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Sample records for somali women delivering

  1. Views of Somali women and men on the use of faith-based messages promoting breast and cervical cancer screening for Somali women: a focus-group study

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    Rebekah Pratt

    2017-03-01

    Full Text Available Abstract Background Screening rates for breast and cervical cancer for Muslim women in the United States are low, particularly for first-generation immigrants. Interpretations of the Muslim faith represent some of the barriers for breast and cervical cancer screening. Working to understand how faith influences breast and cervical screening for Somali women, and working with the community to identify and utilize faith-based assets for promoting screening, may lead to life-saving changes in screening behaviors. Methods We partnered with an Imam to develop faith-based messages addressing the concerns of modesty and predetermination and promoting cancer testing and screening. A total of five focus groups were convened, with 34 Somali women (three groups and 20 Somali men (two groups. Each focus group first discussed participant views of breast and cervical cancer screening in general and then viewed and discussed video clips of the Imam delivering the faith-based messages. Results Both Somali women and men had an overwhelmingly positive response to the faith-based messages promoting breast and cervical cancer screening. The faith-based messages appeared to reinforce the views of those who were already inclined to see screening positively, with participants describing increased confidence to engage in screening. For those who had reservations about screening, there was feedback that the faith-based messages had meaningfully influenced their views. Conclusions Somali immigrant women and men found faith-based messages addressing topics of predestination and modesty and encouraging the use of screening and treatment to be both acceptable and influential. Faith can play an important role as an asset to promote breast and cervical cancer screening, and there may be substantial benefits to adding faith-based messaging to other interventions that focus on improving screening uptake. This may help to address health disparities for Somali women in this area.

  2. Somali women's view of physical activity--a focus group study.

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    Persson, Gerthi; Mahmud, Amina Jama; Hansson, Eva Ekvall; Strandberg, Eva Lena

    2014-10-23

    Physical inactivity presents a major public health challenge and is estimated to cause six to ten percent of the major non-communicable diseases. Studies show that immigrants, especially women, have an increased risk of non-communicable diseases compared to ethnic Swedes. Somali immigrant women have increased rates of overweight and obesity, low fitness levels and low levels of cardiorespiratory fitness compared to non-immigrant women. These findings suggest that Somali women are at increased risk of developing lifestyle-related diseases. Few studies explore determinants of physical activity among Somali women. The aim of this study was to explore Somali women's views and experiences of physical activity after migration to Sweden. A qualitative focused ethnographic approach was used in this study. Four focus groups were conducted with twenty-six Somali women ranging from 17 to 67 years of age. Focus group discussions were recorded, transcribed verbatim and analysed using qualitative content analysis. The analysis resulted in four main themes and ten categories: Life in Somalia and Life in Sweden, Understanding and enhancing health and Facilitators and barriers to physical activity. Great differences were seen between living in Somalia and in Sweden but also similarities such as finding time to manage housework, the family and the health of the woman. The extended family is non-existent in Sweden, making life more difficult. Health was considered a gift from God but living a healthy life was perceived as the responsibility of the individual. Misconceptions about enhancing health occurred depending on the woman's previous life experience and traditions. There was an awareness of the importance of physical activity among the participants but lack of knowledge of how to enhance activity on an individual basis. Enhancing factors to an active lifestyle were identified as being a safe and comfortable environment. Some barriers, such as climate, lack of motivation and time

  3. Postpartum Depression Among Somali Women in Norway.

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    Løvlie, Astrid Louise; Madar, Ahmed Ali

    2017-06-01

    Postpartum depression (PPD) has been described as the most common complication experienced postpartum, affecting about 10-15 % of all new mothers. Factors like a history of mental illness, and experienced recent adverse life events has been associated with an increased risk for developing PPD. Immigrant women in Western countries have been found to have a marked higher prevalence of PPD compared to the general population. In Norway the prevalence of PPD in the general population has been found to be around 8-10 %, and among Pakistani immigrants a rate of 7.6 % was found. Somali people in Norway are the second largest immigrant group in Norway with a non-Western background. No study on PPD and associated factors among Somali women has been found in the literature. The aim of the study was to assess PPD and associated factors among Somali women in greater Oslo region, Norway. A cross-sectional survey was conducted; recruiting new mothers through all maternity wards in the Oslo region. Data was collected with interview-administrated questionnaires. PPD was assessed using Edinburgh Postnatal Depression Scale (EPDS), defining those scoring ≥10 to have a possible PPD. Of the 80 eligible women identified, 39 (49 %) consented to participate, and completed the study. Of the 39 respondents 3 (7.7 %) were assessed to have a possible PPD. Most important associated factors found were history of mental illness, having experienced technical assistance during delivery, self-rated health and experienced economical problems last 12 months. A low prevalence of PPD was found, and both the prevalence and its associated factors should be interpreted with caution. The associated factors do not have enough power to give any strength to the associations. However, some of the results can be used in develop new hypotheses with regard to PPD among Somali women as immigrants in a Western society.

  4. Providers' Perceptions of Challenges in Obstetrical Care for Somali Women

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    Jalana N. Lazar

    2013-01-01

    Full Text Available Background. This pilot study explored health care providers’ perceptions of barriers to providing health care services to Somali refugee women. The specific aim was to obtain information about providers’ experiences, training, practices and attitudes surrounding the prenatal care, delivery, and management of women with Female Genital Cutting (FGC. Methods. Individual semi-structured interviews were conducted with 14 obstetricians/gynecologists and nurse midwives in Columbus, Ohio. Results. While providers did not perceive FGC as a significant barrier in itself, they noted considerable challenges in communicating with their Somali patients and the lack of formal training or protocols guiding the management of circumcised women. Providers expressed frustration with what they perceived as Somali patients' resistance to obstetrical interventions and disappointment with a perception of mistrust from patients and their families. Conclusion. Improving the clinical encounter for both patients and providers entails establishing effective dialogue, enhancing clinical and cultural training of providers, improving health literacy, and developing trust through community engagement.

  5. "A Somali girl is Muslim and does not have premarital sex. Is vaccination really necessary?" A qualitative study into the perceptions of Somali women in the Netherlands about the prevention of cervical cancer.

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    Salad, Jihan; Verdonk, Petra; de Boer, Fijgje; Abma, Tineke A

    2015-08-21

    Participation in Human Papillomavirus (HPV) vaccination and Papanicolaou Screening (Pap smears) is low among ethnic minorities in the Netherlands and hardly any information is available about the cervical cancer prevention methods of Somali women living in the diaspora. This qualitative study, based on the Health Belief Model (HBM) and an intersectionality-based framework, explores the perceptions of Somali women living in the Netherlands regarding measures to prevent cervical cancer. Semi-structured interviews have been conducted with young Somali women aged 17-21 years (n = 14) and Somali mothers aged 30-46 years (n = 6). Two natural group discussions have been conducted with 12 and 14 Somali mothers aged 23-66 years. The collected data has been analyzed thematically for content. In this study, we have identified perceived barriers to the use of preventive measures across three major themes: (1) Somali women and preventive healthcare; (2) Language, knowledge, and negotiating decisions; and (3) Sexual standards, culture, and religion. Many issues have been identified across these themes, e.g., distrust of the Dutch health care system or being embarrassed to get Pap smears due to Female Genital Mutilation (FGM) and having a Dutch, male practitioner; or a perceived low susceptibility to HPV and cancer because of the religious norms that prohibit sex before marriage. Current measures in the Netherlands to prevent women from developing cervical cancer hardly reach Somali women because these women perceive these kinds of preventative measures as not personally relevant. Dutch education strategies about cervical cancer deviate from ways of exchanging information within the Somali community. Teachers can provide culturally sensitive information to young Somali women in schools. For Somali mothers, oral education (e.g., poetry or theater) about the Dutch health care system and men's roles in HPV transmission may be useful. An intersectional approach, grounded in

  6. Being a bridge: Swedish antenatal care midwives' encounters with Somali-born women and questions of violence; a qualitative study.

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    Byrskog, Ulrika; Olsson, Pia; Essén, Birgitta; Allvin, Marie-Klingberg

    2015-01-16

    Violence against women is associated with serious health problems, including adverse maternal and child health. Antenatal care (ANC) midwives are increasingly expected to implement the routine of identifying exposure to violence. An increase of Somali born refugee women in Sweden, their reported adverse childbearing health and possible links to violence pose a challenge to the Swedish maternity health care system. Thus, the aim was to explore ways ANC midwives in Sweden work with Somali born women and the questions of exposure to violence. Qualitative individual interviews with 17 midwives working with Somali-born women in nine ANC clinics in Sweden were analyzed using thematic analysis. The midwives strived to focus on the individual woman beyond ethnicity and cultural differences. In relation to the Somali born women, they navigated between different definitions of violence, ways of handling adversities in life and social contexts, guided by experience based knowledge and collegial support. Seldom was ongoing violence encountered. The Somali-born women's' strengths and contentment were highlighted, however, language skills were considered central for a Somali-born woman's access to rights and support in the Swedish society. Shared language, trustful relationships, patience, and networking were important aspects in the work with violence among Somali-born women. Focus on the individual woman and skills in inter-cultural communication increases possibilities of overcoming social distances. This enhances midwives' ability to identify Somali born woman's resources and needs regarding violence disclosure and support. Although routine use of professional interpretation is implemented, it might not fully provide nuances and social safety needed for violence disclosure. Thus, patience and trusting relationships are fundamental in work with violence among Somali born women. In collaboration with social networks and other health care and social work professions, the

  7. Attitudes towards and perceptions about contraceptive use among married refugee women of Somali descent living in Finland.

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    Degni, F; Koivusilta, L; Ojanlatva, A

    2006-09-01

    To assess attitudes towards and perceptions about contraceptive use among married refugee women of Somali descent living in Finland. A sample of 100 married refugee women of Somali descent (18-50 years of age) were invited to participate in a study on contraceptive use in Finland (30 women refused). Qualitative and quantitative methods were used to collect the data. Questionnaire of the first data set was written in the Somali language. Interviews were conducted in the Somali language. The attitudes and opinions of these women towards contraceptive use (73% did not use contraceptives, 27% did use them) were connected with religious beliefs and issues involving marital relations. Religious or gender issues did not seem to influence those who used contraception. The findings indicated that the majority of the married refugee women of Somali descent living in Finland did not use contraception. The process of starting the use of contraception was possible because of an access to good reproductive health care and family planning services, changes in life situations, and adaptations to Finnish social and cultural norms.

  8. Health literacy: the missing link in improving the health of Somali immigrant women in Oslo.

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    Gele, Abdi A; Pettersen, Kjell Sverre; Torheim, Liv Elin; Kumar, Bernadette

    2016-11-03

    Existing studies report a positive association between inadequate health literacy and immigrant's adverse health outcomes. Despite substantial research on this topic among immigrants, little is known about the level of health literacy among Somali women in Europe, and particularly in Norway. A cross sectional study using respondent driven sampling was conducted in Oslo, Norway. A sample of 302 Somali women, 25 years and older, was interviewed using the short version of the European Health Literacy Questionnaire. Data was analysed using logistic regression. Findings revealed that 71 % of Somali women in Oslo lack the ability to obtain, understand and act upon health information and services, and to make appropriate health decisions. Being unemployed (OR 3.66, CI 1.08-12.3) and socially less integrated (OR 8.17, CI 1.21-54.8) were independent predictors of an inadequate health literacy among Somali women. Enhanced health literacy will most likely increase the chance to better health outcomes for immigrants, thereby moving towards health equity in the Norwegian society. Therefore, policies and programs are required to focus and improve health literacy of immigrant communities.

  9. Health literacy: the missing link in improving the health of Somali immigrant women in Oslo

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    Abdi A. Gele

    2016-11-01

    Full Text Available Abstract Background Existing studies report a positive association between inadequate health literacy and immigrant’s adverse health outcomes. Despite substantial research on this topic among immigrants, little is known about the level of health literacy among Somali women in Europe, and particularly in Norway. Methods A cross sectional study using respondent driven sampling was conducted in Oslo, Norway. A sample of 302 Somali women, 25 years and older, was interviewed using the short version of the European Health Literacy Questionnaire. Data was analysed using logistic regression. Results Findings revealed that 71 % of Somali women in Oslo lack the ability to obtain, understand and act upon health information and services, and to make appropriate health decisions. Being unemployed (OR 3.66, CI 1.08–12.3 and socially less integrated (OR 8.17, CI 1.21–54.8 were independent predictors of an inadequate health literacy among Somali women. Conclusions Enhanced health literacy will most likely increase the chance to better health outcomes for immigrants, thereby moving towards health equity in the Norwegian society. Therefore, policies and programs are required to focus and improve health literacy of immigrant communities.

  10. Beyond Culture and Language: Access to Diabetes Preventive Health Services among Somali Women in Norway.

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    Gele, Abdi A; Torheim, Liv Elin; Pettersen, Kjell Sverre; Kumar, Bernadette

    2015-01-01

    Despite the high prevalence of type 2 diabetes in some immigrant and refugee communities in Norway, there is very little information available on their utilization of diabetes prevention interventions, particularly for women from Somali immigrant communities. A qualitative study of 30 Somali immigrant women aged 25 years and over was carried out in the Oslo area. Unstructured interviews were used to explore women's knowledge of diabetes, their access to preventive health facilities, and factors impeding their reception of preventive health programs targeted for the prevention of type 2 diabetes. The study participants were found to have a good knowledge of diabetes. They knew that a sedentary lifestyle and unhealthy diet are among the risk factors for diabetes. Regardless of their knowledge, participants reported a sedentary lifestyle accompanied with the consumption of an unhealthy diet. This was attributed to a lack of access to tailored physical activity services and poor access to health information. Considering gender-exclusive training facilities for Somali immigrant women and others with similar needs, in addition to access to tailored health information on diet, may encourage Somali women to adopt a healthy lifestyle, and it will definitely contribute to a national strategy for the prevention of diabetes.

  11. Beyond Culture and Language: Access to Diabetes Preventive Health Services among Somali Women in Norway

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    Abdi A. Gele

    2015-01-01

    Full Text Available Despite the high prevalence of type 2 diabetes in some immigrant and refugee communities in Norway, there is very little information available on their utilization of diabetes prevention interventions, particularly for women from Somali immigrant communities. A qualitative study of 30 Somali immigrant women aged 25 years and over was carried out in the Oslo area. Unstructured interviews were used to explore women’s knowledge of diabetes, their access to preventive health facilities, and factors impeding their reception of preventive health programs targeted for the prevention of type 2 diabetes. The study participants were found to have a good knowledge of diabetes. They knew that a sedentary lifestyle and unhealthy diet are among the risk factors for diabetes. Regardless of their knowledge, participants reported a sedentary lifestyle accompanied with the consumption of an unhealthy diet. This was attributed to a lack of access to tailored physical activity services and poor access to health information. Considering gender-exclusive training facilities for Somali immigrant women and others with similar needs, in addition to access to tailored health information on diet, may encourage Somali women to adopt a healthy lifestyle, and it will definitely contribute to a national strategy for the prevention of diabetes.

  12. Communication and cultural issues in providing reproductive health care to immigrant women: health care providers' experiences in meeting the needs of [corrected] Somali women living in Finland.

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    Degni, Filio; Suominen, Sakari; Essén, Birgitta; El Ansari, Walid; Vehviläinen-Julkunen, Katri

    2012-04-01

    Communication problems due to language and cultural differences between health care professionals and patients are widely recognized. Finns are described as more silent whereas one concurrent large immigrant group, the Somalis, are described as more open in their communication. The aim of the study was to explore physicians-nurses/midwives' communication when providing reproductive and maternity health care to Somali women in Finland. Four individual and three focus group interviews were carried out with 10 gynecologists/obstetricians and 15 nurses/midwives from five selected clinics. The health care providers considered communication (including linguistic difficulties), cultural traditions, and religious beliefs to be problems when working with Somali women. Male and female physicians were generally more similar in communication style, interpersonal contacts, and cultural awareness than the nurses/midwives who were engaged in more partnership-building with the Somali women in the clinics. Despite the communication and cultural problems, there was a tentative mutual understanding between the Finnish reproductive health care professionals and the Somali women in the clinics.

  13. Cigarettes and the Somali diaspora: tobacco use among Somali adults in Minnesota.

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    Giuliani, Kristin K W; Mire, Osman; Leinberger-Jabari, Andrea; Ehrlich, Laura C; Stigler, Melissa H; Pryce, Douglas J; DuBois, Diana K

    2012-11-01

    Since the onset of the Somali civil war in 1991, more than 1 million Somalis have been displaced from Somalia. Minnesota has the largest Somali population in the U.S. Informal tobacco prevalence estimates among Somali populations in the U.S. and the United Kingdom range from 13% to 37%, respectively. Little research has been conducted to determine the extent of Somali tobacco use. This paper reports the results from a knowledge, attitudes, and practices (KAP) survey conducted and analyzed in 2009 that explores tobacco use and estimates prevalence among Somali adults aged ≥ 18 years in Minnesota. Modeled after validated state and national tobacco use surveys, the survey was adapted for Somalis and administered to ethnically Somali adults (N=392) from 25 neighborhood clusters in Minnesota. Participants were chosen through probability proportional to size and multistage random sampling methods. Estimated prevalence for cigarette use among Somalis was 24% (44% among men, 4% among women). Ever users were significantly more likely to be men, have attended college, and have friends who used cigarettes (pIslamic prohibition of tobacco was protective and affected current use and future intention to use tobacco (peducation levels. Positive peer pressure and religion are protective factors from tobacco use and should be integrated into prevention and cessation programs. Copyright © 2012 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  14. Sexual Health Care, Sexual Behaviors and Functioning, and Female Genital Cutting: Perspectives From Somali Women Living in the United States.

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    Connor, Jennifer Jo; Hunt, Shanda; Finsaas, Megan; Ciesinski, Amanda; Ahmed, Amira; Robinson, Beatrice Bean E

    2016-01-01

    We investigated the sexual values, attitudes, and behaviors of 30 Somali female refugees living in a large metropolitan area of Minnesota by collecting exploratory sexual health information based on the components of the sexual health model-components posited to be essential aspects of healthy human sexuality. A Somali-born bilingual interviewer conducted the semistructured interviews in English or Somali; 22 participants chose to be interviewed in Somali. Interviews were translated, transcribed, and analyzed using descriptive statistics and thematic analyses. Our study findings highlighted a sexually conservative culture that values sexual intimacy, female and male sexual pleasure, and privacy in marriage; vaginal sexual intercourse as the only sanctioned sexual behavior; and the importance of Islamic religion in guiding sexual practices. Findings related to human immunodeficiency virus (HIV) revealed HIV testing at immigration, mixed attitudes toward condom use, and moderate knowledge about HIV transmission modes. Female genital cutting (FGC) was a pervasive factor affecting sexual functioning in Somali women, with attitudes about the controversial practice in transition. We recommend that health professionals take the initiative to discuss sexual health care and safer sex, sexual behaviors/functioning, and likely challenges to sexual health with Somali women--as they may be unlikely to broach these subjects without permission and considerable encouragement.

  15. Pre-pregnancy body mass index and inter-pregnancy weight change among women of Russian, Somali and Kurdish origin and the general Finnish population.

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    Bastola, Kalpana; Koponen, Päivikki; Härkänen, Tommi; Gissler, Mika; Kinnunen, Tarja I

    2017-05-01

    We studied the differences in the mean pre-pregnancy body mass index (BMI) and mean inter-pregnancy weight change in women of Russian, Somali and Kurdish origin and women in the general Finnish population. The population-based samples were from the Migrant Health and Wellbeing Study and the Health 2011 Survey conducted in six cities in Finland in 2010-2012. This study included women with at least one birth in Finland. Data on their previous pregnancies in Finland were obtained from the National Medical Birth Register for 318 Russian, 584 Somali and 373 Kurdish origin women and for 243 women in the general Finnish population (reference group). Data on pre-pregnancy weight and height were self-reported in early pregnancy. Linear logistic regression was the main method of analysis. The unadjusted mean pre-pregnancy BMI was higher in Somali (27.0 kg/m 2 , p<0.001) and Kurdish (25.8 kg/m 2 , p<0.001) women, but lower in Russian (22.2 kg/m 2 , p<0.001) women than in the reference group (24.1 kg/m 2 ). The adjusted coefficients for the difference in the mean pre-pregnancy BMI were -1.93 (95% CI -2.77 to -1.09) for Russian, 1.82 (95% CI 0.89-2.75) for Somali and 1.30 (95% CI 0.43-2.17) for Kurdish women compared with the reference group. Among women with at least two births, no statistically significant difference was observed in the mean inter-pregnancy weight change between the migrant groups and the reference group. Somali and Kurdish women had higher mean pre-pregnancy BMIs than women in the general Finnish population and may need special support and health promotion strategies for weight management.

  16. Barriers and facilitators to cervical cancer screening among Pakistani and Somali immigrant women in Oslo: a qualitative study

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    Gele AA

    2017-07-01

    Full Text Available Abdi A Gele,1,2 Samera A Qureshi,1 Prabhjot Kour,1 Bernadette Kumar,1 Esperanza Diaz1,3 1Norwegian Center for Minority Health Research, 2Department of Health, Institute of Nursing and Health Promotion, Oslo and Akershus University College, Oslo; 3Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway Abstract: Norway has a low incidence and mortality rate of cervical cancer, which is mainly due to the high participation rate of women in cervical cancer screening. However, the attendance of cervical cancer screening was reported to be low among immigrant women. For this reason, we conducted a qualitative study to obtain better insight into perceived barriers and challenges to cervical cancer screening among Somali and Pakistani women in the Oslo region. A convenient sample of 35 (18 Pakistani, 17 Somali women were recruited for the study in collaboration with Somali and Pakistani community partners. Focus group discussions were used to explore barriers and facilitators to cervical cancer screening, whereas the Ecological Model was used as the framework for the study. The study found three levels of barriers to cervical cancer screening. The individual level included a lack of understanding of the benefits of the screening. The sociocultural level included the stigma attached to the disease and the belief that women who are unmarried are sexually inactive. The system-related level included a lack of trust toward the health care system. Based on the study results, and using a common denominator approach for the immigrant groups included, the study recommends three communication strategies with the potential to improve women’s participation in cervical cancer screening: 1 in-person communication and information material at health centers; 2 verbal communication with women through seminars and workshops to educate them about their risk of cancer and the importance of screening and 3 the initiation of better recall

  17. Barriers and facilitators to cervical cancer screening among Pakistani and Somali immigrant women in Oslo: a qualitative study.

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    Gele, Abdi A; Qureshi, Samera A; Kour, Prabhjot; Kumar, Bernadette; Diaz, Esperanza

    2017-01-01

    Norway has a low incidence and mortality rate of cervical cancer, which is mainly due to the high participation rate of women in cervical cancer screening. However, the attendance of cervical cancer screening was reported to be low among immigrant women. For this reason, we conducted a qualitative study to obtain better insight into perceived barriers and challenges to cervical cancer screening among Somali and Pakistani women in the Oslo region. A convenient sample of 35 (18 Pakistani, 17 Somali) women were recruited for the study in collaboration with Somali and Pakistani community partners. Focus group discussions were used to explore barriers and facilitators to cervical cancer screening, whereas the Ecological Model was used as the framework for the study. The study found three levels of barriers to cervical cancer screening. The individual level included a lack of understanding of the benefits of the screening. The sociocultural level included the stigma attached to the disease and the belief that women who are unmarried are sexually inactive. The system-related level included a lack of trust toward the health care system. Based on the study results, and using a common denominator approach for the immigrant groups included, the study recommends three communication strategies with the potential to improve women's participation in cervical cancer screening: 1) in-person communication and information material at health centers; 2) verbal communication with women through seminars and workshops to educate them about their risk of cancer and the importance of screening and 3) the initiation of better recall through SMS and letters written in native languages. Finally, an intervention study that compares the aforementioned strategies and proves their effectiveness in increasing immigrant women's participation in cervical cancer screening is recommended.

  18. Determinants of institutional delivery service utilization among pastorals of Liben Zone, Somali Regional State, Ethiopia, 2015

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    Zepro NB

    2016-12-01

    Full Text Available Nejimu Biza Zepro,1 Ahmed Tahir Ahmed2 1College of Health Sciences, Samara University, Samara, Afar, Ethiopia; 2College of Health Science, Jigjiga University, Jigjiga, Somali, Ethiopia Abstract: Maternal health service utilizations are poorly equipped, inaccessible, negligible, and not well documented in the pastoral society. This research describes a quantitative and qualitative study on the determinants of institutional delivery among pastoralists of Liben Zone with special emphasis on Filtu and Deka Suftu woredas of Somali Region, Ethiopia. The study was funded by the project “Fostering health care for refugees and pastoral communities in Somali Region, Ethiopia”. This community-based cross-sectional study was conducted during November 2015. Interviews through a questionnaire and focus group discussions were used to collect the data. Proportional to size allocation followed by systematic sampling technique was used to identify the study units. The major determinants of institutional delivery in the study area were as follows: being apparently healthy, lack of knowledge, long waiting time, poor quality services, cultural beliefs, religious misconception, partner decision, and long travel. Around one-third (133, 34.5% of the women had visited at least once for their pregnancy. More than half (78, 58.6% of the women had visited health facilities due to health problems and only 27 (19.9% women had attended the recommended four antenatal care visits. Majority (268, 69.6% of the pregnant women preferred to give birth at home. Women who attended antenatal care were two times more likely to deliver at health facilities (AOR, 95% confidence interval [CI] =2.38, 1.065–4.96. Women whose family members preferred health facilities had 14 times more probability to give birth in health institutions (AOR, 95% CI =13.79, 5.28–35.8. Women living in proximity to a health facility were 13 times more likely to give birth at health facilities than women

  19. Raising Citizens: Parenting Education Classes and Somali Mothers’ Experiences of Childrearing in Canada

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    Melissa Fellin

    2015-09-01

    Full Text Available Mothers are viewed as the people who are raising future citizens of Canada; therefore, their parenting practices are being targeted for intervention by civic organizations funded by the state. In this article, I argue that modernity narratives and neoliberalism approaches to mothering inform parenting education classes for Somali refugee women to Canada. Thus, Somali women are often seen as victims. Stereotyped identities conceal their social and historical agency. This research draws on 15 individual interviews with Somali mothers and participant- observation in two parenting education classes in Canada.

  20. "A Somali girl is Muslim and does not have premarital sex. Is vaccination really necessary?" A qualitative study into the perceptions of Somali women in the Netherlands about the prevention of cervical cancer

    NARCIS (Netherlands)

    Salad, J.; Verdonk, P.; de Boer, F.; Abma, T.A.

    2015-01-01

    Introduction: Participation in Human Papillomavirus (HPV) vaccination and Papanicolaou Screening (Pap smears) is low among ethnic minorities in the Netherlands and hardly any information is available about the cervical cancer prevention methods of Somali women living in the diaspora. This

  1. Food Insecurity: Its Relationship to Dietary Intake and Body Weight among Somali Refugee Women in the United States

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    Dharod, Jigna M.; Croom, Jamar E.; Sady, Christine G.

    2013-01-01

    Objective: To examine the association between food insecurity, dietary intake, and body mass index among Somali refugee women living in the United States. Methods: Cross-sectional study utilizing the snowball sampling method. Results: Most (67%) participants experienced some level of food insecurity, which was common among recent arrivals and…

  2. Somalis giving birth in Sweden: a challenge to culture and gender specific values and behaviours.

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    Wiklund, H; Aden, A S; Högberg, U; Wikman, M; Dahlgren, L

    2000-06-01

    Giving birth in a foreign country implies going through a life event with little or no access to your own traditions and social support. The aim of this study was to study the childbirth experiences of Somali women and men in Sweden. Qualitative. Nine women and seven men were interviewed. Data collection was characterised by an openness to new ideas during the interview and the interviews were analysed according to the grounded theory technique. The meeting of Somalis with Swedish antenatal and delivery care was a multicultural event. It revealed social, medical, cultural and gender factors advocating space in the arena of childbirth. The Somalis constituted a homogeneous group with regard to their cultural belonging and motives for exile. The subjects were heterogeneous in that they represented a great variety in social and demographic background as well as in experiences, feelings and modes of expression. One striking finding was the Somali man's dramatic entrance into childbirth, which seemed to have a strong impact on the Somali woman's well-being during delivery. The study showed difficulties in getting used to the Swedish model of parenthood and in finding new role divisions in the couple relationship. Some of the subjects had experienced a strengthening of their marriage and an increased understanding of each other. Others commented that various aspects of traditional womanhood and manhood were lost as a result of the unfamiliar gender structures in Sweden. The Somalis' experiences of childbirth in Sweden can be understood by using the theoretical concept of gender, rather than culture. Our own and other studies show that women and men may have different frames of reference in childbirth, where the women mainly focus on biological circumstances and the men on the social and cultural aspects of birth. The Somali couple were found to be vulnerably positioned, with the professionals having the important role of supporting and empowering Somali parents.

  3. Somalis in Europe

    OpenAIRE

    FAGIOLI-NDLOVU, Monica

    2015-01-01

    INTERACT - Researching Third Country Nationals? Integration as a Three-way Process - Immigrants, Countries of Emigration and Countries of Immigration as Actors of Integration Somalis have a long history in Europe; the first Somalis were seamen who arrived in the UK working on British ships at the beginning of the 20th century. Throughout different waves of migrations directly related to European colonial history, Somalis have settled down in various cities throughout Europe. More recently,...

  4. Somalis in Copenhagen

    DEFF Research Database (Denmark)

    Farah, Abdulkadir Osman

    , particularly a very high level of discrimination and stereotyping. The study reveals institutional gaps across different areas that need to be addressed urgently but also good practices at the local level.Somalis in Copenhagen is part of a comparative seven-city research series entitled Somalis in European...

  5. Attitudes toward female circumcision among Somali immigrants in Oslo: a qualitative study.

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    Gele, Abdi A; Kumar, Bernadette; Hjelde, Karin Harsløf; Sundby, Johanne

    2012-01-01

    Due to its negative impact on public health, female circumcision (FC) has gained increased attention from international communities and the Norwegian public in recent decades. In 1995, the Norwegian government outlawed the practice and simultaneously developed a package of measures aimed at preventing and ultimately eradicating FC in Norway. Like many other Western countries, immigrants of Somali descent constitute the largest immigrant group in Norway from countries with FC traditions. Although this immigrant group is often perceived as a cultural society that supports FC generally as a practice, there appears to be a lack of studies that explore the impact of acculturation and the Western social context on Somali immigrants' attitudes toward the practice. Against this background, this paper explores the attitudes of Somalis living in Oslo, Norway to the practice of FC. Findings from this qualitative study indicate that Somalis in Oslo have, to a large extent, changed their attitude toward the practice. This was proven by the presence in Oslo of a large number of Somali parents who left their daughters uncut as well as Somali girls, boys, men, and women who attribute being uncircumcised a high status. This study adds to the knowledge of the process of abandonment of FC among immigrants in the Western countries. The study highlights the success that has been achieved in improving attitudes toward the practice of the Somali community in Oslo, Norway, as well as emerging challenges that need to be addressed further.

  6. The Total Somali Clan Genealogy (second edition)

    NARCIS (Netherlands)

    Abbink, G.J.

    2009-01-01

    This paper presents an updated genealogy of all Somali 'clans'. Somali kinship is based on patrilineal descent or 'tol', but there are no equivalents in the Somali language for the words 'clan' and 'lineage'. The Somali terminology for the levels of social segmentation is complex, amongst others

  7. Somali Refugees' Perceptions of Mental Illness.

    Science.gov (United States)

    Bettmann, Joanna E; Penney, Deb; Clarkson Freeman, Pamela; Lecy, Natalie

    2015-01-01

    Nearly 13% of the U.S. population is comprised of foreign-born individuals, with Somalis constituting one of the largest resettled groups. Research suggests that, among Somali refugees, rates of mental illness are high. Yet research shows Somalis underutilize mental health services. Understanding their perceptions of mental illness and its cures may help practitioners to design more effective treatments for this population. Thus, this pilot study investigated Somali refugees' perceptions of mental illness and its treatments. Using purposive sampling, this qualitative study interviewed 20 Somali refugees using a semi-structured interview guide. Qualitative analysis yielded participants' perceptions of mental illness through their descriptions of physical symptoms accompanying mental illness, the stigma of mental illness, causes of mental illness, medical and non-medical treatments for mental illness, spirit possession causing mental illness, and the Qur'an as treatment for mental illness. Such information may help practitioners in the United States approach Somali clients in the most culturally coherent manner.

  8. Attitudes toward female circumcision among Somali immigrants in Oslo: a qualitative study

    Directory of Open Access Journals (Sweden)

    Gele AA

    2012-01-01

    Full Text Available Abdi A Gele1,2, Bernadette Kumar3, Karin Harsløf Hjelde3, Johanne Sundby21The Department of Social Science, Oslo University College, 2Section for International Health, Department of General Practice and Community Medicine, University of Oslo, 3Norwegian Center for Minority Health Research, Oslo, NorwayAbstract: Due to its negative impact on public health, female circumcision (FC has gained increased attention from international communities and the Norwegian public in recent decades. In 1995, the Norwegian government outlawed the practice and simultaneously developed a package of measures aimed at preventing and ultimately eradicating FC in Norway. Like many other Western countries, immigrants of Somali descent constitute the largest immigrant group in Norway from countries with FC traditions. Although this immigrant group is often perceived as a cultural society that supports FC generally as a practice, there appears to be a lack of studies that explore the impact of acculturation and the Western social context on Somali immigrants’ attitudes toward the practice. Against this background, this paper explores the attitudes of Somalis living in Oslo, Norway to the practice of FC. Findings from this qualitative study indicate that Somalis in Oslo have, to a large extent, changed their attitude toward the practice. This was proven by the presence in Oslo of a large number of Somali parents who left their daughters uncut as well as Somali girls, boys, men, and women who attribute being uncircumcised a high status. This study adds to the knowledge of the process of abandonment of FC among immigrants in the Western countries. The study highlights the success that has been achieved in improving attitudes toward the practice of the Somali community in Oslo, Norway, as well as emerging challenges that need to be addressed further.Keywords: female circumcision, attitude, behavior, immigrants, Somalis

  9. The total Somali clan genealogy : a preliminary sketch

    NARCIS (Netherlands)

    Abbink, J.

    1999-01-01

    This paper presents a preliminary genealogy of all Somali 'clans'. Somali kinship is based on patrilineal descent, but there are no equivalents in the Somali language for the words 'clan' and 'lineage'. The Somali terminology for the levels of social segmentation is complex, amongst others because

  10. Consumption of healthy foods and associated socio-demographic factors among Russian, Somali and Kurdish immigrants in Finland.

    Science.gov (United States)

    Adebayo, Folasade A; Itkonen, Suvi T; Koponen, Päivikki; Prättälä, Ritva; Härkänen, Tommi; Lamberg-Allardt, Christel; Erkkola, Maijaliisa

    2017-05-01

    We evaluated the consumption of healthy foods among Russian, Somali and Kurdish immigrants in Finland, and examined the relationship between socio-demographic factors and food consumption. We used data from the Migrant Health and Wellbeing Study (Maamu), a population-based health interview and examination survey in six different municipalities in Finland between 2010 and 2012. Altogether, 635 men and 737 women, aged 18-64 years, of Russian ( n = 527), Somali ( n = 337) and Kurdish ( n = 508) origin were included. The important socio-demographic determinants of healthy food consumption - sex, age, education, place of residence and household size - were assessed by logistic regression. Based on the consumption frequencies of recommended healthy foods - fruits, berries, vegetables, fish and rye bread - immigrants of Russian origin had higher consumption of healthy foods than their peers of Kurdish and Somali origin. Low consumption of fresh vegetables, fruits and berries was found among Somali immigrants. Sex and age were the most important determinants of healthy food consumption, as women and older age groups had diets closer to the national nutrition recommendations. High educational level was also positively associated with healthy food consumption. We found ethnic differences in the consumption of healthy foods among the immigrant groups of Russian, Somali and Kurdish origin in Finland. Socio-demographic factors, especially age, sex and education, seem to also play an important role in immigrants' food consumption. Further studies examining the consumption of fruits, berries and fresh vegetables among Somali immigrants in Finland are needed.

  11. Health is a spiritual thing: perspectives of health care professionals and female Somali and Bangladeshi women on the health impacts of fasting during Ramadan.

    Science.gov (United States)

    Pathy, Rubini; Mills, Kelsey E; Gazeley, Sharon; Ridgley, Andrea; Kiran, Tara

    2011-02-01

    To explore perspectives of health care professionals and female Somali and Bangladeshi Muslim women on practices related to fasting during Ramadan, the impact of fasting on health and the role of health professionals during Ramadan. A cross-sectional qualitative study was conducted. Two culturally specific focus groups were conducted with six Somali and seven Bangladeshi Muslim women who observed Ramadan and lived in an inner-city neighbourhood of Toronto, Canada. Individual semi-structured interviews were conducted with 22 health care professionals practicing in this inner-city area (three of whom were Muslim). Data were analysed using thematic qualitative analysis. Both Muslim women and health care professionals recognised the spiritual significance of the Ramadan fast. Muslim participants considered the fast to be beneficial to health overall, whereas health care professionals tended to reflect on health concerns from fasting. Many health care professionals were not fully aware of fasting practices during Ramadan and some found it challenging to counsel patients about the health effects of fasting. Muslim women expressed disagreement regarding which medical interventions were permitted during fasting. They generally agreed that health care professionals should not specifically advise against fasting, but instead provide guidance on health maintenance while fasting. Both groups agreed that guidelines developed by the health care and faith communities together would be useful. There are a variety of health beliefs and observances among female Muslim Somali and Bangladeshi women and a range of knowledge, experience and opinions among health care professionals related to fasting during Ramadan and health. Overall, there is a need for improved communication between members of the Muslim community and health professionals in Canada about health issues related to fasting during Ramadan. Strategies could include published practice guidelines endorsed by the Muslim

  12. Literacy in Somali: Linguistic Consequences.

    Science.gov (United States)

    Biber, Douglas; Hared, Mohamed

    1991-01-01

    Linguistic consequences of literacy in Somalia are examined in a review of the literature and through a study of five dimensions of variation among Somali registers and the expansion of linguistic variation in Somali resulting from the introduction of written registers. (36 references) (LB)

  13. Health Information in Somali (Af-Soomaali )

    Science.gov (United States)

    ... and Wound Healing - Af-Soomaali (Somali) Bilingual PDF Health Information Translations Fasting Blood Sugar Test - Af-Soomaali (Somali) Bilingual PDF Health Information Translations GTT (Glucose Tolerance Test) - Af-Soomaali ( ...

  14. The ethnic gap in mobility: a comparison of Russian, Somali and Kurdish origin migrants and the general Finnish population

    Directory of Open Access Journals (Sweden)

    S. Rask

    2016-04-01

    Full Text Available Abstract Background Many ethnic minority populations have poorer health than the general population. However, there is limited knowledge on the possible ethnic gap in physical mobility. We aim to examine the prevalence of mobility limitations in working-age Russian, Somali and Kurdish origin migrants in comparison to the general population in Finland. We also determine whether the association between ethnic group and mobility limitation remains after taking into account socio-economic and health-related factors. Methods We used data from the Finnish Migrant Health and Wellbeing Study (Maamu and the Finnish Health 2011 Survey. The participants comprised 1880 persons aged 29–64 years. The age-adjusted prevalence of difficulties in various mobility tasks was calculated using predictive margins. Logistic regression analysis was used to examine the association between socio-economic, health- and migration-related factors and mobility limitation (self-reported difficulty in walking 500 m or stair climbing. The association between ethnic group and mobility limitation was calculated using logistic regression analysis. Results Mobility limitations were much more prevalent among Somali origin women (46 % and Kurdish origin men (32 % and women (57 % compared to men and women in the general Finnish population (5–12 %. In Russian origin men and women, the prevalence of mobility limitation (7–17 % was similar to the general Finnish population. Socio-economic and health-related factors, but not migration-related factors (time lived in Finland and language proficiency in Finnish or Swedish, were found to be associated with mobility limitation in the studied populations. Somali and Kurdish origin migrants were found to have increased odds for mobility limitation compared to the general Finnish population, even after adjusting for socio-economic and health-related factors (Somalis odds ratio [OR] 3.61; 95 % confidence interval [CI] 2.07–6.29, Kurds

  15. Somali Parents' Experiences of Bringing up Children in Finland: Exploring Social-Cultural Change within Migrant Households

    Directory of Open Access Journals (Sweden)

    Filio Degni

    2006-05-01

    Full Text Available Approximately 5,000 to 6,000 Somalis arrived in Finland between 1990 and 1995 through Russia. Currently, 8,096 have settled permanently in the country. The data reported here is from a 1998-1999 research survey carried out in the Finish cities of Helsinki and Turku. The survey of 117 married Somalis explored the social-cultural determinants of contraception use. The paper presented here focuses upon one particular aspect of the survey. We selected 21 Somali parents (11 women and 10 men to look in-depth at the experiences of Somali migrants raising children in Finland. All of the respondents selected have more than 5 children in their family and all were asked to describe their experiences of raising children in Finland and, more generally, in establishing and maintaining family structures. Unlike their experiences in Somali, bringing up large families (by Westerns standards is not a collective matter in Finland where biological parents are left to manage the family for themselves. A number of challenges also accompany this shift in family norms: first, and most notably, there is the need to re-establish control over one's life in an alien environment; second, intergenerational conflict between adult migrants and their adolescent children is often heightened. The findings indicate that Somalis' experiences of raising children in Finland raise important parenting challenges associated with changing generational, gender and family relations within the migrant household. Importantly, this case study of large Somali families shows how migrants' lives are intricately linked to the household dynamic between home and host country. URN: urn:nbn:de:0114-fqs060388

  16. Diabetes Risk by Length of Residence among Somali Women in Oslo Area.

    Science.gov (United States)

    Gele, Abdi A; Pettersen, Kjell Sverre; Kumar, Bernadette; Torheim, Liv Elin

    2016-01-01

    Type 2 diabetes represents a major health problem worldwide, with immigrants strongly contributing to the increase in diabetes in many countries. Norway is not immune to the process, and immigrants in the country are experiencing an increase in the prevalence of diabetes after arrival. However, the dynamics of these transitions in relation to the duration of residence in the new environment in Norway are not clearly understood. From this background, a cross-sectional quantitative study using a respondent-driven sampling method was conducted among 302 Somali women living in Oslo area. The results show that 41% of the study participants will be at risk for developing diabetes in the coming 10 years, which coincides with 85% of the study participants being abdominally obese. Significant associations were found between years of stay in Norway and the risk for diabetes with those who lived in Norway >10 years, having twofold higher odds of being at risk for developing diabetes compared to those who lived in Norway ≤5 years (OR: 2.16, CI: 1.08-4.32). Understanding the mechanisms through which exposure to the Norwegian environment leads to higher obesity and diabetes risk may aid in prevention efforts for the rapidly growing African immigrant population.

