticipated TMS operating conditions to ensure mechanical stability of the new coil and establish expected linear attraction and rotational force values. Calculated temperature increases for typical stimulation periods indicate the helmet-coil system is capable of operating within established medical standards. A prototype of the coil has been fabricated and characterization results are presented.

  17. Downward Trend in Maternal Mortality Ratio in Khorasan Razavi Province, Iran

    Directory of Open Access Journals (Sweden)

    Morteza Talebi Doluee

    2018-01-01

    Full Text Available Background & aim: Maternal mortality is defined as the death during pregnancy or up to 42 days postpartum. This study sought to determine the trend of maternal mortality ratio (MMR and its associated factors in Khorasan Razavi province, Iran. Methods: This retrospective cross-sectional study was conducted in Khorasan Razavi Province, North East of Iran, during 2010 to 2014. Data was collected from the reports of Maternal Mortality Committee of Mashhad University of Medical Sciences, Mashhad, Iran. The MMR was calculated for each period, and its trend was estimated. Chi-square test was used to find the relationship between mode of delivery and direct or indirect causes of maternal death. Results: According to the results, 94 maternal deaths occurred during 2010 to 2014. The total MMR was 17.68 (95%CI: 13.59-21.77 per 100,000 live births. The mean maternal age was 30.7±6.1 years old. Most of the deaths (75.6% occurred during postpartum period, from which 81% happened following a high-risk pregnancy. In addition, 50% of the mothers had proper numbers of visits during pregnancy. The most direct and indirect causes of maternal death were maternal hemorrhage (24.5% and cardiovascular diseases (12.8%, respectively. The relative risk of maternal mortality associated with cesarean section was 1.3 in comparison to normal vaginal delivery. Conclusion: The estimation of MMR is essential for decision-making and resource allocation. To reach this goal, a good registration system is needed to register all deaths and their exact causes.

  18. Maternal Emotional Availability and Its Association with Maternal Psychopathology, Attachment Style Insecurity and Theory of Mind.

    Science.gov (United States)

    Licata, Maria; Zietlow, Anna-Lena; Träuble, Birgit; Sodian, Beate; Reck, Corinna

    High maternal emotional availability (EA) positively affects various domains of child development. However, the question of which factors promote or hinder maternal EA has not been investigated systematically. The present study investigated several maternal characteristics, namely maternal psychopathology, maternal attachment style insecurity, and theory of mind (ToM) as possible factors that influence maternal EA. The sample was comprised of 56 mothers and their preschool-aged children. Half of the mothers were diagnosed with postpartum depression and or anxiety disorders according to DSM-IV, and the other half were healthy controls. The results showed that both low maternal attachment style insecurity and high ToM skills significantly predicted maternal EA sensitivity, independently from maternal postpartum and concurrent psychopathology and education. Moreover, maternal attachment style insecurity fully mediated the link between maternal postpartum psychopathology and sensitivity. The findings suggest that maternal attachment style security can buffer negative effects of maternal psychopathology on maternal sensitivity in the mother-child interaction. © 2016 S. Karger AG, Basel.

  19. Abortion - medical

    Science.gov (United States)

    Therapeutic medical abortion; Elective medical abortion; Induced abortion; Nonsurgical abortion ... A medical, or nonsurgical, abortion can be done within 7 weeks from the first day of the woman's last ...

  20. Maternal and newborn outcomes in planned home birth vs planned hospital births: a metaanalysis.

    Science.gov (United States)

    Wax, Joseph R; Lucas, F Lee; Lamont, Maryanne; Pinette, Michael G; Cartin, Angelina; Blackstone, Jacquelyn

    2010-09-01

    We sought to systematically review the medical literature on the maternal and newborn safety of planned home vs planned hospital birth. We included English-language peer-reviewed publications from developed Western nations reporting maternal and newborn outcomes by planned delivery location. Outcomes' summary odds ratios with 95% confidence intervals were calculated. Planned home births were associated with fewer maternal interventions including epidural analgesia, electronic fetal heart rate monitoring, episiotomy, and operative delivery. These women were less likely to experience lacerations, hemorrhage, and infections. Neonatal outcomes of planned home births revealed less frequent prematurity, low birthweight, and assisted newborn ventilation. Although planned home and hospital births exhibited similar perinatal mortality rates, planned home births were associated with significantly elevated neonatal mortality rates. Less medical intervention during planned home birth is associated with a tripling of the neonatal mortality rate. Copyright 2010 Mosby, Inc. All rights reserved.

  1. Low intensity transcranial electric stimulation

    DEFF Research Database (Denmark)

    Antal, Andrea; Alekseichuk, I; Bikson, M

    2017-01-01

    Low intensity transcranial electrical stimulation (TES) in humans, encompassing transcranial direct current (tDCS), transcutaneous spinal Direct Current Stimulation (tsDCS), transcranial alternating current (tACS), and transcranial random noise (tRNS) stimulation or their combinations, appears...

  2. Prenatal Screening Using Maternal Markers

    Directory of Open Access Journals (Sweden)

    Howard Cuckle

    2014-05-01

    Full Text Available Maternal markers are widely used to screen for fetal neural tube defects (NTDs, chromosomal abnormalities and cardiac defects. Some are beginning to broaden prenatal screening to include pregnancy complications such as pre-eclampsia. The methods initially developed for NTDs using a single marker have since been built upon to develop high performance multi-maker tests for chromosomal abnormalities. Although cell-free DNA testing is still too expensive to be considered for routine application in public health settings, it can be cost-effective when used in combination with existing multi-maker marker tests. The established screening methods can be readily applied in the first trimester to identify pregnancies at high risk of pre-eclampsia and offer prevention though aspirin treatment. Prenatal screening for fragile X syndrome might be adopted more widely if the test was to be framed as a form of maternal marker screening.

  3. Maternal obesity and prenatal programming.

    Science.gov (United States)

    Elshenawy, Summer; Simmons, Rebecca

    2016-11-05

    Obesity is a significant and increasing public health concern in the United States and worldwide. Clinical and epidemiological evidence clearly shows that genetic and environmental factors contribute to the increased susceptibility of humans to obesity and its associated comorbidities; the interplay of these factors is explained by the concept of epigenetics. The impact of maternal obesity goes beyond the newborn period; fetal programming during the critical window of pregnancy, can have long term detrimental effects on the offspring as well as future generations. Emerging evidence is uncovering a link between the clinical and molecular findings in the offspring with epigenetic changes in the setting of maternal obesity. Research targeted towards reducing the transgenerational propagation and developmental programming of obesity is vital in reducing the increasing rates of disease. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  4. Maternal mortality following caesarean sections.

    Science.gov (United States)

    Sikdar, K; Kundu, S; Mandal, G S

    1979-08-01

    A study of 26 maternal deaths following 3647 caesarean sections was conducted in Eden Hospital from 1974-1977. During the time period there were 35,544 births and 308 total maternal deaths (8.74/1000). Indications for Caesarean sections included: 1) abnormal presentation; 2) cephalopelvic disproportion; 3) toxemia; 4) prolonged labor; 5) fetal distress; and 6) post-caesarean pregnancies. Highest mortality rates were among cephalopelvic disproportion, toxemia, and prolonged labor patients. 38.4% of the patients died due to septicaemia and peritonitis, but other deaths were due to preclampsia, shock, and hemorrhage. Proper antenatal care may have prevented anemia and preclampsia and treated other pre-existing or superimposed diseases.

  5. Maternal age and child morbidity

    DEFF Research Database (Denmark)

    Hviid, Malene Meisner; Skovlund, Charlotte Wessel; Mørch, Lina Steinrud

    2017-01-01

    the association between maternal age and overall child morbidity according to main diagnosis groups. MATERIAL AND METHODS: We conducted a national cohort study including 352 027 live firstborn singleton children. The children were born between Jan 1994 and Dec 2009 and followed to Dec 2012. Children were divided...... into groups according to maternal age: 15-24, 25-29, 30-34, and 35+ years. Poisson regression analyses calculated adjusted incidence rate ratios (IRR) of child morbidities according to main diagnoses groups A-Q of the International Classification of Disease 10 with adjustment for year of birth, body mass...... index, smoking, and mother's level of education. RESULTS: Average follow-up time was 11 years. Compared to children born to women 25-29 years, firstborn children to mothers aged 35+ had higher child morbidity in 8 of 19 main diagnosis groups and firstborn children to mothers 15-24 years had higher child...

  6. Effects of a parenting intervention to address maternal psychological wellbeing and child development and growth in rural Uganda: a community-based, cluster-randomised trial

    OpenAIRE

    Dr. Daisy R Singla, PhD; Elias Kumbakumba, MMed; Prof. Frances E Aboud, PhD

    2015-01-01

    Background: Parenting interventions have been implemented to improve the compromised developmental potential among 39% of children younger than 5 years living in low-income and middle-income countries. Maternal wellbeing is important for child development, especially in children younger than 3 years who are vulnerable and dependent on their mothers for nutrition and stimulation. We assessed an integrated, community-based parenting intervention that targeted both child development and maternal...

  7. Hepatitis E and Maternal Deaths

    Centers for Disease Control (CDC) Podcasts

    2012-11-06

    Dr. Alain Labrique, assistant professor in the Department of International Health and Department of Epidemiology at the Bloomberg School of Public Health, gives us his perspective on hepatitis E and maternal deaths.  Created: 11/6/2012 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID); National Center for Immunization and Respiratory Diseases (NCIRD).   Date Released: 11/7/2012.

  8. The measurement of maternal adiposity.

    LENUS (Irish Health Repository)

    Fattah, C

    2012-02-01

    The issue of maternal obesity has become a major public health problem. Internationally, the diagnosis of obesity is based on body mass index (BMI) that is, weight in kg\\/height in m2. While epidemiological associations have been shown between different BMI categories and adverse clinical outcomes, there is also a growing realisation that BMI has significant limitations. In this review, we assess current methods to measure body fat and, in particular, their application in pregnant women.

  9. Newborn follow-up after discharge from the maternity unit: Compliance with national guidelines.

    Science.gov (United States)

    Roisné, J; Delattre, M; Rousseau, S; Bourlet, A; Charkaluk, M-L

    2018-02-01

    In the context of shorter hospital stays in maternity units, in 2014 the French health authorities issued guidelines for newborn follow-up after discharge from maternity units. A medical visit is recommended between the 6th and 10th day of life, as are home visits from midwives. This study was designed to evaluate compliance with these guidelines. The study was observational, prospective, multicenter, and was conducted in March and April 2015 in three maternity units in northern France that participate in the Baby Friendly Hospital Initiative (BFHI). Follow-up practices (medical visit between the 6th and 10th day, home visits from a midwife) and demographic, social, and medical data were recorded during the stay in the maternity unit, and through a phone interview 1 month later, in singleton term-born infants. The study population included 108 mother-infant pairs. The recommended medical visit was effectively performed by a physician between the 6th and 10th day of life for 20 newborns (19%) (95% CI: [11; 26]). During the 1st month, at least one home visit from a midwife was recorded for 96 mother-infant pairs (89%). The only factor positively correlated with a medical visit between the 6th and 10th day was the mother's choice, made early during the hospital stay and independently of the real length of stay, for early discharge from the maternity unit. Compliance with national guidelines was poor for the recommended medical visit between the 6th and 10th day of life. Information needs to be improved. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  10. Deep brain stimulation for cluster headache

    DEFF Research Database (Denmark)

    Grover, Patrick J; Pereira, Erlick A C; Green, Alexander L

    2009-01-01

    Cluster headache is a severely debilitating disorder that can remain unrelieved by current pharmacotherapy. Alongside ablative neurosurgical procedures, neuromodulatory treatments of deep brain stimulation (DBS) and occipital nerve simulation have emerged in the last few years as effective...... treatments for medically refractory cluster headaches. Pioneers in the field have sought to publish guidelines for neurosurgical treatment; however, only small case series with limited long-term follow-up have been published. Controversy remains over which surgical treatments are best and in which...... circumstances to intervene. Here we review current data on neurosurgical interventions for chronic cluster headache focusing upon DBS and occipital nerve stimulation, and discuss the indications for and putative mechanisms of DBS including translational insights from functional neuroimaging, diffusion weighted...

  11. Trends in maternal mortality at the University of Calabar Teaching Hospital, Nigeria, 1999–2009

    Directory of Open Access Journals (Sweden)

    TU Agan

    2010-08-01

    Full Text Available TU Agan1, EI Archibong1, JE Ekabua1, EI Ekanem1, S E Abeshi1, TA Edentekhe2, EE Bassey21Department of Obstetrics and Gynecology and 2Department of Anesthesia, College of Medical Sciences, University of Calabar Teaching Hospital, NigeriaBackground: Maternal mortality remains a major public health challenge, not only at the University of Calabar Teaching Hospital, but in the developing world in general.Objective: The objective of this study was to assess trends in maternal mortality in a tertiary health facility, the maternal mortality ratio, the impact of sociodemographic factors in the deaths, and common medical and social causes of these deaths at the hospital.Methodology: This was a retrospective review of obstetric service delivery records of all maternal deaths over an 11-year period (01 January 1999 to 31 December 2009. All pregnancy-related deaths of patients managed at the hospital were included in the study.Results: A total of 15,264 live births and 231 maternal deaths were recorded during the period under review, giving a maternal mortality ratio of 1513.4 per 100,000 live births. In the last two years, there was a downward trend in maternal deaths of about 69.0% from the 1999 value. Most (63.3% of the deaths were in women aged 20–34 years, 33.33% had completed at least primary education, and about 55.41% were unemployed. Eight had tertiary education. Two-thirds of the women were married. Obstetric hemorrhage was the leading cause of death (32.23%, followed by hypertensive disorders of pregnancy. Type III delay accounted for 48.48% of the deaths, followed by Type I delay (35.5%. About 69.26% of these women had no antenatal care. The majority (61.04% died within the first 48 hours of admission.Conclusion: Although there was a downward trend in maternal mortality over the study period, the extent of the reduction is deemed inadequate. The medical and social causes of maternal deaths identified in this study are preventable, especially

  12. Mental and Medical sciences today

    OpenAIRE

    David L. Rowland; Ion G. Motofei

    2014-01-01

    Journal of Mind and Medical Sciences is designed as a free online, open access, interdisciplinary and peer-reviewed journal. The JMMS mission is to address ideas and issues related to mind and medicine, publishing scientific review and empirical papers regarding mental and medical health and disease. Our goal is to stimulate constructive debates among scholars, researchers, physicians, scientists and health professionals with respect to the latest discoveries and trends in the field. The jour...