  17. Diabetes Risk by Length of Residence among Somali Women in Oslo Area

    Directory of Open Access Journals (Sweden)

    Abdi A. Gele

    2016-01-01

    Full Text Available Type 2 diabetes represents a major health problem worldwide, with immigrants strongly contributing to the increase in diabetes in many countries. Norway is not immune to the process, and immigrants in the country are experiencing an increase in the prevalence of diabetes after arrival. However, the dynamics of these transitions in relation to the duration of residence in the new environment in Norway are not clearly understood. From this background, a cross-sectional quantitative study using a respondent-driven sampling method was conducted among 302 Somali women living in Oslo area. The results show that 41% of the study participants will be at risk for developing diabetes in the coming 10 years, which coincides with 85% of the study participants being abdominally obese. Significant associations were found between years of stay in Norway and the risk for diabetes with those who lived in Norway >10 years, having twofold higher odds of being at risk for developing diabetes compared to those who lived in Norway ≤5 years (OR: 2.16, CI: 1.08–4.32. Understanding the mechanisms through which exposure to the Norwegian environment leads to higher obesity and diabetes risk may aid in prevention efforts for the rapidly growing African immigrant population.

  18. Barriers to outdoor physical activity in wintertime among Somali youth.

    Science.gov (United States)

    Rothe, Elizabeth; Holt, Christina; Kuhn, Celine; McAteer, Timothy; Askari, Isabella; O'Meara, Mary; Sharif, Abdimajid; Dexter, William

    2010-10-01

    To identify barriers to outdoor physical activity in winter among Somali youth in Maine. Despite the many proven health benefits of physical activity among children, such as cardiovascular fitness and health status as an adult, there has been a decrease in physical activity among children in recent years. Specifically, children who are of low socio-economic status or are from communities where many immigrants are at increased risk for developing obesity. Immigrants are also less likely to be physically active. There are many potential barriers to wintertime physical activity among Somali youth in Maine, such as lack of financial resources, transportation, proper winter clothing, and appropriate knowledge of winter safety, and language and cultural barriers. For females, different attire required for outdoor activity may be a barrier. Somali parents and children were recruited from Portland, Maine to participate in focus groups led by a trained facilitator with a Somali translator and cultural broker. Transcripts were coded using NVIVO software to identify barriers to physical activity among Somali youth outside in winter. Eight focus groups were conducted. Sixty-one Somali community members were recruited. Participants felt outdoor physical activity is important, but note that it is decreased in winter. Barriers to outdoor activity in winter cited by focus group participants were lack of resources, health concerns, gender barriers for females, and knowledge barriers. Concern over lack of supervision while children play outside was also cited. This study revealed many of the underlying beliefs, barriers and cultural issues that impact Somali families' intention to be active and ability to be active outdoors in winter. These findings can be used to generate research hypotheses and public health interventions regarding outdoor physical activity among Somali youth.

  19. The Roots and Routes of Somali Transnational Clan Formations

    DEFF Research Database (Denmark)

    Farah, Abdulkadir Osman

    2017-01-01

    In normal circumstances clan represents a real or imagined lineage people claim to belong. Among the Somalis such relations remain largely patriarchal. Clans also have both exclusionary and inclusionary mechanism to expand and restrict power relations in the community and in the society. The social...... and cultural rules and norms that govern such relationship depend on the context as well as the surrounding socio-political and cultural conditions. Due to the fragmentation of the Somali society since 1991 most Somalis are directly or indirectly linked to a clan for diverse motives- including the need...

  20. When female circumcision comes to the West: attitudes toward the practice among Somali Immigrants in Oslo.

    Science.gov (United States)

    Gele, Abdi A; Johansen, Elise B; Sundby, Johanne

    2012-08-27

    Female circumcision (FC) has lifelong adverse social and health consequences for women, and its abolition will not only enhance the health of children and women, but also promote gender equality. Like many other Western countries, Norway hosts a large proportion of immigrants from FC-practicing countries, though primarily from Somalia, which is the country with the highest prevalence of FC in the world. A behavioral change by the practicing communities has the best chance to successfully and sustainably eliminate this practice. However, FC prevention programs require a behavioral surveillance that monitors the process of change, with this being the first quantitative study since the major migration of the Somali community to Norway began in 1991 to investigate whether or not Somali immigrants' attitudes toward the practice has improved in favor of its abandonment. A cross-sectional study using a respondent-driven sampling (RDS) was conducted in Oslo from April to June of 2011. A sample of 214 persons was interviewed, using structured questionnaires. The results show that 70% of Somalis in Oslo support the discontinuation of all forms of FC compared to 30% who support its continuation, with the latter group more likely to be people who lived in Norway ≤ 4 years. Of the 10 girls who came to Norway at the age of ≤ 7 years, only one was circumcised, though whether the circumcision occurred before or after the girl's arrival in Norway remains unclear. The perception that FC is required by religion was the sole factor to be significantly associated with an ongoing support of FC. The study reveals that Somalis in Oslo demonstrate a trend to abandon this practice over time. Nevertheless, the 30% of the people who still support its continuation, and who are primarily newly arrived immigrants, require a targeted intervention that is implemented in the early phase of the immigrants' arrival.

  1. Clan and Islamic Identities in Somali Society

    Science.gov (United States)

    2011-11-01

    les déductions les plus intéressantes, y compris des comparaisons avec les histoires de la Pologne et de l’Ingouchie. Malgré la richesse de ces...Christian (1999). Le sang et le lait: Brève histoire des clans somali. Paris: Maisonneuve et Larose. [22] Bakonyi, Jutta (2009). Moral economies of...Uluslararasi Hukuk ve Politika, 6:24, 115-143. [67] Diriye Abdullahi, Mohamed (2000). Le Somali: Dialectes et histoire . Unpublished PhD

  2. Analysis of Health Behaviors and Personal Values of Childless Women, Pregnant Women and Women Who Recently Delivered.

    Science.gov (United States)

    Nowicki, Grzegorz Józef; Misztal-Okońska, Patrycja; Ślusarska, Barbara; Rudnicka-Drożak, Ewa; Młynarska, Magdalena; Czekierdowski, Artur

    2018-02-27

    Preconception lifestyle modifications and reduction of several known risk factors may have an influence on future pregnancy outcomes. The aim of the study was to analyze health behaviors and personal values as well as to assess the relationship between these factors in women without children, in pregnant women and in women who had already delivered babies. The questionnaire survey included the Health Behavior Inventory (HBI), the Personal Value List (PVL) and sociodemographic data and was conducted in 538 women. These women were divided into three groups: women who had recently delivered ( n = 235), pregnant women ( n = 121) and childless women ( n = 182). Pregnant women demonstrated a significantly higher level of declared health behaviors, and also, they rated higher on the subscales values "positive mental attitude" and "health practices", in comparison to women who had recently delivered and to childless women. In all tested groups, the highest rated personal value was "a successful family life", while the most appreciated symbol of happiness was "love and friendship". Our results suggest that the system of values and the perception of happiness symbols may influence women's health behaviors. Positioning "health" in the hierarchy of personal values as the most important one may facilitate the introduction of healthy behaviors. This, in turn, could reduce several adverse pregnancy outcomes that are potentially modifiable with changing preconception health attitudes. Our results also identify several unanswered questions and highlight areas where new research is needed.

  3. Analysis of Health Behaviors and Personal Values of Childless Women, Pregnant Women and Women Who Recently Delivered

    Science.gov (United States)

    Misztal-Okońska, Patrycja; Rudnicka-Drożak, Ewa; Młynarska, Magdalena; Czekierdowski, Artur

    2018-01-01

    Preconception lifestyle modifications and reduction of several known risk factors may have an influence on future pregnancy outcomes. The aim of the study was to analyze health behaviors and personal values as well as to assess the relationship between these factors in women without children, in pregnant women and in women who had already delivered babies. The questionnaire survey included the Health Behavior Inventory (HBI), the Personal Value List (PVL) and sociodemographic data and was conducted in 538 women. These women were divided into three groups: women who had recently delivered (n = 235), pregnant women (n = 121) and childless women (n = 182). Pregnant women demonstrated a significantly higher level of declared health behaviors, and also, they rated higher on the subscales values “positive mental attitude” and “health practices”, in comparison to women who had recently delivered and to childless women. In all tested groups, the highest rated personal value was “a successful family life”, while the most appreciated symbol of happiness was “love and friendship”. Our results suggest that the system of values and the perception of happiness symbols may influence women’s health behaviors. Positioning “health” in the hierarchy of personal values as the most important one may facilitate the introduction of healthy behaviors. This, in turn, could reduce several adverse pregnancy outcomes that are potentially modifiable with changing preconception health attitudes. Our results also identify several unanswered questions and highlight areas where new research is needed. PMID:29495488

  4. 'The child that tiire doesn't give you, God won't give you either.' The role of Rotheca myricoides in Somali fertility practices.

    Science.gov (United States)

    Mire, Sada

    2016-12-01

    The paper introduces the Baanashada Dumarka, a Somali fertility therapy carried out by a spirit medium, known locally as 'Alaqad. Baanashada is aimed at women whose fertility issues are believed to be caused by spirits. The study also explores a component of the Baanashada, namely, the use of tiire (Rotheca myricoides), or the butterfly bush. Although Rotheca myricoides is known to possess a number of medicinal components as confirmed by studies of modern science, so far, there exist no studies on its potential (or lack of) fertility effects. Hence, the alleged fertility benefits of the butterfly bush need examining. In 2008 a British Somali woman died of herbs placed in her cervix by a traditional healer in Somaliland. This piece of information indicated not only the role of herbal medicine in fertility practices, but also the popularity of traditional reproductive medicine beyond border, class or educational background. Yet, current research into Somali women's health focuses mainly on Female Genital Mutilation (FGM), examined often without the context of wider cultural practices. This paper, however, suggests that rituals, beliefs and material culture play a paramount role in women's practices. For example, as explored elsewhere, the wagar, a wooden and sacred object made of the African olive, is critical for fertility practices. The current paper illuminates further the significance of reproduction practices in Somali society and the potential continuity of traditions associated with the perpetuation of kinship. It concludes that fertility rituals are part of a wider context of interaction with sacred landscapes, objects and archaeological sites, often associated with past legends in the Horn of Africa.

  5. A "domestic" history about the Danish-Somalis at a Museum in Århus

    DEFF Research Database (Denmark)

    Zoppi, Marco

    2017-01-01

    Interview piece with the project coordinator of the exhibition titled “Et somalisk hjem” (A Somali home), at Den Gamle By museum, Denmark. Published on WardheerNews on May 5, 2017. http://www.wardheernews.com/a-domestic-history-about-the-danish-somalis-at-a-museum-in-arhus/......Interview piece with the project coordinator of the exhibition titled “Et somalisk hjem” (A Somali home), at Den Gamle By museum, Denmark. Published on WardheerNews on May 5, 2017. http://www.wardheernews.com/a-domestic-history-about-the-danish-somalis-at-a-museum-in-arhus/...

  6. When female circumcision comes to the West: Attitudes toward the practice among Somali Immigrants in Oslo

    Directory of Open Access Journals (Sweden)

    Gele Abdi A

    2012-08-01

    Full Text Available Abstract Background Female circumcision (FC has lifelong adverse social and health consequences for women, and its abolition will not only enhance the health of children and women, but also promote gender equality. Like many other Western countries, Norway hosts a large proportion of immigrants from FC-practicing countries, though primarily from Somalia, which is the country with the highest prevalence of FC in the world. A behavioral change by the practicing communities has the best chance to successfully and sustainably eliminate this practice. However, FC prevention programs require a behavioral surveillance that monitors the process of change, with this being the first quantitative study since the major migration of the Somali community to Norway began in 1991 to investigate whether or not Somali immigrants’ attitudes toward the practice has improved in favor of its abandonment. Methods A cross-sectional study using a respondent-driven sampling (RDS was conducted in Oslo from April to June of 2011. A sample of 214 persons was interviewed, using structured questionnaires. Results The results show that 70% of Somalis in Oslo support the discontinuation of all forms of FC compared to 30% who support its continuation, with the latter group more likely to be people who lived in Norway ≤ 4 years. Of the 10 girls who came to Norway at the age of ≤ 7 years, only one was circumcised, though whether the circumcision occurred before or after the girl’s arrival in Norway remains unclear. The perception that FC is required by religion was the sole factor to be significantly associated with an ongoing support of FC. Conclusion The study reveals that Somalis in Oslo demonstrate a trend to abandon this practice over time. Nevertheless, the 30% of the people who still support its continuation, and who are primarily newly arrived immigrants, require a targeted intervention that is implemented in the early phase of the immigrants’ arrival.

  7. Culturally adapting a physical activity intervention for Somali women: the need for theory and innovation to promote equity.

    Science.gov (United States)

    Murray, Kate E; Ermias, Azieb; Lung, Amber; Mohamed, Amina Sheik; Ellis, B Heidi; Linke, Sarah; Kerr, Jacqueline; Bowen, Deborah J; Marcus, Bess H

    2017-03-01

    There is pressing need for innovation in clinical research to more effectively recruit, engage, retain, and promote health among diverse populations overburdened by health disparities. The purpose of this study is to provide a detailed illustration of the cultural adaptation of an evidence-based intervention to bolster translational research with currently underserved communities. The cultural adaptation heuristic framework described by Barrera and colleagues is applied to the adaptation of a physical activity evidence-based intervention with adult Somali women. Widespread changes were required to ensure program feasibility and acceptability, including the reduction of assessment protocols and changes discordant with current trends in physical activity research. The cultural adaptation of evidence-based interventions offers an important mechanism for reducing health disparities. Improved reporting standards, assessment of features relevant to underserved communities, and greater funding requirements to ensure better representation are needed to promote more widespread access for all people.

  8. The situation for female survivors of non-partner sexual violence: A focused enquiry of Somali young women's views, knowledge and opinions.

    Science.gov (United States)

    Byrskog, Ulrika; Hussein, Ifrah Hashi; Yusuf, Farah Mohamed; Egal, Jama Ali; Erlandsson, Kerstin

    2018-06-01

    The aim of the study is to elucidate young women's perceptions of the situation for female survivors of non-partner sexual violence in Somaliland. Young Somali women with diverse backgrounds (n = 25) shared views, knowledge and opinions about non partner sexual violence in focus group discussions held in urban settings. Data was analysed using content analysis. A main category "Bound by culture and community perceptions" with four subcategories comprises the informants' perceptions of non-partner sexual violence among young women in Somaliland. Illuminated is the importance of protecting oneself and the family dignity, a fear of being rejected and mistrusted, how the juridical system exists in the shadow of tradition and potential keys to healthcare support. The study raises awareness of the dilemmas which may be faced by young women subjected to non-partner sexual violence and healthcare providers in the intersection between state and traditional norms. Education is a key when it comes to a young woman considering the use of the services available in a society where traditional problem-solving is relied on parallel to state-based support. State-based functions, communities and families need to work together to provide comprehensive support to young female survivors of non-partner sexual violence in Somaliland. Copyright © 2018 Elsevier B.V. All rights reserved.

  9. Somali Immigrant Perceptions of Mental Health and Illness: An Ethnonursing Study.

    Science.gov (United States)

    Wolf, Kimberly M; Zoucha, Rich; McFarland, Marilyn; Salman, Khlood; Dagne, Ahmed; Hashi, Naimo

    2016-07-01

    Knowledge of Somali immigrants' mental health care beliefs and practices is needed so that nurses can promote culturally congruent care. The purpose of this study was to explore, discover, and understand mental health meanings, beliefs, and practices from the perspective of immigrant Somalis. Leininger's qualitative ethnonursing research method was used. Thirty informants (9 key and 21 general) were interviewed in community settings. Leininger's ethnonursing enablers and four phases of analysis for qualitative data were used. Analysis of the interviews revealed 21 categories and nine patterns from which two main themes emerged. The themes are the following: (a) Our religion significantly influences our mental health and (b) Our tribe connectedness, cultural history, and khat usage are significant in mental health. Somali cultural and religious beliefs and practices influence their health care choices. The findings will improve care by promoting culturally congruent care for the Somali immigrant population. © The Author(s) 2014.

  10. Hepatitis B virus infection among pregnant women delivering at ...

    African Journals Online (AJOL)

    Objective: To determine the prevalence of hepatitis B virus (HBV) carrier and infectivity status among women delivering at Harare Maternity Hospital. Design: A serological survey study of pregnant women admitted for labour and delivery. Setting: Harare Maternity Hospital, Harare, Zimbabwe between June 1996 and June ...

  11. Factors Related to Motivating Adult Somalis with Refugee Status to Volunteer for 4-H

    Science.gov (United States)

    Mason, Mitchell D.; Ouellette, Kristy L.

    2016-01-01

    Focus group interviews were held with adult Somali immigrants to assess their likelihood of volunteering for 4-H in Maine. This qualitative study was undertaken to identify best practices for engaging the growing Somali-Mainer population as a volunteer base. Results of the study demonstrate that Somali immigrant adults are willing to volunteer for…

  12. The Role of "Islamic feminism" in Somali Immigrant Women's Intra-and Extra-Household Bargaining Power and in Mitigating the Negative Effects of the Image Problem in their Integration in Norway

    OpenAIRE

    Ngunjiri, Anne Wangui

    2013-01-01

    This research explores the aspirations and life experiences of Somali immigrant women in Bergen as they embark on gender-tuned interpretation of the Quran as a source of bargaining power within the household and in the wider Norwegian immigration context. By bargaining power I mean an individual's interests or preferences and the ability to act on those interests or preferences. I show that, faced by constraints such as restrictive structures within the Norwegian immigration context and pa...

  13. Views of Science Teaching and Learning by Immigrant Somali Elders: Perceptions of Conflict and Acceptance

    Science.gov (United States)

    Albrecht, Nancy Jean

    The gap between a student's home culture and that of classroom science may create challenges for students and families, especially those from recent immigrant cultures, including refugees. As a result, science learning in schools may require a form of cultural border crossing between home cultures and the culture of classroom science. Given this, as educators, how do we make these borders more porous for better science learning experiences? Using the frameworks of funds of knowledge, culturally relevant pedagogy, and socio-constructivism, this study focuses on the perspectives of Somali-American elders and parents about school science. Designed as an in-depth interview study, five purposefully selected participants were interviewed over a period of two years. The guiding questions for the study included: 1) What are the perceptions of Somali elders about school science? and 2) How do Somali elders believe science teaching and learning can facilitate Somali students' engagement in science?. Analysis of the interview data revealed that Somali-American adults have complicated perceptions of school science that include both conflicts and acceptance with current pedagogy and content. For example, science education was highly valued by both individuals and the Somali community, both as a way for individuals to attain economic prosperity and respect, but also as a way to lift up the Somali diaspora, both here and in their native homeland. On the other hand, science was also viewed as an abstract discipline with little connection to students' and families' everyday home lives. Moreover, due to the intrinsic role that Islam plays in traditional and contemporary Somali culture, several areas of science education, including geology, evolution and sex education, were viewed as problematic and unresolvable. Various potential areas of funds of knowledge and culturally relevant pedagogy were discussed including nutrition, food preparation and storage, health education, and

  14. Gli italo-somali dell’Amministrazione Fiduciaria Italiana della Somalia (AFIS: una memoria dimenticata tra le pagine dell’Italia postcoloniale

    Directory of Open Access Journals (Sweden)

    Michele Pandolfo

    2017-07-01

    Full Text Available At the end of the Second World War the United Nations gave to Italy a special protectorate on the own former colony by the International Trusteeship System of Somalia, which concludes in 1960. During the Fifties there are many relationships between the italian men and the somali women: from these liaisons there are a lot of children which have different destinies and their history represents one of the heredity of the italian past in Africa. From this italo-somali métissage, rises an association who asks the recognition of all the pains suffered by a part of that community and in the same time it asks a collective reflections of the historic memories about the Trusteeship System.

  15. Educating Somali Immigrant and Refugee Students: A Review of Cultural-Historical Issues and Related Psychoeducational Supports

    Science.gov (United States)

    Walick, Christopher M.; Sullivan, Amanda L.

    2015-01-01

    Somali immigrants and refugees have entered the United States with increasing frequency due to civil war-induced violence and instability in their native country. The resultant increase of Somali students is of particular relevance to educators and school psychologists because Somali youth possess unique cultural backgrounds. In addition, refugee…

  16. Diabetes Health Literacy Among Somali Patients with Diabetes Mellitus in a US Primary Care Setting.

    Science.gov (United States)

    Njeru, Jane W; Hagi-Salaad, Misbil F; Haji, Habibo; Cha, Stephen S; Wieland, Mark L

    2016-06-01

    The purpose of this study was to describe diabetes literacy among Somali immigrants with diabetes and its association with diabetes outcomes. Among Somali immigrants in North America, the prevalence of diabetes exceeds that of the general population, and their measures of diabetes control are suboptimal when compared with non-Somali patients. Diabetes literacy is an important mediator of diabetes outcomes in general populations that has not been previously described among Somali immigrants and refugees. Diabetes literacy was measured using a translated version of the spoken knowledge in low literacy in diabetes (SKILLD) scale among Somali immigrants and refugees with type 2 diabetes. Diabetes outcome measures, including hemoglobin A1C, low-density lipoprotein (LDL) cholesterol, and blood pressure, were obtained for each patient. Multivariate logistic regression was used to assess associations between diabetes literacy and diabetes outcomes. Among 50 Somali patients with diabetes who completed the survey, the mean SKILLD score was low (42.2 %). The diabetes outcome measures showed a mean hemoglobin A1C of 8 %, LDL cholesterol of 99.17 mg/dL (2.57 mmol/L), systolic blood pressure of 130.9 mmHg, and diastolic blood pressure of 70.2 mmHg. There was no association between diabetes literacy scores and diabetes outcome measures. Somali patients with diabetes mellitus had low diabetes literacy and suboptimal measures of diabetes disease control. However, we found no association between diabetes literacy and diabetes outcomes. Future work aimed at reduction of diabetes-related health disparities among Somali immigrants and refugees to high-income countries should go beyond traditional means of patient education for low-literacy populations.

  17. MEAT-GOAT MARKET ANALYSIS: A PILOT STUDY OF THE SOMALI MARKET IN COLUMBUS, OH

    OpenAIRE

    Worley, C. Thomas; Ellerman, John; Mangione, Dave; West, Travis; Yang, Y.

    2004-01-01

    This case study focuses on meat goat marketing involving one distinct immigrant group residing in one area of Columbus, Ohio: the Somalis. There are about 20,000-25,000 Somalis living in Columbus, the second largest concentration of Somalian immigrants in the U.S. after Minneapolis-St. Paul, Minnesota. It is estimated that Columbus Somalis consume the meat from about 14,000 goats each year. The objective of this pilot study is to analyze the meat goat marketing and consumption patterns of the...

  18. HIV/AIDS knowledge and condom use among Somali and Sudanese immigrants in Denmark

    DEFF Research Database (Denmark)

    Lazarus, Jeff; Himedan, Himedan Mohammed; Østergaard, Lise Rosendal

    2006-01-01

    This study explores the knowledge, attitudes and practices among Somali and Sudanese immigrants in Denmark with regard to HIV/AIDS and condom use.......This study explores the knowledge, attitudes and practices among Somali and Sudanese immigrants in Denmark with regard to HIV/AIDS and condom use....

  19. Winter monsoon circulation of the northern Arabian Sea and Somali Current

    Science.gov (United States)

    Schott, Friedrich A.; Fischer, Jürgen

    2000-03-01

    The winter monsoon circulation in the northern inflow region of the Somali Current is discussed on the basis of an array of moored acoustic Doppler current profiler and current meter stations deployed during 1995-1996 and a ship survey carried out in January 1998. It is found that the westward inflow into the Somali Current regime occurs essentially south of 11°N and that this inflow bifurcates at the Somali coast, with the southward branch supplying the equatorward Somali Current and the northward one returning into the northwestern Arabian Sea. This northward branch partially supplies a shallow outflow through the Socotra Passage between the African continent and the banks of Socotra and partially feeds into eastward recirculation directly along the southern slopes of Socotra. Underneath this shallow surface flow, southwestward undercurrent flows are observed. Undercurrent inflow from the Gulf of Aden through the Socotra Passage occurs between 100 and 1000 m, with its current core at 700-800 m, and is clearly marked by the Red Sea Water (RSW) salinity maximum. The observations suggest that the maximum RSW inflow out of the Gulf of Aden occurs during the winter monsoon season and uses the Socotra Passage as its main route into the Indian Ocean. Westward undercurrent inflow into the Somali Current regime is also observed south of Socotra, but this flow lacks the RSW salinity maximum. Off the Arabian peninsula, eastward boundary flow is observed in the upper 800 m with a compensating westward flow to the south. The observed circulation pattern is qualitatively compared with recent high-resolution numerical model studies and is found to be in basic agreement.

  20. They Bring Their Memories with Them: Somali Bantu Resettlement in a Globalized World

    Science.gov (United States)

    Smith, Yda Jean

    2010-01-01

    The Somali Bantu, arriving in the United States after many years in Kenyan refugee camps, face significant barriers to successful integration into American society. Those responsible for managing initial resettlement at the local level were not prepared to provide appropriate assistance to this group. The arrival of the Somali Bantu highlighted…

  1. The FAV-S Pilot Study: Increasing Self-Efficacy and Fruit and Vegetable Intake Among Somali Women and Children

    Science.gov (United States)

    Kehm, Rebecca; Hearst, Mary O.; Sherman, Shelley; Elwell, Kate L.

    2017-01-01

    The 2012 FAV-S pilot study was developed as a dietary intervention program for low-income Somali mothers grounded in the health belief model. The intervention was geared toward increasing fruit and vegetable intake among participants' children. The purpose of this analysis was to determine the impact of the FAV-S program on participants' (1)…

  2. Discrimination and mental health among Somali refugee adolescents: the role of acculturation and gender.

    Science.gov (United States)

    Ellis, B Heidi; MacDonald, Helen Z; Klunk-Gillis, Julie; Lincoln, Alisa; Strunin, Lee; Cabral, Howard J

    2010-10-01

    This study examines the role of social identity (acculturation and gender) in moderating the association between discrimination and Somali adolescent refugees' mental health. Participants were English-speaking Somali adolescent refugees between the ages of 11 and 20 (N = 135). Perceived discrimination, trauma history, posttraumatic stress disorder (PTSD), depressive symptoms, and behavioral acculturation were assessed in structured interviews. Fourteen in-depth qualitative interviews and 3 focus groups were also conducted. Results indicated that discrimination was common and associated with worse mental health. For girls, greater Somali acculturation was associated with better mental health. Also, the association between discrimination and PTSD was less strong for girls who showed higher levels of Somali acculturation. For boys, greater American acculturation was associated with better mental health, and the association between discrimination and depression was less strong for boys with higher levels of American acculturation. © 2010 American Orthopsychiatric Association.

  3. Emergency within an emergency: Somali IDP s

    Directory of Open Access Journals (Sweden)

    Hassan Noor

    2007-07-01

    Full Text Available International media report that over 300,000 Somalis have been newly displaced by fighting in Mogadishu. Conflict-related displacement hits the headlines but the numbers displaced by environmental change are also colossal. The international response remains woefully inadequate.

  4. Cultural translation of refugee trauma: Cultural idioms of distress among Somali refugees in displacement.

    Science.gov (United States)

    Im, Hyojin; Ferguson, Aidan; Hunter, Margaret

    2017-01-01

    Westernized approaches to mental health care often place limited emphasis on refugees' own experiences and cultural explanations of symptoms and distress. In order to effectively assess community mental health needs and develop interventions grounded in local needs, mental health programs need to be informed by an understanding of cultural features of mental health, including cultural idioms of distress (CIDs). The current study aims to explore CIDs among Somali refugees displaced in Kenya to understand mental health needs in cultural context and serve the community in a culturally responsive and sensitive manner. This research was conducted as a two-phase qualitative study. First, key informant interviews with Somali mental health stakeholders generated a list of 7 common Somali CIDs: buufis, buqsanaan, welwel, murug, qaracan, jinn, and waali. Typologies of each CID were further explored through four focus group interviews with Somali community members. The findings from a template analysis revealed Somali lay beliefs on how trauma and daily stressors are experienced and discussed in the form of CIDs and how each term is utilized and understood in attributing symptoms to associated causes. This study highlights the need to incorporate colloquial terms in mental health assessment and to adopt a culturally relevant framework to encourage wider utilization of services and religious/spiritual support systems.

  5. post partum haemorhage among women delivered at mbeya referral

    African Journals Online (AJOL)

    death is among women who deliver at home either alone or with tradition birth attendant. (TBA) [9]. To date, effort to reduce maternal mortality through training TBAs have been disappointing [2]. Study population and Methods: This study was a hospital based descriptive retrospective hospital based cross-sectional.

  6. "We would never forget who we are": resettlement, cultural negotiation, and family relationships among Somali Bantu refugees.

    Science.gov (United States)

    Frounfelker, Rochelle L; Assefa, Mehret T; Smith, Emily; Hussein, Aweis; Betancourt, Theresa S

    2017-11-01

    Somali refugees are resettling in large numbers in the US, but little is known about the Somali Bantu, an ethnic minority within this population. Refugee youth mental health is linked to the functioning of the larger family unit. Understanding how the process of culturally adjusting to life after resettlement relates to family functioning can help identify what kind of interventions might strengthen families and lead to better mental health outcomes for youth. This paper seeks to address the following research questions: (1) How do different groups of Somali Bantu refugees describe their experiences of culturally adapting to life in the US?; and (2) How, if at all, do processes of cultural adaptation in a new country affect Somali Bantu family functioning? We conducted 14 focus groups with a total of 81 Somali Bantu refugees in New England. Authors analyzed focus groups using principles of thematic analysis to develop codes and an overarching theoretical model about the relationship between cultural adaptation, parent-child relationships, and family functioning. Views and expectations of parent-child relationships were compared between Somali Bantu youth and adults. Cultural negotiation was dependent upon broader sociocultural contexts in the United States that were most salient to the experience of the individual. Adult and youth participants had conflicting views around negotiating Somali Bantu culture, which often led to strained parent-child relationships. In contrast, youth sibling relationships were strengthened, as they turned to each other for support in navigating the process of cultural adaptation.

  7. Liminalities: expanding and constraining the options of Somali youth in the Helsinki Metropolitan Area

    Directory of Open Access Journals (Sweden)

    Alitolppa-Niitamo Anne

    2001-01-01

    Full Text Available Somali youth, "the generation in-between", who arrived in Finland in their early teens or as teenagers in the 1990shave faced specific challenges in Somali diaspora in Finland. Their voice is often ambiguous in the processes of cultural construction and ethnic reconstruction. Dissonant acculturation and role reversal within the families and a family culture that emphasizes strong parental authority place these young people in a liminal position. Measures which balance the pace of the acculturation between the generations could alleviate the situation In addition, the diasporic consciousness and transnational activities among Somalis along with the ethos of 'integration' within the mainstream institutions challenge Somali youth. They may find themselves 'betwixt and between' various future orientations. This should be acknowledged in educational planning, for example. While liminal states may open up new opportunities, it is claimed that several simultaneous states of liminality may be confusing for a young person, and may create risks for becoming marginal from societal and cultural classifications, as well as limit a person from finding his/her own group of reference.

  8. Mental and somatic health and pre- and post-migration factors among older Somali refugees in Finland.

    Science.gov (United States)

    Mölsä, Mulki; Punamäki, Raija-Leena; Saarni, Samuli I; Tiilikainen, Marja; Kuittinen, Saija; Honkasalo, Marja-Liisa

    2014-08-01

    Mental and somatic health was compared between older Somali refugees and their pair-matched Finnish natives, and the role of pre-migration trauma and post-migration stressors among the refugees. One hundred and twenty-eight Somalis between 50-80 years of age were selected from the Somali older adult population living in the Helsinki area (N = 307). Participants were matched with native Finns by gender, age, education, and civic status. The BDI-21 was used for depressive symptoms, the GHQ-12 for psychological distress, and the HRQoL was used for health-related quality of life. Standard instruments were used for sleeping difficulties, somatic symptoms and somatization, hypochondria, and self-rated health. Clinically significant differences in psychological distress, depressive symptoms, sleeping difficulties, self-rated health status, subjective quality of life, and functional capacity were found between the Somali and Finnish groups. In each case, the Somalis fared worse than the Finns. No significant differences in somatization were found between the two groups. Exposure to traumatic events prior to immigrating to Finland was associated with higher levels of mental distress, as well as poorer health status, health-related quality of life, and subjective quality of life among Somalis. Refugee-related traumatic experiences may constitute a long lasting mental health burden among older adults. Health care professionals in host countries must take into account these realities while planning for the care of refugee populations. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  9. Empowering women to tackle cattle lung disease | IDRC ...

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

    2016-06-06

    Jun 6, 2016 ... While Somali women play a key role in cattle rearing, only men tend to ... addressing gender inequalities and empowering women are vital to ... to farmers earning US$160 from milk sales during the first lactation, ... Solutions.

  10. Afghan and Somali (post-conflict migration to the EU

    Directory of Open Access Journals (Sweden)

    Nassim Majidi

    2016-01-01

    Full Text Available There are invisible drivers of migration for Afghans and Somalis to Europe, caused by decades of conflict. Although officially considered as ‘postconflict’, the reality is very different.

  11. Relationships Between English Language Proficiency, Health Literacy, and Health Outcomes in Somali Refugees.

    Science.gov (United States)

    Murphy, Jessica E; Smock, Laura; Hunter-Adams, Jo; Xuan, Ziming; Cochran, Jennifer; Paasche-Orlow, Michael K; Geltman, Paul L

    2018-06-15

    Little is known about the impacts of health literacy and English proficiency on the health status of Somali refugees. Data came from interviews in 2009-2011 of 411 adult Somali refugees recently resettled in Massachusetts. English proficiency, health literacy, and physical and mental health were measured using the Basic English Skills Test Plus, the Short Test of Health Literacy in Adults, and the Physical and Mental Component Summaries of the Short Form-12. Associations were analyzed using multiple linear regression. In adjusted analyses, higher English proficiency was associated with worse mental health in males. English proficiency was not associated with physical health. Health literacy was associated with neither physical nor mental health. Language proficiency may adversely affect the mental health of male Somali refugees, contrary to findings in other immigrant groups. Research on underlying mechanisms and opportunities to understand this relationship are needed.

  12. Prevalence of Autism in Children Born to Somali Parents Living in Sweden: A Brief Report

    Science.gov (United States)

    Barnevik-Olsson, Martina; Gillberg, Christopher; Fernell, Elisabeth

    2008-01-01

    In a geographical area of Stockholm, with a relatively large Somali immigrant population, parents as well as teachers in special schools and staff at habilitation centres have raised concerns over whether children with a Somali background are over-represented in the total group of children with autism. The aim of the study was, therefore, to…

  13. Targeting khat or targeting Somalis? A discourse analysis of project evaluations on khat abuse among Somali immigrants in Scandinavia

    Directory of Open Access Journals (Sweden)

    Nordgren Johan

    2015-09-01

    Full Text Available BACKGROUND – In Denmark, Norway and Sweden, the use of the psychoactive plant khat is widely seen as a social and health problem exclusively affecting the Somali immigrant population. Several projects by governmental and municipal bodies and agencies have been initiated to reduce khat use and abuse within this target population.

  14. Looking Islam in the Teeth: The Social Life of a Somali Toothbrush.

    Science.gov (United States)

    Laird, Lance D; Barnes, Linda L; Hunter-Adams, Jo; Cochran, Jennifer; Geltman, Paul L

    2015-09-01

    The Arabic miswak (Somali, adayge) is a tooth-cleaning stick from the Salvadora persica plant. In this article, we trace the social life of a "thing," examining meanings inscribed in the stick brush, drawing on interviews with 82 Somali refugees in Massachusetts and an analysis of local and transnational science and marketing. The miswak toothbrush symbolizes relationships to nature, homeland culture, global Islam, globalizing dental medicine, and the divine as it intersects with the lives of producers, marketers, distributors, and users, creating hybrid cultural forms in new contexts. © 2015 by the American Anthropological Association.

  15. The Wellbeing of Somali Refugees in Kampala: Perceived ...

    African Journals Online (AJOL)

    Although there is substantial research on the psychological wellbeing of refugees in psychology, especially in acculturation research, there is very little research assessing refugees' objective conditions of living. This study aims to bridge this gap by assessing the perceived satisfaction of Somali refugees' objective elements ...

  16. THE STORY OF AMISOM'S SUCCESSFUL WAR AGAINST SOMALI ...

    African Journals Online (AJOL)

    dogmatic fundamentalism of Al Shabaab is at odds with the pragmatism demanded of Somali daily life. The decision to deploy a regional force into the Somalian imbroglio was something first mooted by Dr. Bashir Hamad Attalla, the Executive Secretary of the regional body the Intergovernmental Authority on Development ...

  17. Prevalence of HBsAg and anti-HBs among delivering women.

    Science.gov (United States)

    Sabău, M; Căpîlnă; Kiss, E

    1979-01-01

    A survey of 2,500 delivering women revealed a 7.6% incidence of past infection with hepatitis B virus (HBV) (HBsAg or anti-HBs). Only 5.9% of the anti-HBs-positive mothers had a possible history of parenteral exposure to hepatitis B and none of the 55 HBsAg carriers had such a history. The findings suggest that HBV is endemic and that it is probably spread in part by nonparenteral means. The high rates of HBsAg and anti-HBs point to the possible preventive value of routine screenings for this system among pregnant women.

  18. Somali Families in Norway: : A Critical Review of The Changing Socio-structural Situation and it's Consequence for the Family

    OpenAIRE

    Gabowduale, Kassim Gabowduale

    2010-01-01

    An increasing number of Somali families have been flashed out of their homes and forced to migrate as a result of the ongoing conflict in Somalia. With the outbreak of the civil war in Somalia in the late eighties and early nineties, a large exodus of refugees fled the country. There are almost twenty three thousand Somalis living in Norway today; the majority of them settled in and around Oslo according to Statistics Norway (Henriksen 2008). Upon arrival, Somalis, still suffering from the tr...

  19. Preterm Birth and Birthweight-for-Gestational Age among Immigrant Women in Denmark 1978-2007

    DEFF Research Database (Denmark)

    Pedersen, Grete S; Mortensen, Laust H; Gerster, Mette

    2012-01-01

    -born women as the reference group. Results:  All immigrant groups had an increased risk of SGA delivery with the highest risk among Lebanese-, Somali- and Pakistani-born women: risk differences (RDs) and 95% confidence intervals [CI] per 1000 deliveries of 50.2 [95% CI 43.7, 56.7], 70.1 [95% CI 62.2, 77...... delivery, RD of -1.9 [95% CI -3.5, -0.3] and Somali-born women a lower risk of moderate preterm delivery, RD of -7.8 [-12.0, -3.6]. No differences were seen for the remaining groups. The association with length of residence for most immigrant groups was U-shaped, with highest risks among recent and long...

  20. Screening for Posttraumatic Stress Disorder among Somali ex-combatants: A validation study

    Directory of Open Access Journals (Sweden)

    Rockstroh Brigitte

    2007-09-01

    Full Text Available Abstract Background In Somalia, a large number of active and former combatants are affected by psychological problems such as Posttraumatic Stress Disorder (PTSD. This disorder impairs their ability to re-integrate into civilian life. However, many screening instruments for Posttraumatic Stress Disorder used in post-conflict settings have limited validity. Here we report on development and validation of a screening tool for PTSD in Somali language with a sample of ex-combatants. Methods We adapted the Posttraumatic Diagnostic Scale (PDS to reflect linguistic and cultural differences within the Somali community so that local interviewers could be trained to administer the scale. For validation purposes, a randomly selected group of 135 Somali ex-combatants was screened by trained local interviewers; 64 of them were then re-assessed by trained clinical psychologists using the Composite International Diagnostic Interview (CIDI and the Self-Report Questionnaire (SRQ-20. Results The screening instrument showed good internal consistency (Cronbach's α = .86, convergent validity with the CIDI (sensitivity = .90; specificity = .90 as well as concurrent validity: positive cases showed higher SRQ-20 scores, higher prevalence of psychotic symptoms, and higher levels of intake of the local stimulant drug khat. Compared to a single cut-off score, the multi-criteria scoring, in keeping with the DSM-IV, produced more diagnostic specificity. Conclusion The results provide evidence that our screening instrument is a reliable and valid method to detect PTSD among Somali ex-combatants. A future Disarmament, Demobilization and Reintegration Program in Somalia is recommended to screen for PTSD in order to identify ex-combatants with special psycho-social needs.

  1. Rainfall trends and variability in selected areas of Ethiopian Somali ...

    African Journals Online (AJOL)

    Moreover, proper spatial distribution of meteorological stations together with early warning system are required to further support local adaptive and coping strategies that the community designed towards rainfall variability in particular and climate change/disaster and risk at large. Keywords: Ethiopian Somali Region, Gode, ...

  2. Prevalence of Autism in Children of Somali Origin Living in Stockholm: Brief Report of an At-Risk Population

    Science.gov (United States)

    Barnevik-Olsson, Martina; Gillberg, Christopher; Fernell, Elisabeth

    2010-01-01

    This work was a follow-up study (birth years 1999-2003) of the prevalence of autism in children of Somali background living in the county of Stockholm, Sweden. In a previous study (birth years 1988-98), the prevalence of autism associated with learning disability was found to be three to four times higher among Somali children compared with other…

  3. The development and evaluation of alternative communication strategies to facilitate interactions with Somali refugees in primary care: a preliminary study

    Directory of Open Access Journals (Sweden)

    Marianne Johnson

    2006-09-01

    Each task was timed and scored for level of correctness; feedback was gained from Somalis and experimenters' observations were noted. Participants clearly found the computerised devices with Somali speech output easier to use and more acceptable than the simpler paper-based device.

  4. Validation of a home food inventory among low-income Spanish- and Somali-speaking families.

    Science.gov (United States)

    Hearst, Mary O; Fulkerson, Jayne A; Parke, Michelle; Martin, Lauren

    2013-07-01

    To refine and validate an existing home food inventory (HFI) for low-income Somali- and Spanish-speaking families. Formative assessment was conducted using two focus groups, followed by revisions of the HFI, translation of written materials and instrument validation in participants’ homes. Twin Cities Metropolitan Area, Minnesota, USA. Thirty low-income families with children of pre-school age (fifteen Spanish-speaking; fifteen Somali-speaking) completed the HFI simultaneously with, but independently of, a trained staff member. Analysis consisted of calculation of both item-specific and average food group kappa coefficients, specificity, sensitivity and Spearman’s correlation between participants’ and staff scores as a means of assessing criterion validity of individual items, food categories and the obesogenic score. The formative assessment revealed the need for few changes/additions for food items typically found in Spanish-speaking households. Somali-speaking participants requested few additions, but many deletions, including frozen processed food items, non-perishable produce and many sweets as they were not typical food items kept in the home. Generally, all validity indices were within an acceptable range, with the exception of values associated with items such as ‘whole wheat bread’ (k = 0.16). The obesogenic score (presence of high-fat, high-energy foods) had high criterion validity with k = 0.57, sensitivity = 91.8%, specificity = 70.6% and Spearman correlation = 0.78. The revised HFI is a valid assessment tool for use among Spanish and Somali households. This instrument refinement and validation process can be replicated with other population groups.

  5. De nasleep van Somalië, Rwanda en Srebrenica: overeenkomsten en verschillen

    Directory of Open Access Journals (Sweden)

    Thijs Brocades Zaalberg

    2010-01-01

    Full Text Available Klep, Christ, Somalië, Rwanda, Srebrenica. De nasleep van drie ontspoorde vredesmissies (Dissertatie Utrecht 2008; Amsterdam: Boom, 2008, 385 blz., ISBN 978 90 8506 668 2The Aftermath of Somalia, Rwanda and Srebrenica: Parallels and DifferencesChrist Klep has written an impressive and highly accessible thesis on the aftermath of three unsuccessful peace operations. By using a bold comparative approach and an ambitious tone of enquiry he places the traumatic Dutch Srebrenica experience in the context of two broadly similar processes of finger-pointing and evading responsibility in Canada and Belgium following their respective interventions in Somalia and Rwanda. He thus exposes many fascinating parallels, yet the historian Klep pays little attention to the differences between his case studies. This is regrettable, as this would have strengthened rather than weakened his otherwise compelling argument. The Somali case in particular differs from ‘Srebrenica’ and ‘Rwanda’, since the murders perpetrated by Canadian soldiers – horrific as they may have been – and the subsequent cover-up in no way constituted a defining moment in the collapsing international mission as a whole. Unlike the genocides in Rwanda and Srebrenica the death of the two Somalis was the result of a purely national Canadian failure, which helps explain why the Somalia Inquiry could identify guilty compatriots far more decisively than, for example, the Netherlands Institute for War Documentation (NIOD in its Srebrenica report.

  6. A comparison of labour and birth experiences of women delivering in a birthing centre and at home in the Netherlands.

    NARCIS (Netherlands)

    Borquez, H.A.; Wiegers, T.A.

    2006-01-01

    OBJECTIVE: to compare the labour and birth experiences of women who delivered at home without complications with the experiences of women who delivered in a birth centre without complications. DESIGN: a descriptive study using postal questionnaires at 1-6 months after birth of a consecutive sample

  7. Trauma, poverty and mental health among Somali and Rwandese refugees living in an African refugee settlement – an epidemiological study

    Directory of Open Access Journals (Sweden)

    Ertl Verena

    2009-05-01

    Full Text Available Abstract Background The aim of this study was to establish the prevalence of posttraumatic stress disorder (PTSD and depression among Rwandese and Somali refugees resident in a Ugandan refugee settlement, as a measure of the mental health consequences of armed conflict, as well as to inform a subsequent mental health outreach program. The study population comprised a sample from 14400 (n = 519 Somali and n = 906 Rwandese refugees resident in Nakivale refugee settlement in South Western Uganda during the year 2003. Methods The Posttraumatic Diagnostic Scale (PDS and the Hopkins Symptom Checklist 25 were used to screen for posttraumatic stress disorder and depression. Results Thirty two percent of the Rwandese and 48.1% of the Somali refugees were found to suffer from PTSD. The Somalis refugees had a mean of 11.95 (SD = 6.17 separate traumatic event types while the Rwandese had 8.86 (SD = 5.05. The Somalis scored a mean sum score of 21.17 (SD = 16.19 on the PDS while the Rwandese had a mean sum score of 10.05 (SD = 9.7. Conclusion Mental health consequences of conflict remain long after the events are over, and therefore mental health intervention is as urgent for post-conflict migrant populations as physical health and other emergency interventions. A mental health outreach program was initiated based on this study.

  8. High frequencies of Y chromosome lineages characterized by E3b1, DYS19-11, DYS392-12 in Somali males

    DEFF Research Database (Denmark)

    Sanchez Sanchez, Juan Jose; Hallenberg, Charlotte; Børsting, Claus

    2005-01-01

    We genotyped 45 biallelic markers and 11 STR systems on the Y chromosome in 201 male Somalis. In addition, 65 sub-Saharan Western Africans, 59 Turks and 64 Iraqis were typed for the biallelic Y chromosome markers. In Somalis, 14 Y chromosome haplogroups were identified including E3b1 (77.6%) and K2...... (10.4%). The haplogroup E3b1 with the rare DYS19-11 allele (also called the E3b1 cluster gamma) was found in 75.1% of male Somalis, and 70.6% of Somali Y chromosomes were E3b1, DYS19-11, DYS392-12, DYS437-14, DYS438-11 and DYS393-13. The haplotype diversity of eight Y-STRs ('minimal haplotype') was 0......f2) (27.1%), R1b3*(xR1b3d, R1b3f) (20.3%), E3b3 and R1a1*(xR1a1b) (both 11.9%). In Iraqis, 12 haplogroups were identified including J2*(xJ2f2) (29.7%) and J*(xJ2) (26.6%). The data suggest that the male Somali population is a branch of the East African population - closely related to the Oromos...

  9. "Robin Hook": The Developmental Effects of Somali Piracy

    OpenAIRE

    Shortland, Anja

    2011-01-01

    Copyright @ 2011 Brunel University Naval counter-piracy measures off Somalia have failed to change the incentives for pirates, raising calls for land-based approaches that may involve replacing piracy as a source of income. This paper evaluates the effects of piracy on the Somali economy to establish which (domestic) groups benefit from ransom monies. Given the paucity of economic data on Somalia, we evaluate province-level market data, nightlight emissions and high resolution satellite im...

  10. Rethinking migration in the digital age : Transglocalization and the Somali diaspora

    NARCIS (Netherlands)

    Kok, S.; Rogers, R.

    2017-01-01

    In this study, we examine the transnational networks of the Somali diaspora online. We explore the claims that the web signifies a shift towards a de-territorialized, transnational diaspora, which constructs its identity and engagement around a transnational imagined community. Based on a network

  11. Breast-feeding and complementary feeding practices in the first 6 months of life among Norwegian-Somali and Norwegian-Iraqi infants: the InnBaKost survey.

    Science.gov (United States)

    Grewal, Navnit Kaur; Andersen, Lene Frost; Sellen, Daniel; Mosdøl, Annhild; Torheim, Liv Elin

    2016-03-01

    To examine breast-feeding and complementary feeding practices during the first 6 months of life among Norwegian infants of Somali and Iraqi family origin. A cross-sectional survey was performed during March 2013-February 2014. Data were collected using a semi-quantitative FFQ adapted from the second Norwegian national dietary survey among infants in 2006-2007. Somali-born and Iraqi-born mothers living in eastern Norway were invited to participate. One hundred and seven mothers/infants of Somali origin and eighty mothers/infants of Iraqi origin participated. Breast-feeding was almost universally initiated after birth. Only 7 % of Norwegian-Somali and 10 % of Norwegian-Iraqi infants were exclusively breast-fed at 4 months of age. By 1 month of age, water had been introduced to 30 % of Norwegian-Somali and 26 % of Norwegian-Iraqi infants, and infant formula to 44 % and 34 %, respectively. Fifty-four per cent of Norwegian-Somali and 68 % of Norwegian-Iraqi infants had been introduced to solid or semi-solid foods at 4 months of age. Breast-feeding at 6 months of age was more common among Norwegian-Somali infants (79 %) compared with Norwegian-Iraqi infants (58 %; P=0·001). Multivariate analyses indicated no significant factors associated with exclusive breast-feeding at 3·5 months of age. Factors positively associated with breast-feeding at 6 months were country of origin (Somalia) and parity (>2). Breast-feeding initiation was common among Iraqi-born and Somali-born mothers, but the exclusive breast-feeding period was shorter than recommended in both groups. The study suggests that there is a need for new culture-specific approaches to support exclusive breast-feeding and complementary feeding practices among foreign-born mothers living in Norway.

  12. Production systems and reproductive performances of Camelus dromedarius in Somali regional state, eastern Ethiopia

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    Simenew Keskes

    2013-12-01

    Full Text Available Across-sectional questionnaire survey and focused group discussions were conducted to characterize camel production systems and to evaluate reproductive performances of camels at their natural pastoralist management systems of Somali region. A total of 100 households were included in the study during the period of October 2012 to March 2013. About 98% of Somali pastoralists preferred camels as their first choice over other livestock species and mainly kept in the society for milk and meat production. The camel management dominating in the study areas of Somali region is traditional nomadic. Camel is one of the most important livestock for Somali pastoralists’ livelihood as a source of milk, meat and draught power. Mature female camels were dominant (54.87% in the camel herd. The ratio of male to female camel was 1:13. Mean age at first calving and calving interval were 62.16±10.44 and 23.28±3.36 months respectively. Age at first calving and calving interval can be minimized to 57±5.52 and 21.84±4.8 months by proper husbandry and health care. The mean lactation length was 11.51±1.91 months. Diseases and predators were reported as the main causes of calf mortality. In the herd dynamic simulation calf mortality rate can be reduced at least to 7% only by preventing predators attack. Diseases (66%, lack of pasture (59% and security (47% were the main constraints in camel production of the study areas. For the better productivity of camels, the major constraints such as disease problems, lack of pasture and tribal conflicts should be mitigated. Proper husbandry and health services can play significant roles in the long term improvement of camel production and productivity of the region.  

  13. Khat use, PTSD and psychotic symptoms among Somali refugees in Nairobi - a pilot study

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    Marina eWidmann

    2014-06-01

    Full Text Available In East-African and Arab countries, khat leaves are traditionally chewed in social settings. They contain the amphetamine-like alkaloid cathinone. Especially among Somali refugees khat use has been associated with psychiatric symptoms. We assessed khat use patterns and psychiatric symptoms among male Somali refugees living in a disadvantaged urban settlement area in Kenya, a large group that has not yet received scientific attention. We wanted to explore consume patterns and study the associations between khat use, traumatic experiences and psychotic symptoms.Using privileged access sampling we recruited 33 healthy male khat chewers and 15 comparable non-chewers. Based on extensive preparatory work, we assessed khat use, khat dependence according to DSM-IV, traumatic experiences, Posttraumatic Stress Disorder and psychotic symptoms using standardized diagnostic instruments that had been adapted to the Somali language and culture.Hazardous use patterns like chewing for more than 24 hours without interruption were frequently reported. All khat users fulfilled the DSM-IV-criteria for dependence and eighty-five percent reported functional khat-use, i.e. that khat helps them to forget painful experiences. We found that the studied group was heavily burdened by traumatic events and posttraumatic symptoms. Khat users had experienced more traumatic events and had more often PTSD than non-users. Most khat users experience khat-related psychotic symptoms and in a quarter of them we found true psychotic symptoms. In contrast, among control group members no psychotic symptoms could be detected.We found first evidence for the existence and high prevalence of severely hazardous use patterns, comorbid psychiatric symptoms and khat use as a self-medication of trauma-consequences among male Somali refugees in urban Kenyan refugee settlements. There is a high burden by psychopathology and adequate community-based interventions urgently need to be developed.

  14. Ancient DNA from Nubian and Somali wild ass provides insights into donkey ancestry and domestication.

    Science.gov (United States)

    Kimura, Birgitta; Marshall, Fiona B; Chen, Shanyuan; Rosenbom, Sónia; Moehlman, Patricia D; Tuross, Noreen; Sabin, Richard C; Peters, Joris; Barich, Barbara; Yohannes, Hagos; Kebede, Fanuel; Teclai, Redae; Beja-Pereira, Albano; Mulligan, Connie J

    2011-01-07

    Genetic data from extant donkeys (Equus asinus) have revealed two distinct mitochondrial DNA haplogroups, suggestive of two separate domestication events in northeast Africa about 5000 years ago. Without distinct phylogeographic structure in domestic donkey haplogroups and with little information on the genetic makeup of the ancestral African wild ass, however, it has been difficult to identify wild ancestors and geographical origins for the domestic mitochondrial clades. Our analysis of ancient archaeological and historic museum samples provides the first genetic information on the historic Nubian wild ass (Equus africanus africanus), Somali wild ass (Equus africanus somaliensis) and ancient donkey. The results demonstrate that the Nubian wild ass was an ancestor of the first donkey haplogroup. In contrast, the Somali wild ass has considerable mitochondrial divergence from the Nubian wild ass and domestic donkeys. These findings resolve the long-standing issue of the role of the Nubian wild ass in the domestication of the donkey, but raise new questions regarding the second ancestor for the donkey. Our results illustrate the complexity of animal domestication, and have conservation implications for critically endangered Nubian and Somali wild ass.

  15. More than re-establishing the partner relationship: Intimate aftercare for Somali parents in diaspora.

    Science.gov (United States)

    Binder, Pauline; Johnsdotter, Sara; Essén, Birgitta

    2013-08-01

    to explore the sexual relationship and couples' perceptions about intimate partner support following childbirth. a hermeneutic design using a naturalistic inquiry framework as a qualitative proxy for medical anthropology. Data were collected using a fictional and culturally-specific narrative during focus group discussions (FGDs) in early 2011. Analysis was conducted by 'functional narrative analysis' and interpreted for conceptual constructions. Recruitment was by snowball and purposive sampling. a diasporic context among participants living in six urban centres across Sweden. successful recruitment included 16 Somali-Swedish fathers and 27 mothers. Three FDGs were conducted with fathers (3-7 participants) and seven with mothers (3-6 participants). within day 40 post partum, parents learn to rely on each other in the absence of traditional support networks. After the first 40 days, the re-introduction of sexual intimacy is likely to occur. Of the fathers experiencing postpartum sexual aversion, these seemed to experience 'existential angst' resulting from a combination of profound remorse over having put the partner into what they perceived as a life-threatening situation during childbirth and their perceived moral and ethical obligations to provide support in this setting. Mothers in general did not directly discuss their own sexuality. Women could imagine men's sexual aversion after witnessing childbirth. However, they seemed unaware of men's potential for angst. Mothers are situated between the loss of traditional postpartum support networks, comprised of close female kin, and their own newly-defined responsibilities in the host setting. Fathers embrace their new role. Both partners articulated the mother's new role as enhancing autonomy and independence in the host setting. However, women held mixed attitudes about fathers replacing traditional kin support. to date, late postpartum aftercare for immigrant African parents is anecdotally linked to evidence

  16. We Left One War and Came to Another: Resource Loss, Acculturative Stress, and Caregiver-Child Relationships in Somali Refugee Families

    Science.gov (United States)

    Betancourt, Theresa S.; Abdi, Saida; Ito, Brandon; Lilienthal, Grace M.; Agalab, Naima; Ellis, Heidi

    2014-01-01

    Background Refugee families often encounter a number of acculturative and resettlement stressors as they make lives for themselves in host countries. These difficulties may be compounded by past trauma and violence exposure posing increased risk for mental health problems. Greater knowledge is needed about protective processes contributing to positive development and adjustment in refugee families despite risk (e.g., resilience). The aims of this research were to identify and examine strengths and resources utilized by Somali refugee children and families in the Boston area to overcome resettlement and acculturative stressors. Methods We used maximum variation sampling to conduct a total of nine focus groups: five focus groups (total participants N=30) among Somali refugee adolescents and youth capturing gender and a range of ages (15-25 years) as well as four focus groups of Somali refugee mothers and fathers in groups (total participants N=32) stratified by gender. Results Drawing from Conservation of Resources Theory (COR), we identified five forms of resources comprising individual, family and collective/community strengths: religious faith; healthy family communication; support networks and peer support. “Community talk” was identified as a community dynamic having both negative and positive implications for family functioning. Conclusions Protective resources among Somali refugee children and families can help to offset acculturative and resettlement stressors. Many of these locally occurring protective resources have the potential to be leveraged by family and community-based interventions. These findings are being used to design preventative interventions that build on local strengths among Somali refugees in the Boston area. PMID:25090142

  17. Provider Adherence to Syphilis Testing Recommendations for Women Delivering a Stillbirth.

    Science.gov (United States)

    Patel, Chirag G; Huppert, Jill S; Tao, Guoyu

    2017-11-01

    To assess overall adherence to Centers for Disease Control and Prevention and American College of Obstetrics and Gynecology recommended guidelines for syphilis testing among women who delivered a stillbirth and compare it with other tests recommended for stillbirth evaluation. We used MarketScan claims data with 40 million commercially insured and 8 million Medicaid enrollees annually to estimate prenatal care and follow-up testing among women who had stillbirths between January 1, 2013, and December 24, 2013. Stillbirth was identified if women had any International Classification of Disease, Ninth Revision codes related to a stillbirth outcome. Among women with stillbirths, we estimated the proportions of women who received prenatal care and prenatal syphilis testing within 280 days before stillbirth, and testing at the time of stillbirth (syphilis testing, complete blood count, placental examination and autopsy) using Physician's Current Procedural Terminology codes. We identified 3672 Medicaid-insured women and 6023 commercially insured women with stillbirths in 2013. Approximately, 61.7% of Medicaid-insured women and 66.0% of commercially insured women had claims data indicating prenatal syphilis testing. At the time of stillbirth, Medicaid-insured and commercially insured women had similar rates of syphilis testing (6.5% vs 9.3%), placental examination (61.6% vs 57.8%), and complete blood count (31.9% vs 37.6%). Autopsies were too infrequent to be reported. Approximately, 34.6% of Medicaid-insured women and 29.7% of commercially insured women had no syphilis testing either prenatally or at the time of stillbirth. Syphilis testing among women after stillbirth was less than 10%, illustrating limited adherence to Centers for Disease Control and Prevention and American College of Obstetrics and Gynecology recommendations. Such low prenatal and delivery syphilis testing rates may impact the number of stillbirth cases identified as congenital syphilis cases and

  18. Norwegian-Somali Parents Who Send Their Children to Schools in Somalia

    Science.gov (United States)

    Thomas, Paul

    2016-01-01

    The perplexing numbers of Somali children withdrawn from schools in Norway and sent to Somalia is the concern of this study. These students are often brought back and re-enroll later as adolescents with concomitant educational challenges. The findings are critically analyzed employing John Ogbu's cultural ecology of minorities and a CHAT-based…

  19. "Where to Start": Learning from Somali Bantu Refugee Students and Families

    Science.gov (United States)

    Roxas, Kevin; Roy, Laura

    2012-01-01

    This article provides an overview of research conducted with Somali Bantu refugee students in two contexts: Michigan and South Texas. We provide recommendations for outreach to refugee families and their families, for instruction in the classroom, for advising and support for these children, and for implementing school and district policy as it…

  20. Migration experiences, employment status and psychological distress among Somali immigrants: a mixed-method international study.

    Science.gov (United States)

    Warfa, Nasir; Curtis, Sarah; Watters, Charles; Carswell, Ken; Ingleby, David; Bhui, Kamaldeep

    2012-09-07

    The discourse about mental health problems among migrants and refugees tends to focus on adverse pre-migration experiences; there is less investigation of the environmental conditions in which refugee migrants live, and the contrasts between these situations in different countries. This cross-national study of two samples of Somali refugees living in London (UK) and Minneapolis, Minnesota, (USA) helps to fill a gap in the literature, and is unusual in being able to compare information collected in the same way in two cities in different countries. There were two parts to the study, focus groups to gather in-depth qualitative data and a survey of health status and quantifiable demographic and material factors. Three of the focus groups involved nineteen Somali professionals and five groups included twenty-eight lay Somalis who were living in London and Minneapolis. The quantitative survey was done with 189 Somali respondents, also living in London and Minneapolis. We used the MINI International Neuropsychiatric Interview (MINI) to assess ICD-10 and DSM-IV mental disorders. The overall qualitative and quantitative results suggested that challenges to masculinity, thwarted aspirations, devalued refugee identity, unemployment, legal uncertainties and longer duration of stay in the host country account for poor psychological well-being and psychiatric disorders among this group. The use of a mixed-methods approach in this international study was essential since the quantitative and qualitative data provide different layers and depth of meaning and complement each other to provide a fuller picture of complex and multi-faceted life situations of refugees and asylum seekers. The comparison between the UK and US suggests that greater flexibility of access to labour markets for this refugee group might help to promote opportunities for better integration and mental well-being.

  1. Migration experiences, employment status and psychological distress among Somali immigrants: a mixed-method international study

    Directory of Open Access Journals (Sweden)

    Warfa Nasir

    2012-09-01

    Full Text Available Abstract Background The discourse about mental health problems among migrants and refugees tends to focus on adverse pre-migration experiences; there is less investigation of the environmental conditions in which refugee migrants live, and the contrasts between these situations in different countries. This cross-national study of two samples of Somali refugees living in London (UK and Minneapolis, Minnesota, (USA helps to fill a gap in the literature, and is unusual in being able to compare information collected in the same way in two cities in different countries. Methods There were two parts to the study, focus groups to gather in-depth qualitative data and a survey of health status and quantifiable demographic and material factors. Three of the focus groups involved nineteen Somali professionals and five groups included twenty-eight lay Somalis who were living in London and Minneapolis. The quantitative survey was done with 189 Somali respondents, also living in London and Minneapolis. We used the MINI International Neuropsychiatric Interview (MINI to assess ICD-10 and DSM-IV mental disorders. Results The overall qualitative and quantitative results suggested that challenges to masculinity, thwarted aspirations, devalued refugee identity, unemployment, legal uncertainties and longer duration of stay in the host country account for poor psychological well-being and psychiatric disorders among this group. Conclusion The use of a mixed-methods approach in this international study was essential since the quantitative and qualitative data provide different layers and depth of meaning and complement each other to provide a fuller picture of complex and multi-faceted life situations of refugees and asylum seekers. The comparison between the UK and US suggests that greater flexibility of access to labour markets for this refugee group might help to promote opportunities for better integration and mental well-being.

  2. Food and Nutrient Intake among 12-Month-Old Norwegian-Somali and Norwegian-Iraqi Infants.

    Science.gov (United States)

    Grewal, Navnit Kaur; Andersen, Lene Frost; Kolve, Cathrine Solheim; Kverndalen, Ingrid; Torheim, Liv Elin

    2016-09-28

    The aim of the present paper was to describe food and nutrient intake among 12-month-old Norwegian-Somali and Norwegian-Iraqi infants, with a focus on iron and vitamin D intake. A cross-sectional survey was conducted from August 2013 through September 2014. Eighty-nine mothers/infants of Somali origin and 77 mothers/infants of Iraqi origin residing in Eastern Norway participated in the study. Data were collected using two 24-h multiple-pass recalls. Forty percent of the Norwegian-Somali infants and 47% of the Norwegian-Iraqi infants were breastfed at 12 months of age ( p = 0.414). Median energy percentages (E%) from protein, fat and carbohydrates were within the recommended intake ranges, except the level of saturated fats (12-13 E%). Median intakes of almost all micronutrients were above the recommended daily intakes. Most of the infants consumed iron-enriched products (81%) and received vitamin D supplements (84%). The median intakes of iron and vitamin D were significantly higher among infants receiving iron-enriched products and vitamin D supplements compared to infants not receiving such products ( p food and nutrient intake of this group of infants in general seems to be in accordance with Norwegian dietary recommendations. Foods rich in iron and vitamin D supplements were important sources of the infants' intake of iron and vitamin D and should continue to be promoted.

  3. When women deliver with no one present in Nigeria: who, what, where and so what?

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    Bolaji M Fapohunda

    Full Text Available With the current maternal mortality ratio (MMR of 630/100,000 live births, Nigeria ranks among the nations with the highest mortality rates in the world. The use of skilled assistants during delivery has been identified a key predictor in the reduction of mortality rates in the world over. Not only are Nigerian women predominantly using unskilled attendants, one in five births are delivered with No One Present (NOP. We assessed who, what, where and the so what of this practice using 2008 Nigeria DHS (NDHS data. The study revealed that the prevalence of NOP is highest in the northern part of Nigeria with 94% of all observed cases. Socio-demographic factors, including, women's age at birth, birth order, being Muslim, and region of residence, were positively associated with NOP deliveries. Mother's education, higher wealth quintiles, urban residence, decision-making autonomy, and a supportive environment for women's social and economic security were inversely associated with NOP deliveries. Women's autonomy and social standing were critical to choosing to deliver with skilled attendance, which were further amplified by economic prosperity. Women's' economic wellbeing is entwined with their feelings of independence and freedom. Programs that seek to improve the autonomy of women and their strategic participation in sound health seeking decisions will, most likely, yield better results with improvements in women's education, income, jobs, and property ownership. As a short term measure, the use of conditional cash transfer, proven to work in several countries, including 18 in sub-Saharan Africa, is recommended. Its use has the potential to reduce household budget constraint by lowering cost-related barriers associated with women's ability to demand and use life-saving services. Given the preponderance of NOP in the Northern region, the study suggests that interventions to eradicate NOP deliveries must initially focus this region as priority.

  4. Knowledge translation in Africa for 21st century integrative biology: the "know-do gap" in family planning with contraceptive use among Somali women.

    Science.gov (United States)

    Ahmed, Ahmed A; Mohamed, Abdullahi A; Guled, Ibrahim A; Elamin, Hayfa M; Abou-Zeid, Alaa H

    2014-11-01

    An emerging dimension of 21(st) century integrative biology is knowledge translation in global health. The maternal mortality rate in Somalia is amongst the highest in the world. We set out to study the "know-do" gap in family planning measures in Somalia, with a view to inform future interventions for knowledge integration between theory and practice. We interviewed 360 Somali females of reproductive age and compared university-educated females to women with less or no education, using structured interviews, with a validated questionnaire. The mean age of marriage was 18 years, with 4.5 pregnancies per marriage. The mean for the desired family size was 9.3 and 10.5 children for the university-educated group and the less-educated group, respectively. Importantly, nearly 90% of the university-educated group knew about family planning, compared to 45.6% of the less-educated group. All of the less-educated group indicated that they would never use contraceptives, as compared to 43.5% of the university-educated group. Prevalence of contraceptive use among ever-married women was 4.3%. In the less-educated group, 80.6% indicated that they would not recommend contraceptives to other women as compared to 66.0% of the university-educated group. There is a huge gap between knowledge and practice regarding family planning in Somalia. The attendant reasons for this gap, such as level of education, expressed personal religious beliefs and others, are examined here. For primary health care to gain traction in Africa, we need to address the existing "know-do" gaps that are endemic and adversely impacting on global health. This is the first independent research study examining the knowledge gaps for family planning in Somalia in the last 20 years, with a view to understanding knowledge integration in a global world. The results shall guide policy makers, donors, and implementers to develop a sound family planning policy and program to improve maternal and child health in 21(st

  5. Utilization of healthcare services in postpartum women in the Philippines who delivered at home and the effects on their health: a cross-sectional analytical study.

    Science.gov (United States)

    Yamashita, Tadashi; Reyes Tuliao, Maria Teresa; Concel Meana, Magdalena; Suplido, Sherri Ann; Llave, Cecilia L; Tanaka, Yuko; Matsuo, Hiroya

    2017-01-01

    A low ratio of utilization of healthcare services in postpartum women may contribute to maternal deaths during the postpartum period. The maternal mortality ratio is high in the Philippines. The aim of this study was to examine the current utilization of healthcare services and the effects on the health of women in the Philippines who delivered at home. This was a cross-sectional analytical study, based on a self-administrated questionnaire, conducted from March 2015 to February 2016 in Muntinlupa, Philippines. Sixty-three postpartum women who delivered at home or at a facility were enrolled for this study. A questionnaire containing questions regarding characteristics, utilization of healthcare services, and abnormal symptoms during postpartum period was administered. To analyze the questionnaire data, the sample was divided into delivery at home and delivery at a facility. Chi-square test, Fisher's exact test, and Mann-Whitney U test were used. There were significant differences in the type of birth attendant, area of residence, monthly income, and maternal and child health book usage between women who delivered at home and those who delivered at a facility ( P Financial and environmental barriers might hinder the utilization of healthcare services by women who deliver at home in the Philippines. Low utilization of healthcare services in women who deliver at home might result in more frequent abnormal symptoms during postpartum.

  6. ‘You are labelled by your children’s disability’:A community-based, participatory study of stigma among Somali parents of children with autism living in the United Kingdom

    OpenAIRE

    Selman, Lucy; Fox, Fiona; Aabe, Nura; Turner, Katrina; Rai, Dheeraj; Redwood, Sabi

    2017-01-01

    Objectives: Social stigma is commonly experienced by parents of children with autism. Our aim was to understand the nature of stigma experienced by Somali parents of children with autism in the United Kingdom (UK), and to consider how they coped with or resisted such stigma. Design: We used a community-based participatory research approach, collaborating with a community organisation of Somali parents. In-depth interviews with simultaneous translation were conducted with 15 Somali parents of ...

  7. The Relationship Between Women's Intention to Request a Labor Epidural Analgesia, Actually Delivering With Labor Epidural Analgesia, and Postpartum Depression at 6 Weeks: A Prospective Observational Study.

    Science.gov (United States)

    Orbach-Zinger, Sharon; Landau, Ruth; Harousch, Avi Ben; Ovad, Oren; Caspi, Liron; Kornilov, Evgeniya; Ioscovich, Alexander; Bracco, Danielle; Davis, Atara; Fireman, Shlomo; Hoshen, Moshe; Eidelman, Leonid A

    2018-05-01

    Postpartum depression (PPD) is associated with pain during and after delivery, with studies showing reduced rates among women delivering with labor epidural analgesia (LEA). We hypothesized that women who intend to deliver with LEA but do not receive it are at higher risk for PPD at 6 weeks due to the combined experience of untreated labor pain and unmatched expectations during labor, and evaluated the interaction between labor plans related to LEA, satisfaction with pain control when actually delivering with LEA, and PPD at 6 weeks after delivery. A total of 1497 women with a vaginal delivery were enrolled into this prospective longitudinal study. Women's initial intention to deliver with or without LEA, how they subsequently delivered, and satisfaction with pain relief were recorded on postpartum day 1. Primary aim was selected as PPD at 6 weeks among women intending to deliver with but subsequently delivering without LEA compared with the rest of the cohort. Primary outcome was PPD at 6 weeks using the Edinburgh Postnatal Depression Scale; PPD was defined with a score ≥10 (scale from 0 to 30). Demographic and obstetric data were recorded. Fisher exact test was used for comparisons between groups. The interaction between intention and actual delivery with regard to LEA and PPD was tested. Overall, 87 of 1326 women completing the study at 6 weeks had PPD (6.6%). For the primary aim, 439 (29.3%) delivered without LEA, of which 193 (12.9%) had intended to deliver with LEA; the PPD rate among these women was 8.1%, which was not statistically different from the rest of the cohort (6.3%; odds ratio [OR], 1.30; 95% confidence interval [CI], 0.72-2.38; P = .41). A total of 1058 women (70.7%) delivered with LEA and 439 (29.3%) delivered without; therefore, 1169 (78.1%) delivered as intended and 328 (21.9%) did not (unmatched expectations). Evaluating the interaction between effects, there was a strong negative additive interaction between intending to deliver without

  8. Somali refugees' experiences with their general practitioners: frames of reference and critical episodes.

    NARCIS (Netherlands)

    Feldmann, C.T.; Bensing, J.M.; Ruijter, A. de; Boeije, H.R.

    2006-01-01

    The article presents the results of a qualitative study based on in-depth interviews with Somali refugees living in The Netherlands, on their experiences with general practitioners (GPs). The central question is: what are the frames of reference participants use to interpret their experiences? The

  9. Somali refugees’ experiences with their general practitioners: frames of reference and critical episodes

    NARCIS (Netherlands)

    Titia Feldmann, C.; Bensing, J.; Ruijter, Arie de; Boeije, H.R.

    2006-01-01

    The article presents the results of a qualitative study based on in-depth interviews with Somali refugees living in The Netherlands, on their experiences with general practitioners (GPs). The central question is: what are the frames of reference participants use to interpret their experiences? The

  10. The role of potential vorticity anomalies in the Somali Jet on Indian Summer Monsoon Intraseasonal Variability

    Science.gov (United States)

    Rai, P.; Joshi, M.; Dimri, A. P.; Turner, A. G.

    2018-06-01

    The climate of the Indian subcontinent is dominated by rainfall arising from the Indian summer monsoon (ISM) during June to September. Intraseasonal variability during the monsoon is characterized by periods of heavy rainfall interspersed by drier periods, known as active and break events respectively. Understanding and predicting such events is of vital importance for forecasting human impacts such as water resources. The Somali Jet is a key regional feature of the monsoon circulation. In the present study, we find that the spatial structure of Somali Jet potential vorticity (PV) anomalies varies considerably during active and break periods. Analysis of these anomalies shows a mechanism whereby sea surface temperature (SST) anomalies propagate north/northwestwards through the Arabian Sea, caused by a positive feedback loop joining anomalies in SST, convection, modification of PV by diabatic heating and mixing in the atmospheric boundary layer, wind-stress curl, and ocean upwelling processes. The feedback mechanism is consistent with observed variability in the coupled ocean-atmosphere system on timescales of approximately 20 days. This research suggests that better understanding and prediction of monsoon intraseasonal variability in the South Asian monsoon may be gained by analysis of the day-to-day dynamical evolution of PV in the Somali Jet.

  11. The role of potential vorticity anomalies in the Somali Jet on Indian Summer Monsoon Intraseasonal Variability

    Science.gov (United States)

    Rai, P.; Joshi, M.; Dimri, A. P.; Turner, A. G.

    2017-08-01

    The climate of the Indian subcontinent is dominated by rainfall arising from the Indian summer monsoon (ISM) during June to September. Intraseasonal variability during the monsoon is characterized by periods of heavy rainfall interspersed by drier periods, known as active and break events respectively. Understanding and predicting such events is of vital importance for forecasting human impacts such as water resources. The Somali Jet is a key regional feature of the monsoon circulation. In the present study, we find that the spatial structure of Somali Jet potential vorticity (PV) anomalies varies considerably during active and break periods. Analysis of these anomalies shows a mechanism whereby sea surface temperature (SST) anomalies propagate north/northwestwards through the Arabian Sea, caused by a positive feedback loop joining anomalies in SST, convection, modification of PV by diabatic heating and mixing in the atmospheric boundary layer, wind-stress curl, and ocean upwelling processes. The feedback mechanism is consistent with observed variability in the coupled ocean-atmosphere system on timescales of approximately 20 days. This research suggests that better understanding and prediction of monsoon intraseasonal variability in the South Asian monsoon may be gained by analysis of the day-to-day dynamical evolution of PV in the Somali Jet.

  12. Working Together in a Deficit Logic: Home-School Partnerships with Somali Diaspora Parents

    Science.gov (United States)

    Matthiesen, Noomi Christine Linde

    2017-01-01

    Drawing on discursive psychology this article examines the understandings teachers and principals in Danish Public Schools have regarding Somali diaspora parenting practices. Furthermore, the article investigates what these understandings mean in interaction with children in the classrooms and with parents in home-school communication. It is…

  13. Communication and US-Somali Immigrant Human Papillomavirus (HPV) Vaccine Decision-Making.

    Science.gov (United States)

    Dailey, Phokeng M; Krieger, Janice L

    2017-09-01

    The current study uses a multiple goal theoretical perspective to explore how Somali immigrant families living in Ohio, USA, make decisions regarding whether to vaccinate their children against human papillomavirus (HPV)-a leading cause of cervical cancer. A focus was placed on the communication goals of parents in HPV vaccine discussions with their child and health care provider. Semi-structured interviews were audiotaped, transcribed, and analyzed using a grounded theory approach. Key themes are the implications of the vaccine for early sexual activity, confusion between HPV and HIV (human immunodeficiency virus), the perception that the HPV vaccine is unnecessary, uncertainty about the vaccine's efficacy and side effects, avoidance of parent-child communication about the vaccine, and a preference for framing the vaccine as a health promotion behavior. Framing the threat of HPV in the context of initiation of sexual activity, uncertainty regarding vaccine efficacy, and anticipated regret account for the inconsistency in HPV vaccine uptake among Somali parents. Clinicians should consider talking about HPV as a distal versus an immediate threat and HPV vaccine uptake as a health-promotion behavior rather than a sexually transmitted infection prevention behavior.

  14. Air-Sea Interaction in the Somali Current Region

    Science.gov (United States)

    Jensen, T. G.; Rydbeck, A.

    2017-12-01

    The western Indian Ocean is an area of high eddy-kinetic energy generated by local wind-stress curl, instability of boundary currents as well as Rossby waves from the west coast of India and the equatorial wave guide as they reflect off the African coast. The presence of meso-scale eddies and coastal upwelling during the Southwest Monsoon affects the air-sea interaction on those scales. The U.S. Navy's Coupled Ocean-Atmosphere Mesoscale Prediction System (COAMPS) is used to understand and quantify the surface flux, effects on surface waves and the role of Sea Surface Temperature anomalies on ocean-atmosphere coupling in that area. The COAMPS atmosphere model component with 9 km resolution is fully coupled to the Navy Coastal Ocean Model (NCOM) with 3.5 km resolution and the Simulating WAves Nearshore (SWAN) wave model with 10 km resolution. Data assimilation using a 3D-variational approach is included in hindcast runs performed daily since June 1, 2015. An interesting result is that a westward jet associated with downwelling equatorial Rossy waves initiated the reversal from the southward Somali Current found during the northeast monsoon to a northward flow in March 2016 more than a month before the beginning of the southwest monsoon. It is also found that warm SST anomalies in the Somali Current eddies, locally increase surface wind speed due to an increase in the atmospheric boundary layer height. This results in an increase in significant wave height and also an increase in heat flux to the atmosphere. Cold SST anomalies over upwelling filaments have the opposite impacts on air-sea fluxes.

  15. Effectiveness of Group-Delivered Cognitive Therapy and Treatment Length in Women Veterans with PTSD

    Directory of Open Access Journals (Sweden)

    Diane T. Castillo

    2014-01-01

    Full Text Available The effectiveness and length of group-delivered cognitive treatment for Posttraumatic Stress Disorder (PTSD was examined in a sample of women veterans. The sample included 271 primarily non-Hispanic white (61% and Hispanic (25% women veterans treated in 8-, 10-, or 12-group length sessions with manualized cognitive therapy for PTSD. Outcome was measured with the PTSD Symptom Checklist (PCL in an intention-to-treat analysis (N = 271, in completer subjects (n = 172, and with group as the unit of analysis (n = 47 groups. Significant decreases in PTSD were found in the full sample (effect size [ES] range = 0.27 to 0.38, completers (ES range = 0.37 to 0.54, and group as the unit of analysis (ES range = 0.71 to 0.92, suggesting effectiveness of cognitive group treatment for PTSD. PCL scores significantly improved in the 8, 10, and 12 group lengths, with no differences between each. Clinical improvement showed a third decreasing 10 or more PCL points and 22% no longer meeting PTSD diagnostic criteria, with the best results in the 10-session group. The results suggest group-delivered cognitive therapy is an effective, efficient, time-limited treatment for PTSD.