  13. Trajectories of parenting behavior and maternal depression.

    Science.gov (United States)

    Azak, Schale; Raeder, Sabine

    2013-06-01

    This study investigated trajectories of maternal parenting behavior across the infants' first 18 months of life in relation to maternal depression. Furthermore, predictors of the quality of the mother-infant relationship at 18 months were examined. Participants consisted of three types of mother-infant dyads: mothers with comorbid depression and anxiety (n=19), mothers with depression (n=7) and nondepressed mothers (n=24). Maternal behaviors and the quality of relationship were rated on a global scale (NICHD) from video-taped mother-infant interactions. Maternal behaviors rated at six, 12 and 18 months were collapsed into a composite variable maternal style. The quality of the relationship captured as dyadic mutuality was rated at 18 months. Comorbid and depressed mothers showed lower quality in maternal style compared with the nondepressed mothers at six months. Over the follow-up the comorbid mothers were lower in maternal style compared to the nondepressed mothers, but the comorbid mothers increased significantly in maternal style despite elevated depression symptoms. Mean maternal style and infant cognitive skills predicted the quality in relationship at 18 months suggesting that the mother-toddler relationship depends on contributions from the mother and the child. Higher growth in maternal style despite of depression symptoms among comorbid mothers was interpreted against the background that the majority of the comorbid mother-infant dyads received several treatments. Copyright © 2013 Elsevier Inc. All rights reserved.

  14. Maternal feeding controls fetal biological clock.

    Directory of Open Access Journals (Sweden)

    Hidenobu Ohta

    Full Text Available BACKGROUND: It is widely accepted that circadian physiological rhythms of the fetus are affected by oscillators in the maternal brain that are coupled to the environmental light-dark (LD cycle. METHODOLOGY/PRINCIPAL FINDINGS: To study the link between fetal and maternal biological clocks, we investigated the effects of cycles of maternal food availability on the rhythms of Per1 gene expression in the fetal suprachiasmatic nucleus (SCN and liver using a transgenic rat model whose tissues express luciferase in vitro. Although the maternal SCN remained phase-locked to the LD cycle, maternal restricted feeding phase-advanced the fetal SCN and liver by 5 and 7 hours respectively within the 22-day pregnancy. CONCLUSIONS/SIGNIFICANCE: Our results demonstrate that maternal feeding entrains the fetal SCN and liver independently of both the maternal SCN and the LD cycle. This indicates that maternal-feeding signals can be more influential for the fetal SCN and particular organ oscillators than hormonal signals controlled by the maternal SCN, suggesting the importance of a regular maternal feeding schedule for appropriate fetal molecular clockwork during pregnancy.

  15. Cognitive enhancement as a pharmacotherapy target for stimulant addiction.

    Science.gov (United States)

    Sofuoglu, Mehmet

    2010-01-01

    No medications have been proven to be effective for cocaine and methamphetamine addiction. Attenuation of drug reward has been the main strategy for medications development, but this approach has not led to effective treatments. Thus, there is a need to identify novel treatment targets in addition to the brain reward system. To propose a novel treatment strategy for stimulant addiction that will focus on medications enhancing cognitive function and attenuating drug reward. Pre-clinical and clinical literature on potential use of cognitive enhancers for stimulant addiction pharmacotherapy was reviewed. Cocaine and methamphetamine users show significant cognitive impairments, especially in attention, working memory and response inhibition functions. The cognitive impairments seem to be predictive of poor treatment retention and outcome. Medications targeting acetylcholine and norepinephrine are particularly well suited for enhancing cognitive function in stimulant users. Many cholinergic and noradrenergic medications are on the market and have a good safety profile and low abuse potential. These include galantamine, donepezil and rivastigmine (cholinesterase inhibitors), varenicline (partial nicotine agonist), guanfacine (alpha(2)-adrenergic agonist) and atomoxetine (norepinephrine transporter inhibitor). Future clinical studies designed optimally to measure cognitive function as well as drug use behavior would be needed to test the efficacy of these cognitive enhancers for stimulant addiction.

  16. Innovating for Maternal and Child Health in Africa teams share early ...

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

    2017-09-29

    Sep 29, 2017 ... As the seven-year Innovating for Maternal and Child Health in Africa (IMCHA) ... delivered babies at home — far from medical care should complications arise. ... can help the healthcare system deliver service to vulnerable populations ... and La Francophonie, announced major funding for an IDRC grantee.

  17. Transcriptome alterations in maternal and fetal cells induced by tobacco smoke

    Czech Academy of Sciences Publication Activity Database

    Votavová, H.; Dostálová-Merkerová, M.; Fejglová, K.; Vašíková, A.; Krejčík, Z.; Pastorková, Anna; Tabashidze, Nana; Topinka, Jan; Veleminský Jr., M.; Šrám, Radim; Brdička, R.

    2011-01-01

    Roč. 32, č. 10 (2011), s. 763-770 ISSN 0143-4004 R&D Projects: GA MŠk 2B06088 Institutional research plan: CEZ:AV0Z50390512 Keywords : maternal smoking * placenta * cord blood Subject RIV: FP - Other Medical Disciplines Impact factor: 3.693, year: 2011

  18. Analysis of maternal-fetal outcomes of valvular heart surgeries in

    Directory of Open Access Journals (Sweden)

    Alireza Yaghoubi

    2010-03-01

    Full Text Available Valvular heart surgery (VHS in pregnancy has its specific complexity and problems.Between years 1983-2007 11 women who underwent VHS during pregnancy were found and analyzed. Valvular heart surgery in pregnancy is associated with the least maternal-fetal side effects. Intensive evaluations before and during pregnancy with a specialized medical team is essential

  19. Application of a Community eS@nté Platform in Maternal and Child ...

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

    Application of a Community eS@nté Platform in Maternal and Child Health in ... electronic patient files and telehealth can improve medical and healthcare data ... New website will help record vital life events to improve access to services for all.

  20. Innovating for Maternal and Child Health in Africa teams share early ...

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

    2017-09-29

    Sep 29, 2017 ... As the seven-year Innovating for Maternal and Child Health in Africa (IMCHA) ... babies at home — far from medical care should complications arise. ... areas, Hajibedru wants to expand the service to the 120 health centres in ...

  1. Effects of maternal obesity on early and long-term outcomes for offspring

    Directory of Open Access Journals (Sweden)

    Stirrat LI

    2014-03-01

    Full Text Available Laura I Stirrat,1,2 Rebecca M Reynolds2,3 1Medical Research Council Centre for Reproductive Health, Queens Medical Research Institute, University of Edinburgh, Edinburgh, UK; 2Tommy's Centre for Maternal and Fetal Health, Queens Medical Research Institute, University of Edinburgh, Edinburgh, UK; 3Endocrinology Unit, University/British Heart Foundation Centre for Cardiovascular Science, Queens Medical Research Institute, University of Edinburgh, Edinburgh, UK Abstract: The prevalence of maternal obesity has increased significantly in recent years, and obesity is currently the most common comorbidity of pregnancy. Pregnancies of obese women are often defined as "high-risk" for the purposes of clinical care, with many well documented risks to the mother and developing baby. Maternal physiology and metabolism is dysregulated in the context of obesity, which may contribute to some of the adverse outcomes during pregnancy. Furthermore, maternal obesity has been hypothesized to cause harmful effects for the developing baby through "early life programming." This review will examine evidence from human studies for outcomes of offspring from obese women during pregnancy, during labor, during the neonatal period, and later in life. Keywords: pregnancy, short-term, physiology, metabolism, early life programming, neonatal complications, adverse intrauterine environment

  2. Parvovirus B19 infection in pregnancy studied by maternal viral load and immune responses

    NARCIS (Netherlands)

    de Haan, Timo R.; Beersma, Matthias F. C.; Claas, Eric C. J.; Oepkes, Dick; Kroes, Aloys C. M.; Walther, Frans J.

    2007-01-01

    Facilitate risk assessment of vital complications in fetuses of pregnancies affected by acute parvovirus B19 (B19V) infection. Study of the natural course of maternal B19V infection in four cases, from early pregnancy on. University Medical Center in the Netherlands. Pregnant mothers attending

  3. Spinal Cord Stimulation

    DEFF Research Database (Denmark)

    Meier, Kaare

    2014-01-01

    Spinal cord stimulation (SCS) is a surgical treatment for chronic neuropathic pain that is refractory to other treatment. Originally described by Shealy et al. in 1967(1), it is used to treat a range of conditions such as complex regional pain syndrome (CRPS I)(2), angina pectoris(3), radicular...... pain after failed back surgery syndrome (FBSS)(4), pain due to peripheral nerve injury, stump pain(5), peripheral vascular disease(6) and diabetic neuropathy(7,8); whereas phantom pain(9), postherpetic neuralgia(10), chronic visceral pain(11), and pain after partial spinal cord injury(12) remain more...

  4. How does maternal oxytocin influence children's mental health problem and maternal mental health problem?

    Science.gov (United States)

    Tse, Wai S; Siu, Angela F Y; Wong, Tracy K Y

    2017-12-01

    This study aims to explore the interrelationship among maternal oxytocin (OT) responsiveness, maternal mental health, maternal parenting behavior, and mental health of children under a free-play interaction. 61 mother-child dyads were recruited for the study. Maternal mental health problem and parenting self-efficacy were measured using self-reported questionnaires. The mental health problems of children were also evaluated using a mother-reported questionnaire. Furthermore, salivary OT was collected before and after a standardized 10min free-play interaction. Parenting behaviors, including eye gaze and touch, were measured during the free-play interaction. Maternal OT responsiveness was significantly associated with less maternal mental health problem, touch frequency, and mental health problem of children but not with parenting self-efficacy. In the multivariate linear regression analysis that considers maternal OT responsiveness and maternal and children's mental health problems, maternal OT responsiveness was not associated with the mental health problems of children. This result suggested that maternal mental health problem played a mediational role between maternal OT responsiveness and the mental health problem of children. Results supported the assertion that maternal OT responsiveness contributed to the increased risk of maternal mental health problems and, subsequently, the risk of mental health problems of their children. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. Maternal emotion regulation during child distress, child anxiety accommodation, and links between maternal and child anxiety.

    Science.gov (United States)

    Kerns, Caroline E; Pincus, Donna B; McLaughlin, Katie A; Comer, Jonathan S

    2017-08-01

    Environmental contributions are thought to play a primary role in the familial aggregation of anxiety, but parenting influences remain poorly understood. We examined dynamic relations between maternal anxiety, maternal emotion regulation (ER) during child distress, maternal accommodation of child distress, and child anxiety. Mothers (N=45) of youth ages 3-8 years (M=4.8) participated in an experimental task during which they listened to a standardized audio recording of a child in anxious distress pleading for parental intervention. Measures of maternal and child anxiety, mothers' affective states, mothers' ER strategies during the child distress, and maternal accommodation of child anxiety were collected. Mothers' resting respiratory sinus arrhythmia (RSA) reactivity during the recording was also acquired. Higher maternal negative affect and greater maternal ER switching (i.e., using multiple ER strategies in a short time without positive regulatory results) during child distress were associated with child anxiety. Sequential mediation modeling showed that maternal anxiety predicted ineffective maternal ER during child distress exposure, which in turn predicted greater maternal accommodation, which in turn predicted higher child anxiety. Findings support the mediating roles of maternal ER and accommodation in linking maternal and child anxiety, and suggest that ineffective maternal ER and subsequent attempts to accommodate child distress may act as mechanisms underlying the familial aggregation of anxiety. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. Information management in Iranian Maternal Mortality Surveillance System.

    Science.gov (United States)

    Sadoughi, Farahnaz; Karimi, Afsaneh; Erfannia, Leila

    2017-07-01

    Maternal mortality is preventable by proper information management and is the main target of the Maternal Mortality Surveillance System (MMSS). This study aimed to determine the status of information management in the Iranian Maternal Mortality Surveillance System (IMMSS). The population of this descriptive and analytical study, which was conducted in 2016, included 96 administrative staff of health and treatment deputies of universities of medical sciences and the Ministry of Health in Iran. Data were gathered by a five-part questionnaire with confirmed validity and reliability. A total of 76 questionnaires were completed, and data were analyzed using SPSS software, version 19, by descriptive and inferential statistics. The relationship between variables "organizational unit" and the four studied axes was studied using Kendall's correlation coefficient test. The status of information management in IMMSS was desirable. Data gathering and storage axis and data processing and compilation axis achieved the highest (2.7±0.46) and the lowest (2.4±0.49) mean scores, respectively. The data-gathering method, control of a sample of women deaths in reproductive age in the universities of medical sciences, use of international classification of disease, and use of this system information by management teams to set resources allocation achieved the lowest mean scores in studied axes. Treatment deputy staff had a more positive attitude toward the status of information management of IMMSS than the health deputy staff (p=0.004). Although the status of information management in IMMSS was desirable, it could be improved by modification of the data-gathering method; creating communication links between different data resources; a periodic sample control of women deaths in reproductive age in the universities of medical sciences; and implementing ICD-MM and integration of its rules on a unified system of death.

  7. Continued versus discontinued oxytocin stimulation, protocol of an rct

    DEFF Research Database (Denmark)

    Boie, Sidsel; Glavind, Julie; Uldbjerg, Niels

    Dutch Centres: AMC, Tergooi Hospital, and AMPHIA Hospital (inclusion expected late 2016) Intervention When the active phase of labour is established (defined as 6 cm dilated orificium), the women will be randomised to either: Continued Syntocinon® or Discontinued Syntocinon® (saline infusion) Primary......Problem Statement: Previous studies on induced labour suggest that, continued stimulation with Syntocinon® in the active phase of labour increases the risk of fetal distress and caesarean delivery whereas discontinued stimulation with Syntocinon® increases the risk of caesarean delivery due to lack...... of progression. No double-blind trial with a study population large enough to show differences in maternal and neonatal outcomes has ever been conducted. The purpose of the study is to investigate how the caesarean delivery rate is affected if Syntocinon® is discontinued at the onset of active phase of labour...