  16. The voices of women in Africa. Love, marriage, slavery, apartheid

    Directory of Open Access Journals (Sweden)

    Ruth Finnegan

    2015-03-01

    Full Text Available The paper documents women’s self expression from Africa, from Limba stories and Somali love poetry to self-told tales of women under slavery and apartheid or of young girls reluctantly but submissively going into marriage, together with the images of deceit and infidelity often attributed to women in male-generated tales and observations. The paper is illustrated by historical texts from first hand research in the field, dating from the mid nineteenth century to the present.

  17. Paleogene magnetic isochrons and palaeo-propagators in the Arabian and Eastern Somali basins, NW Indian Ocean

    Digital Repository Service at National Institute of Oceanography (India)

    Chaubey, A.K.; Dyment, J.; Bhattacharya, G.C.; Royer, J.-Y.; Srinivas, K.; Yatheesh, V.

    A revised magnetic isochron map of the conjugate Arabian and Eastern Somali basins based on an up-to-date compilation of Indian, French, and other available sea-surface magnetic data are presented. The magnetic anomaly and the modulus...

  18. Can radiographers be trained to deliver an intervention to raise breast cancer awareness, and thereby promote early presentation of breast cancer, in older women?

    International Nuclear Information System (INIS)

    Omar, L.; Burgess, C.C.; Tucker, L.D.; Whelehan, P.; Ramirez, A.J.

    2010-01-01

    Aims: To assess the feasibility of training radiographers to deliver a one-to-one intervention to raise breast cancer awareness among older women. The ultimate aim is to increase the likelihood of early presentation of breast cancer by older women and improve survival from the disease. Method: Four radiographers were trained to deliver a 10-min scripted one-to-one intervention. Key elements of training included rehearsal of the intervention using role-play with actors and colleagues and practice interviews with women attending NHS breast screening clinics. All practice interventions were videotaped to facilitate positive, constructive feedback on performance. Competence to deliver the intervention was assessed on delivery of the key messages and the style of delivery. Radiographers' experiences of training and intervention delivery were collated from reflective diaries. Results: Three radiographers were assessed as competent after training and all four increased in confidence to deliver the intervention. Reported benefits to radiographers included increased awareness of communication skills and enhanced interaction with women attending breast screening. Radiographers reported challenges relating to mastering the prescriptive nature of the intervention and to delivering complex health messages within time constraints. Discussion: It was feasible but challenging for radiographers to be trained to deliver a one-to-one intervention designed to raise breast cancer awareness and thereby to promote early presentation of breast cancer. If the intervention is found to be cost-effective it may be implemented across the NHS Breast Screening Programme with diagnostic radiographers playing a key role in promoting early presentation of breast cancer.

  19. Paleogene plate tectonic evolution of the Arabian and Eastern Somali basins

    Digital Repository Service at National Institute of Oceanography (India)

    Royer, J.-Y.; Chaubey, A.K.; Dyment, J.; Bhattacharya, G.C.; Srinivas, K.; Yatheesh, V.; Ramprasad, T.

    with systemahyphenminus tic ridge propagation in both basins (Miles & Roest 1993: Chaubey er at. 1998. Dyment 1998). Ridge propagation explains the large spreading asymmetry between the Arabian and Eastern Somali basins. Between Chrons 26 and 25. c. 65% of the crust..., the differences be- tween the India-Somalia and Capricorn-Somalia motions in Paleogene time can be used to estimate and refine the Capricorn-India integral motion as suggested by Royer & Chang (1991). Such en- deavour would require an accurate assessment...

  20. Beyond the playing field: experiences of sport, social capital and integration among Somalis in Australia

    NARCIS (Netherlands)

    Spaaij, R.

    2012-01-01

    This paper explores the role of recreational sport as a means and marker of social integration by analysing the lived experiences of Somali people from refugee backgrounds with sport. Drawing on a three-year multi-sided ethnography, the paper examines the extent to and ways in which participation in

  1. Utilization of healthcare services in postpartum women in the Philippines who delivered at home and the effects on their health: a cross-sectional analytical study

    Directory of Open Access Journals (Sweden)

    Yamashita T

    2017-09-01

    Full Text Available Tadashi Yamashita,1 Maria Teresa Reyes Tuliao,2 Magdalena Concel Meana,2 Sherri Ann Suplido,3 Cecilia L Llave,4 Yuko Tanaka,5 Hiroya Matsuo6 1Kobe City College of Nursing, Kobe, Japan; 2Health Department of Muntinlupa, Muntinlupa, Philippines; 3Department of Obstetrics and Gynecology, Philippine General Hospital, Manila, Philippines; 4College of Medicine (CM, University of the Philippine (UP, Manila, Philippines; 5Department of School of Health Sciences, Faculty of Medicine, Tokushima University Graduate School, Tokushima, Japan; 6Department of International Health, Kobe University Graduate School of Health Sciences, Kobe, Japan Background: A low ratio of utilization of healthcare services in postpartum women may contribute to maternal deaths during the postpartum period. The maternal mortality ratio is high in the Philippines. The aim of this study was to examine the current utilization of healthcare services and the effects on the health of women in the Philippines who delivered at home. Methods: This was a cross-sectional analytical study, based on a self-administrated questionnaire, conducted from March 2015 to February 2016 in Muntinlupa, Philippines. Sixty-three postpartum women who delivered at home or at a facility were enrolled for this study. A questionnaire containing questions regarding characteristics, utilization of healthcare services, and abnormal symptoms during postpartum period was administered. To analyze the questionnaire data, the sample was divided into delivery at home and delivery at a facility. Chi-square test, Fisher’s exact test, and Mann–Whitney U test were used. Results: There were significant differences in the type of birth attendant, area of residence, monthly income, and maternal and child health book usage between women who delivered at home and those who delivered at a facility (P<0.01. There was significant difference in the utilization of antenatal checkup (P<0.01 during pregnancy, whilst there was no

  2. Phenotypic Characteristics of Autism Spectrum Disorder in a Diverse Sample of Somali and Other Children

    Science.gov (United States)

    Esler, Amy N.; Hall-Lande, Jennifer; Hewitt, Amy

    2017-01-01

    The potential for culture to impact diagnosis of autism spectrum disorder (ASD) is high, yet remains largely unstudied. This study examined differences across racial/ethnic groups in ASD symptoms, cognitive and adaptive skills, and related behaviors in children with ASD that included a unique subgroup, children from the Somali diaspora. Somali…

  3. ‘War on piracy’: the conflation of Somali piracy with terrorism in discourse, tactic and law

    NARCIS (Netherlands)

    C. Singh (Currun); A.S. Bedi (Arjun Singh)

    2012-01-01

    textabstractThis paper argues that since 2005, the global security discourse has confused maritime piracy off the Horn of Africa with terrorism. American and European policymakers and financiers have tapped a vulnerable public imaginary to exaggerate Somali pirates as ‘maritime terrorists’ linked to

  4. Neogene oceanographic variations recorded in manganese nodules from the Somali Basin

    Digital Repository Service at National Institute of Oceanography (India)

    Banakar, V.K.; Nair, R.R.; Tarkian, M.; Haake, B.

    ), their application in interpreting the palaeoceanographic evolution of nodules has been relatively rare (see Segl et al., 1989; Mangini et al., 1990; Hein et al., 1992). In this paper we attempt to reconstruct the palaeocea- nographic history of a nodule from... the Somali Basin and correlate this history with the history inferred from the nearest DSDP Site. Material and methods The two manganese nodules studied here were collected using a free fall grab from a station (10D) located at 6°S and 52°E...

  5. Transitional civil society, Insecurity and Volatile Environment

    DEFF Research Database (Denmark)

    Farah, Abdulkadir Osman; Dini, Shukria

    2014-01-01

    Somali women mobilise nationally – through NGOs and civic movements. They succeeded in overcoming challenges, and confront warlordism and violence. This dimension is well documented and well known by the international community. Lesser-known Somali is the transnational dimension of Somali women......’s mobilisation. Osman Farah and Shukria Dini contend that Somali Women’s transnational efforts for justice and social empowerment, and their efforts of co-operating with transnational NGOs and transnational communities, play a central role in peace and reconciliation processes in Somalia. The two authors argue...

  6. The cultural basis for oral health practices among Somali refugees pre-and post-resettlement in Massachusetts.

    Science.gov (United States)

    Adams, Jo Hunter; Young, Samorga; Laird, Lance D; Geltman, Paul L; Cochran, Jennifer J; Hassan, Ahmed; Egal, Fadumo; Paasche-Orlow, Michael K; Barnes, Linda L

    2013-11-01

    Oral health disparities related to socioeconomic status have been well described in the U.S., but oral health among refugee groups has not been well characterized. This article examines oral health among Somali refugees in Massachusetts. Eighty-three (83) participants were purposively selected for an in-depth, open-ended interview related to oral health. Older individuals associated use of the stick brush with the Islamic practice of cleansing before prayer. When unable to find stick brushes in the U.S., many adopted the Western toothbrush. Parents expressed concern that their children had adopted U.S. practices of brushing with a toothbrush only once or twice a day. Somali oral health practices have changed following arrival to the U.S., but the underlying model for oral health care remains rooted in Islam. By acknowledging the value of traditional practices, dentists may communicate the value of Western preventive and restorative dentistry, and recommend approaches to integrating the two.

  7. Home is best: Why women in rural Zimbabwe deliver in the community.

    Science.gov (United States)

    Dodzo, Munyaradzi Kenneth; Mhloyi, Marvellous

    2017-01-01

    Maternal mortality in Zimbabwe has unprecedentedly risen over the last two and half decades although a decline has been noted recently. Many reasons have been advanced for the rising trend, including deliveries without skilled care, in places without appropriate or adequate facilities to handle complications. The recent decline has been attributed to health systems strengthening through a multi-donor pooled funding mechanism. On the other hand, the proportion of community deliveries has also been growing steadily over the years and in this study we investigate why. We used twelve (12) focus group discussions with child-bearing women and eight (8) key informant interviews (KIIs). Four (4) were traditional birth attendants and four (4) were spiritual birth attendants. A thematic approach was used to analyse the data in Ethnography software. The study shows that women prefer community deliveries due to perceived low economic, social and opportunity costs involved; pliant and flexible services offered; and diminishing quality and appeal of institutional maternity services. We conclude that rural women are very economic, logical and rational in making choices on place of delivery. Delivering in the community offers financial, social and opportunity advantages to disenfranchised women, particularly in remote rural areas. We recommend for increased awareness of the dangers of community deliveries; establishment of basic obstetric care facilities in the community and more efficient emergency referral systems. In the long-term, there should be a sustainable improvement of the public health delivery system to make it accessible, affordable and usable by the public.

  8. A case report of severe panhypopituitarism in a newborn delivered by a women with Turner syndrome.

    Science.gov (United States)

    Olszewska, Marta; Kiełbasa, Grzegorz; Wójcik, Małgorzata; Zygmunt-Górska, Agata; Starzyk, Jerzy B

    2015-01-01

    Turner syndrome (TS) is a congenital disease caused by absence or structural abnormalities of sex chromosomes resulting in gonadal dysgenesis. Spontaneous pregnancies occur in 2-8% of patients, especially with mosaic kariotypes, however they are associated with increased risk of poor outcome both for mother and fetus. We report a 4-day-old male infant delivered by women with mosaic TS who was admitted to the pediatric intensive care unit and presented with severe panhypopituitarism as the early manifestation of pituitary stalk interruption syndrome (PSIS). To the best of our knowledge this is the first report of severe panhypopituitarism in a newborn borne by women with TS.

  9. The EU Comprehensive Approach on Somali Piracy

    Directory of Open Access Journals (Sweden)

    Angela Caramerli

    2015-07-01

    Full Text Available The Gulf of Aden represents a strategic issue for the international community, as its geographical position is fundamental as the major trade maritime route. About 50 percent of the world container ships pass through the Gulf of Aden each year, 80 percent of those cargos coming from Europe. For this reason, the piracy issue affecting Somalia is a problem affecting EU member states’ security and economy. This paper is focused on the comprehensive approach acted by the European Union, with a special attention on proposing the implementation of programs against illegal fishing and waste dumping in order to fight Somali piracy. The evaluation of the military mission offers an overview on a solution for the near future, while the training missions and the development funds sustain the build-up of national tools and focus on the solving of the roots of the issue.

  10. Dervishes, 'moryaan' and freedom fighters : cycles of rebellion and the fragmentation of Somali society, 1900-2000

    NARCIS (Netherlands)

    Abbink, G.J.; Abbink, G.J.; Walraven, van K.; Bruijn, de M.E.

    2003-01-01

    There has been a state of near-permanent revolt in Somali society since 1991. This chapter offers a cultural analysis of patterns of political and military activity from the precolonial era through the Italian and British colonial period, and State independence (1960-1991), to the present period of

  11. Assessment of source of information for polio supplementary immunization activities in 2014 and 2015, Somali, Ethiopia.

    Science.gov (United States)

    Bedada, Selamawit Yilma; Gallagher, Kathleen; Aregay, Aron Kassahun; Mohammed, Bashir; Maalin, Mohammed Adem; Hassen, Hassen Abdisemed; Ali, Yusuf Mohammed; Braka, Fiona; Kilebou, Pierre M'pele

    2017-01-01

    Communication is key for the successful implementation of polio vaccination campaigns. The purpose of this study is to review and analyse the sources of information utilized by caregivers during polio supplementary immunization activities (SIAs) in Somali, Ethiopia in 2014 and 2015. Data on sources of information about the polio campaign were collected post campaign from caregivers by trained data collectors as part of house to house independent monitoring. The sources of information analysed in this paper include town criers (via megaphones), health workers, religious leaders, kebele leaders (Kebele is the lowest administrative structure in Ethiopia), radio, television, text message and others. The repetition of these sources of information was analysed across years and zones for trends. Polio vaccination campaign coverage was also reviewed by year and zones within the Somali region in parallel with the major sources of information used in the respective year and zones. 57,745 responses were used for this analysis but the responses were received from polio SIAs. Zonal trends in using town criers as a major source of information in both study years remained consistent except in two zones. 87.5% of zones that reported at least 90% coverage during both study years had utilized town criers as a major source of information while the rest (12.5%) used health workers. We found that town criers were consistently the major source of information about the polio campaigns for Somali region parents and caregivers during polio immunization days held in 2014 and 2015. Health workers and kebele leaders were also important sources of information about the polio campaign for parents.

  12. Mental health of Somali adolescent refugees: the role of trauma, stress, and perceived discrimination.

    Science.gov (United States)

    Ellis, B Heidi; MacDonald, Helen Z; Lincoln, Alisa K; Cabral, Howard J

    2008-04-01

    The primary purpose of this study was to examine relations between trauma exposure, post-resettlement stressors, perceived discrimination, and mental health symptoms in Somali adolescent refugees resettled in the U.S. Participants were English-speaking Somali adolescent refugees between the ages of 11 and 20 (N = 135) who had resettled in the U.S. Participants were administered an interview battery comprising self-report instruments that included the UCLA Posttraumatic Stress Disorder (PTSD) Index, the War Trauma Screening Scale, the Every Day Discrimination scale, the Adolescent Post-War Adversities Scale, and the Acculturative Hassles Inventory. Results indicated that cumulative trauma was related to PTSD and depression symptoms. Further, post-resettlement stressors, acculturative stressors, and perceived discrimination were also associated with greater PTSD symptoms after accounting for trauma, demographic, and immigration variables. Number of years since resettlement in the US and perceived discrimination were significantly related to depressive symptoms, after accounting for trauma, demographic, and immigration variables. Further research elucidating the relations between post-resettlement stressors, discrimination, and mental health of refugee adolescents may inform intervention development. PsycINFO Database Record (c) 2008 APA, all rights reserved.

  13. Healthy Body Image Intervention Delivered to Young Women via Facebook Groups: Formative Study of Engagement and Acceptability.

    Science.gov (United States)

    Stapleton, Jerod L; Manne, Sharon L; Day, Ashley K; Levonyan-Radloff, Kristine; Pagoto, Sherry L

    2018-02-20

    There is increasing interest in using social media sites such as Facebook to deliver health interventions so as to expose people to content while they are engaging in their usual social media habit. This formative intervention development study is novel in describing a preliminary test of using the secret group feature of Facebook to deliver a behavioral intervention targeting users of indoor tanning beds to reduce their risk of skin cancer. Intervention content was designed to challenge body image-related constructs associated with indoor tanning through the use of dissonance-inducing content. To evaluate engagement with and acceptability of using a secret Facebook group to deliver a healthy body image intervention to young women engaged in indoor tanning. Seventeen young women completed a baseline survey and joined a secret Facebook group with intervention content delivered via daily posts for 4 weeks. Engagement data was extracted and acceptability was measured via a follow-up survey. The study had a high retention rate (94%, [16/17]). On average, posts were viewed by 91% of participants, liked by 35%, and commented on by 26%. The average comment rate was highest (65%) for posts that elicited comments by directly posing questions or discussion topics to the group. Average intervention acceptability ratings were highly positive and participants reported feeling connected to the group and its topic. Average rates of past 1-month indoor tanning reported following the intervention were lower than the baseline rate (P=.08, Cohen d=0.47). This study is novel in demonstrating participant engagement with and acceptability of using Facebook secret groups to deliver a dissonance-inducing intervention approach that utilizes group-based discussions related to body image. The study is also unique within the field of skin cancer prevention by demonstrating the potential value of delivering an indoor tanning intervention within an interactive social media format. The findings

  14. Healthy Body Image Intervention Delivered to Young Women via Facebook Groups: Formative Study of Engagement and Acceptability

    Science.gov (United States)

    Manne, Sharon L; Day, Ashley K; Levonyan-Radloff, Kristine; Pagoto, Sherry L

    2018-01-01

    Background There is increasing interest in using social media sites such as Facebook to deliver health interventions so as to expose people to content while they are engaging in their usual social media habit. This formative intervention development study is novel in describing a preliminary test of using the secret group feature of Facebook to deliver a behavioral intervention targeting users of indoor tanning beds to reduce their risk of skin cancer. Intervention content was designed to challenge body image-related constructs associated with indoor tanning through the use of dissonance-inducing content. Objective To evaluate engagement with and acceptability of using a secret Facebook group to deliver a healthy body image intervention to young women engaged in indoor tanning. Methods Seventeen young women completed a baseline survey and joined a secret Facebook group with intervention content delivered via daily posts for 4 weeks. Engagement data was extracted and acceptability was measured via a follow-up survey. Results The study had a high retention rate (94%, [16/17]). On average, posts were viewed by 91% of participants, liked by 35%, and commented on by 26%. The average comment rate was highest (65%) for posts that elicited comments by directly posing questions or discussion topics to the group. Average intervention acceptability ratings were highly positive and participants reported feeling connected to the group and its topic. Average rates of past 1-month indoor tanning reported following the intervention were lower than the baseline rate (P=.08, Cohen d=0.47). Conclusions This study is novel in demonstrating participant engagement with and acceptability of using Facebook secret groups to deliver a dissonance-inducing intervention approach that utilizes group-based discussions related to body image. The study is also unique within the field of skin cancer prevention by demonstrating the potential value of delivering an indoor tanning intervention within

  15. Body composition and net energy requirements of Brazilian Somali lambs

    Directory of Open Access Journals (Sweden)

    Elzânia S. Pereira

    2014-12-01

    Full Text Available The aim of this study was to determine the energy requirements for maintenance (NEm and growth of 48 Brazilian Somali ram lambs with an average initial body weight of 13.47±1.76 kg. Eight animals were slaughtered at the trials beginning as a reference group to estimate the initial empty body weight (EBW and body composition. The remaining animals were assigned to a randomised block design with eight replications per block and five diets with increasing metabolisable energy content (4.93, 8.65, 9.41, 10.12 and 11.24 MJ/kg dry matter. The logarithm of heat production was regressed against metabolisable energy intake (MEI, and the NEm (kJ/kg0.75 EBW/day were estimated by extrapolation, when MEI was set at zero. The NEm was 239.77 kJ/kg0.75 EBW/day. The animal’s energy and EBW fat contents increased from 11.20 MJ/kg and 208.54 g/kg to 13.54 MJ/kg and 274.95 g/kg of EBW, respectively, as the BW increased from 13 to 28.70 kg. The net energy requirements for EBW gain increased from 13.79 to 16.72 MJ/kg EBW gain for body weights of 13 and 28.70 kg. Our study indicated the net energy requirements for maintenance in Brazilian Somali lambs were similar to the values commonly recommended by the United States’ nutritional system, but lower than the values recommended by Agricultural Research Council and Commonwealth Scientific and Industrial Research Organization. Net requirements for weight gain were less compared to the values commonly recommended by nutritional system of the United States.

  16. Refugee women: the forgotten half.

    Science.gov (United States)

    Ogata, S

    1995-01-01

    The Fourth World Conference on Women in Beijing 1995 presented a global Platform for Action on the consequences of conflict and violence for women. The UN High Commission for Refugees (UNHCR) was given the task of providing international protection and seeking solutions for refugees. Refugees included those who had fled their country, returnees who had come home but were not fully reintegrated and civilians displaced inside their own country. Demographic data was designed for appropriate protection and assistance programs that could be implemented at the outset of any humanitarian crisis. The sample covered Yugoslavian refugees, 64% of whom were female, and Somali women in northern Kenya aged 19-44 years. In humanitarian crises the focus has been on providing basic health care and meeting urgent needs; however, reproductive health has been ignored. Thus, since women have been dynamic actors of change, efforts should be redoubled to ensure that women have access to food, education, health and basic material needs, which would result in the improvement of the health of the whole refugee population.

  17. Development and validation of a postpartum depression risk score in delivered women, Iran

    Directory of Open Access Journals (Sweden)

    Mohammad R Maracy

    2012-01-01

    Full Text Available Background: Investigators describe a dramatic increase in the incidence of mood disorder after childbirth, with the largest risk in the 90 days after delivery. This study is designed to develop a relatively simple screening tool and validate it from the significant variables associated with postpartum depression (PPD to detect delivered women at high risk of having PPD. Materials and Methods: In the cross-sectional study, 6,627 from a total of 7,300 delivered women, 2-12 months after delivery were recruited and screened for PPD. Split-half validation was used to develop the risk score. The training data set was used to develop the model, and the validation data set was used to validate the developed the risk factors of postpartum depression risk score using multiple logistic regression analysis to compute the β coefficients and odds ratio (OR for the dependent variables associated with possible PPD in this study. Calibration was checked using the Hosmer and Lemeshow test. A score for independent variables contributing to PPD was calculated. Cutoff points using a trade-off between the sensitivity and specificity of risk scores derived from PPD model using the Receiver Operating Characteristic (ROC curve. Results: The predicted and observed PPD were not different (P value = 0.885. The aROC with area under the curve (S.E. of 0.611 (0.008 for predicting PPD using the suggested cut-off point of -0.702, the proportion of participants screening positive for PPD was 70.9% (sensitivity (CI 95%; 69.5, 72.3 while the proportion screening negative was 60.1% (specificity (CI 95%; 58.2, 62.1. Conclusion: Despite of the relatively low sensitivity and specificity in this study, it could be a simple, practical and useful screening tool to identify individual at high risk for PPD in the target population.

  18. Comparison of manual and automated AmpliSeq™ workflows in the typing of a Somali population with the Precision ID Identity Panel.

    Science.gov (United States)

    van der Heijden, Suzanne; de Oliveira, Susanne Juel; Kampmann, Marie-Louise; Børsting, Claus; Morling, Niels

    2017-11-01

    The Precision ID Identity Panel was used to type 109 Somali individuals in order to obtain allele frequencies for the Somali population. These frequencies were used to establish a Somali HID-SNP database, which will be used for the biostatistic calculations in family and immigration cases. Genotypes obtained with the Precision ID Identity Panel were found to be almost in complete concordance with genotypes obtained with the SNPforID PCR-SBE-CE assay. In seven SNP loci, silent alleles were identified, of which most were previously described in the literature. The project also set out to compare different AmpliSeq™ workflows to investigate the possibility of using automated library building in forensic genetic case work. In order to do so, the SNP typing of the Somalis was performed using three different workflows: 1) manual library building and sequencing on the Ion PGM™, 2) automated library building using the Biomek ® 3000 and sequencing on the Ion PGM™, and 3) automated library building using the Ion Chef™ and sequencing on the Ion S5™. AmpliSeq™ workflows were compared based on coverage, locus balance, noise, and heterozygote balance. Overall, the Ion Chef™/Ion S5™ workflow was found to give the best results and required least hands-on time in the laboratory. However, the Ion Chef™/Ion S5™ workflow was also the most expensive. The number of libraries that may be constructed in one Ion Chef™ library building run was limited to eight, which is too little for high throughput workflows. The Biomek ® 3000/Ion PGM™ workflow was found to perform similarly to the manual/Ion PGM™ workflow. This argues for the use of automated library building in forensic genetic case work. Automated library building decreases the workload of the laboratory staff, decreases the risk of pipetting errors, and simplifies the daily workflow in forensic genetic laboratories. Copyright © 2017 Elsevier B.V. All rights reserved.

  19. Is female circumcision evolving or dissolving in Norway? A qualitative study on attitudes toward the practice among young Somalis in the Oslo area.

    Science.gov (United States)

    Gele, Abdi A; Sagbakken, Mette; Kumar, Bernadette

    2015-01-01

    Female genital mutilation or female circumcision (FC) is increasingly visible on the global health and development agenda - both as a matter of social justice and equality for women and as a research priority. Norway is one of the global nations hosting a large number of immigrants from FC-practicing countries, the majority from Somalia. To help counteract this practice, Norway has adopted a multifaceted policy approach that employs one of the toughest measures against FC in the world. However, little is known about the impact of Norway's approach on the attitudes toward the practice among traditional FC-practicing communities in Norway. Against this background, this qualitative study explores the attitudes toward FC among young Somalis between the ages of 16 to 22 living in the Oslo and Akershus regions of Norway. Findings indicate that young Somalis in the Oslo area have, to a large extent, changed their attitude toward the practice. This was shown by the participants' support and sympathy toward criminalization of FC in Norway, which they believed was an important step toward saving young girls from the harmful consequences of FC. Most of the uncircumcised girls see their uncircumcised status as being normal, whereas they see circumcised girls as survivors of violence and injustice. Moreover, the fact that male participants prefer a marriage to uncircumcised girls is a strong condition for change, since if uncut girls are seen as marriageable then parents are unlikely to want to circumcise them. As newly arrived immigrants continue to have positive attitudes toward the practice, knowledge of FC should be integrated into introduction program classes that immigrants attend shortly after their residence permit is granted. This study adds to the knowledge of the process of the abandonment of FC among immigrants in Western countries.

  20. Forced residential mobility and social support: impacts on psychiatric disorders among Somali migrants

    Directory of Open Access Journals (Sweden)

    Bhui Kamaldeep

    2012-04-01

    Full Text Available Abstract Background Somali migrants fleeing the civil war in their country face punishing journeys, the loss of homes, possessions, and bereavement. On arrival in the host country they encounter poverty, hostility, and residential instability which may also undermine their mental health. Methods An in-depth and semi-structured interview was used to gather detailed accommodation histories for a five year period from 142 Somali migrants recruited in community venues and primary care. Post-codes were verified and geo-mapped to calculate characteristics of residential location including deprivation indices, the number of moves and the distances between residential moves. We asked about the reasons for changing accommodation, perceived discrimination, asylum status, traumatic experiences, social support, employment and demographic factors. These factors were assessed alongside characteristics of residential mobility as correlates of ICD-10 psychiatric disorders. Results Those who were forced to move homes were more likely to have an ICD-10 psychiatric disorder (OR = 2.64, 1.16-5.98, p = 0.02 compared with those moving through their own choice. A lower risk of psychiatric disorders was found for people with larger friendship networks (0.35, 0.14-0.84, p = 0.02, for those with more confiding emotional support (0.42, 0.18-1.0, p = 0.05, and for those who had not moved during the study period (OR = 0.21, 0.07-0.62, p = 0.01. Conclusions Forced residential mobility is a risk factor for psychiatric disorder; social support may contribute to resilience against psychiatric disorders associated with residential mobility.

  1. "And then one day they all moved to Leicester": the relocation of Somalis from the Netherlands to the UK explained.

    NARCIS (Netherlands)

    Liempt, I.C. van

    2011-01-01

    Since 2000 it is estimated that between 10,000 and 20,000 Somali immigrants have left the Netherlands for the UK. This exceptionally high level of intra-European Union (EU) mobility is in contrast with the general trend of very low levels of intra-EU mobility. Based on 33 in-depth interviews

  2. They receive antenatal care in health facilities, yet do not deliver there: predictors of health facility delivery by women in rural Ghana.

    Science.gov (United States)

    Boah, Michael; Mahama, Abraham B; Ayamga, Emmanuel A

    2018-05-03

    Research has shown that use of antenatal services by pregnant women and delivery in health facilities with skilled birth attendants contribute to better delivery outcomes. However, a gap exists in Ghana between the use of antenatal care provided by health facilities and delivery in health facilities with skilled birth attendants by pregnant women. This study sought to identify the predictors of health facility delivery by women in a rural district in Ghana. This was a cross-sectional study conducted in June 2016. Women who delivered in the past 6 months preceding the study were interviewed. Data on socio-demographic characteristics, use of antenatal care, place of delivery and reasons for home delivery were collected from study participants. Chi-square test and multiple logistic regression analysis were used to assess an association between women's socio-demographic and obstetric characteristics and place of delivery at 95% confidence interval. The study found that 98.8% of women received antenatal care services at least once during their recent pregnancy, and 67.9% attended antenatal care at least four times before delivery. However, 61.9% of the women delivered in a health facility with a skilled attendant. The frequently mentioned reason for home delivery was "unaware of onset of labour and delivery". The odds for delivery at a health facility were reduced among women with four living children [(AOR = 0.07, CI = 0.15-0.36, p = 0.001)], with no exposure to delivery care information [(AOR = 0.06, CI = 0.01-0.34, p = 0.002), who started their first ANC visit from the second trimester of pregnancy[(AOR = 0.003, CI = 0.01-0.15, p facilities although visits to antenatal care sessions were high, an indication that there was the need to intensify health education on early initiation of antenatal care, signs of labour and delivery, and importance of health facility delivery.

  3. Lay explanatory models of depression and preferred coping strategies among Somali refugees in Norway. A mixed method study

    Directory of Open Access Journals (Sweden)

    Valeria Markova

    2016-09-01

    Full Text Available Objective. Refugees are at high risk for mental health problems due to trauma in their pasts and to acculturation stress as they settle in a new country. To develop efficient health services to meet the needs of refugees from various regions, an understanding of how they make sense of and prefer to cope with mental health problems is warranted. This study aims to investigate lay explanatory models of depression and preferred coping strategies among Somali refugees in Norway.Methods. The study used a mixed-method design with a vignette describing a moderately depressed person based on ICD-10 criteria. Firstly, a survey study was performed among Somali refugees (n = 101. Respondents were asked to provide advice to the vignette character, completing the Cross-Cultural Depression Coping Inventory and the General Help-Seeking Questionnaire. Secondly, focus group interviews (n = 10 were done separately with males and females to examine the relationship between the explanatory models of depression and preferred coping strategies.Results. The participants showed a strong preference for coping with depression by religious practices and reliance on family, friends, and their ethnic/religious community rather than seeking professional treatment from public health services (e.g., medical doctors, psychologists. Depressive symptoms were conceptualized as a problem related to cognition (thinking too much and emotion (sadness, but not with biological mechanisms, and were thought to result from spiritual possessions, stress from social isolation, and/or past trauma. Independent of time in exile, the participants showed a strong identification with their ethnic origin and associated values. As participants emphasized the need to obey and follow the viewpoint of elders, fathers, and spiritual leaders, these authorities seemed to be gatekeepers for access to mental health services. Conclusion. The results highlight that mental health programs for Somali refugees

  4. Pseudofaults and associated seamounts in the conjugate Arabian and Eastern Somali basins, NW Indian Ocean - New constraints from high-resolution satellite-derived gravity data

    Science.gov (United States)

    Sreejith, K. M.; Chaubey, A. K.; Mishra, Akhil; Kumar, Shravan; Rajawat, A. S.

    2016-12-01

    Marine gravity data derived from satellite altimeters are effective tools in mapping fine-scale tectonic features of the ocean basins such as pseudofaults, fracture zones and seamounts, particularly when the ocean basins are carpeted with thick sediments. We use high-resolution satellite-generated gravity and seismic reflection data to map boundaries of pseudofaults and transferred crust related to the Paleocene spreading ridge propagation in the Arabian and its conjugate Eastern Somali basins. The study has provided refinement in the position of previously reported pseudofaults and their spatial extensions in the conjugate basins. It is observed that the transferred crustal block bounded by inner pseudofault and failed spreading ridge is characterized by a gravity low and rugged basement. The refined satellite gravity image of the Arabian Basin also revealed three seamounts in close proximity to the pseudofaults, which were not reported earlier. In the Eastern Somali Basin, seamounts are aligned along NE-SW direction forming ∼300 km long seamount chain. Admittance analysis and Flexural model studies indicated that the seamount chain is isostatically compensated locally with Effective Elastic Thickness (Te) of 3-4 km. Based on the present results and published plate tectonic models, we interpret that the seamounts in the Arabian Basin are formed by spreading ridge propagation and are associated with pseudofaults, whereas the seamount chain in the Eastern Somali Basin might have probably originated due to melting and upwelling of upper mantle heterogeneities in advance of migrating/propagating paleo Carlsberg Ridge.

  5. Comparing a telephone- and a group-delivered diabetes prevention program

    DEFF Research Database (Denmark)

    S, Lim; Dunbar, James; Versace, Vin

    2017-01-01

    Aims To explore the acceptability of a telephone- or a group-delivered diabetes prevention program for women with previous gestational diabetes and to compare the characteristics associated with program engagement. Methods Postpartum women participated in a lifestyle modification program delivere...

  6. Attitudes toward Female Circumcision among Men and Women in Two Districts in Somalia: Is It Time to Rethink Our Eradication Strategy in Somalia?

    Directory of Open Access Journals (Sweden)

    Abdi A. Gele

    2013-01-01

    Full Text Available Somalia has the highest global prevalence (98% of female circumcision (FC, and, despite a long history of abandonment efforts, it is not clear as to whether or not these programmes have changed people’s positive attitudes toward the practice. Against this background, this paper explores the attitudes of Somalis living in Hargeisa and Galkayo districts to the practice of FC. Methods. A purposive sampling of 24 Somalis, including activists and practitioners, men and women, was conducted in Somalia. Unstructured interviews were employed to explore the participants' knowledge of FC, their attitudes toward the continuation/discontinuation of the practice, and the type they want to continue or not to continue. Result. The findings of this qualitative study indicate that there is a strong resistance towards the abandonment of the practice in Somalia. The support for the continuation of Sunna circumcision is widespread, while there is a quite large rejection of Pharaonic circumcision. Conclusion. Therefore, since the “zero tolerance policy” has failed to change people’s support for the continuation of the practice in Somalia, programmes that promote the pinch of the clitoral skin and verbal alteration of status, with the goal of leading to total abandonment of FC, should be considered for the Somali context.

  7. Service quality of delivered care from the perception of women with caesarean section and normal delivery.

    Science.gov (United States)

    Tabrizi, Jafar S; Askari, Samira; Fardiazar, Zahra; Koshavar, Hossein; Gholipour, Kamal

    2014-01-01

    Our aim was to determine the service quality of delivered care for people with Caesarean Section and Normal Delivery. A cross-sectional study was conducted among 200 people who had caesarean section and normal delivery in Al-Zahra Teaching Hospital in Tabriz, north western Iran. Service quality was calculated using: Service Quality = 10 - (Importance × Performance) based on importance and performance of service quality aspects from the postpartum women's perspective.A hierarchical regression analysis was applied in two steps using the enter method to examine the associations between demographics and SQ scores. Data were analysed using the SPSS-17 software. "Confidentiality", "autonomy", "choice of care provider" and "communication" achieved scores at the highest level of quality; and "support group", "prompt attention", "prevention and early detection", "continuity of care", "dignity", "safety", "accessibility and "basic amenities" got service quality score less than eight. Statistically significant relationship was found between service quality score and continuity of care (P=0.008). A notable gap between the participants‟ expectations and what they have actually received in most aspects of provided care. So, there is an opportunityto improve the quality of delivered care.

  8. Ethnic disparity in stillbirth and infant mortality in Denmark 1981-2003

    DEFF Research Database (Denmark)

    Villadsen, Sarah Fredsted; Mortensen, Laust Hvas; Andersen, Anne-Marie Nybo

    2009-01-01

    .60-2.77) for Somali women. The relative risks of infant mortality were 1.41 (1.22-1.63), 1.88 (1.53-2.30), 1.39 (1.03-1.89) for children born of Turkish, Pakistani, and Somali mothers, respectively. The fetal and infant mortality in offspring of Lebanese and Former Yugoslavian women was not different from...... the mortality in the Danish group. The differences found were, in general, not attributable to ethnic differences in socioeconomic position. Turkish, Pakistani, and Somali children had an excess relative risk of infant death due to congenital malformations and the risk of death of perinatal causes was increased...... among the Pakistani offspring. CONCLUSION: Among the five largest ethnic minorities, the Turkish. Pakistani, and Somali population had substantially higher fetal and infant mortality compared to the Danish majority population, while the Lebanese and Former Yugoslavian minorities were at the same level...

  9. Creating a roadmap for delivering gender-sensitive comprehensive care for women Veterans: results of a national expert panel.

    Science.gov (United States)

    deKleijn, Miriam; Lagro-Janssen, Antoine L M; Canelo, Ismelda; Yano, Elizabeth M

    2015-04-01

    Women Veterans are a significant minority of users of the VA healthcare system, limiting provider and staff experience meeting their needs in environments historically designed for men. The VA is nonetheless committed to ensuring that women Veterans have access to comprehensive care in environments sensitive to their needs. We sought to determine what aspects of care need to be tailored to the needs of women Veterans in order for the VA to deliver gender-sensitive comprehensive care. Modified Delphi expert panel process. Eleven clinicians and social scientists with expertise in women's health, primary care, and mental health. Importance of tailoring over 100 discrete aspects of care derived from the Institute of Medicine's definition of comprehensive care and literature-based domains of sex-sensitive care on a 5-point scale. Panelists rated over half of the aspects of care as very-to-extremely important (median score 4+) to tailor to the needs of women Veterans. The panel arrived at 14 priority recommendations that broadly encompassed the importance of (1) the design/delivery of services sensitive to trauma histories, (2) adapting to women's preferences and information needs, and (3) sex awareness and cultural transformation in every facet of VA operations. We used expert panel methods to arrive at consensus on top priority recommendations for improving delivery of sex-sensitive comprehensive care in VA settings. Accomplishment of their breadth will require national, regional, and local strategic action and multilevel stakeholder engagement, and will support VA's national efforts at improving customer service for all Veterans.

  10. Effects of polio eradication activities on routine immunization: lessons from the 2013 outbreak response in Somali region of Ethiopia.

    Science.gov (United States)

    Tafesse, Belete; Tekle, Ephrem; Wondwossen, Liya; Bogale, Mengistu; Fiona, Braka; Nsubuga, Peter; Tomas, Karengera; Kassahun, Aron; Kathleen, Gallagher; Teka, Aschalew

    2017-01-01

    Ethiopia experienced several WPV importations with a total of 10 WPV1 cases confirmed during the 2013 outbreak alone before it is closed in 2015. We evaluated supplemental immunization activities (SIAs), including lessons learned for their effect on the routine immunization program during the 2013 polio outbreak in Somali regional state. We used descriptive study to review documents and analyse routine health information system reports from the polio outbreak affected Somali regional state. All data and technical reports of the 15 rounds of polio SIAs from June 2013 through June 2015 and routine immunization coverages for DPT-Hib-HepB 3 and measles were observed. More than 93% of the SIAs were having administrative coverage above 95%. The trend of routine immunization for the two antigens, over the five years (2011 through 2015) did not show a consistent pattern against the number of SIAs. Documentations showed qualitative positive impacts of the SIAs strengthening the routine immunization during all courses of the campaigns. The quantitative impact of polio SIAs on routine immunization remained not so impressive in this study. Clear planning, data consistencies and completeness issues need to be cleared for the impact assessment in quantitative terms, in polio legacy planning as well as for the introduction of injectable polio vaccine through the routine immunization.

  11. Who delivers where? The effect of obstetric risk on facility delivery in East Africa.

    Science.gov (United States)

    Virgo, Sandra; Gon, Giorgia; Cavallaro, Francesca L; Graham, Wendy; Woodd, Susannah

    2017-09-01

    Skilled attendance at birth is key for the survival of pregnant women. This study investigates whether women at increased risk of maternal and newborn complications in four East African countries are more likely to deliver in a health facility than those at lower risk. Demographic and Health Survey data for Kenya 2014, Rwanda 2014-15, Tanzania 2015-16 and Uganda 2011 were used to study women with a live birth in the three years preceding the survey. A three-level obstetric risk index was created using known risk factors. Generalised linear Poisson regression was used to investigate the association between obstetric risk and facility delivery. We analysed data from 13 119 women across the four countries of whom 42-45% were considered at medium risk and 12-17% at high risk, and the remainder were at low risk. In Rwanda, 93% of all women delivered in facilities but this was lower (59-66%) in the other three countries. There was no association between a woman's obstetric risk level and her place of delivery in any country; greater wealth and more education were, however, independently strongly associated with facility delivery. In four East African countries, women at higher obstetric risk were not more likely to deliver in a facility than those with lower risk. This calls for a renewed focus on antenatal risk screening and improved communication on birth planning to ensure women with an increased chance of maternal and newborn complications are supported to deliver in facilities with skilled care. © 2017 John Wiley & Sons Ltd.