  8. Work-family balance after childbirth: the association between employer-offered leave characteristics and maternity leave duration.

    Science.gov (United States)

    Guendelman, Sylvia; Goodman, Julia; Kharrazi, Martin; Lahiff, Maureen

    2014-01-01

    Early return to work after childbirth has been increasing among working mothers in the US. We assessed the relationship between access to employer-offered maternity leave (EOML) (both paid and unpaid) and uptake and duration of maternity leave following childbirth in a socio-economically diverse sample of full-time working women. We focus on California, a state that has long provided more generous maternity leave benefits than those offered by federal maternity leave policies through the State Disability Insurance program. The sample included 691 mothers who gave birth in Southern California in 2002-2003. Using weighted logistic regression, we examined the EOML-maternity leave duration relationship, controlling for whether the leave was paid, as well as other occupational, personality and health-related covariates. Compared with mothers who were offered more than 12 weeks of maternity leave, mothers with leave had six times higher odds of an early return. These relationships were similar after controlling for whether the leave was paid and after controlling for other occupational and health characteristics. Access to and duration of employer-offered maternity leave significantly determine timing of return to work following childbirth, potentially affecting work-family balance. Policy makers should recognize the pivotal role of employers in offering job security during and after maternity leave and consider widening the eligibility criteria of the Family and Medical Leave Act.

  9. The Medical Ethics of Cognitive Neuroenhancement

    Directory of Open Access Journals (Sweden)

    Erick H. Cheung

    2015-07-01

    Full Text Available Prescription stimulant medications have been sought for cognitive “neuroenhancement”, the practice of enhancing ostensibly normal cognitive function such as attention span, focus, and memory. This trend, particularly studied in college students, has driven a debate about many ethical aspects related to cognitive enhancement; however, the central role of physicians and the medical ethics of this practice have been minimally investigated. In this paper, a clinical case serves as the focal point to review the current state of prescription stimulant use for enhancement, beginning with the medical and legal problems related to the surreptitious, yet common, behaviors of diversion and malingering. In contrast, there may be a growing trend for individuals to seek prescription stimulants “openly” (without malingering or diversion as a direct request from their physician, which leads to complex ethical questions. A model of clinical-ethical decision making (the “four-box model” from Jonsen et al. is applied to analyze the factors that a physician must consider when deciding whether to engage in the open prescribing of a stimulant neuroenhancer to otherwise healthy, autonomous adults. Four domains are explored in depth: medical indications, quality of life/beneficence, patient preferences, and contextual factors. Relevant experiences from the medical disciplines involved in athletic enhancement and cosmetic enhancement are discussed. Although an overall ethical framework for neuroenhancement continues to evolve, from a perspective of medical ethics there are presently significant reasons to be wary of cognitive neuroenhancement with stimulant medications.

  10. Maternal death inquiry and response in India - the impact of contextual factors on defining an optimal model to help meet critical maternal health policy objectives

    Directory of Open Access Journals (Sweden)

    Kalter Henry D

    2011-11-01

    Full Text Available Abstract Background Maternal death reviews have been utilized in several countries as a means of identifying social and health care quality issues affecting maternal survival. From 2005 to 2009, a standardized community-based maternal death inquiry and response initiative was implemented in eight Indian states with the aim of addressing critical maternal health policy objectives. However, state-specific contextual factors strongly influenced the effort's success. This paper examines the impact and implications of the contextual factors. Methods We identified community, public health systems and governance related contextual factors thought to affect the implementation, utilization and up-scaling of the death inquiry process. Then, according to selected indicators, we documented the contextual factors' presence and their impact on the process' success in helping meet critical maternal health policy objectives in four districts of Rajasthan, Madhya Pradesh and West Bengal. Based on this assessment, we propose an optimal model for conducting community-based maternal death inquiries in India and similar settings. Results The death inquiry process led to increases in maternal death notification and investigation whether civil society or government took charge of these tasks, stimulated sharing of the findings in multiple settings and contributed to the development of numerous evidence-based local, district and statewide maternal health interventions. NGO inputs were essential where communities, public health systems and governance were weak and boosted effectiveness in stronger settings. Public health systems participation was enabled by responsive and accountable governance. Communities participated most successfully through India's established local governance Panchayat Raj Institutions. In one instance this led to the development of a multi-faceted intervention well-integrated at multiple levels. Conclusions The impact of several contextual

  11. Maternal Depression and Parent Management Training Outcomes.

    Science.gov (United States)

    Dempsey, Jack; McQuillin, Samuel; Butler, Ashley M; Axelrad, Marni E

    2016-09-01

    This study examines the impact of maternal depression on reductions in children's behavior problems severity following implementation of the Brief Behavioral Intervention-a brief, manualized parent management training treatment. The parents of 87 children aged 2-6 years of age received parent management training at a metropolitan hospital. Parents of participants completed measures of externalizing behavior and maternal depression. The association between pre-post treatment change in externalizing behavior and maternal depression was examined using an autoregressive cross-lagged model. Results showed that self-reported maternal depressive symptoms at pre-treatment negatively influenced the overall magnitude of reduction of reported externalizing behaviors in children following treatment. Results indicate that aspects of family functioning not specifically targeted by parent management training, such as maternal depression, significantly affect treatment outcomes. Clinicians providing parent management training may benefit from assessing for maternal depression and modifying treatment as indicated.

  12. Maternal burn-out: an exploratory study.

    Science.gov (United States)

    Séjourné, N; Sanchez-Rodriguez, R; Leboullenger, A; Callahan, S

    2018-02-21

    Maternal burn-out is a psychological, emotional and physiological condition resulting from the accumulation of various stressors characterised by a moderate but also a chronic and repetitive dimension. Little research has focused on this syndrome. The current study aims to assess maternal burn-out rate and to identify factors associated with this state of exhaustion. 263 French mothers aged between 20 and 49 years answered five scales quantifying maternal burn-out, perceived social support, parental stress, depression and anxiety symptoms and history of postnatal depression. About 20% of mothers were affected by maternal burn-out. The main factors related to maternal burn-out were having a child perceived as difficult, history of postnatal depression, anxiety, satisfaction of a balance between professional and personal life and parental stress. This research shows the need for further work on maternal burn-out to better understand and prevent this syndrome.

  13. Medical uses of Ca47

    International Nuclear Information System (INIS)

    1962-01-01

    The IAEA sponsored a Panel in December 1961 on the medical uses of calcium-47. Many of the participants in the Panel presented papers summarizing their work, and all took part in the informal discussions that the papers stimulated. This volume contains the presented papers and transcripts of the discussion sessions. The individual papers have been indexed separately. Refs, 57 figs, 30 tabs

  14. Radiation dosimeters for medical use

    International Nuclear Information System (INIS)

    Risticj, S. Goran

    2013-01-01

    The several personal radiation dosimeter types for medical use, which look like promising for this kind of application, as pMOS (RADFET) dosimeter, direct ion storage (DIS) dosimeters, thermoluminescent (TL) and optically stimulated luminescent (OSL) dosimeters, are described, and their advantages and disadvantages are analyzed. The p-channel metal-oxide-semiconductor (pMOS) dosimetric transistors allow dose measurements in vivo in real time, and they are especially important for radiotherapy. Direct ion storage (DIS) dosimeters are a hybrid of ion chamber and floating gate MOSFETs (FGMOSFETs), show very high sensitivity. Radiative processes that happen during the exposure of crystal to radiation are classified as prompt luminescence or radioluminescence (RL). In the case of an emission during stimulation, this phenomenon is referred to thermoluminescence or optically stimulated luminescence depending on whether the stimulation source is heat or light. TL and OSL dosimeters are natural or synthetic materials, which the intensity of emitted light is proportional to the irradiation dose. (Author)

  15. Maternal mortality in Mexico, beyond millennial development objectives: An age-period-cohort model.

    Science.gov (United States)

    Rodríguez-Aguilar, Román

    2018-01-01

    The maternal mortality situation is analyzed in México as an indicator that reflects the social development level of the country and was one of the millennial development objectives. The effect of a maternal death in the related social group has multiplier effects, since it involves family dislocation, economic impact and disruption of the orphans' normal social development. Two perspectives that causes of maternal mortality were analyzed, on one hand, their relationship with social determinants and on the other, factors directly related to the health system. Evidence shows that comparing populations based on group of selected variables according to social conditions and health care access, statistically significant differences prevail according to education and marginalization levels, and access to medical care. In addition, the Age-Period-Cohort model raised, shows significant progress in terms of a downward trend in maternal mortality in a generational level. Those women born before 1980 had a greater probability of maternal death in relation to recent generations, which is a reflection of the improvement in social determinants and in the Health System. The age effect shows a problem in maternal mortality in women under 15 years old, so teen pregnancy is a priority in health and must be addressed in short term. There is no clear evidence of a period effect.

  16. Clinical handover practices in maternity services in Ireland: A qualitative descriptive study.

    Science.gov (United States)

    Fealy, Gerard; Munroe, Deirdre; Riordan, Fiona; Croke, Eilish; Conroy, Celine; McNamara, Martin; Shannon, Michael

    2016-08-01

    the objective was to examine and describe clinical handover practices in Irish maternity services. the study design incorporated interviews and focus group discussions with a purposive sample of healthcare practitioners working in Irish maternity services. five maternity hospitals and fourteen co-located maternity units. midwives, obstetricians and other healthcare professionals, specifically physiotherapists and radiologists, midwifery students and health care assistants working in maternity services. the study participants provided nuanced and differentiated accounts of clinical handover practices, which indicated a general absence of formal policy and training on clinical handover and the practice of midwifery and medical teams holding separate clinical handovers based on their separate, respective needs for transferring information and clinical responsibility. Participants spoke of barriers to effective clinical handover, including unsuitable environments, lack of dedicated time and fatigue during duty shift clinical handover, lack of supportive information technology (IT) infrastructure, and resistance of some staff to the adoption of new technologies to support clinical handover. whether internal and external to clinical handover events, the barriers to effective clinical handover represent threats to patient safety and quality of care, since effective clinical handover is essential to the provision of safe quality care. clear and effective communication between collaborating professionals within maternity teams is essential. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. Development and validation of a questionnaire to identify severe maternal morbidity in epidemiological surveys

    Directory of Open Access Journals (Sweden)

    Parpinelli Mary A

    2010-07-01

    Full Text Available Abstract Objective to develop and validate a questionnaire on severe maternal morbidity and to evaluate the maternal recall of complications related to pregnancy and childbirth. Design: validity of a questionnaire as diagnostic instrument. Setting: a third level referral maternity in Campinas, Brazil. Population: 386 survivors of severe maternal complications and 123 women that delivered without major complications between 2002 and 2007. Methods eligible women were traced and interviewed by telephone on the occurrence of obstetric complications and events related to their treatment. Their answers were compared with their medical records as gold standard. Sensitivity, specificity and likelihood ratios plus their correspondent 95% confidence intervals were used as main estimators of accuracy. Main outcomes: diagnosis of severe maternal morbidity associated with past pregnancies, including hemorrhage, eclampsia, infections, jaundice and related procedures (hysterectomy, admission to ICU, blood transfusion, laparotomy, inter-hospital transfer, mechanical ventilation and post partum stay above seven days. Results Women did not recall accurately the occurrence of obstetric complications, especially hemorrhage and infection. The likelihood ratios were Conclusion Process indicators are better recalled by women than obstetric complication and should be considered when applying a questionnaire on severe maternal morbidity.

  18. Maternal hepatitis B infection and gestational diabetes mellitus.

    Science.gov (United States)

    Lao, Terence T; Chan, Ben C P; Leung, Wing-Cheong; Ho, Lai-Fong; Tse, Ka-Yu

    2007-07-01

    This retrospective cohort study was performed to examine the relationship between maternal hepatitis B virus infection, as indicated by the surface antigen status, with the development of gestational diabetes mellitus in a normal-risk Chinese obstetric population. Maternal demographics, risk factors, and pregnancy outcome of 13,683 singleton pregnancies delivering in 1998-2001 were analysed according to maternal hepatitis B surface antigen status, which was routinely screened. Multiple logistic regression analysis was performed to examine the role of hepatitis B infection in the development of gestational diabetes mellitus. The 1138 women (8.3%) with hepatitis B infection had lower mean weight and body mass index, similar prevalence of chronic medical diseases and smokers, but increased prevalence of gestational diabetes mellitus, which remained significant (odds ratio 1.24, 95% confidence interval 1.01-1.51) after adjustment for confounding variables. However, there was no difference in pregnancy outcome. Our results confirmed the independent association between hepatitis B infection with gestational diabetes mellitus. The magnitude of chronic hepatitis B infection in the developing world and certain ethnic groups could have contributed to the high prevalence of gestational and possibly type 2 diabetes in these populations. Further studies on the long-term implications of our finding are warranted.

  19. IS THERE ANY ASSOCIATION BETWEEN MATERNAL DEPRESSION AND BIOPHYSICAL PROFILE?

    Directory of Open Access Journals (Sweden)

    M Z Pezeshki

    2008-11-01

    Full Text Available "nMother's mental health status during pregnancy has important effects on fetal growth and development. However, there are few studies concerning association of maternal depression and biophysical profile (BPP of the fetus. We performed this research to know if maternal depression has any association with fetal BPP score. For measuring depression, Farsi version of Patient Health Questionnaire-9 (PHQ-9 was completed. A total of 100 pregnant women in their third trimester (>24 weeks who had not hyperthyroidism, hypothyroidism, eclampsia and preeclampsia, fever, infection, diabetes or a fetus with intrauterine growth retardation (IUGR and were not using any medication entered the study. Spearman correlation coefficient between the score of PHQ-9 questionnaire and BPP score was -0.08 (P = 0.43. Based on Kruskal Wallis test, there was no difference in BPP score of depressed and nondepressed women (P = 0.65. We found no relationship between maternal depression and BPP score in third trimester of pregnancy. Further studies for elucidating neuro-hormonal mechanisms related to the result of our study are suggested

  20. The Impact of Teenage Pregnancy on Maternal and Perinatal Outcome

    Directory of Open Access Journals (Sweden)

    Chaitra Ramachandra

    2016-05-01

    Full Text Available To study the impact of teenage pregnancy on maternal and perinatal outcome. This is a randomized prospective clinical study carried out in the Obstetrics and Gynaecology department, BGS Global Medical College, over a period of one year from January 2015 to December 2015. In study group (Group A included a total of 200 primigravid teenage mothers(age <20 years and the control group included 200 primigavid adult mothers (20- 30years of age . The maternal status, labour progress, delivery characteristics and neonatal outcomes were reviewed and analysed. Proportion of mothers in the study group who delivered vaginally was 61.5% compared to 80.5% in the control group. Instrumental delivery rate, emergency LSCS and elective LSCS rates were higher in the study group (teenage pregnancy compared to the control group. (9.5% Vs 5%, 17% Vs 9.5%, 12% Vs 5% respectively. Anaemia, Premature Rupture of Membranes, Oligohydraminos, Post partum Haemorrhage was found to be higher among teenage mothers when compared to adult mothers. PIH, polyhydraminos were found to be higher in control group than in the study group. In regard to adverse perinatal outcomes, higher risks of intra uterine growth restriction, preterm births, stillbirths, low APGAR scores, NICU admission were higher were higher in the study group compared to the control group. In this study, we found that women with teenage pregnancies were at increased risk for adverse pregnancy outcomes in regard to maternal, foetal and neonatal complications as compared with adult control mothers.

  1. [Maternal and fetal outcome in Mexican women with rheumatoid arthritis].

    Science.gov (United States)

    Saavedra, Miguel A; Sánchez, Antonio; Bustamante, Reyna; Miranda-Hernández, Dafhne; Soliz-Antezana, Jimena; Cruz-Domínguez, Pilar; Morales, Sara; Jara, Luis J

    2015-01-01

    To report our experience in maternal-fetal outcome in women with RA in a national medical referral center. A retrospective analysis of the records of pregnant women with rheumatoid arthritis attending at a Pregnancy and Autoimmune Rheumatic Diseases Clinic was performed. Maternal-fetal outcomes such as disease activity, preclampsia/eclampsia, rate of live births, abortions, stillbirths, preterm birth, weeks of gestation, birth weight, congenital malformations and use of anti-rheumatic drugs were studied. We included 73 pregnancies in 72 patients. Disease activity was documented in 47.2% of patients during pregnancy and/or postpartum and 87.7% of patients received some antirheumatic drug. Preclampsia developed in 8.2% of cases. The live birth rate was 98.6%, with preterm delivery in 15.9% and low weight at term in 17.6% of cases. Cesarean section was performed in 77.1% of cases. The disease activity was not associated with a higher percentage of maternal-fetal complications. Our study showed that most patients do not experience significant activity of RA during pregnancy, fetal outcome is satisfactory and disease activity did not appear to influence significantly the obstetric outcome.

  2. Costs of publicly provided maternity services in Rosario, Argentina

    Directory of Open Access Journals (Sweden)

    Borghi Josephine

    2003-01-01

    Full Text Available OBJECTIVE: This study estimates the costs of maternal health services in Rosario, Argentina. MATERIAL AND METHODS: The provider costs (US$ 1999 of antenatal care, a normal vaginal delivery and a caesarean section, were evaluated retrospectively in two municipal hospitals. The cost of an antenatal visit was evaluated in two health centres and the patient costs associated with the visit were evaluated in a hospital and a health centre. RESULTS: The average cost per hospital day is $114.62. The average cost of a caesarean section ($525.57 is five times greater than that of a normal vaginal delivery ($105.61. A normal delivery costs less at the general hospital and a c-section less at the maternity hospital. The average cost of an antenatal visit is $31.10. The provider cost is lower at the health centre than at the hospital. Personnel accounted for 72-94% of the total cost and drugs and medical supplies between 4-26%. On average, an antenatal visit costs women $4.70. Direct costs are minimal compared to indirect costs of travel and waiting time. CONCLUSIONS: These results suggest the potential for increasing the efficiency of resource use by promoting antenatal care visits at the primary level. Women could also benefit from reduced travel and waiting time. Similar benefits could accrue to the provider by encouraging normal delivery at general hospitals, and complicated deliveries at specialised maternity hospitals.

  3. Medical education... meet Michel Foucault.

    Science.gov (United States)

    Hodges, Brian D; Martimianakis, Maria A; McNaughton, Nancy; Whitehead, Cynthia

    2014-06-01

    There have been repeated calls for the greater use of conceptual frameworks and of theory in medical education. Although it is familiar to few medical educators, Michel Foucault's work is a helpful theoretical and methodological source. This article explores what it means to use a 'Foucauldian approach', presents a sample of Foucault's historical-genealogical studies that are relevant to medical education, and introduces the work of four researchers currently undertaking Foucauldian-inspired medical education research. Although they are not without controversy, Foucauldian approaches are employed by an increasing number of scholars and are helpful in shedding light on what it is possible to think, say and be in medical education. Our hope in sharing this Foucauldian work and perspective is that we might stimulate a dialogue that is forward-looking and optimistic about the possibilities for change in medical education. © 2014 John Wiley & Sons Ltd.

  4. A distributed current stimulator ASIC for high density neural stimulation.

    Science.gov (United States)

    Jeong Hoan Park; Chaebin Kim; Seung-Hee Ahn; Tae Mok Gwon; Joonsoo Jeong; Sang Beom Jun; Sung June Kim

    2016-08-01

    This paper presents a novel distributed neural stimulator scheme. Instead of a single stimulator ASIC in the package, multiple ASICs are embedded at each electrode site for stimulation with a high density electrode array. This distributed architecture enables the simplification of wiring between electrodes and stimulator ASIC that otherwise could become too complex as the number of electrode increases. The individual ASIC chip is designed to have a shared data bus that independently controls multiple stimulating channels. Therefore, the number of metal lines is determined by the distributed ASICs, not by the channel number. The function of current steering is also implemented within each ASIC in order to increase the effective number of channels via pseudo channel stimulation. Therefore, the chip area can be used more efficiently. The designed chip was fabricated with area of 0.3 mm2 using 0.18 μm BCDMOS process, and the bench-top test was also conducted to validate chip performance.

  5. The perinatal and maternal outcome in pregnancy with advanced maternal age 35 years and >35 years

    OpenAIRE

    Pallavi S. Kalewad; Trupti Nadkarni

    2016-01-01

    Background: Purpose of this study is to evaluate maternal and perinatal outcome in advanced maternal age women. As numbers of pregnancies in advanced maternal age continue to grow, obstetric care provider would benefit from up to date outcome data to enhance their preconceptional and antenatal counseling. Methods: It is observational prospective analytic study, conducted in Nowrosjee Wadia maternity hospital, Parel, Mumbai. Total 100 patients were included in study, fulfilling inclusion cr...

  6. Maternal bereavement and cryptorchidism in offspring

    DEFF Research Database (Denmark)

    Ingstrup, Katja Glejsted; Olsen, Jørn; Wu, Chunsen

    2015-01-01

    BACKGROUND: Cryptorchidism (undescended testis) is a common anomaly with largely unexplained etiology. Animal studies have suggested maternal emotional stress as a potential risk factor, but this has not been studied in humans. We aimed to investigate whether maternal bereavement due to the death...... interval = 0.92-1.14]). Results were similar when the diagnosis was verified with surgery. We adjusted for maternal and paternal age, birth year, and family history of cryptorchidism. CONCLUSION: We observed no association between maternal bereavement before and during pregnancy and the occurrence...

  7. Maternal mortality in Denmark, 1985-1994

    DEFF Research Database (Denmark)

    Andersen, Betina Ristorp; Westergaard, Hanne Brix; Bødker, Birgit

    2008-01-01

    fortuitous causes. Hypertensive disorders of pregnancy were the major cause of direct maternal deaths. The rate of maternal deaths constituted 9.8/100,000 maternities (i.e. the number of women delivering registrable live births at any gestation or stillbirths at 24 weeks of gestation or later). CONCLUSION......: This is the first systematic report on deaths in Denmark based on data from national registries. The maternal mortality rate in Denmark is comparable to the rates in other developed countries. Fortunately, statistics are low, but each case represents potential learning. Obstetric care has changed and classification...

  8. Maternal and pregnancy-related death: causes and frequencies in an autopsy study population.

    Science.gov (United States)

    Buschmann, Claas; Schmidbauer, Martina; Tsokos, Michael

    2013-09-01

    Maternal deaths during pregnancy, both from pregnancy-related or other causes, are rare in Western industrialized countries. In this study we report maternal and pregnancy-related deaths in a large autopsy population focusing on medical history, autopsy findings and histological examinations. Medico-legal autopsy files (n = 11,270) from the Institute of Legal Medicine and Forensic Sciences, University Medical Centre Charité, University of Berlin, and the State Institute of Legal and Social Medicine, Berlin, from 2005 to 2010 were reviewed. All female cases between 15 and 49 years were checked for maternal and pregnancy-related death, and deaths of pregnant women from non-natural causes were also included. Fatalities that met the chosen criteria were classified as "direct gestational death," "indirect gestational death" or "non-gestational death." 13 female fatalities (0.12 %) met the chosen criteria (median age 28 years ± 6.87 SD). Eight (61.5 %) women died in-hospital, four (30.8 %) at home, and one woman died in public. Three cases (23.1 %) were "non-gestational deaths," and one case (7.7 %) remained unclear after autopsy and additional examinations. Of the remaining nine cases, six cases (46.5 %) were "direct gestational deaths," and two cases (15.4 %) were "indirect gestational deaths." One case (7.7 %) was not to be defined as "late maternal death," but the cause of death seemed to be directly related to previous gestation ["(very) late maternal death"]. Maternal deaths during pregnancy, both from pregnancy-related or other causes, remain an uncommon event in routine forensic autopsy practice. We report on the collection and analysis of maternal and pregnancy-related deaths in a large autopsy population, with particular attention to the phenomenology of pregnancy, pathophysiological changes in different organ systems and their detection, and the forensic autopsy assessment.

  9. Maternal mortality in the rural Gambia, a qualitative study on access to emergency obstetric care

    Directory of Open Access Journals (Sweden)

    Sundby Johanne

    2005-05-01

    Full Text Available Abstract Background Maternal mortality is the vital indicator with the greatest disparity between developed and developing countries. The challenging nature of measuring maternal mortality has made it necessary to perform an action-oriented means of gathering information on where, how and why deaths are occurring; what kinds of action are needed and have been taken. A maternal death review is an in-depth investigation of the causes and circumstances surrounding maternal deaths. The objectives of the present study were to describe the socio-cultural and health service factors associated with maternal deaths in rural Gambia. Methods We reviewed the cases of 42 maternal deaths of women who actually tried to reach or have reached health care services. A verbal autopsy technique was applied for 32 of the cases. Key people who had witnessed any stage during the process leading to death were interviewed. Health care staff who participated in the provision of care to the deceased was also interviewed. All interviews were tape recorded and analyzed by using a grounded theory approach. The standard WHO definition of maternal deaths was used. Results The length of time in delay within each phase of the model was estimated from the moment the woman, her family or health care providers realized that there was a complication until the decision to seeking or implementing care was made. The following items evolved as important: underestimation of the severity of the complication, bad experience with the health care system, delay in reaching an appropriate medical facility, lack of transportation, prolonged transportation, seeking care at more than one medical facility and delay in receiving prompt and appropriate care after reaching the hospital. Conclusion Women do seek access to care for obstetric emergencies, but because of a variety of problems encountered, appropriate care is often delayed. Disorganized health care with lack of prompt response to

  10. Maternal morbid obesity and obstetric outcomes.

    LENUS (Irish Health Repository)

    Farah, Nadine

    2012-02-01

    OBJECTIVE: The purpose of this retrospective cohort study was to review pregnancy outcomes in morbidly obese women who delivered a baby weighing 500 g or more in a large tertiary referral university hospital in Europe. METHODS: Morbid obesity was defined as a BMI > or =40.0 kg\\/m2 (WHO). Only women whose BMI was calculated at their first antenatal visit were included. The obstetric out-comes were obtained from the hospital\\'s computerised database. RESULTS: The incidence of morbid obesity was 0.6% in 5,824 women. Morbidly obese women were older and were more likely to be multigravidas than women with a normal BMI. The pregnancy was complicated by hypertension in 35.8% and diabetes mellitus in 20.0% of women. Obstetric interventions were high, with an induction rate of 42.1% and a caesarean section rate of 45.3%. CONCLUSIONS: Our findings show that maternal morbid obesity is associated with an alarmingly high incidence of medical complications and an increased level of obstetric interventions. Consideration should be given to developing specialised antenatal services for morbidly obese women. The results also highlight the need to evaluate the effectiveness of prepregnancy interventions in morbidly obese women.

  11. [Maternal posture and its influence on birthweight].

    Science.gov (United States)

    Takito, Monica Yuri; Benício, Maria Helena D'Aquino; Latorre, Maria do Rosário Dias de Oliveira

    2005-06-01

    To analyze the relationship between maternal posture/physical activity and inadequate birthweight. Prospective cohort study involving 152 pregnant women from a public low-risk antenatal care facility. Three interviews evaluating the frequency of physical activity were administered to each pregnant woman during gestation. Birthweight (inadequate when or =3,000 g) was the dependent variable and the frequency of physical activity the independent variable. Statistical analysis was performed using logistic univariate analysis and multiple regression controlling for schooling, smoking, living with spouse, and baseline nutritional status. The practice of walking for at least 50 minutes during the first period of pregnancy was identified as a protective factor against inadequate birthweight (adjusted OR=0.44; 95% CI: 0.20-0.98). Standing for 2.5 hours or longer during the second semester of pregnancy was associated with increased risk (adjusted OR=3.23; 95% CI: 1.30-7.99). Dose-response relationships were identified for washing clothing by hand and cooking (p-value for linear trend clothing during the second trimester of gestation remained statistically significant. Our results show the importance of medical orientation regarding posture and physical activity during antenatal care, aiming at the reduction of inadequate birthweight.