  12. Effects of polio eradication activities on routine immunization: lessons from the 2013 outbreak response in Somali region of Ethiopia

    OpenAIRE

    Tafesse, Belete; Tekle, Ephrem; Wondwossen, Liya; Bogale, Mengistu; Fiona, Braka; Nsubuga, Peter; Tomas, Karengera; Kassahun, Aron; Kathleen, Gallagher; Teka, Aschalew

    2017-01-01

    Introduction Ethiopia experienced several WPV importations with a total of 10 WPV1 cases confirmed during the 2013 outbreak alone before it is closed in 2015. We evaluated supplemental immunization activities (SIAs), including lessons learned for their effect on the routine immunization program during the 2013 polio outbreak in Somali regional state. Methods We used descriptive study to review documents and analyse routine health information system reports from the polio outbreak affected Som...

  13. La Somalie en mauvais État

    Directory of Open Access Journals (Sweden)

    Alain Gascon

    2008-05-01

    Full Text Available La Somalie a sombré depuis 1988 dans une guerre civile que rien ne semble pouvoir arrêter. Les chefs de guerre se disputent des portions du territoire en autant de repaires pour y organiser leurs trafics criminels. Expulsés de Mogadiscio par les milices des tribunaux islamiques, ils y sont revenus avec le gouvernement provisoire, réinstallé par l’Éthiopie. Toutefois, au Somaliland, au Nord, les autorités séparatistes ont rétabli la paix sur tout leur territoire, reconstruit les infrastructures et organisé des élections que personne n’a contestées, mais l’ONU, sous la pression conjuguée de la Ligue Arabe et de l’Union africaine, refuse de reconnaître l’indépendance de l’ex-colonie britannique. Après vingt ans d’indifférence à ce lointain conflit, l’État somalien est menacé de disparition.Since 1988 Somalia has sunk into an endless civil war. Warlords have been fighting over parts of the national territory in order to expand their criminal traffics. They were expelled from the capital by the Islamic court militias but they have returned to it when the Provisionnal Government of Somalia was restored by Ethiopia in Mogadisico. Under the pressures of the Arab League and of the African Union the United Nations have constantly refused to recognize the independence of Somaliland, a former British colony, despite its separatist government has brought peace on all their territory, rebuilt equipments and held fair elections. Twenty years of indifference to this remote conflict have threatened the Somalian state to death.

  14. Distribution of maternity units and spatial access to specialised care for women delivering before 32 weeks of gestation in Europe

    DEFF Research Database (Denmark)

    Pilkington, Hugo; Blondel, Béatrice; Papiernik, Emile

    2009-01-01

    Survival and quality of life are improved for very preterm babies when delivery occurs in a maternity unit with on-site neonatal intensive care (level III unit). We investigated the impact of distance on the probability of delivering in such a unit for births before 32 weeks of gestation from 9...... European regions with diverse perinatal health systems (the MOSAIC cohort). We analysed distances between women's homes, and the nearest level III in population quartiles, adjusting for maternal and pregnancy characteristics. Living farther away from a level III reduced access to specialised care...

  15. Future of Food : Shaping the Food System to Deliver Jobs

    OpenAIRE

    Townsend, Robert; Benfica, Rui Manuel; Prasann, Ashesh; Lee, Maria

    2017-01-01

    Shaping the Food System to Deliver Jobs is the fourth paper in a series on The Future of Food. This paper focuses on how the food system can deliver jobs. It provides a framework for understanding the factors determining the number and quality of jobs in the food system, including inclusion of women and youth. It highlights a set of actions that countries can adopt, adapt, and apply to the...

  16. Contraceptive use among migrant women with a history of induced abortion in Finland.

    Science.gov (United States)

    Väisänen, Heini; Koponen, Päivikki; Gissler, Mika; Kontula, Osmo

    2018-06-25

    Women's contraceptive choices may change after an induced abortion, due to contraceptive counselling or a behavioural change prompted by the experience. The effect may vary between women; sociocultural background, for example, may affect their subsequent reproductive choices. We examined whether women's current contraceptive use was differently associated with a history of induced abortion among immigrant groups in Finland (Russian, Kurdish and Somali) and the general Finnish population. We analysed data from two surveys, the Migrant Health and Wellbeing study and the Health 2011 study, linked to the Finnish register of induced abortions. Propensity score weighted logistic regression was used to analyse the data. The likelihood of using contraceptives after an abortion varied depending on women's sociocultural background. A history of induced abortion increased contraceptive use among all groups, except Russian women, in whom there was no effect. The effect was particularly strong for Kurdish women. Sociocultural background was an important determinant of post-abortion contraceptive use. Some immigrants may struggle to navigate the Finnish health care system due to language or literacy issues. Attention should be paid to improving access to family planning among these groups.

  17. Intrinsic structural variation of the complex microsatellite marker MYCL1 in Finnish and Somali populations and its relevance to gastrointestinal tumors

    Directory of Open Access Journals (Sweden)

    Hanna Vauhkonen

    2006-01-01

    Full Text Available The structurally complex MYCL1 microsatellite marker is often used to determine microsatellite instability in colorectal cancers but the allelic variation of this marker has remained largely uncharacterized in both populations and in cancers. Our study describes the allelic distributions of MYCL1 in Finnish (n = 117 and Somali population samples (n = 61 of non-related individuals and compares this distribution with the instability pattern obtained from 61 gastrointestinal tumors.

  18. Trends and inequities in where women delivered their babies in 25 low-income countries: evidence from Demographic and Health Surveys.

    Science.gov (United States)

    Limwattananon, Supon; Tangcharoensathien, Viroj; Sirilak, Supakit

    2011-05-01

    In low-income countries, the coverage of institutional births is low. Using data from the two most recent Demographic and Health Surveys (1995-2001 and 2001-2006) for 25 low-income countries, this study examined trends in where women delivered their babies--public or private facilities or non-institutional settings. More than half of deliveries were in institutional settings in ten countries, mostly public facilities. In the other 15 countries, the majority of births were in women's homes, which was often their only option. Between the two survey periods, all five Asian countries studied (except Bangladesh) had an increase of 10-20 percentage points in institutional coverage, whereas none of the 19 sub-Saharan African countries saw an increase of more than 10 percentage points. More urban women and more in the richest (least poor) quintile gave birth in public or private facilities than rural and poorest quintile women. The rich-poor gap of institutional births was wider than the urban-rural gap. Inadequate public investment in health system infrastructure in rural areas and lack of skilled health professionals are major obstacles in reducing maternal mortality. Governments in low-income countries must invest more, especially in rural maternity services. Strengthening private, for-profit providers is not a policy choice for poor, rural communities. Copyright © 2011 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

  19. Who Delivers without Water? A Multi Country Analysis of Water and Sanitation in the Childbirth Environment.

    Directory of Open Access Journals (Sweden)

    Giorgia Gon

    Full Text Available Hygiene during childbirth is essential to the health of mothers and newborns, irrespective of where birth takes place. This paper investigates the status of water and sanitation in both the home and facility childbirth environments, and for whom and where this is a more significant problem.We used three datasets: a global dataset, with information on the home environment from 58 countries, and two datasets for each of four countries in Eastern Africa: a healthcare facility dataset, and a dataset that incorporated information on facilities and the home environment to create a comprehensive description of birth environments in those countries. We constructed indices of improved water, and improved water and sanitation combined (WATSAN, for the home and healthcare facilities. The Joint Monitoring Program was used to construct indices for household; we tailored them to the facility context-household and facility indices include different components. We described what proportion of women delivered in an environment with improved WATSAN. For those women who delivered at home, we calculated what proportion had improved WATSAN by socio-economic status, education and rural-urban status.Among women delivering at home (58 countries, coverage of improved WATSAN by region varied from 9% to 53%. Fewer than 15% of women who delivered at home in Sub-Saharan Africa, had access to water and sanitation infrastructure (range 0.1% to 37%. This was worse among the poorest, the less educated and those living in rural areas. In Eastern Africa, where we looked at both the home and facility childbirth environment, a third of women delivered in an environment with improved water in Uganda and Rwanda; whereas, 18% of women in Kenya and 7% in Tanzania delivered with improved water and sanitation. Across the four countries, less than half of the facility deliveries had improved water, or improved water and sanitation in the childbirth environment.Access to water and

  20. MENOS4 trial: a multicentre randomised controlled trial (RCT) of a breast care nurse delivered cognitive behavioural therapy (CBT) intervention to reduce the impact of hot flushes in women with breast cancer: Study Protocol.

    Science.gov (United States)

    Fenlon, Deborah; Nuttall, Jacqueline; May, Carl; Raftery, James; Fields, Jo; Kirkpatrick, Emma; Abab, Julia; Ellis, Mary; Rose, Taylor; Khambhaita, Priya; Galanopoulou, Angeliki; Maishman, Tom; Haviland, Jo; Griffiths, Gareth; Turner, Lesley; Hunter, Myra

    2018-05-08

    Women who have been treated for breast cancer may identify vasomotor symptoms, such as hot flushes and night sweats (HFNS), as a serious problem. HFNS are unpleasant to experience and can have a significant impact on daily life, potentially leading to reduced adherence to life saving adjuvant hormonal therapy. It is known that Cognitive Behavioural Therapy (CBT) is effective for the alleviation of hot flushes in both well women and women who have had breast cancer. Most women with breast cancer will see a breast care nurse and there is evidence that nurses can be trained to deliver psychological treatments to a satisfactory level, whilst also maintaining treatment fidelity. The research team will assess whether breast care nurses can effectively deliver a CBT intervention to alleviate hot flushes in women with breast cancer. This study is a multi-centre phase III individually randomised controlled trial of group CBT versus usual care to reduce the impact of hot flushes in women with breast cancer. 120-160 women with primary breast cancer experiencing seven or more problematic HFNS a week will be randomised to receive either treatment as usual (TAU) or participation in the group CBT intervention plus TAU (CBT Group). A process evaluation using May's Normalisation Process Theory will be conducted, as well as practical and organisational issues relating to the implementation of the intervention. Fidelity of implementation of the intervention will be conducted by expert assessment. The cost effectiveness of the intervention will also be assessed. There is a need for studies that enable effective interventions to be implemented in practice. There is good evidence that CBT is helpful for women with breast cancer who experience HFNS, yet it is not widely available. It is not yet known whether the intervention can be effectively delivered by breast care nurses or implemented in practice. This study will provide information on both whether the intervention can effectively

  1. Determination of the delivered hemodialysis dose using standard methods and on-line clearance monitoring

    Directory of Open Access Journals (Sweden)

    Vlatković Vlastimir

    2006-01-01

    Full Text Available Background/aim: Delivered dialysis dose has a cumulative effect and significant influence upon the adequacy of dialysis, quality of life and development of co-morbidity at patients on dialysis. Thus, a great attention is given to the optimization of dialysis treatment. On-line Clearance Monitoring (OCM allows a precise and continuous measurement of the delivered dialysis dose. Kt/V index (K = dialyzer clearance of urea; t = dialysis time; V = patient's total body water, measured in real time is used as a unit for expressing the dialysis dose. The aim of this research was to perform a comparative assessment of the delivered dialysis dose by the application of the standard measurement methods and a module for continuous clearance monitoring. Methods. The study encompassed 105 patients who had been on the chronic hemodialysis program for more than three months, three times a week. By random choice, one treatment per each controlled patient was taken. All the treatments understood bicarbonate dialysis. The delivered dialysis dose was determined by the calculation of mathematical models: Urea Reduction Ratio (URR singlepool index Kt/V (spKt/V and by the application of OCM. Results. Urea Reduction Ratio was the most sensitive parameter for the assessment and, at the same time, it was in the strongest correlation with the other two, spKt/V indexes and OCM. The values pointed out an adequate dialysis dose. The URR values were significantly higher in women than in men, p < 0.05. The other applied model for the delivered dialysis dose measurement was Kt/V index. The obtained values showed that the dialysis dose was adequate, and that, according to this parameter, the women had significantly better dialysis, then the men p < 0.05. According to the OCM, the average value was slightly lower than the adequate one. The women had a satisfactory dialysis according to this index as well, while the delivered dialysis dose was insufficient in men. The difference

  2. Overweight and obesity among African immigrants in Oslo.

    Science.gov (United States)

    Gele, Abdi A; Mbalilaki, Aneth J

    2013-03-26

    Norway is experiencing an increase in overweight/obese adults, with immigrants from developing countries carrying a heavy burden. The aim of this study is to assess the prevalence of overweight and obesity among Somali immigrants in Oslo. A cross-sectional study involving 208 respondents aged 25 and over was conducted among Somali immigrants in Oslo, using a structured questionnaire. Prevalence of overweight/obesity varied by gender, with women having a significantly higher prevalence (66%) than men (28%). The mean BMI for females and males were 27.4 and 23.6, respectively. Similarly, 53% of women and 28% of men were abdominally obese. In a logistic regression analysis, both generalized and abdominal obesity were significantly associated with increasing duration of residence in Norway, and with being less physically active. Public health policymakers should facilitate an environment that enables Somali immigrants, particularly women, to lead healthy lifestyles. In this time of epidemiological transition, health education in the areas of physical exercise and healthy eating should be a major focus for working with new immigrants.

  3. Ante natal care (ANC) utilization, dietary practices and nutritional outcomes in pregnant and recently delivered women in urban slums of Delhi, India: an exploratory cross-sectional study.

    Science.gov (United States)

    Ghosh-Jerath, Suparna; Devasenapathy, Niveditha; Singh, Archna; Shankar, Anuraj; Zodpey, Sanjay

    2015-03-20

    Antenatal Care (ANC) is one of the crucial factors in ensuring healthy outcomes in women and newborns. Nutrition education and counselling is an integral part of ANC that influences maternal and child health outcomes. A cross sectional study was conducted in Pregnant Women (PW) and mothers who had delivered in the past three months; Recently Delivered Women (RDW) in urban slums of North-east district of Delhi, India, to explore ANC utilization, dietary practices and nutritional outcomes. A household survey was conducted in three urban slums to identify PW and RDW. Socio-economic and demographic profile, various components of ANC received including nutrition counselling, dietary intake and nutritional outcomes based on anthropometric indices and anaemia status were assessed. Socio-demographic characteristics, nutrient intake and nutritional status were compared between those who availed ANC versus those who did not using logistic regression. Descriptive summary for services and counselling received; dietary and nutrient intake during ANC were presented. Almost 80% (274 out of 344) women received some form of ANC but the package was inadequate. Determinants for non-utilization of ANC were poverty, literacy, migration, duration of stay in the locality and high parity. Counselling on nutrition was reported by a fourth of the population. Nutrient intake showed suboptimal consumption of protein and micronutrients like iron, calcium, vitamin A, vitamin C, thiamine, riboflavin niacin, zinc and vitamin B12 by more than half of women. A high prevalence of anaemia among PW (85%) and RDW (97.1%) was observed. There was no difference in micronutrient intake and anaemia prevalence among women who received ANC versus who did not. Pregnant women living in urban poor settlements have poor nutritional status. This may be improved by strengthening the nutrition counselling component of ANC which was inadequate in the ANC package received. Empowering community based health workers in

  4. A Randomised Controlled Trial of Therapist-Assisted, Internet-Delivered Cognitive Behavior Therapy for Women with Maternal Depression.

    Directory of Open Access Journals (Sweden)

    Nicole E Pugh

    Full Text Available Postpartum depression impacts up to 15% of Canadian women following childbirth. Remarkably, many women suffering from this disorder do not receive appropriate treatment. The aim of this study was to conduct a parallel-group randomized controlled trial to determine the efficacy of Therapist-Assisted Internet-delivered Cognitive Behavior Therapy (TA-ICBT for the treatment of postpartum depression. This study was registered with the International Standard Randomized Controlled Trials (85456371 and received funding from Canadian Institutes of Health Research (#101526 and the Saskatchewan Health Research Foundation. Fifty women who gave birth to an infant in the past year, who scored above 10 on the Edinburgh Postnatal Depression Scale (EPDS, and who resided in Saskatchewan, Canada were eligible to participate. Participants were randomly assigned to receive either TA-ICBT (n = 25 or waitlist control (n = 25. The efficacy of the treatment was investigated at baseline and at seven- to 10-week follow-up. TA-ICBT participants were also contacted four-weeks following treatment completion. Symptoms of postpartum depression decreased more for participants in the TA-ICBT group (average reduction of 6.24 points on the EPDS; n = 21 included in analyses compared to those participants in the waitlist control group (average reduction of 2.42 points on the EPDS; n = 20 included in analyses, and these results were clinically significant and maintained at four-week follow-up. TA-ICBT participants demonstrated a reduction in postnatal anxiety, general stress, and parental distress, and an increase in psychological and environmental quality of life when compared to the waitlist control participants. Study implications, limitations, and future research directions are discussed. Trial registration: Controlled-Trials.com ISRCTN85456371.

  5. Secondary analysis of a national health survey on factors influencing women in the Philippines to deliver at home and unattended by a healthcare professional.

    Science.gov (United States)

    Sobel, Howard L; Oliveros, Yolanda E; Nyunt-U, Soe

    2010-11-01

    To elucidate factors that influence Philippine women to deliver at home and not be attended by a healthcare professional. Analysis of hospital data that were collected through Global Positioning System technology uploaded into the WHO HealthMapper and data on 7380 women from the Philippines Demographic and Health Survey, 2003. Most of the home deliveries that were not attended by healthcare professionals occurred within 15 km of a hospital. Women who had home deliveries and were not attended by a healthcare professional were more likely to be of low educational and economic status and to reside in rural houses without basic amenities (PFinancial barriers will need to be addressed to increase the number of deliveries in a healthcare facility. The apparent failure of hospitals to reduce newborn mortality may be related to suboptimal newborn care practices. Copyright © 2010 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  6. Effect of feeding Neem (Azadirachta indica) and Acacia (Acacia senegal) tree foliage on nutritional and carcass parameters in short-eared Somali goats.

    Science.gov (United States)

    Hailemariam, Samson; Urge, Mengistu; Menkir, Sissay

    2016-02-01

    The study was conducted to determine the effects of dried foliage of Acacia senegal and Neem (Azadirachta indica) tree supplementations on feed intake, nutrient digestibility, growth, and carcass parameters in short-eared Somali goats. Twenty male intact short-eared Somali goat yearlings with an average live weight of 16.2 ± 1.08 (Mean ± SD) were assigned to four treatment groups, which comprised a basal diet of hay alone (T1) and supplementation with the tree foliages. Supplements consisted Neem tree (T2), A. senegal (T3) and the mixture of the two (1:1 ratio; T4) dried foliages. The crude protein (CP) content of Neem tree foliage, A. senegal, and their mixture were 16.92, 17.5 and 17.01 % of dry matter (DM), respectively. Total DM intake and digestibility of DM and organic matter were significantly (P senegal (67 %). The final body weights were higher (P Senegal. An average daily body weight (BW) gain was higher (P senegal (8.3 kg) among the supplemented groups, all of which are higher than the control (4.9 kg). It is concluded that the supplementation with tree foliage, especially with A. senegal tree foliage, on grass hay encouraged a better utilization of nutrients and animal performance as compared to goats fed on a basal diet of grass hay only.

  7. Inadequate knowledge of neonatal danger signs among recently delivered women in southwestern rural Uganda: a community survey.

    Directory of Open Access Journals (Sweden)

    Jacob Sandberg

    Full Text Available BACKGROUND: Early detection of neonatal illness is an important step towards improving newborn survival. Every year an estimated 3.07 million children die during their first month of life and about one-third of these deaths occur during the first 24 hours. Ninety-eight percent of all neonatal deaths occur in low- and middle-income countries like Uganda. Inadequate progress has been made globally to reduce the amount of neonatal deaths that would be required to meet Millennium Development Goal 4. Poor knowledge of newborn danger signs delays care seeking. The aim of this study was to explore the knowledge of key newborn danger signs among mothers in southwestern Uganda. METHODS: Results from a community survey of 765 recently delivered women were analyzed using univariate and multivariate logistic regressions. Six key danger signs were identified, and spontaneous responses were categorized, tabulated, and analyzed. RESULTS: Knowledge of at least one key danger sign was significantly associated with being birth prepared (adjusted OR 1.7, 95% CI 1.2-2.3. Birth preparedness consisted of saving money, identifying transportation, identifying a skilled birth attendant and buying a delivery kit or materials. Overall, respondents had a poor knowledge of key newborn danger signs: 58.2% could identify one and 14.8% could identify two. We found no association between women attending the recommended number of antenatal care visits and their knowledge of danger signs (adjusted OR 1.0, 95% CI 0.8-1.4, or between women using a skilled birth attendant at delivery and their knowledge of danger signs (adjusted OR 1.2, 95% CI 0.9-1.7. CONCLUSIONS: Our findings indicate the need to enhance education of mothers in antenatal care as well as those discharged from health facilities after delivery. Further promotion of birth preparedness is encouraged as part of the continuum of maternal care.

  8. Effectiveness of a facebook-delivered physical activity intervention for post-partum women: a randomized controlled trial protocol.

    Science.gov (United States)

    Kernot, Jocelyn; Olds, Tim; Lewis, Lucy K; Maher, Carol

    2013-05-29

    Physical activity is reduced during the post-partum period. Facebook is frequently used by Australian mothers, and offers flexibility, high levels of engagement and the ability to disseminate information and advice via social contacts. The Mums Step it Up Program is a newly developed 50 day team-based physical activity intervention delivered via a Facebook app. The program involves post-partum women working in teams of 4-8 friends aiming to achieve 10,000 steps per day measured by a pedometer. Women are encouraged to use the app to log their daily steps and undertake social and supportive interactions with their friends and other participants. This study aims to determine the effectiveness of the Mums Step it Up Program. A sample of 126 women up to 12 months post-partum will be recruited through community-based health and family services. Participants will be randomly allocated into one of three groups: control, pedometer only and the Mums Step it Up Program. Assessments will be completed at baseline, 6 weeks and 6 months. The primary outcome (objective physical activity) and the secondary outcomes (sleep quality and quantity, depressive symptoms, weight and quality of life) will be used to determine the effectiveness of the Mums Step it Up Program compared with the control and pedometer only groups. Analyses will be undertaken on an intention-to-treat-basis using random effects mixed modeling. The effect of theorized mediators (physical activity attitudes, subjective norms and perceived behavioral control) will also be examined. This study will provide information about the potential of a Facebook app for the delivery of health behavior interventions. If this intervention proves to be effective it will be released on a mass scale and promoted to the general public. Australia and New Zealand Clinical Trials Register: ACTRN12613000069752.

  9. Mapping of lithologic and structural units using multispectral imagery. [Afar-Triangle/Ethiopia and adjacent areas (Ethiopian Plateau, Somali Plateau, and parts of Yemen and Saudi Arabia)

    Science.gov (United States)

    Kronberg, P. (Principal Investigator)

    1974-01-01

    The author has identified the following significant results. ERTS-1 MSS imagery covering the Afar-Triangle/Ethiopia and adjacent regions (Ethiopian Plateau, Somali Plateau, and parts of Yemen and Saudi Arabi) was applied to the mapping of lithologic and structural units of the test area at a scale 1:1,000,000. Results of the geological evaluation of the ERTS-1 imagery of the Afar have proven the usefullness of this type of satellite data for regional geological mapping. Evaluation of the ERTS images also resulted in new aspects of the structural setting and tectonic development of the Afar-Triangle, where three large rift systems, the oceanic rifts of the Red Sea and Gulf of Aden and the continental East African rift system, seem to meet each other. Surface structures mapped by ERTS do not indicate that the oceanic rift of the Gulf of Aden (Sheba Ridge) continues into the area of continental crust west of the Gulf of Tadjura. ERTS data show that the Wonji fault belt of the African rift system does not enter or cut through the central Afar. The Aysha-Horst is not a Horst but an autochthonous spur of the Somali Plateau.

  10. BEING DELIVERED: SPIRITUALITY IN SURVIVORS OF SEXUAL VIOLENCE

    Science.gov (United States)

    Knapik, Gregory P.; Martsolf, Donna S.; Draucker, Claire B.

    2011-01-01

    A theoretical framework explaining how survivors of sexual violence use spirituality to respond to or recover from sexual violence is presented. Data were drawn from open-ended interviews of 27 women and 23 men who participated in a larger, ongoing study of women’s and men’s responses to sexual violence. Grounded theory methodology was used to develop the core category of Being Delivered, reflecting the participants’ experiences of being rescued, saved, or set free from the effects of sexual violence by a spiritual being or power. The theoretical framework describing Being Delivered is composed of three dimensions: Spiritual Connection, Spiritual Journey, and Spiritual Transformation. The framework can be used by clinicians to guide discussions of spirituality and healing with survivors of sexual violence. PMID:18382913

  11. Comparison of maternal and newborn outcomes of Tibetan and Han Chinese delivering in Lhasa, Tibet

    Science.gov (United States)

    Miller, Suellen; Tudor, Carrie; Thorsten, Vanessa; Nyima; Sonam; Droyoung; Wright, Linda; Varner, Michael

    2009-01-01

    Aim To compare maternal and neonatal outcomes of Tibetan and Han Chinese women delivering vaginally at high altitude (3650 meters) in Lhasa, Tibet Autonomous Region, People’s Republic of China. Method Comparative analysis of data from a prospective observational study of Tibetan (n = 938) and Han Chinese (n = 146) women delivering at three hospitals between January 2004 and May 2005. Results Han Chinese women had higher rates of pre-eclampsia/gestational hypertension than Tibetan women, (10.3% vs 5.9%, P = 0.04). There was no difference in rates of postpartum hemorrhage between Tibetan and Han women (12.8% vs 17.1%, P = 0.15). Han newborns weighed significantly less than Tibetan newborns (P < 0.01), and were twice as likely to be small for gestational age, (24.5% vs 11.6%, P < 0.01). Tibetan newborns were less likely to have poor neonatal outcomes than Han newborns (P < 0.01). Conclusion In high altitude deliveries in Tibet, adverse outcomes were significantly more common among Han Chinese. PMID:19012697

  12. Pregnant in a foreign city: A qualitative analysis of diet and nutrition for cross-border migrant women in Cape Town, South Africa.

    Science.gov (United States)

    Hunter-Adams, Jo; Rother, Hanna-Andrea

    2016-08-01

    How do migrant women navigate their food environment during pregnancy? Foods are imbued with new meanings in a new place, and in low-and-middle-income countries including South Africa, a changing food environment leaves the poor, including many migrants, vulnerable to malnutrition. Thus, one of the ways economic and social vulnerability may be experienced and reproduced is via the foods one consumes. Examining food perceptions in the context of pregnancy offers a potentially powerful lens on wellbeing. Nine focus group discussions (N = 48) with Somali, Congolese, and Zimbabwean men and women, and 23 in-depth interviews with Congolese, Somali and Zimbabwean women living in Cape Town were conducted, exploring maternal and infant nutrition. We used thematic analysis to guide analysis. (1) Participants described longing for self-categorised "traditional" foods, yet had limited access and little time and space to prepare these foods in the manner they had back home. (2) Sought-after foods available-and even celebratory-for migrants in Cape Town during pregnancy tended to be calorie-dense, nutrient poor fast foods and junk foods. (3) The fulfilment of cravings was presented as the embodiment of health during pregnancy. (4) Iron-folic acid supplementation was perceived as curative rather than preventive. (5) While participants did not describe hunger during pregnancy, food scarcity seemed possible. Food perceptions during pregnancy reflected migrants' orientation towards home. Fast foods were widely acceptable and available during pregnancy. These foods were not perceived to have negative health consequences. Nutrition interventions targeting migrants should consider the symbolic nature of food, the increasingly globalised food environment in urban LMIC settings, as well as the contexts in which health perceptions evolve. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. Neoliberal Sexual Humanitarianism and Story-Telling: The case of Somaly Mam

    Directory of Open Access Journals (Sweden)

    Heidi Hoefinger

    2016-09-01

    Full Text Available Stories of trafficking into the sex industry in Cambodia are a popular feature in local and international media, academic and development literature, policy and humanitarian debates, social and political discourse, and NGO interventions. These stories are powerful for their ability to evoke deep emotions and outrage from their intended audiences. However, they are equally powerful for the ways in which they can cause harm—namely to already marginalised populations of migrants and people involved in the sex trade either by choice, circumstance or coercion. One of the most contentious contemporary trafficking stories is that of the controversial case of Somaly Mam—the self-declared ‘sex slave’ turned ‘modern-day hero’. This paper outlines Mam’s prolific trajectory of self-representation according to the tropes of sexual humanitarianism and argues that these narratives helped to set in motion one of the most lucrative, and in many ways, most exploitative and problematic anti-trafficking endeavours in Cambodia, to date. The paper concludes with offering suggestions for how the anti-trafficking industry might better address real cases of trafficking and exploitation by focusing on structural violence and systemic injustice rather than on sensationalised humanitarian rhetoric, which can perpetuate harms.

  14. A Multilevel Approach to Breastfeeding Promotion: Using Healthy Start to Deliver Individual Support and Drive Collective Impact.

    Science.gov (United States)

    Leruth, Chelsey; Goodman, Jacqueline; Bragg, Brian; Gray, Dara

    2017-12-01

    Purpose Breastfeeding has been linked to a host of positive health effects for women and children. However, disparities in breastfeeding initiation and duration prevent many low-income and African-American women from realizing these benefits. Existing breastfeeding promotion efforts often do not reach women who need support the most. In response, the Westside Healthy Start program (WHS), located in Chicago, Illinois, developed an ongoing multilevel approach to breastfeeding promotion. Description Key elements of our WHS breastfeeding model include individual education and counseling from pregnancy to 6 months postpartum and partnership with a local safety-net hospital to implement the Baby-Friendly Hospital Initiative and provide lactation support to delivering patients. Assessment In the year our model was implemented, 44.6% (49/110) of prenatal WHS participants reported that they planned to breastfeed, and 67.0% (183/273) of delivered participants initiated. Among participants reaching 6 months postpartum, 10.5% (9/86) were breastfeeding. WHS also had 2667 encounters with women delivering at our partner hospital during breastfeeding rounds, with 65.1% of contacts initiating. Community data was not available to assess the efficacy of our model at the local level. However, WHS participants fared better than all delivering patients at our partner hospital, where 65.0% initiated in 2015. Conclusion Healthy Start programs are a promising vehicle to improve breastfeeding initiation at the individual and community level. Additional evaluation is necessary to understand barriers to duration and services needed for this population.

  15. Self-reported prenatal oral health-care practices of preterm low birth weight-delivered women belonging to different socioeconomic status: A postnatal survey.

    Science.gov (United States)

    Elangovan, Gayathri Priyadarshni; Muthu, Jananni; Periyasamy, Indra Kumar; Balu, Pratebha; Kumar, R Saravana

    2017-01-01

    The differences in the oral health status between the individuals with a high socioeconomic status (SES) and those with a low SES had markedly increased. There is, however, minimal information available on women understanding the need of dental hygiene for overall health and whether pregnant women comply with the current oral health strategies. In Lieu with the above, the present study aims to assess the awareness, dental hygiene practices, and the frequency of dental visits during pregnancy in postnatal women who delivered preterm low birth weight babies of different SES in and around Puducherry. A total of 200 individuals who visited Rajiv Gandhi Maternity Centre, Puducherry for delivery were selected. Information regarding onset of prenatal care, referral to dentist, and oral hygiene habits such as frequency of brushing, type of brush used, method of brushing, and frequency of brush change were obtained. Periodontal health status was recorded using PSR system. Awareness of oral hygiene practices was more among upper middle class and lower middle class compared to upper lower strata. Visit to dentist during perinatal period was high among upper middle class compared to other socioeconomic strata. The awareness of oral health-care practices and importance of oral care during perinatal period were less among low socioeconomic strata.

  16. Afraid of Delivering at the Hospital or Afraid of Delivering at Home: A Qualitative Study of Thai Hmong Families' Decision-Making About Maternity Services.

    Science.gov (United States)

    Culhane-Pera, Kathleen A; Sriphetcharawut, Sarinya; Thawsirichuchai, Rasamee; Yangyuenkun, Wirachon; Kunstadter, Peter

    2015-11-01

    Thailand has high rates of maternity services; both antenatal care (ANC) and hospital delivery are widely used by its citizens. A recent Northern Thailand survey showed that Hmong women used maternity services at lower rates. Our objectives were to identify Hmong families' socio-cultural reasons for using and not using maternity services, and suggest ways to improve Hmong women's use of maternity services. In one Hmong village, we classified all 98 pregnancies in the previous 5 years into four categories: no ANC/home birth, ANC/home, no ANC/hospital, ANC/hospital. We conducted life-history case studies of 4 women from each category plus their 12 husbands, and 17 elders. We used grounded theory to guide qualitative analysis. Families not using maternity services considered pregnancy a normal process that only needed traditional home support. In addition, they disliked institutional processes that interfered with cultural birth practices, distrusted discriminatory personnel, and detested invasive, involuntary hospital procedures. Families using services perceived physical needs or potential delivery risks that could benefit from obstetrical assistance not available at home. While they disliked aspects of hospital births, they tolerated these conditions for access to obstetrical care they might need. Families also considered cost, travel distance, and time as structural issues. The families ultimately balanced their fear of delivering at home with their fear of delivering at the hospital. Providing health education about pregnancy risks, and changing healthcare practices to accommodate Hmong people's desires for culturally-appropriate family-centered care, which are consistent with evidence-based obstetrics, might improve Hmong women's use of maternity services.

  17. Northern and Southern Somali on the outskirts of Aarhus – a linguistic ethnographic analysis of language and belonging across time and space

    DEFF Research Database (Denmark)

    Daugaard, Line Møller

    -layered and ambivalent ways. The paper is based on a linguistic ethnographic study of language teaching across the curriculum in a Year 2 class in a public primary school in Denmark (Daugaard 2015). Using fieldwork as overarching research strategy, I followed obligatory teaching in Danish and English as well as ‘mother...... tongue teaching’ in Arabic, Dari, Pashto and Somali. The empirical material consists of fieldnotes, photographs, video and audio recordings and texts collected during participant observation in the language classroom, supplemented by interviews with children, mother tongue teachers and school management....

  18. Detection of Rickettsia aeschlimannii and Rickettsia africae in ixodid ticks from Burkina Faso and Somali Region of Ethiopia by new real-time PCR assays.

    Science.gov (United States)

    Tomassone, L; De Meneghi, D; Adakal, H; Rodighiero, P; Pressi, G; Grego, E

    2016-10-01

    In the framework of cooperation for development projects in Burkina Faso and Ethiopia, we collected ixodid ticks from cattle, small ruminants and camels. We optimized new TaqMan Probe real-time PCR assays to detect Rickettsia aeschlimannii and Rickettsia africae OmpA gene in the collected samples. Rickettsia africae was identified in 75.0% Amblyomma variegatum (95%CI: 56.6-88.5), while R. aeschlimannii in 24.0% Hyalomma truncatum (95%CI: 9.4-45.1) and 50.0% H. rufipes (95%CI: 29.9-70.0) collected from cattle in different provinces throughout Burkina Faso. Ticks from the Libaan zone, Somali Region of Ethiopia, were also infected by R. africae (28.5% prevalence in Amblyomma gemma, 95%CI: 14.7-46.0) and R. aeschlimannii (27.0% H. truncatum, 95%CI: 5.0-62.9; 88.3% H. rufipes, 95%CI: 60.5-99.3). All tested ticks were adults. The developed diagnostic tools were highly sensitive and enabled us to rapidly classify R. aeschlimannii and R. africae, which were identified in Burkina Faso and in the Somali Region of Ethiopia for the first time. Further studies are needed to assess the zoonotic risk and prevalence of infection in local human populations, who have high contact rates with ticks and their animal hosts. Copyright © 2016 Elsevier GmbH. All rights reserved.

  19. The Impact of Acculturation Style and Acculturative Hassles on the Mental Health of Somali Adolescent Refugees.

    Science.gov (United States)

    Lincoln, Alisa K; Lazarevic, Vanja; White, Matthew T; Ellis, B Heidi

    2016-08-01

    Refugee adolescents often immigrate to a new society because of experiences of persecution and trauma, which can have profound effects on their mental health. Once they immigrate, many refugees experience stressors related to resettlement and acculturation in the new society. The current study examined relationships among acculturation styles and hassles and the well-being of young refugees as well as the role of gender. Data were collected from 135 young refugees (M age = 15.39, SD = 2.2; 62 % male) from Somalia resettled in the United States The findings from our study indicate that in addition to trauma history, acculturative hassles and acculturation style impact the wellbeing of Somali refugee adolescents. These findings indicate the need to understand both past experiences as well as current challenges. Potential areas for intervention are discussed.

  20. Cost-effectiveness of peer-delivered interventions for cocaine and alcohol abuse among women: a randomized controlled trial.

    Directory of Open Access Journals (Sweden)

    Jennifer Prah Ruger

    Full Text Available To determine whether the additional interventions to standard care are cost-effective in addressing cocaine and alcohol abuse at 4 months (4 M and 12 months (12 M from baseline.We conducted a cost-effectiveness analysis of a randomized controlled trial with three arms: (1 NIDA's Standard intervention (SI; (2 SI plus a Well Woman Exam (WWE; and, (3 SI, WWE, plus four Educational Sessions (4ES.To obtain an additional cocaine abstainer, WWE compared to SI cost $7,223 at 4 M and $3,611 at 12 M. Per additional alcohol abstainer, WWE compared to SI cost $3,611 and $7,223 at 4 M and 12 M, respectively. At 12 M, 4ES was dominated (more costly and less effective by WWE for abstinence outcomes.To our knowledge, this is the first cost-effectiveness analysis simultaneously examining cocaine and alcohol abuse in women. Depending on primary outcomes sought and priorities of policy makers, peer-delivered interventions can be a cost-effective way to address the needs of this growing, underserved population.ClinicalTrials.gov NCT01235091.

  1. C-SAFE: A Computer-Delivered Sexual Health Promotion Program for Latinas.

    Science.gov (United States)

    Klein, Charles H; Kuhn, Tamara; Altamirano, Midori; Lomonaco, Carmela

    2017-07-01

    This article describes the development and evaluation of C-SAFE (Sexual Awareness for Everyone), a computer-delivered sexual health promotion program for Latinas. We first describe the process of adapting an evidence-based, group-level intervention into an individually administered computer-delivered program. We then present the methods and results of a randomized control trial with 321 Latinas in California and Florida to test C-SAFE's preliminary efficacy in reducing sexual health risk. We found no statistically significant differences between the two conditions at a six-month follow-up in terms of sexual behaviors or attitudes toward sexually transmitted infections and condoms, although C-SAFE women reported fewer days in the past month when their mental health was not good (p = .02). C-SAFE condition women also reported more satisfaction than control condition women in their assessment of information presentation (on a scale of 1 = poor and 5 = excellent; C-SAFE = 4.45 vs. control = 4.25, p = .053) and having learned something new (C-SAFE = 95.1% vs. control = 79.3%, χ 2 importance of teachable moments, matching of delivery modalities to implementation contexts, and possible directions for evidence-based sexual health promotion programs given the current sexual health landscape.

  2. Self-reported prenatal oral health-care practices of preterm low birth weight-delivered women belonging to different socioeconomic status: A postnatal survey

    Directory of Open Access Journals (Sweden)

    Gayathri Priyadarshni Elangovan

    2017-01-01

    Full Text Available Background: The differences in the oral health status between the individuals with a high socioeconomic status (SES and those with a low SES had markedly increased. There is, however, minimal information available on women understanding the need of dental hygiene for overall health and whether pregnant women comply with the current oral health strategies. In Lieu with the above, the present study aims to assess the awareness, dental hygiene practices, and the frequency of dental visits during pregnancy in postnatal women who delivered preterm low birth weight babies of different SES in and around Puducherry. Materials and Methods: A total of 200 individuals who visited Rajiv Gandhi Maternity Centre, Puducherry for delivery were selected. Information regarding onset of prenatal care, referral to dentist, and oral hygiene habits such as frequency of brushing, type of brush used, method of brushing, and frequency of brush change were obtained. Periodontal health status was recorded using PSR system. Results: Awareness of oral hygiene practices was more among upper middle class and lower middle class compared to upper lower strata. Visit to dentist during perinatal period was high among upper middle class compared to other socioeconomic strata. Conclusions: The awareness of oral health-care practices and importance of oral care during perinatal period were less among low socioeconomic strata.

  3. Comparison of radiation delivered by current diagnostic procedures for herniated disc

    International Nuclear Information System (INIS)

    Gasquet, C.; Drouineau, J.; Goubault, F.; Hurmic, A.; Lavigne, B.; Vandermarcq, P.