  12. Sectio på maternal request

    DEFF Research Database (Denmark)

    Forstholm, Malene Merete; Lidegaard, Øjvind; Forstholm, Malene Merete

    2009-01-01

    over the past five years, and now amounts to 1.3% of all births for P0 women and 3.6% for P1+ women. Previous birth complications and the age and living area of the mother are associated with MRS. Better knowledge of the reasons why some women choose MRS would provide professionals with better tools......INTRODUCTION: An increasing number of women give birth by caesarean section (CS) in Denmark, some without any medical reasons for this procedure. This is called maternal request sectio (MRS). To analyse the development of MRS over a five-year period and investigate how parity, former birth......-24. MRS was most frequent in the Capital Region. Women who had experienced CS, third degree perineal tear, or perinatal death in their first delivery, had a 3.8, 1.3 and 2.0 times increased risk of MRS in their next delivery. The weight of the child had no influence on MRS. CONCLUSION: MRS has increased...

  13. Computationally Developed Sham Stimulation Protocol for Multichannel Desynchronizing Stimulation

    Directory of Open Access Journals (Sweden)

    Magteld Zeitler

    2018-05-01

    Full Text Available A characteristic pattern of abnormal brain activity is abnormally strong neuronal synchronization, as found in several brain disorders, such as tinnitus, Parkinson's disease, and epilepsy. As observed in several diseases, different therapeutic interventions may induce a placebo effect that may be strong and hinder reliable clinical evaluations. Hence, to distinguish between specific, neuromodulation-induced effects and unspecific, placebo effects, it is important to mimic the therapeutic procedure as precisely as possibly, thereby providing controls that actually lack specific effects. Coordinated Reset (CR stimulation has been developed to specifically counteract abnormally strong synchronization by desynchronization. CR is a spatio-temporally patterned multichannel stimulation which reduces the extent of coincident neuronal activity and aims at an anti-kindling, i.e., an unlearning of both synaptic connectivity and neuronal synchrony. Apart from acute desynchronizing effects, CR may cause sustained, long-lasting desynchronizing effects, as already demonstrated in pre-clinical and clinical proof of concept studies. In this computational study, we set out to computationally develop a sham stimulation protocol for multichannel desynchronizing stimulation. To this end, we compare acute effects and long-lasting effects of six different spatio-temporally patterned stimulation protocols, including three variants of CR, using a no-stimulation condition as additional control. This is to provide an inventory of different stimulation algorithms with similar fundamental stimulation parameters (e.g., mean stimulation rates but qualitatively different acute and/or long-lasting effects. Stimulation protocols sharing basic parameters, but inducing nevertheless completely different or even no acute effects and/or after-effects, might serve as controls to validate the specific effects of particular desynchronizing protocols such as CR. In particular, based on

  14. Patients' perceptions of safety and quality of maternity clinical handover

    Directory of Open Access Journals (Sweden)

    Chin Georgiana SM

    2011-08-01

    Full Text Available Abstract Background Maternity clinical handover serves to address the gaps in knowledge existing when transitions between individuals or groups of clinicians occur throughout the antenatal, intra-partum and postnatal period. There are limited published studies on maternity handover and a paucity of information about patients' perceptions of the same. This paper reports postnatal patients' perceptions of how maternity handover contributes to the quality and safety of maternity care. Methods This paper reports on a mixed-methods study consisting of qualitative interviews and quantitative medical record analysis. Thirty English-speaking postnatal patients who gave birth at an Australian tertiary maternity hospital participated in a semi-structured interview prior to discharge from hospital. Interview data were coded thematically using the constant comparative method and managed via NVivo software; this data set was supplemented by medical record data analysed using STATA. Results Almost half of the women were aware of a handover process. Clinician awareness of patient information was seen as evidence that handover had taken place and was seen as representing positive aspects of teamwork, care and communication by participants, all important factors in the perception of quality health care. Collaborative cross-checking, including the use of cognitive artefacts such as hand held antenatal records and patient-authored birth plans, and the involvement of patients and their support people in handover were behaviours described by participants to be protective mechanisms that enhanced quality and safety of care. These human factors also facilitated team situational awareness (TSA, shared decision making and patient motivation in labour. Conclusions This study illustrates that many patients are aware of handover processes. For some patients, evidence of handover, through clinician awareness of information, represented positive aspects of teamwork, care and

  15. The Effect of Marital Violence on Maternal Parenting Style and Maternal Stress.

    Science.gov (United States)

    Niesman, Cindy S.

    A study examined the effect of extreme marital discord, involving abuse of the mother, on maternal parenting style and level of maternal stress. It was hypothesized that battered women experience a higher level of maternal stress and choose an authoritarian parenting style as a consequence of marital discord. Subjects were 30 mothers of children…

  16. Evidence from Maternity Leave Expansions of the Impact of Maternal Care on Early Child Development

    Science.gov (United States)

    Baker, Michael; Milligan, Kevin

    2010-01-01

    We study the impact of maternal care on early child development using an expansion in Canadian maternity leave entitlements. Following the leave expansion, mothers who took leave spent 48-58 percent more time not working in their children's first year of life. This extra maternal care primarily crowded out home-based care by unlicensed…

  17. Severe maternal morbidity: A population-based study of an expanded measure and associated factors.

    Directory of Open Access Journals (Sweden)

    Victoria Lazariu

    Full Text Available Severe maternal morbidity conditions such as sepsis, embolism and cardiac arrest during the delivery hospitalization period can lead to extended length of hospital stays, life-long maternal health problems, and high medical costs. Most importantly, these conditions also contribute to the risk of maternal death. This population-based observational study proposed and evaluated the impact of expanding the Centers for Disease Control and Prevention (CDC measure of severe maternal morbidity by including additional comorbidities and intensive care admissions during delivery hospitalizations and examined associated factors. A New York State linked hospitalization and birth record database was used. Study participants included all New York State female residents, ages 10 to 55 years, who delivered a live infant in a New York acute care hospital between 2008 and 2013, inclusive. Incidence trends for both severe maternal morbidity measures were evaluated longitudinally. Associations between covariates and the two severe maternal morbidity measures were examined with logistic regression models, solved using generalized estimating equations and stratified by method of delivery. The New York expanded severe maternal morbidity measure identified 34,478 cases among 1,352,600 hospital deliveries (estimated incidence 2.55% representing a 3% increase in the number of cases compared to the CDC measure. Both estimates increased over the study period (p 1.5 included most measured comorbidities (e.g., pregnancy-induced hypertension, placentation disorder, multiple births, preterm birth, no prenatal care, hospitalization prior to delivery, higher levels of perinatal care birthing facilities and race/ethnicity. Expanding the measure for severe maternal morbidity during delivery to capture intensive care admissions provides a more sensitive estimate of disease burden. Perinatal regionalization in New York appears effective in routing high risk pregnancies to higher

  18. Maternal mortality ratio in Lebanon in 2008: a hospital-based reproductive age mortality study (RAMOS).

    Science.gov (United States)

    Hobeika, Elie; Abi Chaker, Samer; Harb, Hilda; Rahbany Saad, Rita; Ammar, Walid; Adib, Salim

    2014-01-01

    International agencies have recently assigned Lebanon to the group H of countries with "no national data on maternal mortality," and estimated a corresponding maternal mortality ratio (MMR) of 150 per 100,000 live births. The Ministry of Public Health addressed the discrepancy perceived between the reality of the maternal mortality ratio experience in Lebanon and the international report by facilitating a hospital-based reproductive age mortality study, sponsored by the World Health Organization Representative Office in Lebanon, aiming at providing an accurate estimate of a maternal mortality ratio for 2008. The survey allowed a detailed analysis of maternal causes of deaths. Reproductive age deaths (15-49 years) were initially identified through hospital records. A trained MD traveled to each hospital to ascertain whether recorded deaths were in fact maternal deaths or not. ICD10 codes were provided by the medical controller for each confirmed maternal deaths. There were 384 RA death cases, of which 13 were confirmed maternal deaths (339%) (numerator). In 2008, there were 84823 live births in Lebanon (denominator). The MMR in Lebanon in 2008 was thus officially estimated at 23/100,000 live births, with an "uncertainty range" from 153 to 30.6. Hemorrhage was the leading cause of death, with double the frequency of all other causes (pregnancy-induced hypertension, eclampsia, infection, and embolism). This specific enquiry responded to a punctual need to correct a clearly inadequate report, and it should be relayed by an on-going valid surveillance system. Results indicate that special attention has to be devoted to the management of peri-partum hemorrhage cases. Arab, postpartum hemorrhage, development, pregnancy management, verbal autopsy

  19. Maternal obesity and vitamin D sufficiency are associated with cord blood vitamin D insufficiency.

    Science.gov (United States)

    Josefson, Jami L; Feinglass, Joseph; Rademaker, Alfred W; Metzger, Boyd E; Zeiss, Dinah M; Price, Heather E; Langman, Craig B

    2013-01-01

    An inverse relationship between total serum 25-hydroxyvitamin D (25-OH D) and increased adiposity has been established in children, adolescents, and adults. However, the relationship between neonatal adiposity and vitamin D status has not been reported. Both maternal obesity and vitamin D deficiency in pregnancy are common and are associated with adverse pregnancy outcomes. The aim of the study was to determine the relationship between vitamin D levels in mothers and newborns, as influenced by maternal obesity, and evaluate these associations with neonatal adiposity. Sixty-one maternal-neonatal pairs participated in this cross-sectional study at an academic medical center. Mothers had a prepregnancy body mass index that was normal or obese. Maternal and cord blood sera were assayed for 25-OH D, and neonatal body composition was measured by air displacement plethysmography. Mothers had similar and sufficient levels of 25-OH D when measured at 36-38 wk gestation, irrespective of body mass index category (normal weight, 46.05, vs. obese, 49.84 ng/ml; P = not significant). However, cord blood 25-OH D was higher in neonates of normal-weight mothers compared to neonates of obese mothers (27.45 vs. 20.81 ng/ml; P = 0.02). The variance in cord blood 25-OH D was explained by four factors: maternal 25-OH D level, the presence of maternal obesity, maternal age, and neonatal adiposity (r(2) = 0.66). Obese women transfer less 25-OH D to offspring than normal-weight women, despite similar serum levels. Cord blood 25-OH D levels directly correlate to neonatal percentage body fat. These novel findings underscore the evolving relationships between maternal obesity, vitamin D nutritional status, and adiposity in the neonatal period that may influence subsequent childhood and adulthood vitamin D-dependent processes.

  20. Prenatal ultrasound screening: false positive soft markers may alter maternal representations and mother-infant interaction.

    Directory of Open Access Journals (Sweden)

    Sylvie Viaux-Savelon

    Full Text Available In up to 5% of pregnancies, ultrasound screening detects a "soft marker" (SM that places the foetus at risk for a severe abnormality. In most cases, prenatal diagnostic work-up rules out a severe defect. We aimed to study the effects of false positive SM on maternal emotional status, maternal representations of the infant, and mother-infant interaction.Utilizing an extreme-case prospective case control design, we selected from a group of 244 women undergoing ultrasound, 19 pregnant women whose foetus had a positive SM screening and a reassuring diagnostic work up, and 19 controls without SM matched for age and education. In the third trimester of pregnancy, within one week after delivery, and 2 months postpartum, we assessed anxiety, depression, and maternal representations. Mother-infant interactions were videotaped during feeding within one week after delivery and again at 2 months postpartum and coded blindly using the Coding Interactive Behavior (CIB scales. Anxiety and depression scores were significantly higher at all assessment points in the SM group. Maternal representations were also different between SM and control groups at all study time. Perturbations to early mother-infant interactions were observed in the SM group. These dyads showed greater dysregulation, lower maternal sensitivity, higher maternal intrusive behaviour and higher infant avoidance. Multivariate analysis showed that maternal representation and depression at third trimester predicted mother-infant interaction.False positive ultrasound screenings for SM are not benign and negatively affect the developing maternal-infant attachment. Medical efforts should be directed to minimize as much as possible such false diagnoses, and to limit their psychological adverse consequences.

  1. Community perspectives on the determinants of maternal health in rural southern Mozambique: a qualitative study.

    Science.gov (United States)

    Firoz, Tabassum; Vidler, Marianne; Makanga, Prestige Tatenda; Boene, Helena; Chiaú, Rogério; Sevene, Esperança; Magee, Laura A; von Dadelszen, Peter; Munguambe, Khátia

    2016-09-30

    Mozambique has one of the highest rates of maternal mortality in sub-Saharan Africa. The main influences on maternal health encompass social, economic, political, environmental and cultural determinants of health. To effectively address maternal mortality in the post-2015 agenda, interventions need to consider the determinants of health so that their delivery is not limited to the health sector. The objective of this exploratory qualitative study was to identify key community groups' perspectives on the perceived determinants of maternal health in rural areas of southern Mozambique. Eleven focus group discussions were conducted with women of reproductive age, pregnant women, matrons, male partners, community leaders and health workers. Participants were recruited using sampling techniques of convenience and snow balling. Focus groups had an average of nine participants each. The heads of 12 administrative posts were also interviewed to understand the local context. Data were coded and analysed thematically using NVivo software. A broad range of political, economic, socio-cultural and environmental determinants of maternal health were identified by community representatives. It was perceived that the civil war has resulted in local unemployment and poverty that had a number of downstream effects including lack of funds for accessing medical care and transport, and influence on socio-cultural determinants, particularly gender relations that disadvantaged women. Socio-cultural determinants included intimate partner violence toward women, and strained relationships with in-laws and co-spouses. Social relationships were complex as there were both negative and positive impacts on maternal health. Environmental determinants included natural disasters and poor access to roads and transport exacerbated by the wet season and subsequent flooding. In rural southern Mozambique, community perceptions of the determinants of maternal health included political, economic, socio

  2. Maternal dental radiography during pregnancy is not associated with term low birth weight

    International Nuclear Information System (INIS)

    Mortazavi, S.M.J.; Center for Radiation Research, Shiraz University, Shiraz; Aminzadeh, F.; Manshouri, A.; Kamali, M.; Rezaiean, M.; Vazirinejad, R.