    1983-01-01

    Three methods are currently employed for the diagnosis of sciatica due to disc lesions: radiculography, spinal phlebography, and computed tomography. Though their indications vary according to the author, it seemed worthwhile to compare radiation delivered by each of them, because of the often young age of the patients. Dosimetric studies using a Rando Phantom enabled calculation of doses to the skin, spinal cord, and gonads. Results indicated that low doses were delivered by the scanner, relatively high doses by spinal phlebography, and intermediate doses by radiculography. These findings suggest that the initial examination preoperatively in cases of simple sciatica due to herniated disc should be a CT scan whenever possible. Phlebography, on the contrary, and particularly in young women, should be used only exceptionally, as a result of the high doses delivered to the ovaries even during technically simple explorations [fr

  4. Comparing a telephone- and a group-delivered diabetes prevention program: Characteristics of engaged and non-engaged postpartum mothers with a history of gestational diabetes.

    Science.gov (United States)

    Lim, Siew; Dunbar, James A; Versace, Vincent L; Janus, Edward; Wildey, Carol; Skinner, Timothy; O'Reilly, Sharleen

    2017-04-01

    To explore the acceptability of a telephone- or a group-delivered diabetes prevention program for women with previous gestational diabetes and to compare the characteristics associated with program engagement. Postpartum women participated in a lifestyle modification program delivered by telephone (n=33) or group format (n=284). Semi-structured interviews on barriers and enablers to program engagement (defined as completing≥80% sessions) were conducted before (Group) and after (Group and Telephone) interventions. The Health Action Process Approach theory was used as the framework for inquiry. Psychological measures were compared between engagement subgroups before and after group-delivered intervention. In the telephone-delivered program 82% participants met the engagement criteria compared with 38% for the group-delivered program. Engaged participants (Group) had significantly higher risk perception, outcome expectancy, and activity self-efficacy at baseline (P<0.05). There was a greater decrease in body weight (-1.45±3.9 vs -0.26±3.5, P=0.024) and waist circumference (-3.56±5.1 vs -1.24±5.3, P=0.002) for engaged vs non-engaged participants following group program completion. Telephone delivery was associated with greater engagement in postpartum women. Engagement was associated with greater reduction in weight and waist circumference. Further studies are required to confirm the effectiveness of telephone-delivered program for diabetes prevention in postpartum women. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. Pedagogies of Muslim Feminisms: Reflections on Faith, Space and Citizenship

    Science.gov (United States)

    Eidoo, Sameena

    2018-01-01

    In this article, I offer a qualitative study of three spaces created by and for young Muslim women in Toronto, Canada: an after-school drop-in programme for Muslim girls, a Somali women's group and a Muslim women's collective. I focus on data gathered from interviews of seven Muslim women in their 20s who created the spaces, which offered refuge…

  6. Gestational age and birth weight centiles of singleton babies delivered normally following spontaneous labor, in Southern Sri Lanka

    Science.gov (United States)

    Attanayake, K; Munasinghe, S; Goonewardene, M; Widanapathirana, P; Sandeepani, I; Sanjeewa, L

    2018-03-31

    To estimate the gestational age and birth weight centiles of babies delivered normally, without any obstetric intervention, in women with uncomplicated singleton pregnancies establishing spontaneous onset of labour. Consecutive women with uncomplicated singleton pregnancies, attending the Academic Obstetrics and Gynecology Unit of the Teaching Hospital Mahamodara Galle, Sri Lanka, with confirmed dates and establishing spontaneous onset of labor and delivering vaginally between gestational age of 34 - 41 weeks, without any obstetric intervention , during the period September 2013 to February 2014 were studied. The gestational age at spontaneous onset of labor and vaginal delivery and the birth weights of the babies were recorded. There were 3294 consecutive deliveries during this period, and of them 1602 (48.6%) met the inclusion criteria. Median gestational age at delivery was 275 days (range 238-291 days, IQR 269 to 280 days) and the median birth weight was 3000 g (range1700g - 4350g; IQR 2750-3250g). The 10th, 50th and 90th birth weight centiles of the babies delivered at a gestational age of 275 days were approximately 2570g, 3050g and 3550g respectively. The median gestational age among women with uncomplicated singleton pregnancies who established spontaneous onset of labor and delivered vaginally, without any obstetric intervention, was approximately five days shorter than the traditionally accepted 280 days. At a gestational age of 275 days, the mean birth weight was approximately 3038g and the 50th centile of the birth weight of the babies delivered was approximately 3050g.

  7. Sex preferences among mothers delivering at Patan Hospital.

    Science.gov (United States)

    Chhetri, U D; Ansari, I; Bandary, S; Adhikari, N

    2011-01-01

    High sex ratios at birth (SRB) are seen in China, Taiwan, South Korea, parts of India and Vietnam. The imbalance is the result of son preference, accentuated by declining fertility. Prenatal sex determination and female feticides are common in many countries. It is reflected in sex ratio To determine reasons for the preferences for different sex; to find out whether there is altered sex ratio at birth and to find out whether female feticide are common among women who had abortion. It is a prospective study. Women who had previous history of abortion and had delivered at Patan Hospital in the year 2066 were interviewed as per questionnaires. Among 560 women with total live births of 965, (462 male and 503 female) during their life time the overall sex ratio was 92 male per 100 female birth; total abortions were 663. Preferences for male were 10%, female 15.4% and either was for 74%. The reason for male preference was to continue family lineage, to bring honor, old age security, and performing funeral rites while the reasons for daughter preferences were that they understand mothers pain, help in household work. The sex ratio of the babies born during the study period was 113 male per 100 female births. The Sex ratio at birth from 1st to 6th deliveries was 61, 79, 101, 210, 286 and 1100 male per 100 female birth respectively. Prenatal sex selection was 8% (by USG) but none had sex selected abortion. Sex ratio of those delivered during the study period was skewed (136 boys per 100 girls) towards male. There was shift in SRB in 4th and subsequent pregnancies in favor of boys. As the male sex ratio increased the number of induced abortion decreased in subsequent pregnancies.

  8. Print versus a culturally-relevant Facebook and text message delivered intervention to promote physical activity in African American women: a randomized pilot trial.

    Science.gov (United States)

    Joseph, Rodney P; Keller, Colleen; Adams, Marc A; Ainsworth, Barbara E

    2015-03-27

    African American women report insufficient physical activity and are disproportionally burdened by associated disease conditions; indicating the need for innovative approaches to promote physical activity in this underserved population. Social media platforms (i.e. Facebook) and text messaging represent potential mediums to promote physical activity. This paper reports the results of a randomized pilot trial evaluating a theory-based (Social Cognitive Theory) multi-component intervention using Facebook and text-messages to promote physical activity among African American women. Participants (N = 29) were randomly assigned to receive one of two multi-component physical activity interventions over 8 weeks: a culturally-relevant, Social Cognitive Theory-based, intervention delivered by Facebook and text message (FI) (n = 14), or a non-culturally tailored print-based intervention (PI) (n = 15) consisting of promotion brochures mailed to their home. The primary outcome of physical activity was assessed by ActiGraph GT3X+ accelerometers. Secondary outcomes included self-reported physical activity, physical activity-related psychosocial variables, and participant satisfaction. All randomized participants (N = 29) completed the study. Accelerometer measured physical activity showed that FI participants decreased sedentary time (FI = -74 minutes/week vs. PI = +118 minute/week) and increased light intensity (FI = +95 minutes/week vs. PI = +59 minutes/week) and moderate-lifestyle intensity physical activity (FI = + 27 minutes/week vs. PI = -34 minutes/week) in comparison to PI participants (all P's  .05). Results of secondary outcomes showed that in comparison to the PI, FI participants self-reported greater increases in moderate-to-vigorous physical activity (FI = +62 minutes/week vs. PI = +6 minutes/week; P = .015) and had greater enhancements in self-regulation for physical activity (P program to a friend

  9. A qualitative study of women's lived experience after deinfibulation in the UK.

    Science.gov (United States)

    Safari, Faezeh

    2013-02-01

    to explore women's experiences of deinfibulation and its aftermath. a qualitative study using semi-structured interviews with data collection via audio-recording and field notes. The audio-recorded interviews were transcribed verbatim and analysed using Interpretive Phenomenological Analysis (IPA) method for qualitative data analysis. recruitment for the study was carried out in an African Well Women Clinic in London, United Kingdom. there were nine women participants of Somali and Eritrean origin who had Female Genital Mutilation (FGM) type III previously and underwent deinfibulation between January 2008 and September 2009. key themes identified were the cultural meaning and social acceptability of deinfibulation; the consequences of deinfibulation within marital relationships; feelings about the appearance of genitalia post deinfibulation and thoughts on reinfibulation. marital factors and stability of the relationship influence the experience of deinfibulation. Those women who said they had discussed deinfibulation with their husband in advance, and that he had agreed to the procedure, reported less problems afterwards. Single women who had deinfibulation before marriage may face more difficulties in terms of social acceptability within their community. sensitivity to social consequences of deinfibulation is important as well as recognition that these consequences vary. When deinfibulation is carried out for medical purposes some women may appreciate the offer of an official letter from a health-care practitioner confirming the medical nature of the procedure. The data suggests that deinfibulated women may dislike the new appearance of their genitalia; therefore, the practicality of performing a concurrent minor cosmetic surgery with deinfibulation procedure may need to be examined. The need for further research conducted in women's primary language is pressing and should explore issues such as the situation of single women, men's knowledge of the complications

  10. Becoming Resilient: Promoting the Mental Health and Well-Being of Immigrant Women in a Canadian Context

    Directory of Open Access Journals (Sweden)

    Judith A. MacDonnell

    2012-01-01

    Full Text Available This paper reports on grounded theory findings that are relevant to promoting the mental health and well-being of immigrant women in Canada. The findings illustrate how relationships among settlement factors and dynamics of empowerment had implications for “becoming resilient” as immigrant women and how various health promotion approaches enhanced their well-being. Dimensions of empowerment were embedded in the content and process of the feminist health promotion approach used in this study. Four focus groups were completed in Toronto, Ontario, Canada with 35 racialized immigrant women who represented diverse countries of origin: 25 were from Africa; others were equally represented from South Asia (5, Asia (5, and Central or South America and the Caribbean (5. Participants represented diverse languages, family dynamics, and educational backgrounds. One focus group was conducted in Somali; three were conducted in English. Constructivist grounded theory, theoretical sampling, and a critical feminist approach were chosen to be congruent with health promotion research that fostered women’s empowerment. Findings foreground women’s agency in the study process, the ways that immigrant women name and frame issues relevant to their lives, and the interplay among individual, family, community, and structural dynamics shaping their well-being. Implications for mental health promotion are discussed.

  11. The Mediterranean diet adherence by pregnant women delivering prematurely: association with size at birth and complications of prematurity.

    Science.gov (United States)

    Parlapani, Elisavet; Agakidis, Charalampos; Karagiozoglou-Lampoudi, Thomais; Sarafidis, Kosmas; Agakidou, Eleni; Athanasiadis, Apostolos; Diamanti, Elisavet

    2017-11-13

    The Mediterranean diet (MD) is associated with decreased risk of metabolic syndrome and gestational diabetes due to the anti-inflammatory and antioxidative properties of its components. The aim was to investigate the potential association of MD adherence (MDA) during pregnancy by mothers delivering prematurely, with intrauterine growth as expressed by neonates' anthropometry at birth and complications of prematurity. This is a single-center, prospective, observational cohort study of 82 women who delivered preterm singletons at post conceptional age (PCA) ≤ 34 weeks and their live-born neonates. Maternal and neonatal demographic and clinical data were recorded. All mothers filled in a food frequency questionnaire, and the MDA score was calculated. Based on 50th centile of MD score, participants were classified into high-MDA and low-MDA groups. The low-MDA mothers had significantly higher pregestational BMI and rates of overweight/obesity (odd ratios (OR) 3.5) and gestational hypertension/preeclampsia (OR 3.8). Neonates in the low-MDA group had significantly higher incidence of intrauterine growth restriction (IUGR) (OR 3.3) and lower z-scores of birth weight and BMI. Regarding prematurity-related complications, the low MDA-group was more likely to develop necrotizing enterocolitis, bronchopulmonary dysplasia, and retinopathy of prematurity (OR 3.2, 1.3, and 1.6, respectively), while they were less likely to develop respiratory distress syndrome (OR 0.49), although the differences were not statistically significant. However, adjustment for confounders revealed MDA as a significant independent predictor of hypertension/preeclampsia, IUGR, birth weight z-score, necrotizing enterocolitis, and bronchopulmonary dysplasia. High MDA during pregnancy may favorably affect intrauterine growth and certain acute and chronic complications of prematurity as well as maternal hypertension/preeclampsia.

  12. Barriers to acceptance of self-sampling for human papillomavirus across ethnolinguistic groups of women.

    Science.gov (United States)

    Howard, Michelle; Lytwyn, Alice; Lohfeld, Lynne; Redwood-Campbell, Lynda; Fowler, Nancy; Karwalajtys, Tina

    2009-01-01

    Immigrant and low socio-economic (SES) women in North America underutilize Papanicolaou screening. Vaginal swab self-sampling for oncogenic human papillomavirus (HPV) has the potential to increase cervical cancer screening participation. The purpose of this qualitative study was to understand the perceptions of lower SES and immigrant women regarding self-sampling for HPV. Eleven focus-group interviews were conducted: one with Canadian-born English-speaking lower SES women, and two groups each with Arabic, Cantonese, Dari (Afghani), Somali and Spanish (Latino)-speaking women (one group conducted in English, the other in the native language) recently immigrated to Canada. Five to nine women aged 35 to 65 years and married with children participated in each group. Themes included 1) who might use self-sampling and why; 2) aversion to self-sampling and reasons to prefer physician; 3) ways to improve the appeal of self-sampling. Women generally perceived benefits of self-sampling and a small number felt they might use the method, but all groups had some reservations. Reasons included: uncertainty over performing the sampling correctly; fear of hurting themselves; concern about obtaining appropriate material; and concerns about test accuracy. Women preferred testing by a health care professional because they were accustomed to pelvic examinations, it was more convenient, or they trusted the results. Perceptions of self-sampling for HPV were similar across cultures and pertained to issues of confidence in self-sampling and need for physician involvement in care. These findings can inform programs and studies planning to employ self-sampling as a screening modality for cervical cancer.

  13. Impact of combat and sexual harassment on the severity of posttraumatic stress disorder among men and women peacekeepers in Somalia.

    Science.gov (United States)

    Fontana, A; Litz, B; Rosenheck, R

    2000-03-01

    The impact of combat and sexual harassment on the severity of posttraumatic stress disorder (PTSD) is compared for 1,307 men and 197 women peacekeepers who served in the same military units. A theoretical model was proposed to express the nature of the impact. Structural equation modeling was used to evaluate the model separately for men and women. Good-fitting, parsimonious models were developed that showed substantial similarity for men and women. For men, severity of PTSD symptoms was impacted by exposure to combat directly and indirectly through fear and sexual harassment. For women, severity of PTSD symptoms was impacted by combat indirectly through the same two influences, although the mechanisms involving fear and sexual harassment were somewhat different. For both genders, moreover, PTSD severity was impacted directly by exposure to the dying of the Somali people. These similarities suggest that in modern stressful overseas military missions, both genders may be susceptible to the same types of risk for the development of PTSD. The incidence and impact of sexual harassment is particularly noteworthy in the case of men and calls for more detailed investigation in future studies.

  14. Affiliative and aggressive behavior in a group of female Somali wild ass (Equus africanus somalicus).

    Science.gov (United States)

    Asa, Cheryl S; Marshall, Fiona; Fischer, Martha

    2012-01-01

    We observed a group of three young female Somali wild asses to develop an ethogram of social behavior in the first phase of a longer term study of social, sexual, and maternal/infant behavior. The most unexpected finding was the frequency and extent of aggressive interactions, which included Charge, Drive, Neck Wrestle, Head Butt, and Body Slam, behaviors previously reported only for males of other equid species. The overall frequency of aggressive behavior was higher than that of affiliative behavior (84±16.5 vs. 32±5.5, P=0.03), yet no injuries occurred. The dyadic directionality of aggressive behavior suggested a dominance hierarchy, a feature not previously reported for either wild ass or domestic donkeys. The aggression observed may be an accurate representation of the behavior of this species, or their relatively young ages, or their recent transfer from their natal group through quarantine and into a new enclosure may have heightened agonistic tendencies. Further studies will determine whether with time their aggressive behavior becomes more intense or dissipates with maturity. © 2011 Wiley Periodicals, Inc.

  15. Incidence of stillbirth and perinatal mortality and their associated factors among women delivering at Harare Maternity Hospital, Zimbabwe: a cross-sectional retrospective analysis

    Directory of Open Access Journals (Sweden)

    Welch Kathy

    2005-05-01

    Full Text Available Abstract Background Death of an infant in utero or at birth has always been a devastating experience for the mother and of concern in clinical practice. Infant mortality remains a challenge in the care of pregnant women worldwide, but particularly for developing countries and the need to understand contributory factors is crucial for addressing appropriate perinatal health. Methods Using information available in obstetric records for all deliveries (17,072 births at Harare Maternity Hospital, Zimbabwe, we conducted a cross-sectional retrospective analysis of a one-year data, (1997–1998 to assess demographic and obstetric risk factors for stillbirth and early neonatal death. We estimated risk of stillbirth and early neonatal death for each potential risk factor. Results The annual frequency of stillbirth was 56 per 1,000 total births. Women delivering stillbirths and early neonatal deaths were less likely to receive prenatal care (adjusted relative risk [RR] = 2.54; 95% confidence intervals [CI] 2.19–2.94 and RR = 2.52; 95% CI 1.63–3.91, which for combined stillbirths and early neonatal deaths increased with increasing gestational age (Hazard Ratio [HR] = 3.98, HR = 7.49 at 28 and 40 weeks of gestation, respectively. Rural residence was associated with risk of infant dying in utero, (RR = 1.33; 95% CI 1.12–1.59, and the risk of death increased with increasing gestational age (HR = 1.04, HR = 1.69, at 28 and 40 weeks of gestation, respectively. Older maternal age was associated with risk of death (HR = 1.50; 95% CI 1.21–1.84. Stillbirths were less likely to be delivered by Cesarean section (RR = 0.64; 95% CI 0.51–0.79, but more likely to be delivered as breech (RR = 4.65; 95% CI 3.88–5.57, as were early neonatal deaths (RR = 3.38; 95% CI 1.64–6.96. Conclusion The frequency of stillbirth, especially macerated, is high, 27 per 1000 total births. Early prenatal care could help reduce perinatal death linking the woman to the health

  16. Juvenile hyposomatotropism in a Somali cat presenting with seizures due to intermittent hypoglycaemia

    Directory of Open Access Journals (Sweden)

    Maya Laura König

    2018-03-01

    Full Text Available Case summary A 3-month-old intact male Somali cat was evaluated for a history of seizures, hypoglycaemia and mental dullness 4 weeks after being bitten in the head by a dog. The cat’s body size and weight were approximately half that of his littermates and its haircoat was woolly, with fewer guard hairs. Multiple hypoglycaemic episodes were documented over a period of 4 weeks, which resolved rapidly after correction of the hypoglycaemia. Juvenile hyposomatotropism was presumptively diagnosed by demonstrating low circulating levels of insulin-like growth factor 1 and after exclusion of other endocrine and non-endocrine causes of small stature and hypoglycaemia. The cat’s intermittent hypoglycaemia resolved spontaneously within 1 month and the cat never showed any more neurological signs. Nevertheless, the physical retardation and the coat abnormalities remained unchanged. A year later, the cat was diagnosed with chronic kidney disease IRIS stage 2. Relevance and novel information Hyposomatotropism is an extremely rare feline endocrinopathy. This is the second case reported in the veterinary literature, and the only one to describe hypoglycaemic events associated with growth hormone deficiency. Although hypoglycaemia is one of the most common disease manifestations in children with pituitary dwarfism, this has not yet been reported in veterinary medicine.

  17. Using the Women's Community Education Approach to Deliver Community Employment Training: A Case Study from Longford Women's Link

    Science.gov (United States)

    Patterson, Lorne; Dowd, Kathleen

    2010-01-01

    The recent economic downturn and surge in unemployment has focused attention on education and training as a strategic response to Ireland's socio-economic crisis. However, that attention has been concentrated on training through statutory institutions, particularly FAS and the VECs. Longford Women's Link, a Women's Community Education centre in Co…

  18. Patient-delivered partner treatment for Trichomonas vaginalis infection: a randomized controlled trial.

    Science.gov (United States)

    Kissinger, Patricia; Schmidt, Norine; Mohammed, Hamish; Leichliter, Jami S; Gift, Thomas L; Meadors, Bernadette; Sanders, Cheryl; Farley, Thomas A

    2006-07-01

    Infections with Trichomonas vaginalis (TV) are common and recurrence rates are high. Better methods of treating partners of women with trichomoniasis are needed. To determine if patient-delivered partner treatment (PDPT) is better and more cost-effective than partner referral. Women attending a family planning clinic who were culture-positive and treated for TV (N = 463) were randomized to either standard partner referral (PR), booklet-enhanced partner referral (BEPR), or PDPT. At baseline and 1 month, women were interviewed and cultured for TV. Detailed cost information was also collected. Most women had 1 partner, were less than 24 years old, and were black. The percentage of women reporting that their partners were treated was similar for PDPT but significantly lower for BEPR compared to PR. TV follow-up rates were similar. PDPT cost less and was cost saving compared to PR and BEPR. Among women with TV, PDPT did not result in more partners taking the medicine or lower follow-up rates than PR but was less costly.

  19. Temperament, post-partum depression, hopelessness, and suicide risk among women soon after delivering.

    Science.gov (United States)

    Girardi, Paolo; Pompili, Maurizio; Innamorati, Marco; Serafini, Gianluca; Berrettoni, Claudia; Angeletti, Gloria; Koukopoulos, Alexia; Tatarelli, Roberto; Lester, David; Roselli, Domenico; Primiero, Francesco M

    2011-07-22

    The aim of the authors in this study was to assess the prevalence of postpartum depression and evaluate the association of affective temperaments with emotional disorders in a sample of 92 pregnant women consecutively admitted for delivery between March and December 2009. In the first few days postpartum, women completed the Suicidal History Self-rating Screening Scale, the Beck Hopelessness Scale, the Edinburgh Postnatal Depression Scale, the Temperament Evaluation of the Memphis, Pisa, Paris and San Diego Autoquestionnaire, and the Gotland Male Depression Scale. Fifty percent of the women reported an Edinburgh Postnatal Depression Scale score of 9 or higher, and 23% a score of 13 or higher. Women with a dysphoric-dysregulated temperament had higher mean scores on the Beck Hopelessness Scale (p Depression Scale (p Depression Scale (p Depression Scale was significantly associated with temperament when controlling for the presence of other variables. Women with a dysphoric-dysregulated temperament were 1.23 times as likely to have higher depressive symptom scores. Future studies should evaluate the effectiveness of psychiatric screening programs in the postpartum period as well as factors associated with depression and suicidality during the same period.

  20. Motivations for Entering the Doula Profession: Perspectives From Women of Color.

    Science.gov (United States)

    Hardeman, Rachel R; Kozhimannil, Katy B

    2016-11-01

    The imperative to diversify the health care workforce is evident: increased diversity contributes to the overall health of the nation. Given persistent racial and ethnic disparities in birth outcomes, workforce diversity is particularly urgent in the context of clinical and supportive care during pregnancy and childbirth. The goal of this analysis was to characterize the intentions and motivations of racially and ethnically diverse women who chose to become doulas (maternal support professionals) and to describe their early doula careers, including the experiences that sustain their work. In 2014, 12 women of color in the Minneapolis, Minnesota, metropolitan area (eg, African American, Somali, Hmong, Latina, American Indian) applied and were selected (from a pool of 58) to receive doula training and certification. In January and February 2015, we conducted semistructured interviews (30 to 90 minutes) with the newly trained doulas. We used an inductive qualitative approach to analyze key themes related to motivation and satisfaction with doula work. For many of the women of color we interviewed, the underlying motivation for becoming a doula was related directly to a desire to support women from the doula's own racial, ethnic, and cultural community. Other key themes related to both motivation and satisfaction included perceiving birth work as a calling, easing women's transitions to motherhood by "holding space," honoring the ritual and ceremony of childbirth, and providing culturally competent support, often as the sole source of cultural knowledge during labor and birth. Doulas of color have a strong commitment to supporting women from their communities. Given the evidence linking doula support to improved birth outcomes, successful recruitment and retention of women of color as doulas may support broader efforts to reduce long-standing disparities in birth outcomes. © 2016 by the American College of Nurse-Midwives.

  1. Maternal care and birth outcomes among ethnic minority women in Finland

    Directory of Open Access Journals (Sweden)

    Gissler Mika

    2009-03-01

    Full Text Available Abstract Background Care during pregnancy and labour is of great importance in every culture. Studies show that people of migrant origin have barriers to obtaining accessible and good quality care compared to people in the host society. The aim of this study is to compare the access to and use of maternity services, and their outcomes among ethnic minority women having a singleton birth in Finland. Methods The study is based on data from the Finnish Medical Birth Register in 1999–2001 linked with the information of Statistics Finland on woman's country of birth, citizenship and mother tongue. Our study data included 6,532 women of foreign origin (3.9% of all singletons giving singleton birth in Finland during 1999–2001 (compared to 158,469 Finnish origin singletons. Results Most women have migrated during the last fifteen years, mainly from Russia, Baltic countries, Somalia and East Europe. Migrant origin women participated substantially in prenatal care. Interventions performed or needed during pregnancy and childbirth varied between ethnic groups. Women of African and Somali origin had most health problems resulted in the highest perinatal mortality rates. Women from East Europe, the Middle East, North Africa and Somalia had a significant risk of low birth weight and small for gestational age newborns. Most premature newborns were found among women from the Middle East, North Africa and South Asia. Primiparous women from Africa, Somalia and Latin America and Caribbean had most caesarean sections while newborns of Latin American origin had more interventions after birth. Conclusion Despite good general coverage of maternal care among migrant origin women, there were clear variations in the type of treatment given to them or needed by them. African origin women had the most health problems during pregnancy and childbirth and the worst perinatal outcomes indicating the urgent need of targeted preventive and special care. These study results

  2. Efeitos genéticos aditivos e não-aditivos em características de crescimento, reprodutivas e habilidade materna em ovinos das raças Santa Inês, Somalis Brasileira, Dorper e Poll Dorset Additive and non-additive genetic effects on growth, reproductive and maternal traits in sheep of Santa In��s, Brazilian Somali, Dorper and Poll Dorset breeds

    Directory of Open Access Journals (Sweden)

    Adriano Caminha Barbosa Neto

    2010-09-01

    Full Text Available Efeitos genético aditivo, de dominância e de recombinação em cruzamentos entre as raças Santa Inês (SI, Somalis Brasileira (So, Dorper (Do e Poll Dorset (Po foram estimados para as características de crescimento, reprodutivas e de habilidade materna. Os dados foram obtidos da Gaasa e Alimentos LTDA, uma empresa que participa do Programa de Melhoramento Genético de Caprinos e Ovinos (GENECOC da Embrapa Caprinos. Inicialmente, 3.573 registros foram analisados por meio do procedimento MIXED do pacote estatístico SAS (1999. As análises foram realizadas considerando os efeitos da diferença genética aditiva entre as raças, de dominância e de recombinação. O peso ao nascer foi influenciado pelos efeitos genéticos aditivos, enquanto o peso ao desmame e o ganho de peso pré-desmame foram influenciados por efeitos genéticos não-aditivos. A estimativa de herdabilidade direta para o peso ao nascer foi moderada, o que indica a existência de variabilidade genética passível de ser explorada por meio da seleção individual. Do mesmo modo, as estimativas de herdabilidade das características idade ao primeiro parto e peso total das crias ao nascer indicaram a existência de variabilidade genética para obter ganhos genéticos por meio da seleção. Os genes das raças Poll Dorset e Dorper tiveram papel importante para melhor desempenho ponderal, portanto, essas raças podem ser indicadas como paternas no cruzamento terminal. A utilização de matrizes F1 Santa Inês x Somalis Brasileira em cruzamentos com reprodutores Poll Dorset pode levar a maior eficiência reprodutiva.Additive genetic, dominance and recombination effects in breedings among Santa Inês (SI, Brazilian Somali (So, Dorper (Do and Poll Dorset (Po breeds were estimated for growth, reproductive and maternal hability traits. Data were obtained from Gaasa e Alimentos LTDA, a company that participates on the Programa de Melhoramento Genético de Caprinos e Ovinos (GENECOC

  3. Beliefs, Perceptions, and Views of Pregnant Women about ...

    African Journals Online (AJOL)

    2018-04-04

    Apr 4, 2018 ... including Europe, Northern America, Japan, Australia, and New Zealand, have an average of 21.1%.[3] Despite the above figures, there has been a rising trend in CS ..... Cultural Traditions and Reproductive Health of Somali. Refugees and Immigrants. Master's Thesis, University of San. Francisco; 2012.

  4. Initiating a different story about immigrant Somali parents’ support of their primary school children’s education

    Directory of Open Access Journals (Sweden)

    Doria Daniels

    2017-08-01

    Full Text Available The ability of parents to nurture and support their children during their primary school years is considered to be fundamental for the child’s development and learning. Teachers and educational psychologists assign great prominence to parental involvement as a tool to advance educational success for children, especially for those who are faced with disadvantages. In the past two decades, we have seen South African schools radically shifting from being racially and ethnically homogenous to becoming culturally, ethnically and linguistically heterogeneous. It is especially the schools in the lower socioeconomic areas that find themselves under tremendous pressure to serve their growing immigrant school population. Not enough is known about the cultural capital that lies embedded in these learners’ home contexts and the roles that their parents play in their education. In this manuscript, I investigate the potential intersectionality of school and home and critique the affiliation between teachers and immigrant parents as an important dimension of learning success in the primary school. I situate the discussion in a community school with a strong Somali immigrant population.

  5. A cluster randomized controlled trial to assess the impact on intimate partner violence of a 10-session participatory gender training curriculum delivered to women taking part in a group-based microfinance loan scheme in Tanzania (MAISHA CRT01): study protocol.

    Science.gov (United States)

    Harvey, Sheila; Lees, Shelley; Mshana, Gerry; Pilger, Daniel; Hansen, Christian; Kapiga, Saidi; Watts, Charlotte

    2018-04-02

    Worldwide, almost one third (30%) of women who have been in a relationship have experienced physical and/or sexual violence from an intimate partner. Given the considerable negative impacts of intimate partner violence (IPV) on women's physical health and well-being, there is an urgent need for rigorous evidence on violence prevention interventions. The study, comprising a cluster randomized controlled trial (RCT) and in-depth qualitative study, will assess the impact on women's past year experience of physical and/or sexual IPV of a participatory gender training curriculum (MAISHA curriculum) delivered to women participating in group-based microfinance in Tanzania. More broadly, the study aims to learn more about the factors that contribute to women's vulnerability to violence and understand how the intervention impacts on the lives of women and their families. Sixty-six eligible microfinance loan groups are enrolled and randomly allocated to: the 10-session MAISHA curriculum, delivered over 20 weeks (n = 33); or, to no intervention (n = 33). Study participants are interviewed at baseline and at 24 months post-intervention about their: household; partner; income; health; attitudes and social norms; relationship (including experiences of different forms of violence); childhood; and community. For the qualitative study and process evaluation, focus group discussions are being conducted with study participants and MAISHA curriculum facilitators. In-depth interviews are being conducted with a purposive sample of 18 participants. The primary outcome, assessed at 24 months post-intervention, is a composite of women's reported experience of physical and/or sexual IPV during the past 12 months. Secondary outcomes include: reported experience of physical, sexual and emotional/psychological IPV during the past 12 months, attitudes towards IPV and reported disclosure of IPV to others. The study forms part of a wider programme of research (MAISHA) that includes

  6. Project LifeSkills - a randomized controlled efficacy trial of a culturally tailored, empowerment-based, and group-delivered HIV prevention intervention for young transgender women: study protocol.

    Science.gov (United States)

    Kuhns, Lisa M; Mimiaga, Matthew J; Reisner, Sari L; Biello, Katie; Garofalo, Robert

    2017-09-16

    Transgender women in the U.S. have an alarmingly high incidence rate of HIV infection; condomless anal and vaginal sex is the primary risk behavior driving transmission. Young transgender women are the subpopulation at the highest risk for HIV. Despite this, there are no published randomized controlled efficacy trials testing interventions to reduce sexual risk for HIV among this group. This paper describes the design of a group-based intervention trial to reduce sexual risk for HIV acquisition and transmission in young transgender women. This study, funded by the National Institutes of Health, is a randomized controlled trial of a culturally-specific, empowerment-based, and group-delivered six-session HIV prevention intervention, Project LifeSkills, among sexually active young transgender women, ages 16-29 years in Boston and Chicago. Participants are randomized (2:2:1) to either the LifeSkills intervention, standard of care only, or a diet and nutrition time- and attention-matched control. At enrollment, all participants receive standardized HIV pre- and post-test counseling and screening for HIV and urogenital gonorrhea and chlamydia infections. The primary outcome is difference in the rate of change in the number of self-reported condomless anal or vaginal sex acts during the prior 4-months, assessed at baseline, 4-, 8-, and 12-month follow-up visits. Behavioral interventions to reduce sexual risk for HIV acquisition and transmission are sorely needed for young transgender women. This study will provide evidence to determine feasibility and efficacy in one of the first rigorously designed trials for this population. ClinicalTrials.gov number, NCT01575938 , registered March 29, 2012.

  7. Prevalence and Distribution of Schistosomiasis in Afder and Gode Zone of Somali Region, Ethiopia

    Science.gov (United States)

    Negussu, Nebiyu; Wali, Mohamed; Ejigu, Milion; Debebe, Fikiru; Aden, Sirage; Abdi, Rashid; Mohamed, Yusuf; Deribew, Amare; Deribe, Kebede

    2013-01-01

    Background: There is no recent information about the prevalence and distribution of schistosomiasis in the Somali national regional state of Ethiopia. Ethiopia launched the national integrated neglected tropical diseases (NTDs) Master Plan in June 2013. The Master Plan identified mapping NTDs as a prerequisite for launching control programs. Therefore it is important to understand the prevalence and distribution of schistosomiasis in respective regions. Materials and Methods: From February to March 2011, a cross-sectional survey was done in school-aged children from six districts of Afder Gode zone. Urine samples were collected and examined for ova of Schistosoma haematobium using the sedimentation technique and stool samples were collected and examined for S. mansoni using the Kato-Katz technique. A semistructured questionnaire was used to collect sociodemographic characteristics of the participants. Results: Of the 523 children, 513 (98%) of them participated in the study. The prevalence of S. haematobium was 16.0% (95% confidence interval (CI); 12.8-19.2). The rate of the disease was not uniform across the various six communities studied (x2 = 208.8, P region with varying distribution across the districts. According to the World Health Organization, mass drug administration should be considered in some of the districts. PMID:24672176

  8. The composition and stability of the vaginal microbiota of normal pregnant women is different from that of non-pregnant women

    DEFF Research Database (Denmark)

    Romero, Roberto; Hassan, Sonia S; Gajer, Pawel

    2014-01-01

    was higher than that of non-pregnant women; however, during normal pregnancy, bacterial communities shift almost exclusively from one CST dominated by Lactobacillus spp. to another CST dominated by Lactobacillus spp. CONCLUSION: We report the first longitudinal study of the vaginal microbiota in normal......BACKGROUND: This study was undertaken to characterize the vaginal microbiota throughout normal human pregnancy using sequence-based techniques. We compared the vaginal microbial composition of non-pregnant patients with a group of pregnant women who delivered at term. RESULTS: A retrospective case......-control longitudinal study was designed and included non-pregnant women (n = 32) and pregnant women who delivered at term (38 to 42 weeks) without complications (n = 22). Serial samples of vaginal fluid were collected from both non-pregnant and pregnant patients. A 16S rRNA gene sequence-based survey was conducted...

  9. The world needs more women scientists | IDRC - International ...

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

    2017-10-23

    Oct 23, 2017 ... The Centre currently supports three flagship women in STEM programs delivered ... In addition, the AIMS Women in STEM Initiative promotes a pan-African ... Teresa de Jesus Palacios, checks her cell phone on her porch.

  10. Training radiographers to deliver an intervention to promote early presentation of breast cancer

    International Nuclear Information System (INIS)

    Burgess, Caroline; Teasdale, Emma; Omar, Lynne; Tucker, Lorraine; Ramirez, Amanda-Jane

    2012-01-01

    Aim: To evaluate the feasibility of training sufficient radiographers to deliver an intervention to promote early presentation of breast cancer to all older women attending for their final routine mammogram within the NHS Breast Screening Programme. If the Promoting Early Presentation (PEP) intervention is demonstrated to be cost-effective, it may be implemented across the NHS requiring at least four radiographers per screening service to deliver the intervention. Methods: A pilot study in a single breast screening service was conducted to assess the feasibility of training sufficient radiographers to meet this objective. Quantitative and qualitative methods were used to evaluate the impact of training on participating radiographers and the screening service. Competency to deliver the intervention was assessed at key points during training according to quality criteria based on delivery of the key messages and style of delivery. Confidence to deliver the intervention was assessed using a self-report measure before and after training. Radiographers' experiences of training were elicited in face-to-face qualitative interviews. Results: Seven of eight radiographers who were released to undertake the training achieved the required level of competency to deliver the intervention within four months. All improved over time in their confidence to deliver the key messages of the intervention. The qualitative analysis revealed the benefits and challenges of training from the perspective of the radiographers. Conclusion: It was feasible and acceptable to train sufficient radiographers to deliver the PEP Intervention. The training package will be streamlined to improve efficiency for large implementation trials and clinical practice across the NHS.

  11. Interpreting habits in a new place: Migrants' descriptions of geophagia during pregnancy.

    Science.gov (United States)

    Hunter-Adams, Jo

    2016-10-01

    Previous studies of soil eating, or geophagia, among pregnant women in sub-Saharan Africa indicate the practice is widespread. Various explanations have been explored to explain the global phenomenon of soil eating, with the most compelling explanation focused on clay's ability to prevent or treat intestinal infection. The urban South African context for clay eating is not well understood. This paper explores clay consumption amongst pregnant migrants who are nationals of countries where clay consumption may be common. I conducted in-depth interviews with a purposively selected group of Somali, Congolese, and Zimbabwean women (n = 23). Interviews included questions broadly related to maternal and infant nutrition. In addition, I conducted nine focus group discussions (n = 48) with adult Somali, Congolese (DRC), and Zimbabwean men (N = 3) and women (N = 6), segregated by country of origin and gender. This paper focuses specifically on responses related to geophagia. While Somali women did not report consuming clay or charcoal, Congolese and Zimbabwean participants self-reported commonly consuming clay during pregnancy, and at times also when not pregnant. Despite having heard public health messaging that discouraged the practice, participants largely did not describe this consumption in terms of health, but rather in terms of craving and habit. Participants described continued consumption of clay in South Africa, and the only reason for ceasing consumption was in cases of severe constipation. The widespread consumption of clay soil by Congolese and Zimbabwean women during pregnancy may be a mechanism through which identity was reasserted and reproduced in a foreign country. Participants' emphasis on clay consumption seemed related to the absence or expense of other craved foods, and perhaps also to feelings of loss in Cape Town. Copyright © 2016 Elsevier Ltd. All rights reserved.

  12. Neonatal outcomes of Syrian refugees delivered in a tertiary hospital in Ankara, Turkey.

    Science.gov (United States)

    Büyüktiryaki, Mehmet; Canpolat, Fuat Emre; Alyamaç Dizdar, Evrim; Okur, Nilüfer; Kadıoğlu Şimşek, Gülsüm

    2015-01-01

    We retrospectively reviewed the medical records of all Syrian immigrants from the TurkishSyrian border who delivered the Zekai Tahir Burak Maternity and Teaching Hospital Neonatal Intensive Care Unit (NICU) in Ankara, Turkey. Between January 2013 and December 2014 a total of 36,346 women gave birth at this center. Of these, 457 women were Syrian immigrants, comprising 1.2 % (457/36,346) of all deliveries. The number of births among Syrian refugees in Turkey appears to be increasing. Further research is needed to understand the relative morbidity of babies born to Syrian refugees compared to the local population, as well as the economic impact on facilities treating these cases.

  13. The effect of prenatal and intrapartum care on the stillbirth rate among women in rural Ethiopia.

    Science.gov (United States)

    Ballard, Karen; Belete, Zelalem; Kinfu, Hirut; Tadesse, Mebkyou; Amin, Mohammed; Atnafu, Habtamu

    2016-05-01

    To determine whether community-based prenatal and intrapartum care in Ethiopia results in a lower stillbirth rate. Between May and December 2014, a randomly selected sample of women in northern and eastern Ethiopia who had delivered a neonate in the preceding 12months completed a face-to-face survey about their experiences of maternal services and the fetal outcome for each delivery. The stillbirth rates among women delivering at home and at health facilities were compared. Overall, 4442 women completed surveys. Stillbirth was reported by 42 (1.7%) of the 2437 women who had received prenatal care and 53 (2.8%) of the 1921 women who did not receive prenatal care (P=0.01). The stillbirth rate was similar among women who delivered in a health center (27/1417 [1.9%]), in a hospital (6/126 [4.8%]), and at home (62/2725 [2.3%]; P=0.13). However, women experiencing an intrapartum emergency were twice as likely to deliver in a health facility (odds ratio 2.6, 95% confidence interval 2.2-3.0). Satisfaction with health-center care was moderately good (median score 77.5/100). The stillbirth rate was reduced among women receiving prenatal care, although delivering in a health facility did not reduce the risk of stillbirth. Improving the quality of health-center care could lead to their planned use for childbirth, which might reduce stillbirth rates. Copyright © 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  14. Childhood lead poisoning in a Somali refugee resettlement community in New Hampshire.