    2007-01-01

    Complete text of publication follows. Objective: In a report published in JAMA in 2004, Hujoel and colleagues indicated that maternal dental radiography during pregnancy may be associated with term low birth weight. Interestingly, they concluded that dental radiographies cause measurable radiation doses to the hypothalamus-pituitary-thyroid axis and the radiation effects on this axis is the reason for term low birth weight. On the other hand, low birth weight is the second leading cause of infant death. In this paper the results obtained in a 2 year study conducted at a midwifery hospital in Rafsanjan, IR Iran are reported. Methods: Four hundred seventy-five singleton infants with gestational periods of 37-44 wk born between 2006 and 2007 at the Niknafs Teaching Hospital affiliated with Rafsanjan University of Medical Sciences and met the inclusion criteria were enrolled in the study. Demographic data and clinical findings at birth including gestation age, sex of infant, birth order, season of birth, maternal age, and maternal education were collected from maternal and newborn hospital records and by interviews with parents. Maternal history of exposure to common sources of man-made ionizing and non-ionizing (exposure to radiations emitted by mobile phones, CRTs, cordless phones) radiation before and during pregnancy were carefully recorded. Results: Among the 475 infants who were studied, there were only 15 cases with a history of maternal dental radiography during pregnancy. The average newborn infants' birth weight in non-exposed and exposed (maternal dental radiography during pregnancy) groups were 3166.69±481.31 g and 3118.67±341.42 g respectively. This difference was not statistically significant. Conclusions: In this study, low birth weight was not associated with maternal dental radiography during pregnancy. These results are generally inconsistent with those reported by Hujoel and colleagues.

  3. Cytokine production of in vitro stimulated peripheral lymphocytes during the course of pregnancy and pseudopregnancy in the rat

    NARCIS (Netherlands)

    Faas, MM; Eenling, R; van der Schaaf, G; Moes, H; Heineman, MJ; Vos, P

    Problem Does maternal lymphocyte cytokine production after in vitro stimulation vary with the stage of pregnancy in the rat? Method of study Blood samples were taken during the estrus cycle in rats (n = 11). Thereafter, rats were rendered pregnant (n = 6) or pseudopregnant (n = 5) and blood samples

  4. An emerging model of maternity care: smartphone, midwife, doctor?

    Science.gov (United States)

    Tripp, Nadia; Hainey, Kirsten; Liu, Anthony; Poulton, Alison; Peek, Michael; Kim, Jinman; Nanan, Ralph

    2014-03-01

    Mobile technology in the form of the smartphone is widely used, particularly in pregnancy and they are an increasing and influential source of information. To describe the diverse nature of pregnancy related applications (apps) for the smartphone and to flag that these apps can potentially affect maternity care and should be considered in future planning of care provision. The 2 smartphone platforms, Apple and Android, were searched for pregnancy related apps and reviewed for their purpose and popularity. iTunes and Google Play returned 1059 and 497 pregnancy related apps respectively. Forty percent of the apps were informative, 13% interactive, 19% had features of a medical tool and 11% were social media apps. By far the most popular apps, calculated as the number of reviews multiplied by average reviewer rating, were those with interactive features. The popularity of pregnancy-related apps could indicate a shift towards patient empowerment within maternity care provision. The traditional model of 'shared maternity care' needs to accommodate electronic devices into its functioning. Reliance on healthcare professionals may be reduced by the availability of interactive and personalised information delivered via a smartphone. This combined with the fact that smartphones are widely used by many women of childbearing age, has the potential to modify maternity care and experiences of pregnancy. Therefore it is important that healthcare professionals and policy-makers are more aware of these new developments, which are likely to influence healthcare and alter health-seeking behaviour. In addition healthcare professionals need to consider whether to discuss the use of apps in pregnancy with the women in their care. Copyright © 2013 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  5. Maternal sociodemographic characteristics and risk factors of antepartum fetal death.

    Science.gov (United States)

    Azim, M A; Sultana, N; Chowdhury, S; Azim, E

    2012-04-01

    The objectives of this study were to assess the sociodemographic profile and to identify the risk factors of ante-partum fetal death which occurs after the age of viability of fetus. This prospective observational study was conducted in the Obstetrics department of Ad-din Women Medical College Hospital during the period of June, 2009 to July, 2010. A total of 14,015 pregnant patients were admitted in the study place after the age of viability, which was taken as 28 weeks of gestation for our facilities. Eighty-three (0.59%) of them were identified as intrauterine fetal death. Assessment of maternal sociodemographic characteristics and maternal-fetal risk factors were evaluated with a semi structured questionnaire pretested. Majority (81.92%, n=68) of the patients were below 30 years of age, 78.31% belonged to middle socioeconomic group. Almost 58% women had education below SSC level and 28.91% took regular antenatal checkup. About 61.45% patients were multigravida. Most (59.04%) ante-partum deaths were identified below 32 weeks of pregnancy. Out of 83 patients, maternal risk factors were identified in 41(49.59%) cases where fetal risk factors were found in 16(19.27%) cases; no risk factors could be determined in rests. Hypertension (48.78%), diabetes (21.95%), hyperpyrexia (17.3%), abruptio placentae (4.88%) and UTI (7.36%) were identified as maternal factors; and congenital anomaly (37.5%), Rh incompatibility (37.5%), multiple pregnancy (12.5%) and post-maturity (12.5%) were the fetal risk factors. Here, proximal biological risk factors are most important in ante-partum fetal deaths. More investigations and facilities are needed to explain the causes of antepartum deaths.

  6. Maternal Obesity, Gestational Weight Gain, and Asthma in Offspring.

    Science.gov (United States)

    Polinski, Kristen J; Liu, Jihong; Boghossian, Nansi S; McLain, Alexander C

    2017-11-09

    Obesity is common among women of childbearing age; intrauterine exposure to maternal obesity or gestational weight gain may influence the development of asthma in early childhood. We examined the relationships of maternal obesity and gestational weight gain with asthma in offspring. We used data from the Early Childhood Longitudinal Study-Birth Cohort, which has a nationally representative sample of children followed from birth in 2001 through age 4 (n = 6,450). Asthma was based on parental report of a medical professional's diagnosis. We used generalized estimating equation binomial models to compute adjusted odds ratios (ORs) of childhood asthma with maternal obesity and 4 measures of gestational weight gain. Compared with children of normal-weight mothers, children of obese mothers had increased risk of asthma (adjusted OR, 1.63; 95% confidence interval [CI], 1.26-2.12) by age 4, and children born to overweight mothers had similar risk (adjusted OR, 1.25; 95% CI, 0.99-1.59). Extreme-low weight gain (gain (≥25 kg) were associated with increased risk of asthma; however, the following measures were not significant predictors of asthma: meeting gestational weight gain recommendations of the Institute of Medicine, total gestational weight gain, and weekly rate of weight gain in the second and third trimesters. Extreme-low or extreme-high gestational weight gain and maternal obesity are risk factors for early childhood asthma, further evidence of the long-term impact of intrauterine exposure on children and the need to target preconception care to improve child health indicators.

  7. Has the Janani Suraksha Yojana (a conditional maternity benefit transfer scheme) succeeded in reducing the economic burden of maternity in rural India? Evidence from the Varanasi district of Uttar Pradesh.

    Science.gov (United States)

    Mukherjee, Saradiya; Singh, Aditya

    2018-02-05

    One of the constraints in the utilisation of maternal healthcare in India is the out-of-pocket expenditure. To improve the utilisation and to reduce the out-of-pocket expenditure, India launched a cash incentive scheme, Janani Suraksha Yojana (JSY), which provides monetary incentive to the mothers delivering in public facility. However, no study has yet examined the extent to which the JSY payments reduce the maternal healthcare induced catastrophic out-of-pocket expenditure burden of the households. This paper therefore attempts to examine the extent to which the JSY reduces the catastrophic expenditure estimate household expenditure on maternity, i.e. , all direct and indirect expenditure. The study used data on 396 mothers collected through a primary survey conducted in the rural areas of the Varanasi district of Uttar Pradesh state in 2013-2014. The degree and variation in the catastrophic impact of households' maternity spending was computed as share of out-of-pocket payment in total household income in relation to specific thresholds, across socioeconomic categories. Logistic regression was used to understand the determinants of catastrophic expenditure and whether the JSY has any role in influencing the expenditure pattern. Results revealed that the JSY beneficiaries on an average spent about 8.3% of their Annual Household Consumption Expenditure on maternity care. The JSY reimbursement could reduce this share only by 2.1%. The study found that the expenditure on antenatal and postnatal care made up a significant part of the direct medical expenditure on maternity among the JSY beneficiaries. The indirect or non-medical expenditure was about four times higher than the direct expenditure on maternity services. The out-of-pocket expenditure across income quintiles was found to be regressive i.e. the poor paid a greater proportion of their income towards maternity care than the rich. Results also showed that the JSY reimbursement helped only about 8% households

  8. Maternal fitness at the onset of the second trimester of pregnancy: correlates and relationship with infant birth weight.

    Science.gov (United States)

    Bisson, M; Alméras, N; Plaisance, J; Rhéaume, C; Bujold, E; Tremblay, A; Marc, I

    2013-12-01

    What is already known about this subject A healthy life begins in utero and a healthy pregnancy requires a fit and healthy mother. Physical activity during pregnancy provides a stimulation that is essential for promoting optimal body oxygenation and composition as well as metabolic fitness during pregnancy. Although a higher maternal fitness is expected to provide a beneficial fetal environment, it is still unclear whether physical fitness during pregnancy contributes to perinatal health. What this study adds Participation in sports and exercise previously and at the beginning of pregnancy can benefit maternal health by improving cardiorespiratory fitness during pregnancy, irrespective of maternal body mass index. Maternal strength, an indicator of muscular fitness, is an independent determinant of infant fetal growth and can positively influence birth weight. It is still unclear whether maternal physical activity and fitness during pregnancy contributes to perinatal health. The aims of this study were to characterize maternal physical fitness at 16 weeks of pregnancy and to examine its effects on infant birth weight. Maternal anthropometry (body mass index [BMI] and skin-folds), physical activity, cardiorespiratory fitness (VO2 peak) and muscular fitness (handgrip strength) were assessed at 16 weeks of gestation in 65 healthy pregnant women. Offspring birth weight was collected from maternal charts after delivery. A higher VO2 peak was associated with physical activity spent at sports and exercise before and in early pregnancy (P = 0.0005). Maternal BMI was negatively associated with cardiorespiratory fitness (P pregnancy as a new determinant of infant birth weight. © 2012 The Authors. Pediatric Obesity © 2012 International Association for the Study of Obesity.

  9. Stimulated Thomson scattering

    International Nuclear Information System (INIS)

    Spencer, R.L.

    1979-03-01

    The theory of stimulated Thomson scattering is investigated both quantum mechanically and classically. Two monochromatic electromagnetic waves of like polarization travelling in opposite directions are allowed to interact for a time tau with the electrons in a collisionless plasma. The electromagnetic waves have frequencies well above the plasma frequency, and their difference frequency is allowed to range upward from the plasma frequency. With the difference frequency well above the plasma frequency, the rate at which energy is transferred from one wave to the other is calculated quantum mechanically, classically from a fluid theory, and classically from an independent electron theory. The rate is calculated in both the homogeneously broadened limit, and in the inhomogeneously broadened limit

  10. Engagement sensitive visual stimulation

    Directory of Open Access Journals (Sweden)

    Deepesh Kumar

    2016-06-01

    Full Text Available Stroke is one of leading cause of death and disability worldwide. Early detection during golden hour and treatment of individual neurological dysfunction in stroke using easy-to-access biomarkers based on a simple-to-use, cost-effective, clinically-valid screening tool can bring a paradigm shift in healthcare, both urban and rural. In our research we have designed a quantitative automatic home-based oculomotor assessment tool that can play an important complementary role in prognosis of neurological disorders like stroke for the neurologist. Once the patient has been screened for stroke, the next step is to design proper rehabilitation platform to alleviate the disability. In addition to the screening platform, in our research, we work in designing virtual reality based rehabilitation exercise platform that has the potential to deliver visual stimulation and in turn contribute to improving one’s performance.

  11. Educación maternal

    OpenAIRE

    Carnicer Fuentes, Inmaculada Concepción

    2010-01-01

    Definir y/o describir los objetivos, metodología y contenidos de la educación maternal como componente del proceso asistencial integrado de atención al “Embarazo, Parto y Puerperio” de la Consejería de Salud de la Junta de Andalucía. Definir y/o describir los aspectos básicos del crecimiento y desarrollo ovular Definir y/o describir los aspectos básicos de la educación sanitaria durante el embarazo, incluyendo aspectos como nutrición, fármacos, vacunas, atención prenatal y prevención ...

  12. Islet neogenesis is stimulated by brief occlusion of the main ...

    African Journals Online (AJOL)

    Islet neogenesis is stimulated by brief occlusion of the main pancreatic duct. ... South African Medical Journal ... where the initial events that culminate in increased pancreatic endocrine mass caube studied. ... The animals were killed 56 days post .occlusion, and the pancreata excised and fiXed tor histological analysis.

  13. Stimulated coherent transition radiation

    International Nuclear Information System (INIS)

    Hung-chi Lihn.