    Science.gov (United States)

    Caron, Rosemary M; Tshabangu-Soko, Thandi; Finefrock, Krysten

    2013-08-01

    Despite the gradual decrease in childhood lead poisoning in the United States, the risk for lead poisoning among African refugee children who resettle in the United States remains elevated. Communication methods implemented by resettlement agencies in the public health system for preventing childhood lead poisoning in this at-risk population warrant further investigation. We utilized structured interviews with key stakeholders (resettlement agencies, social service agencies developed by African refugees and resettled Somali refugees) involved in the refugee resettlement process to (1) describe the agency's role in the refugee resettlement process; (2) examine communication methods utilized and barriers experienced by the public health system in reference to childhood lead poisoning; (3) describe the refugee population's perception of childhood lead poisoning; (4) examine general challenges experienced by the public health system and the refugee population during the resettlement process; and (5) describe stakeholders' recommendations to improve health communication efforts. Based on our findings, we propose that communities are important determinants in health-related problems for refugee populations. Each community has its own environment and public health system that interacts with each other to influence health risks and risk perceptions of its populations. We advocate that understanding a community's ecology and implementing a culture-centered approach is essential for the public health system to help educate and prevent communication inequalities and health disparities among an at-risk African refugee population. This action can reduce a population's resistance to communication and help build a community's capacity to address a persistent public health problem, such as childhood lead poisoning.

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

    African Journals Online (AJOL)

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

  16. Understanding the unique experiences, perspectives and sexual and reproductive health needs of very young adolescents: Somali refugees in Ethiopia.

    Science.gov (United States)

    Ortiz-Echevarria, Luis; Greeley, Meghan; Bawoke, Tenaw; Zimmerman, Linnea; Robinson, Courtland; Schlecht, Jennifer

    2017-01-01

    Kobe Refugee camp hosts roughly 39,000 refugees displaced from Somalia during the 2011-2012 Horn of Africa Crisis. Sexual and reproductive health, as with the greater issues of health and well-being for adolescents displaced from this crisis remain largely unknown and neglected. In 2013, the Women's Refugee Commission, Johns Hopkins University, and International Medical Corps in Ethiopia, implemented qualitative and quantitative research to explore the factors and risks that impact the health of very young adolescents (VYAs), those 10-14 years of age, in this setting. This paper presents findings from the qualitative effort. Focus group discussions (FGD), incorporating community mapping and photo elicitation activities, were conducted with 10-12 and 13-14 year-olds to obtain information about their own perspectives, experiences and values. FGDs were also implemented with 15-16 year-olds and adults, to consider their perspectives on the sexual and reproductive health needs and risks of VYAs. This research identified several factors that were found to influence the health and well-being of VYAs in Kobe refugee camp, including newfound access to education and security, combined with gender divisions and parental communication around early SRH and puberty that remained intact from traditional Somali culture. Girls were found to face an additional risk of child marriage and early pregnancy exacerbated since displacement, which significantly limited their ability to access education and achieve future aspirations. Findings from this study could help to inform future programs in Kobe and similar contexts involving long-term displacement from conflict, focusing on the health and development needs of VYAs. Future programs should consider the determinants of positive VYA health and development, including access to education, gender equity, and safety.By better understanding the unique experiences, perspectives and needs of VYAs, practitioners, policy makers and donors can

  17. Tohoku Women's Hurdling Project: Science Angels (abstract)

    Science.gov (United States)

    Mizuki, Kotoe; Watanabe, Mayuko

    2009-04-01

    Tohoku University was the first National University to admit three women students in Japan in 1913. To support the university's traditional ``open-door'' policy, various projects have been promoted throughout the university since its foundation. A government plan, the Third-Stage Basic Plan for Science and Technology, aims to increase the women scientist ratio up to 25% nationwide. In order to achieve this goal, the Tohoku Women's Hurdling Project, funded by the Japanese Ministry of Education, Culture, Sports, Science and Technology (MEXT), was adopted in 2006. This project is threefold: support for child/family, improvement of facilities, and support for the next generation, which includes our Science Angels program. ``Science Angels'' are women PhD students appointed by the university president, with the mission to form a strong support system among each other and to become role-models to inspire younger students who want to become researchers. Currently, 50 women graduate students of the natural sciences are Science Angels and are encouraged to design and deliver lectures in their areas of specialty at their alma maters. Up to now, 12 lectures have been delivered and science events for children in our community have been held-all with great success.

  18. Gender and enterprise in fragile refugee settings: female empowerment amidst male emasculation-a challenge to local integration?

    Science.gov (United States)

    Ritchie, Holly A

    2018-01-01

    This paper examines gender and enterprise in fragile refugee settings. Building on previous research in Afghanistan, it analyses refugee women's evolving economic lives and enterprise initiatives and related social dynamics in refugee communities. Case studies look specifically at two Islamic refugee contexts: Nairobi, Kenya (Somali refugees), and Irbid and Zarqa, Jordan (Syrian refugees). The discussion spotlights the precarious nature of refugee women's new practices and work norms under forced and strained circumstances, without a process of negotiation with male family members. In the case of longer-term refugees (Somalis), it describes new collective agency among refugee women, boosting support for new practices. The paper reflects on emerging gender roles and relations in such hostile conditions, particularly as men remain excluded and struggle for their own identity and authority. In addition, it draws attention to the gap relating to refugee men and policymaking, and highlights ways to address better their needs for refugee resilience, inclusion, and local integration. © 2018 The Author(s). Disasters © Overseas Development Institute, 2018.

  19. Obstetric outcome in pregnant women subjected to domestic violence.

    Science.gov (United States)

    Ameh, N; Shittu, S O; Abdul, M A

    2009-06-01

    To determine the prevalence of domestic violence and its relationship to adverse obstetric outcomes amongst pregnant women who deliver at a tertiary level hospital in Zaria, Nigeria. A cross-sectional study involving 310 women who delivered at the labour ward. Questionnaires were administered to parturient women. Details of their socio-demographic characteristics and obstetric outcome were compiled and the relationship to experiences of domestic violence studied. The prevalence of domestic violence was 28.4%. There was positive relationship between domestic violence during pregnancy, non-supervision of pregnancy and poor attendances to antenatal clinic (pviolence, and complications of labour and neonatal outcome (p>0.05). The prevalence of domestic violence in pregnancy is high in this environment. Poor attendances to the antenatal clinic is a significant association.

  20. The Impact of Food Consumption, Government Type and Effectiveness, on the Rate of Somali Maritime Piracy, 2000-2008

    Directory of Open Access Journals (Sweden)

    Sam Rohrer

    2011-10-01

    Full Text Available The analysis of maritime piracy off the Horn of Africa is still a developing area of academic research. The work that has been conducted to date has remained largely qualitative.   Two recurring assumptions made but not empirically tested in this area of research are 1 the perceived link between government stability and the rate of maritime piracy, and 2 drought conditions implying food shortages in Somalia, and their impact on the rate of maritime piracy off the Horn of Africa.  The findings of this project show a strong increase in maritime piracy following the transition from assorted Islamic Courts to the Transitional Federal Government (TFG.  However, variations in the consumption of staple foodstuffs, and an index of the World Bank Governance Indicators do not have a significant impact on the frequency of maritime piracy in the region.  If maritime piracy off the Somali coast is to be eliminated, rather than policed, efforts should be made to encourage the development of governmental institutions that utilize culturally-respected institutions supported by the local populace.

  1. Pelvimetry by Three-Dimensional Computed Tomography in Non-Pregnant Multiparous Women Who Delivered Vaginally

    International Nuclear Information System (INIS)

    Salk, Ismail; Cetin, Ali; Salk, Sultan; Cetin, Meral

    2016-01-01

    We assessed retrospectively the reference values of pelvic dimensions by 3D CT performed for non-obstetrical indications in non-pregnant multiparous women with a successful vaginal delivery. We further aimed to evaluate the impact of maternal short stature on these parameters. The 3D CT pelvimetry was performed retrospectively in 203 non-pregnant women selected consecutively if they had at least one singleton term delivery with head presentation and if there was no history of maternal or fetal birth trauma or cerebral palsy after childbirth. With standard sagittal and reformatted axial-oblique views, anteroposterior including three conjugates of pelvic inlet, transverse, posterior sagittal diameters of pelvic inlet, the plane of greatest diameter, the plane of least diameter, and pelvic outlet were measured. Selected obstetric parameters were collected. Overall, the pelvises had transverse oval appearance in inlet and size of the female pelvis. The diagonal conjugate was at least 15 mm longer than the obstetric conjugate. Women with short stature had lower maximal birth weight, and this was in accordance with their somewhat lower pelvic diameters. The findings of this study present the reference values of the main planes of the true pelvis by 3D CT pelvimetry in a relatively large group of multiparous women who passed a trial of labor successfully. Overall, the pelvises had features of female pelvic bony structure although pelvic diameters were somewhat lower in multiparous women with short stature. The 3D pelvimetry with CT applications may be used as an adjunct to clinical and ultrasonographic examinations to rule out cephalopelvic dystocia in selected cases

  2. SisterTalk: final results of a culturally tailored cable television delivered weight control program for Black women

    OpenAIRE

    Risica, Patricia Markham; Gans, Kim M; Kumanyika, Shiriki; Kirtania, Usree; Lasater, Thomas M

    2013-01-01

    Background Obesity among Black women continues to exceed that of other women. Most weight loss programs created without reference to specific cultural contexts are less effective for Black than White women. Weight control approaches accessible to Black women and adapted to relevant cultural contexts are important for addressing this problem. This paper reports the final results of SisterTalk, the randomized controlled trial of a cable TV weight control program oriented toward Black women. Met...

  3. Use of antenatal services and delivery care among women in rural western Kenya: a community based survey

    Directory of Open Access Journals (Sweden)

    Rosen Daniel H

    2006-04-01

    Full Text Available Abstract Background Improving maternal health is one of the UN Millennium Development Goals. We assessed provision and use of antenatal services and delivery care among women in rural Kenya to determine whether women were receiving appropriate care. Methods Population-based cross-sectional survey among women who had recently delivered. Results Of 635 participants, 90% visited the antenatal clinic (ANC at least once during their last pregnancy (median number of visits 4. Most women (64% first visited the ANC in the third trimester; a perceived lack of quality in the ANC was associated with a late first ANC visit (Odds ratio [OR] 1.5, 95% confidence interval [CI] 1.0–2.4. Women who did not visit an ANC were more likely to have 90%, but provision of other services was low, e.g. malaria prevention (21%, iron (53% and folate (44% supplementation, syphilis testing (19.4% and health talks (14.4%. Eighty percent of women delivered outside a health facility; among these, traditional birth attendants assisted 42%, laypersons assisted 36%, while 22% received no assistance. Factors significantly associated with giving birth outside a health facility included: age ≥ 30 years, parity ≥ 5, low SES, 1 hour walking distance from the health facility. Women who delivered unassisted were more likely to be of parity ≥ 5 (AOR 5.7, 95% CI 2.8–11.6. Conclusion In this rural area, usage of the ANC was high, but this opportunity to deliver important health services was not fully utilized. Use of professional delivery services was low, and almost 1 out of 5 women delivered unassisted. There is an urgent need to improve this dangerous situation.

  4. Comparison of manual and automated AmpliSeq™ workflows in the typing of a Somali population with the Precision ID Identity Panel

    DEFF Research Database (Denmark)

    van der Heijden, Suzanne; de Oliveira, Susanne Juel; Kampmann, Marie-Louise

    2017-01-01

    to compare different AmpliSeq™ workflows to investigate the possibility of using automated library building in forensic genetic case work. In order to do so, the SNP typing of the Somalis was performed using three different workflows: 1) manual library building and sequencing on the Ion PGM™, 2) automated...... workflows. The Biomek(®)3000/Ion PGM™ workflow was found to perform similarly to the manual/Ion PGM™ workflow. This argues for the use of automated library building in forensic genetic case work. Automated library building decreases the workload of the laboratory staff, decreases the risk of pipetting...... library building using the Biomek(®)3000 and sequencing on the Ion PGM™, and 3) automated library building using the Ion Chef™ and sequencing on the Ion S5™. AmpliSeq™ workflows were compared based on coverage, locus balance, noise, and heterozygote balance. Overall, the Ion Chef™/Ion S5™ workflow...

  5. Factors influencing women's preference for health facility deliveries in Jharkhand state, India: a cross sectional analysis.

    Science.gov (United States)

    Bhattacharyya, Sanghita; Srivastava, Aradhana; Roy, Reetabrata; Avan, Bilal I

    2016-03-07

    Expanding institutional deliveries is a policy priority to achieve MDG5. India adopted a policy to encourage facility births through a conditional cash incentive scheme, yet 28% of deliveries still occur at home. In this context, it is important to understand the care experience of women who have delivered at home, and also at health facilities, analyzing any differences, so that services can be improved to promote facility births. This study aims to understand women's experience of delivery care during home and facility births, and the factors that influence women's decisions regarding their next place of delivery. A community-based cross-sectional survey was undertaken in a district of Jharkhand state in India. Interviews with 500 recently delivered women (210 delivered at facility and 290 delivered at home) included socio-demographic characteristics, experience of their recent delivery, and preference of future delivery site. Data analysis included frequencies, binary and multiple logistic regressions. There is no major difference in the experience of care between home and facility births, the only difference in care being with regard to pain relief through massage, injection and low cost of delivery for those having home births. 75% women wanted to deliver their next child at a facility, main reasons being availability of medicine (29.4%) and perceived health benefits for mother and baby (15%). Women with higher education (AOR = 1.67, 95% CI = 1.04-3.07), women who were above 25 years (AOR = 2.14, 95% CI = 1.26-3.64), who currently delivered at facility (AOR = 5.19, 95% CI = 2.97-9.08) and had health problem post-delivery (AOR = 1.85, 95% CI = 1.08-3.19) were significant predictors of future facility-based delivery. The predictors for facility deliveries include, availability of medicines and supplies, potential health benefits for the mother and newborn and the perception of good care from the providers. There is a growing

  6. The development of SisterTalk: a cable TV-delivered weight control program for black women.

    Science.gov (United States)

    Gans, Kim M; Kumanyika, Shiriki K; Lovell, H Joan; Risica, Patricia M; Goldman, Roberta; Odoms-Young, Angela; Strolla, Leslie O; Decaille, Donna O; Caron, Colleen; Lasater, Thomas M

    2003-12-01

    Overweight and obesity have reached epidemic proportions in the United States, with black women disproportionately affected. SisterTalk is a weight control program designed specifically for delivery to black women via cable TV. The theoretical and conceptual frameworks and formative research that guided the development and cultural tailoring of SisterTalk are described. Social Action Theory was applied in the development of SisterTalk along with a detailed behavioral analysis of the way that black women view weight and weight loss within the context of their cultural and social realities. The entire intervention development process was framed using this information, rather than by changing only superficial aspects of program delivery. Community networking and both qualitative and quantitative interview techniques from the fields of social marketing and cultural anthropology were used to involve black women from Boston in the design and implementation of a program that would be practical, appealing, and culturally sensitive. Also discussed are strategies for evaluating the program, and lessons learned that might have broader applicability are highlighted. The development of the SisterTalk program could provide a useful starting point for development of successful weight control programs for black women in other parts of the United States as well as for other ethnic and racial groups.

  7. Diabetic Nephropathy in Women With Preexisting Diabetes

    DEFF Research Database (Denmark)

    Ringholm, Lene; Damm, Julie Agner; Vestgaard, Marianne

    2016-01-01

    In women with preexisting diabetes and nephropathy or microalbuminuria, it is important to deliver careful preconception counselling to assess the risk for the mother and the foetus, for optimizing glycaemic status and to adjust medical treatment. If serum creatinine is normal in early pregnancy,....... Supplementation with folic acid in early pregnancy and low-dose aspirin from 10 to 12 weeks reduces the risk of adverse pregnancy outcomes. During breastfeeding, several ACE inhibitors are considered safe.......In women with preexisting diabetes and nephropathy or microalbuminuria, it is important to deliver careful preconception counselling to assess the risk for the mother and the foetus, for optimizing glycaemic status and to adjust medical treatment. If serum creatinine is normal in early pregnancy......, kidney function is often preserved during pregnancy, but complications such as severe preeclampsia and preterm delivery are still common. Perinatal mortality is now comparable with that in women with diabetes and normal kidney function. Besides strict glycaemic control before and during pregnancy, early...

  8. Why some women deliver in health institutions and others do not: A ...

    African Journals Online (AJOL)

    All three indicators of status employed by the study were significantly associated with whether a woman had an institutional delivery or not. This association however ... through some socio-economic variables. Wealth and educational status of the women and their partners emerged predictors of choice of place of delivery.

  9. Randomized Controlled Trial of Telephone-Delivered Cognitive Behavioral Therapy for Chronic Insomnia

    Science.gov (United States)

    Arnedt, J. Todd; Cuddihy, Leisha; Swanson, Leslie M.; Pickett, Scott; Aikens, James; Chervin, Ronald D.

    2013-01-01

    Study Objectives: To compare the efficacy of telephone-delivered cognitive-behavioral therapy for insomnia to an information pamphlet control on sleep and daytime functioning at pretreatment, posttreatment, and 12-wk follow-up. Design: Randomized controlled parallel trial. Setting: N/A. Participants: Thirty individuals with chronic insomnia (27 women, age 39.1 ± 14.4 years, insomnia duration 8.7 ± 10.7 years). Interventions: Cognitive behavioral therapy for insomnia (CBTI) delivered in up to eight weekly telephone sessions (CBTI-Phone, n = 15) versus an information pamphlet control (IPC, n = 15). Measurements and Results: Sleep/wake diary, sleep-related questionnaires (Insomnia Severity Index, Pittsburgh Sleep Quality Index, 16-item Dysfunctional Beliefs and Attitudes about Sleep), and daytime symptom assessments (fatigue, depression, anxiety, and quality of life) were completed at pretreatment, posttreatment, and 12-wk follow-up. Linear mixed models indicated that sleep/wake diary sleep efficiency and total sleep time improved significantly at posttreatment in both groups and remained stable at 12-wk follow-up. More CBTI-Phone than IPC patients showed posttreatment improvements in unhelpful sleep-related cognitions (P insomnia at follow-up (P insomnia. Future larger-scale studies with more diverse samples are warranted. Some individuals with insomnia may also benefit from pamphlet-delivered CBTI with brief telephone support. Citation: Arnedt JT; Cuddihy L; Swanson LM; Pickett S; Aikens J; Chervin RD. Randomized controlled trial of telephone-delivered cognitive behavioral therapy for chronic insomnia. SLEEP 2013;36(3):353-362. PMID:23450712

  10. Use of Technology for HIV Prevention Among Adolescent and Adult Women in the United States.

    Science.gov (United States)

    Blackstock, Oni J; Patel, Viraj V; Cunningham, Chinazo O

    2015-12-01

    Although the proportion of new HIV infections in the USA among women has decreased over the last few years, still, approximately 20 % of new infections occur annually among adolescent and adult women. The development of effective evidence-based prevention interventions remains an important approach to further decreasing these numbers. Technology-delivered prevention interventions hold tremendous potential due, in part, to their ability to reach beyond the walls of brick-and-mortar intervention sites to engage individuals where they are. While most technology-delivered interventions have focused on adolescents and men who have sex with men, much fewer have specifically targeted adolescent or adult women despite evidence showing that interventions tailored to specific target populations are most effective. We summarize the recently published literature on technology-delivered HIV prevention interventions for US adolescent and adult women and provide suggestions for next steps in this nascent but emergent area of prevention research.

  11. Recruiting low-income postpartum women into two weight loss interventions: in-person versus Facebook delivery.

    Science.gov (United States)

    Silfee, Valerie J; Lopez-Cepero, Andrea; Lemon, Stephenie C; Estabrook, Barbara; Nguyen, Oanh; Rosal, Milagros C

    2018-02-21

    Several studies, such as the Diabetes Prevention Program (DPP), have provided foundational evidence for the efficacy of lifestyle interventions on weight loss and cardiometabolic prevention. However, translating these interventions to real-world settings and engaging at-risk populations has proven difficult. Social media-delivered interventions have high potential for reaching high-risk populations, but there remains a need to understand the extent to which these groups are interested in social media as a delivery mode. One potential way to this is by examining recruitment rates as a proxy for interest in the intervention delivery format. The aim of this study was to describe the recruitment rates of overweight and obese low-income postpartum women into two asynchronous behavioral weight loss interventions: one delivered in-person and the other delivered via Facebook. Both interventions used the same recruitment methods: participants were overweight low-income postpartum women who were clients of Women, Infants, and Children (WIC) clinics in Worcester, MA, screened for the study by nutritionists during routine WIC visits. Similarly, eligibility criteria were the same for both interventions except for a requirement for the Facebook-delivered intervention to currently use Facebook at least once per week. Among women pre-eligible for the in-person intervention, 42.6% gave permission to be contacted to determine full eligibility and 24.1% of eligible women enrolled. Among women pre-eligible for the Facebook intervention, 31.8% gave permission to be contacted and 28.5% of eligible women enrolled. Recruitment rates for a Facebook-based weight loss intervention were similar to recruitment rates for an in-person intervention, suggesting similar interest in the two program delivery modes among low-income postpartum women.

  12. The fate in of women who deliver at home in rural Kwazulu ...

    African Journals Online (AJOL)

    A community survey was carried out to establish the fate of rural Zulu women and their infants after home delivery. The results of a pilot project fortraining traditional birth attendants (TBAs) in the area are described. The authors conclude that potentially there is an important place for TBAs in the obstetric .services of rural ...

  13. Excessive iodine intake during pregnancy in Somali refugees.

    Science.gov (United States)

    Kassim, Ismail A R; Ruth, Laird J; Creeke, Paul I; Gnat, Danielle; Abdalla, Fathia; Seal, Andrew J

    2012-01-01

    Iodine deficiency and excess are both associated with adverse health consequences, with fetuses, children and pregnant women being most vulnerable to the devastating effects of severe deficiency. It is often assumed that the iodine status of a population if displaced or in a remote or emergency situation is low. However, there is little evidence available to support this assumption, especially among long-term food-aid-dependent pregnant women. An effectiveness trial of a prenatal multiple-micronutrient supplement that contained 150 µg day(-1) iodine was conducted in two refugee camps in the North Eastern Province of Kenya in 2002. Urinary iodine concentration (UIC) was measured in a subsample of pregnant women attending antenatal care in Dagahaley (control camp) (n = 74) and Ifo (intervention camp) (n = 63). There was no significant difference in median UIC between the two camps (P = 0.118). The combined median UIC was 730 µg L(-1) (interquartile range, 780) (5.77 µmol L(-1)) and exceeded the upper safe limit of 500 µg L(-1) (3.95 µmol L(-1)) for pregnant women (P refugee camps. Further research needs to be conducted to investigate the source of excess iodine, to determine the measures needed to address excessive iodine intake and to reconsider the World Health Organization/World Food Programme/United Nations Children's Fund guidance on supplementation of vulnerable groups in emergencies.

  14. Tibetan women's perspectives and satisfaction with delivery care in a rural birth center.

    Science.gov (United States)

    Gipson, Jessica D; Gyaltsen, Kunchok; Gyal, Lhusham; Kyi, Tsering; Hicks, Andrew L; Pebley, Anne R

    2015-06-01

    To identify sociodemographic characteristics and factors involved in Tibetan women's decisions to deliver at the Tibetan Birth and Training Center (TBTC) in rural western China. In the present mixed-methods study, a random sample of married women who delivered at the TBTC between June 2011 and June 2012 were surveyed. Additionally, four focus group discussions were conducted among married women living in the TBTC catchment area. Descriptive analyses were conducted, and dominant themes were identified. In focus group discussions, women (n=33) reported that improved roads and transportation meant that access to health facilities was easier than in the past. Although some of the 114 survey participants voiced negative perceptions of healthcare facilities and providers, 99 (86.8%) indicated that they chose to deliver at the TBTC because they preferred to have a doctor present. Most women (75 [65.8%]) said their mother/mother-in-law made the final decision about delivery location. Women valued logistic and cultural aspects of the TBTC, and 108 (94.7%) said that they would recommend the TBTC to a friend. Study participants preferred delivery care that combines safety and comfort. The findings highlight avenues for further promotion of facility delivery among populations with lower rates of skilled deliveries. Copyright © 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  15. Socio Demographic Determinants of Delivery Practice in Rural Women of Bangladesh

    Directory of Open Access Journals (Sweden)

    Meherunnessa Begum

    2013-07-01

    Full Text Available Background: Every year, world wide, 200 million women become pregnant. The development of urban areas allowed women to receive more care and treatment. However, in rural areas such measures are not available to every woman. Data on delivery practice of rural woman may help the social and public health planners and decision makers to minimize and prevent maternal mortality and morbidity ensuring safe motherhood.Objective: The aim of the study was to observe the delivery practice of rural women of Bangladesh.Materials and method: A cross-sectional study was conducted and data were collected from Dhamrai upazila, Dhaka, Bangladesh in April 2008. Total 159 women of reproductive age group at least having one child were selected purposively to elicit information on various demographic, socioeconomic, cultural and selected programmatic variables including maternal health care and delivery practices.Results: Among the respondents about 55% were literate. Majority (80% of the respondents delivered at home and most of the them (71% felt that home delivery was comfortable where as about 29% of the respondents were compelled to deliver at home due to family decision and financial constraint. Among the deliveries about 82% occurred normally and 18.2% were by cesarean section. A considerable percentage of deliveries (49% were attended by traditional birth attendants. Blade was used for cutting umbilical cord in majority of the cases (74% who delivered at home. Most of the respondents (90% took ante natal check up and about 74% were vaccinated by tetanus toxoid.Conclusion: The results of the study suggest that a lot of work is still to do for the policy makers and health planners to target, plan, develop and deliver maternal health services to the rural women of Bangladesh.

  16. Why Is Oral Health Important for Women?

    Science.gov (United States)

    ... 2018 About | Contact InfoBites Quick Reference Learn more Oral Health and Overal Health Gum Disease and Cardiovascular Health ... delivered directly to your desktop! more... Why Is Oral Health Important for Women? Article Chapters Why Is Oral ...

  17. Mentoring--Is It Failing Women?

    Science.gov (United States)

    Ghosh, Rajashi

    2015-01-01

    Mentoring programs are gaining traction as human resource development initiatives that can support women to advance in their careers in organizations. However, some of these programs are falling short of delivering on this promise due to particular inherent flaws. This case study considers the following three potential flaws of formal mentoring…

  18. Why some women fail to give birth at health facilities: a qualitative study of women’s perceptions of perinatal care from rural Southern Malawi

    Directory of Open Access Journals (Sweden)

    Kumbani Lily

    2013-02-01

    Full Text Available Abstract Background Despite Malawi government’s policy to support women to deliver in health facilities with the assistance of skilled attendants, some women do not access this care. Objective The study explores the reasons why women delivered at home without skilled attendance despite receiving antenatal care at a health centre and their perceptions of perinatal care. Methods A descriptive study design with qualitative data collection and analysis methods. Data were collected through face-to-face in-depth interviews using a semi- structured interview guide that collected information on women’s perception on perinatal care. A total of 12 in- depth interviews were conducted with women that had delivered at home in the period December 2010 to March 2011. The women were asked how they perceived the care they received from health workers before, during, and after delivery. Data were manually analyzed using thematic analysis. Results Onset of labor at night, rainy season, rapid labor, socio-cultural factors and health workers’ attitudes were related to the women delivering at home. The participants were assisted in the delivery by traditional birth attendants, relatives or neighbors. Two women delivered alone. Most women went to the health facility the same day after delivery. Conclusions This study reveals beliefs about labor and delivery that need to be addressed through provision of appropriate perinatal information to raise community awareness. Even though, it is not easy to change cultural beliefs to convince women to use health facilities for deliveries. There is a need for further exploration of barriers that prevent women from accessing health care for better understanding and subsequently identification of optimal solutions with involvement of the communities themselves.

  19. Does patient-delivered partner treatment improve disclosure for treatable sexually transmitted diseases?

    Science.gov (United States)

    Mohammed, Hamish; Leichliter, Jami S; Schmidt, Norine; Farley, Thomas A; Kissinger, Patricia

    2010-03-01

    The objective of this research was to determine the factors associated with disclosure of three treatable sexually transmitted diseases (STDs). Data were obtained from two intervention trials to determine the ideal means of partner referral. Men diagnosed with urethritis and women diagnosed with trichomoniasis at public clinics in New Orleans, Louisiana were randomly assigned to partner referral (PR), booklet-enhanced partner referral (BEPR), or patient-delivered partner treatment (PDPT). Participants were asked about sex partners at baseline, then whether they disclosed to them at follow-up. The male trial was conducted from December 2001 to March 2004 and the female trial from December 2001 to August 2004. Data on men and women were analyzed separately. Nine hundred seventy-seven men and 463 women-reporting information on 1991 and 521 sex partners-were respectively enrolled in each trial. Disclosure occurred to 57.8% and 87.3% of their partners, respectively. Most men (68.3%) reported having two or more partners and disclosure was more likely to occur in: those who reported only one sex partner (adjusted odds ratio [aOR] 95% confidence interval [CI]: 1.54 [1.10, 2.16]); those in steady relationships (OR [95% CI]: 1.37 [1.08,1.74]); and those assigned PDPT [OR [95% CI]: 2.71 [1.93,3.82]). Most women reported having only one partner (86.8%) and disclosure was more likely to occur in steady relationships (OR [95% CI]: 2.65 [1.24,5.66]), and when sex was reinitiated with partners during the follow-up period (OR [95% CI]: 3.30 [1.54,7.09]). The provision of PDPT was associated with increased STD disclosure among men but not among women. Both men and women were less likely to disclose to casual partners. Women had high rates of disclosure irrespective of intervention arm.

  20. Delivering at home or in a health facility? health-seeking behaviour of women and the role of traditional birth attendants in Tanzania.

    Science.gov (United States)

    Pfeiffer, Constanze; Mwaipopo, Rosemarie

    2013-02-28

    Traditional birth attendants retain an important role in reproductive and maternal health in Tanzania. The Tanzanian Government promotes TBAs in order to provide maternal and neonatal health counselling and initiating timely referral, however, their role officially does not include delivery attendance. Yet, experience illustrates that most TBAs still often handle complicated deliveries. Therefore, the objectives of this research were to describe (1) women's health-seeking behaviour and experiences regarding their use of antenatal (ANC) and postnatal care (PNC); (2) their rationale behind the choice of place and delivery; and to learn (3) about the use of traditional practices and resources applied by traditional birth attendants (TBAs) and how they can be linked to the bio-medical health system. Qualitative and quantitative interviews were conducted with over 270 individuals in Masasi District, Mtwara Region and Ilala Municipality, Dar es Salaam, Tanzania. The results from the urban site show that significant achievements have been made in terms of promoting pregnancy- and delivery-related services through skilled health workers. Pregnant women have a high level of awareness and clearly prefer to deliver at a health facility. The scenario is different in the rural site (Masasi District), where an adequately trained health workforce and well-equipped health facilities are not yet a reality, resulting in home deliveries with the assistance of either a TBA or a relative. Instead of focusing on the traditional sector, it is argued that more attention should be paid towards (1) improving access to as well as strengthening the health system to guarantee delivery by skilled health personnel; and (2) bridging the gaps between communities and the formal health sector through community-based counselling and health education, which is provided by well-trained and supervised village health workers who inform villagers about promotive and preventive health services, including

  1. Losing women along the path to safe motherhood: why is there such a gap between women's use of antenatal care and skilled birth attendance? A mixed methods study in northern Uganda.

    Science.gov (United States)

    Anastasi, Erin; Borchert, Matthias; Campbell, Oona M R; Sondorp, Egbert; Kaducu, Felix; Hill, Olivia; Okeng, Dennis; Odong, Vicki Norah; Lange, Isabelle L

    2015-11-04

    Thousands of women and newborns still die preventable deaths from pregnancy and childbirth-related complications in poor settings. Delivery with a skilled birth attendant is a vital intervention for saving lives. Yet many women, particularly where maternal mortality ratios are highest, do not have a skilled birth attendant at delivery. In Uganda, only 58 % of women deliver in a health facility, despite approximately 95 % of women attending antenatal care (ANC). This study aimed to (1) identify key factors underlying the gap between high rates of antenatal care attendance and much lower rates of health-facility delivery; (2) examine the association between advice during antenatal care to deliver at a health facility and actual place of delivery; (3) investigate whether antenatal care services in a post-conflict district of Northern Uganda actively link women to skilled birth attendant services; and (4) make recommendations for policy- and program-relevant implementation research to enhance use of skilled birth attendance services. This study was carried out in Gulu District in 2009. Quantitative and qualitative methods used included: structured antenatal care client entry and exit interviews [n = 139]; semi-structured interviews with women in their homes [n = 36], with health workers [n = 10], and with policymakers [n = 10]; and focus group discussions with women [n = 20], men [n = 20], and traditional birth attendants [n = 20]. Seventy-five percent of antenatal care clients currently pregnant reported they received advice during their last pregnancy to deliver in a health facility, and 58 % of these reported having delivered in a health facility. After adjustment for confounding, women who reported they received advice at antenatal care to deliver at a health facility were significantly more likely (aOR = 2.83 [95 % CI: 1.19-6.75], p = 0.02) to report giving birth in a facility. Despite high antenatal care coverage, a number of demand and supply side

  2. Acceptability of woman-delivered HIV self-testing to the male partner, and additional interventions: a qualitative study of antenatal care participants in Malawi.

    Science.gov (United States)

    Choko, Augustine Talumba; Kumwenda, Moses Kelly; Johnson, Cheryl Case; Sakala, Doreen Wongera; Chikalipo, Maria Chifuniro; Fielding, Katherine; Chikovore, Jeremiah; Desmond, Nicola; Corbett, Elizabeth Lucy

    2017-06-26

    In the era of ambitious HIV targets, novel HIV testing models are required for hard-to-reach groups such as men, who remain underserved by existing services. Pregnancy presents a unique opportunity for partners to test for HIV, as many pregnant women will attend antenatal care (ANC). We describe the views of pregnant women and their male partners on HIV self-test kits that are woman-delivered, alone or with an additional intervention. A formative qualitative study to inform the design of a multi-arm multi-stage cluster-randomized trial, comprised of six focus group discussions and 20 in-depth interviews, was conducted. ANC attendees were purposively sampled on the day of initial clinic visit, while men were recruited after obtaining their contact information from their female partners. Data were analysed using content analysis, and our interpretation is hypothetical as participants were not offered self-test kits. Providing HIV self-test kits to pregnant women to deliver to their male partners was highly acceptable to both women and men. Men preferred this approach compared with standard facility-based testing, as self-testing fits into their lifestyles which were characterized by extreme day-to-day economic pressures, including the need to raise money for food for their household daily. Men and women emphasized the need for careful communication before and after collection of the self-test kits in order to minimize the potential for intimate partner violence although physical violence was perceived as less likely to occur. Most men stated a preference to first self-test alone, followed by testing as a couple. Regarding interventions for optimizing linkage following self-testing, both men and women felt that a fixed financial incentive of approximately USD$2 would increase linkage. However, there were concerns that financial incentives of greater value may lead to multiple pregnancies and lack of child spacing. In this low-income setting, a lottery incentive was

  3. An exploration of the connection between two meaning perspectives: an evidence-based approach to health information delivery to vulnerable groups of Arabic- and Somali-speaking asylum seekers in a Swedish context.

    Science.gov (United States)

    Ekblad, Solvig; Linander, Andrea; Asplund, Maria

    2012-09-01

    The right to health care is significant for asylum seekers, particularly as many of them have experienced traumatic life events in their home country, during flight or in their host country. Post-migration living conditions have more impact than pre-migration conditions on ill health among asylum seekers, which underscores the importance of health care-related refugee reception policies. The purpose of this article is to explore the perceived meaning of comprehensive health information provided by a nurse to Arabic- and Somali-speaking adult asylum seekers, in a Swedish context, during its introduction at the Migration Board. In our study, the endpoint was whether asylum seekers found such health information relevant, understandable and respectful. Following an oral presentation, participants filled in a questionnaire consisting of three close-ended questions. A total of 39 groups of presentation attendees included 626 asylum seekers (415 Arabic- and 211 Somali-speaking). Data were analysed with descriptive statistics. Comments underwent content analysis. We also present some socio-demographic data on these asylum seekers. Independently of gender and language, the participants expressed their gratitude for and the meaningfulness of receiving professional, fact-based information, as well as being treated with concern and respect. They indicated a great need for this and felt relieved by being listened to. They liked the pedagogic group method, the opportunity for dialogue and to practice exercising their rights. These promising results indicate that exercising the asylum-seekers' right to receive such health information would improve future reception policies not only in Sweden, but throughout the EU. A renewed focus on communication and pedagogic skills, instead of just cultural training, should be considered for health care professionals assisting asylum seekers.

  4. Reproduction and mode of delivery in women with vaginismus or localised provoked vestibulodynia: a Swedish register-based study.

    Science.gov (United States)

    Möller, L; Josefsson, A; Bladh, M; Lilliecreutz, C; Sydsjö, G

    2015-02-01

    To compare sociodemographics, parity and mode of delivery between women diagnosed with vaginismus or localised provoked vestibulodynia (LPV) to women without a diagnosis before first pregnancy. Retrospective, population-based register study. Sweden. All women born in Sweden 1973-83 who gave birth for the first time or remained nulliparous during the years 2001-09. Nationally linked registries were used to identify the study population. Women diagnosed with vaginismus or LPV were compared to all other women. Odds ratios for parity and mode of delivery were calculated using multinominal regression analysis and logistic regression. Parity and mode of delivery. Women with vaginismus/LPV were more likely to be unmarried (P = 0.001), unemployed (P = 0.012), have a higher educational level (P vaginismus/LPV more often delivered by caesarean section (P vaginismus/LPV were more likely to suffer a perineal laceration (adjusted OR 1.87, 95% CI 1.56-2.25). Women with vaginismus/LPV are less likely to give birth and those that do are more likely to deliver by caesarean section and have a caesarean section based upon maternal request. Those women delivering vaginally are more likely to suffer perineal laceration. These findings point to the importance of not only addressing sexual function in women with vaginismus/LPV but reproductive function as well. © 2014 Royal College of Obstetricians and Gynaecologists.

  5. Investigating the Relationship between Self-Esteem and Postpartum Blues among Delivered Women

    Directory of Open Access Journals (Sweden)

    Masoumeh Sharifzadeh

    2018-04-01

    Full Text Available Postpartum period is the most risky time for mental and psychological disorders including sadness, depression and psychosis. Postpartum depression is the most common postpartum disorder that may disturb relationship of mother with child and family and in the absence of appropriate attention and treatment may have irreparable damages. Therefore, the purpose of this study is investigating the relationship between self-esteem and postpartum depression. This study is cross-sectional and descriptive-analytic and was conducted in 2014 with 322 available samples from the research population, consisted of women who gave birth at Mobini Hospital, Sabzevar. The data collection tools were demographic and midwifery questionnaire, Edinburgh Postnatal Depression Scale, and Rosenberg’s Self-Esteem Scale. Questionnaire within the first 24 hours after giving birth, in the situation where the mother was able to answer the questions, on the third, seventh and tenth day after childbirth, were completed. Then the data were analyzed using SPSS 18 and descriptive and Pearson tests, T-test, and Chi-squared test. The significance level was considered (p=0.05. Blues of giving birth in different days did not differ significantly (p > 05. The relationship between self-esteem and postpartum depression was significant (p < 0.001. Results showed that increased self-esteem in pregnant women results in a reduction in postpartum depression.

  6. Use of vaginal estrogen in Danish women

    DEFF Research Database (Denmark)

    Meaidi, Amani; Goukasian, Irina; Lidegaard, Oejvind

    2016-01-01

    INTRODUCTION: We know little about the use of vaginal estrogen in perimenopausal and postmenopausal women. We aimed to assess the prevalence of vaginal estrogen use in Denmark. MATERIAL AND METHODS: The study was designed as a nationwide cross-sectional study of all Danish women aged 40-79 years......, living in Denmark during the period 2007-2013. The Danish Prescription Register delivered data permitting us to assess the prevalence, age and regional geographical belonging of women purchasing prescribed vaginal estradiol. The number of women using over-the-counter vaginal estriol products...... was estimated from sale statistics from the same register. RESULTS: In 2013, 10.2% of all Danish women between 40 and 79 years of age used vaginal estradiol. The prevalence of women using this type of vaginal estrogen increased from 8.5% in year 2007 to 10.2% in 2013. The use peaked at 16.5% in women aged 60...