    1996-03-01

    Coherent radiation emitted from a relativistic electron bunch consists of wavelengths longer than or comparable to the bunch length. The intensity of this radiation out-numbers that of its incoherent counterpart, which extends to wavelengths shorter than the bunch length, by a factor equal to the number of electrons in the bunch. In typical accelerators, this factor is about 8 to 11 orders of magnitude. The spectrum of the coherent radiation is determined by the Fourier transform of the electron bunch distribution and, therefore, contains information of the bunch distribution. Coherent transition radiation emitted from subpicosecond electron bunches at the Stanford SUNSHINE facility is observed in the far-infrared regime through a room-temperature pyroelectric bolometer and characterized through the electron bunch-length study. To measure the bunch length, a new frequency-resolved subpicosecond bunch-length measuring system is developed. This system uses a far-infrared Michelson interferometer to measure the spectrum of coherent transition radiation through optical autocorrelation with resolution far better than existing time-resolved methods. Hence, the radiation spectrum and the bunch length are deduced from the autocorrelation measurement. To study the stimulation of coherent transition radiation, a special cavity named BRAICER is invented. Far-infrared light pulses of coherent transition radiation emitted from electron bunches are delayed and circulated in the cavity to coincide with subsequent incoming electron bunches. This coincidence of light pulses with electron bunches enables the light to do work on electrons, and thus stimulates more radiated energy. The possibilities of extending the bunch-length measuring system to measure the three-dimensional bunch distribution and making the BRAICER cavity a broadband, high-intensity, coherent, far-infrared light source are also discussed

  14. Medical and Family Leave: Benefits Available to Female Workers in the United States.

    Science.gov (United States)

    National Council of Jewish Women, New York, NY. Center for the Child.

    This paper discusses a national survey of employee benefits designed to investigate the extent to which employers have independently implemented basic components of a comprehensive maternity plan. Components include: (1) standard policies that set the period of leave; (2) job-protected medical leave for maternity; (3) employer contributions to…

  15. Gestational urinary bisphenol A and maternal and newborn thyroid hormone concentrations: The HOME Study

    International Nuclear Information System (INIS)

    Romano, Megan E.; Webster, Glenys M.; Vuong, Ann M.; Thomas Zoeller, R.; Chen, Aimin; Hoofnagle, Andrew N.; Calafat, Antonia M.; Karagas, Margaret R.; Yolton, Kimberly; Lanphear, Bruce P.; Braun, Joseph M.

    2015-01-01

    Bisphenol A (BPA), an endocrine disruptor used in consumer products, may perturb thyroid function. Prenatal BPA exposure may have sex-specific effects on thyroid hormones (THs). Our objectives were to investigate whether maternal urinary BPA concentrations during pregnancy were associated with THs in maternal or cord serum, and whether these associations differed by newborn sex or maternal iodine status. We measured urinary BPA concentrations at 16 and 26 weeks gestation among pregnant women in the HOME Study (2003–2006, Cincinnati, Ohio). Thyroid stimulating hormone (TSH) and free and total thyroxine (T 4 ) and triiodothyronine (T 3 ) were measured in maternal serum at 16 weeks (n=181) and cord serum at delivery (n=249). Associations between BPA concentrations and maternal or cord serum TH levels were estimated by multivariable linear regression. Mean maternal urinary BPA was not associated with cord THs in all newborns, but a 10-fold increase in mean BPA was associated with lower cord TSH in girls (percent change=−36.0%; 95% confidence interval (CI): −58.4, −1.7%), but not boys (7.8%; 95% CI: −28.5, 62.7%; p-for-effect modification=0.09). We observed no significant associations between 16-week BPA and THs in maternal or cord serum, but 26-week maternal BPA was inversely associated with TSH in girls (−42.9%; 95% CI: −59.9, −18.5%), but not boys (7.6%; 95% CI: −17.3, 40.2%; p-for-effect modification=0.005) at birth. The inverse BPA–TSH relation among girls was stronger, but less precise, among iodine deficient versus sufficient mothers. Prenatal BPA exposure may reduce TSH among newborn girls, particularly when exposure occurs later in gestation. - Highlights: • Examined associations of BPA with thyroid hormones in pregnant women and newborns. • Assessed effect modification of BPA–thyroid hormone associations by newborn sex. • Greater BPA related to decreased thyroid stimulating hormone in girls' cord serum. • Results may suggest

  16. Gestational urinary bisphenol A and maternal and newborn thyroid hormone concentrations: The HOME Study

    Energy Technology Data Exchange (ETDEWEB)

    Romano, Megan E., E-mail: megan_romano@brown.edu [Department of Epidemiology, Brown University School of Public Health, Providence, RI (United States); Webster, Glenys M. [Child and Family Research Institute, BC Children' s and Women' s Hospital and Faculty of Health Sciences, Simon Fraser University, Vancouver, British Columbia (Canada); Vuong, Ann M. [Division of Epidemiology and Biostatistics, Department of Environmental Health, University of Cincinnati College of Medicine, Cincinnati, OH (United States); Thomas Zoeller, R. [Department of Biology, University of Massachusetts, Amherst, MA (United States); Chen, Aimin [Division of Epidemiology and Biostatistics, Department of Environmental Health, University of Cincinnati College of Medicine, Cincinnati, OH (United States); Hoofnagle, Andrew N. [Department of Laboratory Medicine, University of Washington, Seattle, WA (United States); Calafat, Antonia M. [Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA (United States); Karagas, Margaret R. [Children' s Environmental Health and Disease Prevention Research Center and Department of Community and Family Medicine, Geisel School of Medicine at Dartmouth, Hanover, NH (United States); Yolton, Kimberly [Division of General and Community Pediatrics, Department of Pediatrics, Cincinnati Children' s Hospital Medical Center, Cincinnati, OH (United States); Lanphear, Bruce P. [Child and Family Research Institute, BC Children' s and Women' s Hospital and Faculty of Health Sciences, Simon Fraser University, Vancouver, British Columbia (Canada); Braun, Joseph M. [Department of Epidemiology, Brown University School of Public Health, Providence, RI (United States)

    2015-04-15

    Bisphenol A (BPA), an endocrine disruptor used in consumer products, may perturb thyroid function. Prenatal BPA exposure may have sex-specific effects on thyroid hormones (THs). Our objectives were to investigate whether maternal urinary BPA concentrations during pregnancy were associated with THs in maternal or cord serum, and whether these associations differed by newborn sex or maternal iodine status. We measured urinary BPA concentrations at 16 and 26 weeks gestation among pregnant women in the HOME Study (2003–2006, Cincinnati, Ohio). Thyroid stimulating hormone (TSH) and free and total thyroxine (T{sub 4}) and triiodothyronine (T{sub 3}) were measured in maternal serum at 16 weeks (n=181) and cord serum at delivery (n=249). Associations between BPA concentrations and maternal or cord serum TH levels were estimated by multivariable linear regression. Mean maternal urinary BPA was not associated with cord THs in all newborns, but a 10-fold increase in mean BPA was associated with lower cord TSH in girls (percent change=−36.0%; 95% confidence interval (CI): −58.4, −1.7%), but not boys (7.8%; 95% CI: −28.5, 62.7%; p-for-effect modification=0.09). We observed no significant associations between 16-week BPA and THs in maternal or cord serum, but 26-week maternal BPA was inversely associated with TSH in girls (−42.9%; 95% CI: −59.9, −18.5%), but not boys (7.6%; 95% CI: −17.3, 40.2%; p-for-effect modification=0.005) at birth. The inverse BPA–TSH relation among girls was stronger, but less precise, among iodine deficient versus sufficient mothers. Prenatal BPA exposure may reduce TSH among newborn girls, particularly when exposure occurs later in gestation. - Highlights: • Examined associations of BPA with thyroid hormones in pregnant women and newborns. • Assessed effect modification of BPA–thyroid hormone associations by newborn sex. • Greater BPA related to decreased thyroid stimulating hormone in girls' cord serum. • Results may

  17. Childhood obesity : medical, cultural and psychological factors

    NARCIS (Netherlands)

    Radhakishun, N.N.E.

    2014-01-01

    The aim of this thesis was to examine medical, cultural and psychological factors of childhood obesity in a multi-ethnic cohort. Medical factors Several associations between weight measured and hormones were determined in obese children between 6 and 18 years. Thyroid stimulating hormone (TSH) was

  18. Childhood obesity: medical, cultural and psychological factors

    NARCIS (Netherlands)

    Radhakishun, N.N.E.

    2014-01-01

    The aim of this thesis was to examine medical, cultural and psychological factors of childhood obesity in a multi-ethnic cohort. Medical factors Several associations between weight measured and hormones were determined in obese children between 6 and 18 years. Thyroid stimulating hormone (TSH)

  19. Stimulator with arbitrary waveform for auditory evoked potentials

    International Nuclear Information System (INIS)

    Martins, H R; Romao, M; Placido, D; Provenzano, F; Tierra-Criollo, C J

    2007-01-01

    The technological improvement helps many medical areas. The audiometric exams involving the auditory evoked potentials can make better diagnoses of auditory disorders. This paper proposes the development of a stimulator based on Digital Signal Processor. This stimulator is the first step of an auditory evoked potential system based on the ADSP-BF533 EZ KIT LITE (Analog Devices Company - USA). The stimulator can generate arbitrary waveform like Sine Waves, Modulated Amplitude, Pulses, Bursts and Pips. The waveforms are generated through a graphical interface programmed in C++ in which the user can define the parameters of the waveform. Furthermore, the user can set the exam parameters as number of stimuli, time with stimulation (Time ON) and time without stimulus (Time OFF). In future works will be implemented another parts of the system that includes the acquirement of electroencephalogram and signal processing to estimate and analyze the evoked potential

  20. Stimulator with arbitrary waveform for auditory evoked potentials

    Energy Technology Data Exchange (ETDEWEB)

    Martins, H R; Romao, M; Placido, D; Provenzano, F; Tierra-Criollo, C J [Universidade Federal de Minas Gerais (UFMG), Departamento de Engenharia Eletrica (DEE), Nucleo de Estudos e Pesquisa em Engenharia Biomedica NEPEB, Av. Ant. Carlos, 6627, sala 2206, Pampulha, Belo Horizonte, MG, 31.270-901 (Brazil)

    2007-11-15

    The technological improvement helps many medical areas. The audiometric exams involving the auditory evoked potentials can make better diagnoses of auditory disorders. This paper proposes the development of a stimulator based on Digital Signal Processor. This stimulator is the first step of an auditory evoked potential system based on the ADSP-BF533 EZ KIT LITE (Analog Devices Company - USA). The stimulator can generate arbitrary waveform like Sine Waves, Modulated Amplitude, Pulses, Bursts and Pips. The waveforms are generated through a graphical interface programmed in C++ in which the user can define the parameters of the waveform. Furthermore, the user can set the exam parameters as number of stimuli, time with stimulation (Time ON) and time without stimulus (Time OFF). In future works will be implemented another parts of the system that includes the acquirement of electroencephalogram and signal processing to estimate and analyze the evoked potential.

  1. Medical tourism.

    Science.gov (United States)

    Leggat, Peter

    2015-01-01

    Medical tourism is a burgeoning industry in our region. It involves patients travelling outside of their home country for medical treatment. This article provides an outline of the current research around medical tourism, especially its impact on Australians. Patients are increasingly seeking a variety of medical treatments abroad, particularly those involving cosmetic surgery and dental treatment, often in countries in South-East Asia. Adverse events may occur during medical treatment abroad, which raises medico-legal and insurance issues, as well as concerns regarding follow-up of patients. General practitioners need to be prepared to offer advice, including travel health advice, to patients seeking medical treatment abroad.

  2. Components of Maternal Healthcare Delivery System Contributing to ...

    African Journals Online (AJOL)

    Components of Maternal Healthcare Delivery System Contributing to Maternal Deaths ... transcripts were analyzed using a directed approach to content analysis. Excerpts were categorized according to three main components of the maternal ...

  3. Innova ng for Maternal and Child Health in Africa

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

    Innova ng for Maternal and Child Health in Africa ... spacing are cri cal to maternal and child health programming. It is ... APHRC is the only African ins tu on ... Maternal death review and outcomes: An assessment in Lagos State, Nigeria.

  4. Luminescence optically stimulated: theory and applications

    International Nuclear Information System (INIS)

    Rivera M, T.; Azorin N, J.

    2002-01-01

    The thermally stimulated luminescence (Tl) has occupied an important place in the Solid state physics (FES) by the flexibility of the phenomena, mainly for its applications in the fields of Radiation Physics (FR) and Medical Physics (MF). The reason of this phenomena lies in the fact of the electrons release by the action of heat. Under that same reason, it can be used the action of another stimulant agent for releasing the trapped electrons in the metastable states (EM), this agent is the light which has the same effect that the heat, giving as result the production of light photons at using light in the visible spectra, of different wavelength that the excitation light. This phenomena is called Luminescence optically stimulated (LOE). The LOE has a great impact in the Solid State Physics (FES), dating and now in the use of the phenomena as a dosimetric method, alternate to the Tl, for its use in the ionizing and non-ionizing radiations fields. (Author)

  5. May maternal lifestyle have an impact on neonatal glucose levels?

    Science.gov (United States)

    Hoirisch-Clapauch, Silvia; Porto, Maria Amelia S; Nardi, Antonio E

    2016-02-01

    Neonatal glucose levels correlate negatively with umbilical cord levels of C-peptide, a polypeptide secreted with insulin. In other words, neonatal hypoglycemia results from excessive insulin secretion from fetal/neonatal beta cells. Given that insulin causes fat to be stored rather than to be used for energy, one would expect that chronic hyperinsulinemia would result in large-for-gestational-age neonates. The finding that many small-for-gestational-age neonates have hypoglycemia suggests that the stimulus for insulin production occurs close to delivery. We postulated that a potent stimulation of maternal insulin production close to delivery would also provide a potent stimulus for fetal and neonatal insulin production, causing neonatal hypoglycemia. This study has evaluated 155 mothers with markers of excessive insulin production (such as acanthosis or grade III obesity), or with situations characterized by increased insulin requirements (such as an invasive bacterial infection or use of systemic corticosteroid within a week before delivery; or sedentariness or high-carbohydrate intake within 24h before delivery) and their 158 neonates who were screened for glycemic levels at 1, 2 and 4h after birth. The minimum glucose level was correlated to the maternal parameters, and to classical predictors of neonatal hypoglycemia, such as low-birth weight and preterm delivery. The only independent predictors were sedentariness and high-carbohydrate intake within 24h before delivery. The risk of neonatal hypoglycemia increased five-fold with sedentariness, 11-fold with high-carbohydrate intake, and 329-fold with both risk factors. The risk of neonatal hypoglycemia seems to be highly influenced by maternal lifestyle within 24h before delivery. Controlled randomized trials may help determine whether a controlled carbohydrate diet combined with regular physical activity close to delivery can prevent neonatal hypoglycemia and all its severe complications to the newborn

  6. Association between maternal hypothyroidism and autism spectrum disorders in children.

    Science.gov (United States)

    Getahun, Darios; Jacobsen, Steven J; Fassett, Michael J; Wing, Deborah A; Xiang, Anny H; Chiu, Vicki Y; Peltier, Morgan R

    2018-03-01

    BackgroundTo determine whether hypothyroidism is associated with autism spectrum disorders (ASD) and how this association is influenced by race-ethnicity, sex, and timing of exposure.MethodsA retrospective cohort study was conducted using records from 397,201 children who were delivered from 1991 to 2011 and remained health plan members from 1993 to 2014.ResultsChildren of hypothyroid women had higher ASD rates than children of women without the diagnosis (2.14 vs. 1.62/1,000 person-years; adjusted hazard ratios (adj.HR), 1.31; 95% confidence interval (CI), 1.13-1.53). This occurred in women diagnosed before as well as during pregnancy. Maternal hypothyroidism was associated with ASD for both boys (3.93 vs. 2.62/1,000 person-years; adj.HR, 1.27; 95% CI, 1.07-1.50) and girls (1.10 vs. 0.61/1,000 person-years; adj.HR, 1.51; 95% CI, 1.10-2.08). Of women with a diagnosis of hypothyroidism during pregnancy, normal thyroid-stimulating hormone (TSH) and free thyroxine (fT4) levels were not associated with an increased risk of ASD in children. Compared with white children, prenatal hypothyroidism was associated with an increased risk of ASD in children of Hispanics (adj.HR, 1.09; 95% CI, 1.01-1.17) and women of other/mixed race-ethnicity (adj.HR, 1.08; 95% CI, 1.00-1.16).ConclusionMaternal hypothyroidism is associated with ASD in children in a manner dependent on race-ethnicity. Management of maternal hypothyroidism may ameliorate the risk of ASD.

  7. Effects of early maternal employment on maternal health and well-being

    Science.gov (United States)

    Markowitz, Sara; Brooks-Gunn, Jeanne

    2012-01-01

    This study uses data from the National Institute of Child Health and Human Development Study on Early Child Care to examine the effects of maternal employment on maternal mental and overall health, self-reported parenting stress, and parenting quality. These outcomes are measured when children are 6 months old. Among mothers of 6-month-old infants, maternal work hours are positively associated with depressive symptoms and parenting stress and negatively associated with self-rated overall health. However, maternal employment is not associated with quality of parenting at 6 months, based on trained assessors’ observations of maternal sensitivity. PMID:23645972

  8. Determinants of adherence to methylphenidate and the impact of poor adherence on maternal and family measures.

    Science.gov (United States)

    Gau, Susan S F; Shen, Hsin-Yi; Chou, Miao-Churn; Tang, Ching-Shu; Chiu, Yen-Nan; Gau, Churn-Shiouh

    2006-06-01

    The aim of this study was to examine the association between adherence to immediate-release methylphenidate (IR MPH) and maternal psychological distress, parenting style, parent- child relationship, and perceived family support. The sample consisted of 307 children with attention-deficit hyperactivity disorder (ADHD) (271 boys and 36 girls), 6-17 years of age, who had been treated with IR MPH for the past 6 months. The measures included the Chinese Health Questionnaire, Parental Bonding Instrument, Family APGAR, and Home Behaviors of the Social Adjustment Inventory for Children and Adolescents. Reasons for poor adherence (n = 79; 25.7%) included forgetting medication (72.7%), the medication having no effect (20.0%), and refusing medication (12.7%). Increased age and three-times-daily administration were the major predictors for poor adherence to IR MPH. Poor adherence was associated with increased degree of maternal psychological distress, indifferent parenting, maternal overprotection/control, poor family support, decreased interaction with parents, and increased problems at home. Findings indicate that multiple daily dosing of MPH increases the likelihood of poor adherence, particularly in adolescents, and that poor adherence is associated with impaired maternal/family process. Once-daily administration of MPH is necessary to improve adherence and to decrease the possible exacerbation of tense parent-child relationships caused by poor drug adherence.

  9. Elevated thyroid stimulating hormone in a neonate: Drug induced or disease?

    Directory of Open Access Journals (Sweden)

    Sunil Kumar Kota

    2011-01-01

    Full Text Available Dyshormonogenesis is an uncommon cause of congenital hypothyroidism. The most common abnormality is absent or insufficient thyroid peroxidase enzyme. Maternal intake of antithyroid drug can also lead to elevated thyroid stimulating hormone (TSH in a neonate, albeit the scenario is temporary. We report one such interesting case where a clinically euthyroid neonate borne to a mother on antithyroid drug presents on 12 th day of life with reports of elevated TSH and increased tracer uptake in 99mTc thyroid scan. Disproportionately high TSH in comparison to low maternal antithyroid drug dosage and further elevation of TSH after stopping mother′s antithyroid drugs ruled out maternal antithyroid drug-induced congenital hypothyroidism in the baby. Early institution of therapy in these patients can prevent mental retardation and other features of hypothyroidism.

  10. Prenatal maternal stress in relation to the effects of prenatal lead exposure on toddler cognitive development.

    Science.gov (United States)

    Zhou, Leilei; Xu, Jian; Zhang, Jinsong; Yan, Chonghuai; Lin, Yanfen; Jia, Yinan; Hu, Wenjing

    2017-03-01

    To evaluate the effects of maternal lead exposure during pregnancy on toddler cognitive development and the potential effect modification by maternal stress. We conducted a prospective birth-cohort study in Shanghai from 2010 to 2012 and investigated 225 mother-infant pairs. The mothers were recruited in mid-to-late pregnancy and children were followed up until 24-36 months old. A self-administered Symptom Checklist-90-Revised Scale (SCL-90-R) was used to assess maternal emotional stress during pregnancy. Maternal whole blood lead levels were measured during gestational weeks 28-36. The toddlers' cognitive levels were assessed using the Gesell Development Scale. Multiple linear regression models were established to explore the main effects of prenatal lead exposure on toddlers' cognitive abilities and the modifying effects of maternal stress. Covariate information was collected through interviews, questionnaires and medical records. The mean maternal blood lead concentration was 3.30 (95%CI: 3.05, 3.57) μg/dL. After adjusting for relevant confounders, no significant associations of maternal blood lead concentrations with toddlers' cognitive levels were observed in all five domains of the Gesell scale (P>0.05). However, the interaction between prenatal maternal blood lead and stress was significant in the domains of adaptive behavior, language and social behavior. When stratified by maternal stress levels, compared with non-significant associations (P>0.05) among low (P1-P75) prenatal stress group, adverse associations between maternal blood lead concentrations (log10-transformed) and toddlers' cognitive levels were observed among high (P75-P100) prenatal stress group in the domains of language (β=-33.82, 95%CI: -60.04, -7.59), social behavior (β=-41.00, 95%CI: -63.11, -18.89) and adaptive behavior (β=-17.93, 95%CI: -35.83, -0.03). Prenatal maternal stress may exacerbate the deleterious effects of prenatal exposure to lead on toddler cognitive development

  11. Ultrasound stimulation on bone healing. The optimization of stimulation time

    International Nuclear Information System (INIS)

    Rosim, R.C.; Paulin, J.B.P.; Goncalves, R.P.

    1990-01-01

    Previous works in ultrasonic simulation of bone healing dealt with parameters optimization. Albertin (1983) studied the stimulation time and found forty minutes as ideal. However, this stimulation time was the largest one employed and remained some doubt about the most appropriated value. 30, 40, 50 and 60 minutes of stimulation time were selected, while others parameters were held constant with: pulse width in 200 μs, repetition rate in 1000 pulses per second and amplitude in 30 V. Partial incomplete transverse osteotomies were done in the middle third of radio in the right forearm of rabbits. Twenty four animals divided in four subgroups, with 6 animals each were stimulated. The daily stimulation time for each subgroup was 30, 40, 50 and minutes respectively, during 15 consecutive days. The stimulation procedure started 24 hours after surgery. After the stimulation period, radiological, histological and morphometric evaluations were done and greater bone healing was found for the 50 minutes stimulation subgroup, in them new bone was also prominent. (author)

  12. Anaesthesia for a patient with Deep Brain Stimulator: Case Report and Review of Literature

    Directory of Open Access Journals (Sweden)

    Raj mala

    2014-07-01

    Full Text Available Deep brain stimulator (DBS devices are used for unilateral or bilateral stimulation of thalamus, subthalamus and globus pallidus to treat movement disorders. DBS can interfere with domestic and medical equipment such as electrocardiography (ECG, slow wave diathermy, electrocautery, peripheral nerve stimulators, pacemakers, external and implantable cardioverters and defibrillators. This case report describes a patient with such a device who presented for bilateral (B/L cataract surgery.

  13. Sport club participation of adolescents with asthma: maternal factors and adolescent cognitions.

    Science.gov (United States)

    Tiggelman, Dana; van de Ven, Monique O M; van Schayck, Onno C P; Kleinjan, Marloes; Engels, Rutger C M E

    2014-09-01

    Sport participation is especially important for patients with asthma in that it decreases psychosocial and physiological problems associated with inactivity. However, adolescents with asthma seem to participate less in sports compared to their non-asthmatic peers. The current study tested the direct associations between maternal sport-specific factors and sport club participation of early adolescents with asthma and the indirect effect through adolescent's sport-specific cognitions. During home visits, 261 adolescents (aged 10-15) completed questionnaires about self-efficacy, beliefs regarding sport participation, and their actual sport club participation. Their mothers reported their sport-specific support, beliefs about offspring's and own sport participation, their own levels of physical activity, and their self-efficacy to stimulate offspring to participate in sports. Path analyses were used to examine the direct and indirect associations of maternal sport-specific factors with adolescents sport club participation via adolescent sport-specific cognitions. Analyses showed that maternal sport-specific support (β = 0.20, P = 0.007) and self-efficacy to stimulate offspring to participate in sports (β = 0.20, P = 0.027) related positively to adolescents' sport club participation. Adolescents' self-efficacy (indirect effect = 0.09, SE = 3.01, P adolescents' participation in sport clubs. Maternal sport-specific factors related to adolescents' sport club participation directly and indirectly through adolescents' sport-specific cognitions. Intervention programs should focus on maternal sport-specific support and self-efficacy and adolescents' self-efficacy to increase sport participation of adolescents with asthma. © 2013 Wiley Periodicals, Inc.

  14. Medical Management

    Science.gov (United States)

    ... org Close Charcot-Marie-Tooth Disease (CMT) Medical Management Although there’s no cure for CMT, there are ... individualized physical therapy program. For more on medical management of CMT, see Surgery Sometimes, Bracing Often, Caution ...

  15. Medical Identity

    DEFF Research Database (Denmark)

    Musaeus, Peter

    2015-01-01

    Purpose: To examine philosophical stances underpinning medical identity and assess the conceptual relationship between physician, medical practice and culture. Argument: Medical identity is about the ideals and moral positions that physicians take when justifying themselves. Medical identity...... hedonistic versus sentimentalist approaches to medical identity. The sociocultural philosophical analysis of medical identity can shed light on what it means conceptually for a physician to harbor beliefs associated with him/her being taken to be an autonomous professional. It is important because it touches...... on the meaning of being a compassionate, good and skilled physician, making its relevance to person-centered medicine self-evident. Conclusion: Medical identity should be analyzed with reference to literature, philosophy and medical practice in order for the physician to exercise a reflective position...

  16. [Medical negligence].

    Science.gov (United States)

    Zipper, St G

    2016-06-01

    Medical negligence is a matter of growing public interest. This review outlines various aspects of medical negligence: epidemiology, taxonomy, and the risks, causes, psychology, management and prevention of errors.

  17. Medical Illustration

    Science.gov (United States)

    ... as medical books, journals, magazines, pharma or biotech marketing, films, online video, exhibits, posters, wall charts, educational ... of the health career profession with strong communication skills, medical illustrators work closely with clients to interpret ...

  18. Student midwives' views on maternity care just before their graduation.

    Science.gov (United States)

    Van Kelst, Liesbeth; Spitz, Bernard; Sermeus, Walter; Thomson, Ann M

    2013-03-01

    To report a hermeneutic study of student midwives' views on maternity care just before their graduation. background: Woman-centred care, which is the hallmark of midwifery, is taught to midwifery students around the globe. Woman-centred care is advantageous for women at low obstetric risk. However, adopting this ideology might be a problem for student midwives whose clinical placements are mainly in a medicalized obstetric-led hospital setting. A hermeneutic phenomenological study was conducted. In 2010, three focus groups were held where 19 student midwives participated. Data were transcribed verbatim and analysed using van Manen's approach. The choice for midwifery was a 'positive' choice and not the result of an elimination process. Students' description of a midwife as a coach was in line with the international definition of a midwife. With regard to maternity care, midwifery students identified two types of care, factory-style care and tailored care, both of which were ascribed to caregivers and hospital culture. Furthermore, student midwives made the distinction between hierarchy and teamwork, referring to the professional relations in maternity care. Hierarchy was driven by tradition, it implied that decisions were made top-down, and it resulted in impersonal relations. Midwifery students felt it was unjust that midwives were not allowed to perform deliveries while having the legal autonomy to do so. In spite of the medicalized context, midwifery education succeeded in educating midwives who hold a woman-centred ideology. Midwifery students linked style of care to a person rather than to a profession. © 2012 Blackwell Publishing Ltd.

  19. Commentary Improving child outcomes through maternal mental ...

    African Journals Online (AJOL)

    This commentary will provide a general overview of the public health considerations of maternal mental illness, both from a global perspective as well as from the South African context. The paper will outline the consequences of maternal mental illness for mothers as well as their offspring, through the life stages from ...

  20. Infant Communicative Behaviors and Maternal Responsiveness

    Science.gov (United States)

    DiCarlo, Cynthia F.; Onwujuba, Chinwe; Baumgartner, Jennifer I.

    2014-01-01

    Background: This study applies attachment and transactional theories in evaluating the dyadic interactions observed between a mother and her infant. Infant communication and maternal responsivity are highlighted as the medium for positive interaction. Objective: The impact of individualized maternal training on mother infant communicative…