  7. Design and feasibility testing of a novel group intervention for young women who binge drink in groups.

    Science.gov (United States)

    Irvine, Linda; Crombie, Iain K; Swanson, Vivien; Dimova, Elena D; Melson, Ambrose J; Fraser, Tracey M; Barbour, Rosaline; Rice, Peter M; Allan, Sheila

    2018-01-01

    Young women frequently drink alcohol in groups and binge drinking within these natural drinking groups is common. This study describes the design of a theoretically and empirically based group intervention to reduce binge drinking among young women. It also evaluates their engagement with the intervention and the acceptability of the study methods. Friendship groups of women aged 18-35 years, who had two or more episodes of binge drinking (>6 UK units on one occasion; 48g of alcohol) in the previous 30 days, were recruited from the community. A face-to-face group intervention, based on the Health Action Process Approach, was delivered over three sessions. Components of the intervention were woven around fun activities, such as making alcohol free cocktails. Women were followed up four months after the intervention was delivered. The target of 24 groups (comprising 97 women) was recruited. The common pattern of drinking was infrequent, heavy drinking (mean consumption on the heaviest drinking day was UK 18.1 units). Process evaluation revealed that the intervention was delivered with high fidelity and acceptability of the study methods was high. The women engaged positively with intervention components and made group decisions about cutting down. Twenty two groups set goals to reduce their drinking, and these were translated into action plans. Retention of individuals at follow up was 87%. This study successfully recruited groups of young women whose patterns of drinking place them at high risk of acute harm. This novel approach to delivering an alcohol intervention has potential to reduce binge drinking among young women. The high levels of engagement with key steps in the behavior change process suggests that the group intervention should be tested in a full randomised controlled trial.

  8. They Just Respect You for Who You Are: Contributors to Educator Positive Youth Development Promotion for Somali, Latino, and Hmong Students.

    Science.gov (United States)

    Allen, Michele L; Rosas-Lee, Maira; Ortega, Luis; Hang, Mikow; Pergament, Shannon; Pratt, Rebekah

    2016-02-01

    Youth from immigrant communities may experience barriers to connecting with schools and teachers, potentially undermining academic achievement and healthy youth development. This qualitative study aimed to understand how educators serving Somali, Latino, and Hmong (SLH) youth can best promote educator-student connectedness and positive youth development, by exploring the perspectives of teachers, youth workers, and SLH youth, using a community based participatory research approach. We conducted four focus groups with teachers, 18 key informant interviews with adults working with SLH youth, and nine focus groups with SLH middle and high school students. Four themes emerged regarding facilitators to educators promoting positive youth development in schools: (1) an authoritative teaching approach where teachers hold high expectations for student behavior and achievement, (2) building trusting educator-student relationships, (3) conveying respect for students as individuals, and (4) a school infrastructure characterized by a supportive and inclusive environment. Findings suggest a set of skills and educator-student interactions that may promote positive youth development and increase student-educator connectedness for SLH youth in public schools.

  9. Association between intimate partner violence during pregnancy and maternal pregnancy complications among recently delivered women in Bangladesh.

    Science.gov (United States)

    Ferdos, Jannatul; Rahman, Md Mosfequr; Jesmin, Syeda S; Rahman, Md Aminur; Sasagawa, Toshiyuki

    2018-05-01

    Intimate partner violence (IPV), an actual or threatened physical, sexual, or psychological abuse by a current or former partner or spouse, is a common global public health issue. Understanding both the prevalence of IPV during pregnancy and its potential impact on the health of pregnant women is important for the development and implementation of interventions to prevent maternal morbidity and mortality. The purpose of this study was to explore the association between maternal experiences of IPV during pregnancy and pregnancy complications. A health-facility-based cross-sectional study was conducted from July 2015 to April 2016 among 400 randomly selected women who were admitted to the postnatal wards of Rajshahi Medical College Hospital for delivery. Data were collected through face-to-face interviews using a structured questionnaire. Multivariable logistic regressions were performed to assess relationships between variables of interest after controlling for potential confounders. Results indicated that 39.0% of women reported physical IPV and 26.3% of women reported sexual IPV during pregnancy. Additionally, 69.5% of women experienced medical complications (MCs); of this group, 44.3% experienced obstetric complications (OCs) and 79.3% experienced any pregnancy complication (AC) during their last pregnancy. The experience of physical IPV during pregnancy was significantly associated with the experience of MCs (adjusted odds ratio (AOR): 2.05, 95% confidence interval (CI): 1.15-4.01), OCs (AOR: 4.23, 95% CI: 2.01-7.12) and AC (AOR: 5.26, 95% CI: 2.98-10.52). Women who experienced sexual IPV during pregnancy were also at increased risk of suffering from any MC, any OC, and AC. Maternal experience of IPV during pregnancy is positively associated with pregnancy complications. Preventing IPV directed at pregnant women might reduce maternal morbidity and mortality in Bangladesh. © 2018 Wiley Periodicals, Inc.

  10. Efficacy of a health educator-delivered HIV prevention intervention for Latina women: a randomized controlled trial.

    Science.gov (United States)

    Wingood, Gina M; DiClemente, Ralph J; Villamizar, Kira; Er, Deja L; DeVarona, Martina; Taveras, Janelle; Painter, Thomas M; Lang, Delia L; Hardin, James W; Ullah, Evelyn; Stallworth, JoAna; Purcell, David W; Jean, Reynald

    2011-12-01

    We developed and assessed AMIGAS (Amigas, Mujeres Latinas, Inform andonos, Gui andonos, y Apoy andonos contra el SIDA [friends, Latina women, informing each other, guiding each other, and supporting each other against AIDS]), a culturally congruent HIV prevention intervention for Latina women adapted from SiSTA (Sistas Informing Sistas about Topics on AIDS), an intervention for African American women. We recruited 252 Latina women aged 18 to 35 years in Miami, Florida, in 2008 to 2009 and randomized them to the 4-session AMIGAS intervention or a 1-session health intervention. Participants completed audio computer-assisted self-interviews at baseline and follow-up. Over the 6-month follow-up, AMIGAS participants reported more consistent condom use during the past 90 (adjusted odds ratio [AOR] = 4.81; P < .001) and 30 (AOR = 3.14; P < .001) days and at last sexual encounter (AOR = 2.76; P < .001), and a higher mean percentage condom use during the past 90 (relative change = 55.7%; P < .001) and 30 (relative change = 43.8%; P < .001) days than did comparison participants. AMIGAS participants reported fewer traditional views of gender roles (P = .008), greater self-efficacy for negotiating safer sex (P < .001), greater feelings of power in relationships (P = .02), greater self-efficacy for using condoms (P < .001), and greater HIV knowledge (P = .009) and perceived fewer barriers to using condoms (P < .001). Our results support the efficacy of this linguistically and culturally adapted HIV intervention among ethnically diverse, predominantly foreign-born Latina women.

  11. Birth in a health facility--inequalities among the Ethiopian women: results from repeated national surveys.

    Directory of Open Access Journals (Sweden)

    Elias Ali Yesuf

    Full Text Available BACKGROUND: Uptake of health facilities for delivery care in Ethiopia has not been examined in the light of equality. We investigated differences in institutional deliveries by urbanity, administrative region, economic status and maternal education. METHODS: This study was based on nation-wide repeated surveys undertaken in the years 2000, 2005, and 2011. The surveys used a cluster sampling design. Women of reproductive age were interviewed on the place of their last delivery. Data was analyzed using logistic regressions to estimate the weighted association between birth in a health facility and study's predictors. RESULTS: Utilization of health institutions for deliveries has improved throughout the study period, however, rates remain low (5.4%,2000 and 11.8%,2011. Compared with women from rural places, women from urban areas had independent OR of a health facility delivery of 4.9 (95% CI: 3.4, 7.0, 5.0 (95% CI: 3.6, 6.9, and 4.6 (95% CI: 3.5, 6.0 in 2000, 2005, and 2011, respectively. Women with secondary/higher education had more deliveries in a healthcare facility than women with no education, and these gaps widened over the years (OR: 35.1, 45.0 and 53.6 in 2000, 2005, and 2011, respectively. Women of the upper economic quintile had 3.0-7.2 times the odds of healthcare facility deliveries, compared with the lowest quintile, with no clear trend over the years. While Addis-Ababa and Dire Dawa remained with the highest OR for deliveries in a health facility compared with Amhara, other regions displayed shifts in their relative ranking with Oromiya, SNNPR, Afar, Harari, and Somali getting relatively worse over time. CONCLUSIONS: The disparity related to urbanity or education in the use of health facility for birth in Ethiopia is staggering. There is a small inequality between most regions except Addis Ababa/Dire Dawa and sign of abating inequity between economic strata except for the richest households.

  12. Feasibility and Acceptability of Delivering a Postpartum Weight Loss Intervention via Facebook: A Pilot Study.

    Science.gov (United States)

    Waring, Molly E; Moore Simas, Tiffany A; Oleski, Jessica; Xiao, Rui S; Mulcahy, Julie A; May, Christine N; Pagoto, Sherry L

    2018-01-01

    To evaluate the feasibility and acceptability of a Facebook-delivered postpartum weight loss intervention. Overweight and obese postpartum women received a 12-week weight loss intervention via Facebook. Feasibility outcomes were recruitment, retention, engagement, and acceptability. Weight loss was an exploratory outcome. Participants (n = 19) were 3.5 (SD 2.2) months postpartum with a baseline body mass index of 30.1 (SD 4.2) kg/m 2 . Retention was 95%. Forty-two percent of participants visibly engaged on the last day of the intervention, and 100% in the last 4 weeks; 88% were likely or very likely to participate again and 82% were likely or very likely to recommend the program to a postpartum friend. Average 12-week weight loss was 4.8% (SD 4.2%); 58% lost ≥5%. Findings suggested that this Facebook-delivered intervention is feasible and acceptable and supports research to test efficacy for weight loss. Research is needed to determine how best to engage participants in social network-delivered weight loss interventions. Copyright © 2017 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

  13. Delivering Breast Reconstruction Information to Patients: Women Report on Preferred Information Delivery Styles and Options.

    Science.gov (United States)

    Webb, Carmen; Sharma, Vishal; Temple-Oberle, Claire

    2018-02-01

    To discover missed opportunities for providing information to women undergoing breast reconstruction in an effort to decrease regret and improve patient education, teaching modalities, and satisfaction. Thirty- to 45-minute semi-structured interviews were conducted exploring patient experiences with information provision on breast reconstruction. Purposeful sampling was used to include women with a variety of reconstruction types at different time points along their recovery. Using grounded theory methodology, 2 independent reviewers analyzed the transcripts and generated thematic codes based on patient responses. BREAST-Q scores were also collected to compare satisfaction scores with qualitative responses. Patients were interested in a wide variety of topics related to breast reconstruction including the pros and cons of different options, nipple-sparing mastectomies, immediate breast reconstruction, oncological safety/monitoring and the impact of chemotherapy and radiotherapy, secondary procedures (balancing, nipple reconstruction), post-operative recovery, and long-term expectations. Patients valued accessing information from multiple sources, seeing numerous photographs, being guided to reliable information online, and having access to a frequently asked questions file or document. Information delivery via interaction with medical personnel and previously reconstructed patients was most appreciated. Compared with BREAST-Q scores for satisfaction with the plastic surgeon (mean: 95.7, range: 60-100), informational satisfaction scores were lower at 74.7 (50-100), confirming the informational gaps expressed by interviewees. Women having recently undergone breast reconstruction reported key deficiencies in information provided prior to surgery and identified preferred information delivery options. Addressing women's educational needs is important to achieve appropriate expectations and improve satisfaction.

  14. Where do poor women in developing countries give birth? A multi-country analysis of demographic and health survey data.

    Science.gov (United States)

    Montagu, Dominic; Yamey, Gavin; Visconti, Adam; Harding, April; Yoong, Joanne

    2011-02-28

    In 2008, over 300,000 women died during pregnancy or childbirth, mostly in poor countries. While there are proven interventions to make childbirth safer, there is uncertainty about the best way to deliver these at large scale. In particular, there is currently a debate about whether maternal deaths are more likely to be prevented by delivering effective interventions through scaled up facilities or via community-based services. To inform this debate, we examined delivery location and attendance and the reasons women report for giving birth at home. We conducted a secondary analysis of maternal delivery data from Demographic and Health Surveys in 48 developing countries from 2003 to the present. We stratified reported delivery locations by wealth quintile for each country and created weighted regional summaries. For sub-Saharan Africa (SSA), where death rates are highest, we conducted a subsample analysis of motivations for giving birth at home. In SSA, South Asia, and Southeast Asia, more than 70% of all births in the lowest two wealth quintiles occurred at home. In SSA, 54.1% of the richest women reported using public facilities compared with only 17.7% of the poorest women. Among home births in SSA, 56% in the poorest quintile were unattended while 41% were attended by a traditional birth attendant (TBA); 40% in the wealthiest quintile were unattended, while 33% were attended by a TBA. Seven per cent of the poorest women reported cost as a reason for not delivering in a facility, while 27% reported lack of access as a reason. The most common reason given by both the poorest and richest women for not delivering in a facility was that it was deemed "not necessary" by a household decision maker. Among the poorest women, "not necessary" was given as a reason by 68% of women whose births were unattended and by 66% of women whose births were attended. In developing countries, most poor women deliver at home. This suggests that, at least in the near term, efforts to

  15. Where do poor women in developing countries give birth? A multi-country analysis of demographic and health survey data.

    Directory of Open Access Journals (Sweden)

    Dominic Montagu

    2011-02-01

    Full Text Available In 2008, over 300,000 women died during pregnancy or childbirth, mostly in poor countries. While there are proven interventions to make childbirth safer, there is uncertainty about the best way to deliver these at large scale. In particular, there is currently a debate about whether maternal deaths are more likely to be prevented by delivering effective interventions through scaled up facilities or via community-based services. To inform this debate, we examined delivery location and attendance and the reasons women report for giving birth at home.We conducted a secondary analysis of maternal delivery data from Demographic and Health Surveys in 48 developing countries from 2003 to the present. We stratified reported delivery locations by wealth quintile for each country and created weighted regional summaries. For sub-Saharan Africa (SSA, where death rates are highest, we conducted a subsample analysis of motivations for giving birth at home. In SSA, South Asia, and Southeast Asia, more than 70% of all births in the lowest two wealth quintiles occurred at home. In SSA, 54.1% of the richest women reported using public facilities compared with only 17.7% of the poorest women. Among home births in SSA, 56% in the poorest quintile were unattended while 41% were attended by a traditional birth attendant (TBA; 40% in the wealthiest quintile were unattended, while 33% were attended by a TBA. Seven per cent of the poorest women reported cost as a reason for not delivering in a facility, while 27% reported lack of access as a reason. The most common reason given by both the poorest and richest women for not delivering in a facility was that it was deemed "not necessary" by a household decision maker. Among the poorest women, "not necessary" was given as a reason by 68% of women whose births were unattended and by 66% of women whose births were attended.In developing countries, most poor women deliver at home. This suggests that, at least in the near term

  16. Where Do Poor Women in Developing Countries Give Birth? A Multi-Country Analysis of Demographic and Health Survey Data

    Science.gov (United States)

    Montagu, Dominic; Yamey, Gavin; Visconti, Adam; Harding, April; Yoong, Joanne

    2011-01-01

    Background In 2008, over 300,000 women died during pregnancy or childbirth, mostly in poor countries. While there are proven interventions to make childbirth safer, there is uncertainty about the best way to deliver these at large scale. In particular, there is currently a debate about whether maternal deaths are more likely to be prevented by delivering effective interventions through scaled up facilities or via community-based services. To inform this debate, we examined delivery location and attendance and the reasons women report for giving birth at home. Methodology/Principal Findings We conducted a secondary analysis of maternal delivery data from Demographic and Health Surveys in 48 developing countries from 2003 to the present. We stratified reported delivery locations by wealth quintile for each country and created weighted regional summaries. For sub-Saharan Africa (SSA), where death rates are highest, we conducted a subsample analysis of motivations for giving birth at home. In SSA, South Asia, and Southeast Asia, more than 70% of all births in the lowest two wealth quintiles occurred at home. In SSA, 54.1% of the richest women reported using public facilities compared with only 17.7% of the poorest women. Among home births in SSA, 56% in the poorest quintile were unattended while 41% were attended by a traditional birth attendant (TBA); 40% in the wealthiest quintile were unattended, while 33% were attended by a TBA. Seven per cent of the poorest women reported cost as a reason for not delivering in a facility, while 27% reported lack of access as a reason. The most common reason given by both the poorest and richest women for not delivering in a facility was that it was deemed “not necessary” by a household decision maker. Among the poorest women, “not necessary” was given as a reason by 68% of women whose births were unattended and by 66% of women whose births were attended. Conclusions In developing countries, most poor women deliver at home

  17. Determinants of poor utilization of antenatal care services among recently delivered women in Rwanda; a population based study.

    Science.gov (United States)

    Rurangirwa, Akashi Andrew; Mogren, Ingrid; Nyirazinyoye, Laetitia; Ntaganira, Joseph; Krantz, Gunilla

    2017-05-15

    In Rwanda, a majority of pregnant women visit antenatal care (ANC) services, however not to the extent that is recommended. Association between socio-demographic or psychosocial factors and poor utilization of antenatal care services (≤2 visits during the course of pregnancy irrespective of the timing) among recently pregnant women in Rwanda were investigated. This population-based, cross sectional study included 921 women who gave birth within the past 13 months. Data was obtained using an interviewer-administered questionnaire. For the analyses, bi-and multivariable logistic regression was used and odds ratios were presented with their 95% confidence intervals. About 54% of pregnant women did not make the recommended four visits to ANC during pregnancy. The risk of poor utilization of ANC services was higher among women aged 31 years or older (AOR, 1.78; 95% CI: 1.14, 2.78), among single women (AOR, 2.99; 95% CI: 1.83, 4.75) and women with poor social support (AOR, 1.71; 95% CI: 1.09, 2.67). No significant associations were found for school attendance or household assets (proxy for socio-economic status) with poor utilization of ANC services. Older age, being single, divorced or widowed and poor social support were associated with poor utilization of ANC services. General awareness in communities should be raised on the importance of the number and timing of ANC visits. ANC clinics should further be easier to access, transport should be available, costs minimized and opening hours may be extended to facilitate visits for pregnant women.

  18. Black women in menopausal transition.

    Science.gov (United States)

    Im, Eun-Ok; Lee, Seung Hee; Chee, Wonshik

    2010-01-01

    To describe the experience of menopausal symptoms of midlife Black women in the United States. Qualitative online forum using a feminist perspective. Internet communities for midlife women and Blacks. Twenty midlife Black women recruited using a quota sampling method. A 6-month online forum was conducted with seven discussion topics on menopausal symptoms. The discussion topics were posted sequentially on the forum site, and the women posted messages at their convenience over 6 months. The data were analyzed using thematic analysis. The identified themes were raised to be strong, accepting a natural aging process, silent and without knowledge, and our own experience. The women tried to be strong during their menopausal transitions while dealing with other important family matters. The women did not report their menopausal symptoms and were silent about or downplayed their symptoms, but many emphasized the importance of education about menopausal symptoms and highlighted their own lack of knowledge. These women generally did not talk about their symptoms because they believed that nobody except other Black midlife women could understand their menopausal experience. Health care providers need to develop a mechanism to deliver the necessary knowledge about menopausal symptoms and management strategies to Black midlife women in their health care practices.

  19. Efficacy of a Nurse-Delivered Intervention to Prevent and Delay Postpartum Return to Smoking: The Quit for Two Trial.

    Science.gov (United States)

    Pollak, Kathryn I; Fish, Laura J; Lyna, Pauline; Peterson, Bercedis L; Myers, Evan R; Gao, Xiaomei; Swamy, Geeta K; Brown-Johnson, Angela; Whitecar, Paul; Bilheimer, Alicia K; Pletsch, Pamela K

    2016-10-01

    Most pregnant women who quit smoking return to smoking postpartum. Trials to prevent this return have been unsuccessful. We tested the efficacy of a nurse-delivered intervention in maintaining smoking abstinence after delivery among pregnant women who quit smoking that was tailored on their high risk of relapse (eg, had strong intentions to return). We recruited 382 English-speaking spontaneous pregnant quitters from 14 prenatal clinics and randomized them to receive either a smoking abstinence booklet plus newsletters about parenting and stress (control) or a nurse-delivered smoking abstinence intervention that differed in intensity for the high and low risk groups. Our primary outcome was smoking abstinence at 12 months postpartum. Using intent-to-treat analyses, there was a high rate of biochemically validated smoking abstinence at 12 months postpartum but no arm differences ( 36% [95% confidence interval [CI]: 29-43] vs. 35% [95% CI: 28-43], P = .81). Among women at low risk of returning to smoking, the crude abstinence rate was significantly higher in the control arm (46%) than in the intervention arm (33%); among women at high risk of returning to smoking, the crude abstinence rate was slightly lower but not different in the control arm (31%) than in the intervention arm (37%). Low-risk women fared better with a minimal intervention that focused on parenting skills and stress than when they received an intensive smoking abstinence intervention. The opposite was true for women who were at high risk of returning to smoking. Clinicians might need to tailor their approach based on whether women are at high or low risk of returning to smoking. Results suggest that high-risk and low-risk women might benefit from different types of smoking relapse interventions. Those who are lower risk of returning to smoking might benefit from stress reduction that is devoid of smoking content, whereas those who are higher risk might benefit from smoking relapse prevention. © The

  20. Women's mental health before, during, and after pregnancy: a population-based controlled cohort study.

    Science.gov (United States)

    van Bussel, Johan C H; Spitz, Bernard; Demyttenaere, Koen

    2006-12-01

    Common mental health disorders like depressive and anxiety disorders are frequent in antenatal and postpartum women. However, no agreement about the prevalence of these disorders and the course of women's mental health during the transition to motherhood exists. This study compared women's mental health before, during, and after pregnancy with a control group of nonpregnant women. Three hundred and twenty-four women were assessed before, during, and after their pregnancy with the 12-item version of the General Health Questionnaire (GHQ-12). A control group of 324 women who did not deliver during 3 subsequent years was assessed with the GHQ-12 at corresponding time-points. No differences in GHQ-12 mean scores, prevalence, and incidence of common mental health disorders between the study and control groups were found. No differences in prevalence and incidence rates within each group were found. The presence of a common mental health disorder before pregnancy or in early pregnancy predicted common mental health disorders in the postpartum period. Common mental health disorders are frequent during pregnancy and the postpartum period, but pregnant or postpartum women are not more at risk than those who are not pregnant or who did not deliver.

  1. Payment in Heaven: Can Early Childhood Education Policies Help Women Too?

    Science.gov (United States)

    Newberry, Jan; Marpinjun, Sri

    2018-01-01

    Based on research and activism on early childhood education and care in the area of Yogyakarta, Indonesia, we argue that the Indonesian government's focus on early childhood has come at a cost to local women. Community-based early childhood programs are delivered by women whose work is unpaid or underpaid. Although early childhood education in the…

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

    Science.gov (United States)

    Thompson, Rachel; Wojcieszek, Aleena M

    2012-06-18

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

  3. Service Quality of Delivered Care from the Perception of Women with Caesarean Section and Normal Delivery

    Directory of Open Access Journals (Sweden)

    Jafar S. Tabrizi

    2014-12-01

    Full Text Available Background: Our aim was to determine the service quality of delivered care for people with Caesarean Section and Normal Delivery. Methods: A cross-sectional study was conducted among 200 people who had caesarean section and normal delivery in Al-Zahra Teaching Hospital in Tabriz, north western Iran. Service quality was calculated using: Service Quality = 10 – (Importance × Performance based on importance and performance of service quality aspects from the postpartum women‟s perspective.A hierarchical regression analysis was applied in two steps using the enter method to examine the associations between demographics and SQ scores. Data were analysed using the SPSS-17 software. Results: “Confidentiality”, “autonomy”, “choice of care provider” and “communication” achieved scores at the highest level of quality; and “support group”, “prompt attention”, “prevention and early detection”, “continuity of care”, “dignity”, “safety”, “accessibility and “basic amenities” got service quality score less than eight. Statistically significant relationship was found between service quality score and continuity of care (P=0.008. Conclusion: A notable gap between the participants‟ expectations and what they have actually received in most aspects of provided care. So, there is an opportunityto improve the quality of delivered care.

  4. Guidance on management of asymptomatic neonates born to women with active genital herpes lesions.

    Science.gov (United States)

    Kimberlin, David W; Baley, Jill

    2013-02-01

    Herpes simplex virus (HSV) infection of the neonate is uncommon, but genital herpes infections in adults are very common. Thus, although treating an infant with neonatal herpes is a relatively rare occurrence, managing infants potentially exposed to HSV at the time of delivery occurs more frequently. The risk of transmitting HSV to an infant during delivery is determined in part by the mother's previous immunity to HSV. Women with primary genital HSV infections who are shedding HSV at delivery are 10 to 30 times more likely to transmit the virus to their newborn infants than are women with recurrent HSV infection who are shedding virus at delivery. With the availability of commercial serological tests that reliably can distinguish type-specific HSV antibodies, it is now possible to determine the type of maternal infection and, thus, further refine management of infants delivered to women who have active genital HSV lesions. The management algorithm presented herein uses both serological and virological studies to determine the risk of HSV transmission to the neonate who is delivered to a mother with active herpetic genital lesions and tailors management accordingly. The algorithm does not address the approach to asymptomatic neonates delivered to women with a history of genital herpes but no active lesions at delivery.

  5. Predictors of Low Uptake of Prenatal Tetanus Toxoid, Reduced Diphtheria Toxoid, and Acellular Pertussis Immunization in Privately Insured Women in the United States.

    Science.gov (United States)

    Butler, Anne M; Layton, J Bradley; Li, Dongmei; Hudgens, Michael G; Boggess, Kim A; McGrath, Leah J; Weber, David J; Becker-Dreps, Sylvia

    2017-04-01

    To examine the uptake of prenatal tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) immunization among pregnant women in the United States. Using MarketScan data, we conducted a historical cohort study among pregnant women with employer-based commercial insurance in the United States who delivered between January 1, 2010, and December 31, 2014. We examined temporal trends of uptake, predictors of uptake, and timing of Tdap immunization. Among 1,222,384 eligible pregnancies in 1,147,711 women, receipt of prenatal Tdap immunization increased from 0.0% of women who delivered in January 2010 to 9.8% who delivered in October 2012 (the date of the recommendation by the Advisory Committee on Immunization Practices for Tdap during every pregnancy) to 44.4% who delivered in December 2014. Among women who received Tdap during pregnancy, the majority were immunized between 27 weeks and 36 6/7 weeks of gestation per the Advisory Committee on Immunization Practices recommendation. In multivariable analyses among women who delivered between November 2012 and December 2014, rates of prenatal Tdap immunization were lower for women younger than 25 years of age (eg, 20-24 compared with 30-34 years rate ratio [RR] 0.83, 95% confidence interval [CI] 0.85-0.88), with other children (eg, three compared with zero children: RR 0.86, 95% CI 0.84-0.88), residing in the South compared with the Midwest (RR 0.81, 95% CI 0.80-0.82), or with emergency department visits in early pregnancy (RR 0.93, 95% CI 0.92-0.95). The proportion of pregnant women who received prenatal Tdap increased with increasing gestational age at birth. By the end of 2014, fewer than half of pregnant women in the United States were receiving prenatal Tdap immunization. Implementation and dissemination strategies are needed to increase Tdap coverage among pregnant women, especially those who are young, have other children, or reside in the South.

  6. Using mHealth to Deliver Behavior Change Interventions Within Prenatal Care at Community Health Centers.

    Science.gov (United States)

    Mauriello, Leanne M; Van Marter, Deborah F; Umanzor, Cindy D; Castle, Patricia H; de Aguiar, Emma L

    2016-09-01

    To test an iPad-delivered multiple behavior tailored intervention (Healthy Pregnancy: Step by Step) for pregnant women that addresses smoking cessation, stress management, and fruit and vegetable consumption. A randomized 2 × 5 factorial repeated measures design was employed with randomization on the individual level stratified on behavior risk. Women completed three sessions during pregnancy and two postpartum at postdelivery months 1 and 4. Women were recruited from six locations of federally funded health centers across three states. Participants (N = 335) were English- and Spanish-speaking women at up to 18 weeks gestation. The treatment group received three interactive sessions focused on two priority health behavior risks. The sessions offered individually tailored and stage-matched change strategies based on the transtheoretical model of behavior change. The usual care group received March of Dimes brochures. The primary outcome was the number of behavior risks. Stage of change and continuous measures for all behaviors also were assessed. Data were analyzed across all time points using generalized estimating equations examining repeated measures effects. Women in the treatment group reported significantly fewer risks than those in usual care at 1 month (.85 vs. 1.20, odds ratio [OR] = .70) and 4 months postpartum (.72 vs. .91, OR = .81). Healthy Pregnancy is an evidence-based and personalized program that assists pregnant women with reducing behavior risks and sustaining healthy lifestyle behaviors. © 2016 by American Journal of Health Promotion, Inc.

  7. SisterTalk: final results of a culturally tailored cable television delivered weight control program for Black women.

    Science.gov (United States)

    Risica, Patricia Markham; Gans, Kim M; Kumanyika, Shiriki; Kirtania, Usree; Lasater, Thomas M

    2013-12-27

    Obesity among Black women continues to exceed that of other women. Most weight loss programs created without reference to specific cultural contexts are less effective for Black than White women. Weight control approaches accessible to Black women and adapted to relevant cultural contexts are important for addressing this problem. This paper reports the final results of SisterTalk, the randomized controlled trial of a cable TV weight control program oriented toward Black women. A five group design included a comparison group and a 2 × 2 factorial comparison of a) interactive vs. passive programming and b) telephone social support vs no telephone support, with 12 weekly initial cable TV programs followed by 4 monthly booster videos. At baseline, 3, 8, and 12 months post randomization, telephone and in person surveys were administered on diet, physical activity, and physical measurements of height and weight were taken to calculate body mass index (BMI). Analysis of variance (ANOVA) was used to examine differences over time, and between treatment and comparison groups. Dose variables reflecting use of the TV/video and written materials were also assessed. At 3 months, BMI, weight, and dietary fat were significantly lower and physical activity significantly higher among women exposed to the Cable TV intervention compared to the wait-list comparison group. Significant dietary fat differences were still observed at 8 and 12 month evaluations, but not BMI or physical activity differences. Main effects were not observed for interactive programming or enhanced social support at any time point. Within the intervention group, higher watching of the TV series and higher reading of educational materials were both (separately) associated with significantly lower dietary fat. Cable TV was an effective delivery channel to assist Black women with weight control, increasing physical activity and decreasing dietary fat during an initial intervention period, but only dietary

  8. How should we discuss genetic testing with women newly diagnosed with breast cancer? Design and implementation of a randomized controlled trial of two models of delivering education about treatment-focused genetic testing to younger women newly diagnosed with breast cancer

    Directory of Open Access Journals (Sweden)

    Watts Kaaren J

    2012-07-01

    Full Text Available Abstract Background Germline BRCA1 and BRCA2 mutation testing offered shortly after a breast cancer diagnosis to inform women’s treatment choices - treatment-focused genetic testing ‘TFGT’ - has entered clinical practice in specialist centers and is likely to be soon commonplace in acute breast cancer management, especially for younger women. Yet the optimal way to deliver information about TFGT to younger women newly diagnosed with breast cancer is not known, particularly for those who were not suspected of having a hereditary breast cancer syndrome prior to their cancer diagnosis. Also, little is known about the behavioral and psychosocial impact or cost effectiveness of educating patients about TFGT. This trial aims to examine the impact and efficiency of two models of educating younger women newly diagnosed with breast cancer about genetic testing in order to provide evidence for a safe and effective future clinical pathway for this service. Design/methods In this non-inferiority randomized controlled trial, 140 women newly diagnosed with breast cancer (aged less than 50 years are being recruited from nine cancer centers in Australia. Eligible women with either a significant family history of breast and/or ovarian cancer or with other high risk features suggestive of a mutation detection rate of > 10% are invited by their surgeon prior to mastectomy or radiotherapy. After completing the first questionnaire, participants are randomized to receive either: (a an educational pamphlet about genetic testing (intervention or (b a genetic counseling appointment at a family cancer center (standard care. Each participant is offered genetic testing for germline BRCA mutations. Decision-related and psychosocial outcomes are assessed over 12 months and include decisional conflict (primary outcome;uptake of bilateral mastectomy and/or risk-reducing salpingo-oophorectomy; cancer-specific- and general distress; family involvement in decision

  9. FACTORS RELATED TO KNOWLEDGE ON NEWBORN DANGER SIGNS AMONG THE RECENTLY DELIVERED WOMEN IN SUB-DISTRICT HOSPITALS OF BANGLADESH

    Directory of Open Access Journals (Sweden)

    Sojib Bin Zaman

    2017-06-01

    Full Text Available Background: Bangladesh continues to be one of the top ten countries with the highest burden of neonatal mortality. While, most of the neonatal deaths are preventable; health system delays, delayed identification of newborn danger signs, late diagnosis and initiation of treatment are claimed to be the main challenges. Objective: 1 to determine the level of knowledge among the recently delivered women (RDW about newborn danger signs and 2 to distinguish the factors associated with ability of identifying the danger signs. Methods: A facility based cross-sectional study was conducted in three sub-district hospitals of Bangladesh among 135 RDW between 1 January 2015 and 30 April 2015. Seven key danger signs were identified, and responses were categorized accordingly. Bivariable logistic regression was conducted to determine the likelihood of the association of factors with danger signs identification. Results: About 51% of RDW could identify one key danger sign. Knowledge on “fever’’ was the most commonly known danger sign (65%. Middle age (OR 1.67, 95% CI: 1.09 - 2.18, high education (OR 2.37, 95% CI: 1.46 - 2.77, increased parity (OR 1.91, 95% CI: 1.17 - 2.89, and previous hospital delivery (OR 1.79, 95% CI: 1.14 - 2.68 were found associated with the knowl¬edge of the danger signs. Conclusion: The findings indicate the immediate need to enhance health education among the RDW about newborn danger signs before their hospital discharge. Community based health education programs can be a cost effective intervention to increase awareness and early recognition of neonatal danger signs.

  10. Preference in place of delivery among rural Indian women.

    Directory of Open Access Journals (Sweden)

    Ashoke Gorain

    Full Text Available India accounts for the highest number of maternal and child deaths globally. A large body of empirical research suggests that improvement in the coverage of institutional delivery is essential to reduce the burden of maternal and child death. However the dynamics of choice of place of delivery is poorly understood. Using qualitative survey data consisting of twelve focus group discussions, conducted in a rural setting of West Bengal, India, this study aims to understand the reasons behind preferring home or institution for delivery. Findings reveal that some women who underwent an institutional delivery preferred to deliver their baby at home. On the other hand, of women who delivered their baby at home, 60% wanted to deliver their babies in institutions but could not do so, primarily due to the unwillingness of family members and misreporting of the onset of true labour pain. With the help of Accredited Social Health Activists, the village level health workers, there is need for an intervention that focuses on educating household members (essentially targeting husbands and mother-in-laws about birth preparedness, and identification of true labour pain.

  11. Can an evidence-based book club intervention delivered via a tablet computer improve physical activity in middle-aged women?

    Science.gov (United States)

    Ehlers, Diane K; Huberty, Jennifer L; de Vreede, Gert-Jan

    2015-02-01

    Fewer than 50% of middle-aged women participate in regular physical activity (PA). Innovative approaches that engage women who may not otherwise participate in PA programs are warranted. The purpose of this study was to explore the acceptability and feasibility of a 12-week tablet-based book club for improving middle-aged women's PA. Thirty women (35-64 years of age) were randomized to the Fit Minded Tablet (n=15) and the Standard Fit Minded (i.e., face-to-face intervention) (n=15) groups. The Fit Minded Tablet was adapted from the Standard Fit Minded, a previously tested, theory-based book club intervention using books as a platform for discussion and group support to help women adopt regular PA. Both interventions met weekly for 3 months, for a total of 12 sessions. Tablet group participants accessed materials (e.g., e-books, workbook, live/recorded videoconferencing) via a tablet computer; Standard group participants received materials (e.g., printed books, workbook, live face-to-face meetings) in person. Feasibility (i.e., implementation and expansion) was assessed using process evaluation, qualitative interviews, satisfaction surveys, and quantitative outcome assessments. Women in the Tablet group attended fewer meetings (mean, 8.25) than women in the Standard group (mean, 9.9). Videoconferencing, digital literacy, and participant engagement limitations were observed in the Tablet group. Tablet participants enjoyed the e-books but thought technology barriers hindered their engagement during meetings. Women in both groups valued the support they received from other group members. Standard participants cited this support as a key contributor to their PA changes, whereas Tablet participants reported needing in-person contact to feel more connected. Given the popularity of tablet computers and the value that middle-aged women place on group interaction to support their PA behaviors, additional research is warranted to determine best strategies for optimizing

  12. Risk of cesarean delivery among pregnant women with class III obesity.

    Science.gov (United States)

    Borghesi, Yves; Labreuche, Julien; Duhamel, Alain; Pigeyre, Marie; Deruelle, Philippe

    2017-02-01

    To identify factors associated with cesarean delivery among women with class III obesity attempting vaginal delivery. In a retrospective study, medical charts were reviewed for women aged 18 years or older with a singleton pregnancy of at least 37 weeks and a body mass index (calculated as weight in kilograms divided by the square of height in meters) of 40 or higher who were eligible to attempt vaginal delivery at a maternity hospital in Lille, France, between 1999 and 2012. Among 345 eligible women, 301 (87.2%) attempted vaginal delivery; 211 (70.1%) were successful and 90 (29.9%) delivered by cesarean. The frequency of nulliparity was higher among those undergoing cesarean after a trial of labor (64 [71.1%]) than among those who delivered vaginally (57 [27.0%]; Pcesarean (61 [67.8%] vs 96 [45.5%]; Pcesarean among women attempting vaginal delivery (odds ratio [OR] 2.30, 95% confidence interval [CI] 1.25-4.22), whereas history of vaginal delivery was protective (OR 0.08, 95% CI 0.04-0.17). Nulliparous women with class III obesity attempting a vaginal delivery should be warned of the high risk of cesarean delivery, especially if they require induction. © 2016 International Federation of Gynecology and Obstetrics.

  13. Delivering Online Examinations: A Case Study

    Directory of Open Access Journals (Sweden)

    John MESSING

    2004-07-01

    Full Text Available Delivering Online Examinations: A Case Study Jason HOWARTH John MESSING Irfan ALTAS Charles Sturt University Wagga Wagga-AUSTRALIA ABSTRACT This paper represents a brief case study of delivering online examinations to a worldwide audience. These examinations are delivered in partnership with a commercial online testing company as part of the Industry Master’s degree at Charles Sturt University (CSU. The Industry Master’s degree is an academic program for students currently employed in the IT industry. Using Internet Based Testing (IBT, these students are examined in test centres throughout the world. This offers many benefits. For example, students have the freedom of sitting exams at any time during a designated interval. Computer-based testing also provides instructors with valuable feedback through test statistics and student comments. In this paper, we document CSU’s use of the IBT system, including how tests are built and delivered, and how both human and statistical feedback is used to evaluate and enhance the testing process.

  14. Fetal Outcomes among Grand Multiparous and Multiparous Women ...

    African Journals Online (AJOL)

    Objective: To compare fetal outcomes among grand multiparous (para 5-9) and multiparous (para 2-4) delivering in Mulago hospital, Uganda. Design: Prospective cohort study. Setting: Mulago hospital, Uganda. Subjects: One hundred and fifty six grand multiparous and multiparous women were recruited on admission in ...

  15. Contemporary second stage labor patterns in Taiwanese women with normal neonatal outcomes.

    Science.gov (United States)

    Hung, Tai-Ho; Chen, Szu-Fu; Lo, Liang-Ming; Hsieh, T'sang-T'ang

    2015-08-01

    To compare the duration of second stage labor among modern Taiwanese women who achieved vaginal delivery without adverse neonatal outcomes and women who delivered during the early 1990 s. Data were collected from women who underwent spontaneous labor and vaginally delivered cephalic singleton fetuses with normal neonatal outcomes at the Taipei Chang Gung Memorial Hospital, Taipei, Taiwan from 1991-1995 (Cohort 1, n = 10,721) and 2010-2014 (Cohort 2, n = 3734). We calculated the median duration and 95th percentiles of second stage labor. The women were stratified according to analgesia and parity. Multiple linear regression analysis was used to determine the association between the maternal/pregnancy characteristics and second stage labor duration. The median second stage labor duration was significantly longer for Cohort 2 than for Cohort 1. For nulliparous women, the 95th percentile second stage labor thresholds were 255 minutes and 152 minutes (Cohort 2) and 165 minutes and 107 minutes (Cohort 1) for women with and without epidural analgesia, respectively. For multiparous women, the 95th percentile second stage labor thresholds were 136 minutes and 43 minutes (Cohort 2) and 125 minutes and 39 minutes (Cohort 1) for women with and without epidural analgesia, respectively. Birth weight, maternal age at delivery, and time period (2010-2014 vs. 1991-1995) were significant factors associated with the duration of second stage labor. Modern Taiwanese women who achieved vaginal delivery without adverse neonatal outcomes experienced longer second stage labors than women 25 years ago. The 95th percentile thresholds differed between nulliparous and multiparous women with and without epidural analgesia. Copyright © 2015. Published by Elsevier B.V.

  16. Creating a Roadmap for Delivering Gender-sensitive Comprehensive Care for Women Veterans: Results of a National Expert Panel

    NARCIS (Netherlands)

    Kleijn, M.J.J. de; Lagro-Janssen, A.L.M.; Canelo, I.; Yano, E.M.

    2015-01-01

    BACKGROUND: Women Veterans are a significant minority of users of the VA healthcare system, limiting provider and staff experience meeting their needs in environments historically designed for men. The VA is nonetheless committed to ensuring that women Veterans have access to comprehensive care in

  17. Women Health Outreach Program; a New Experience for all Egyptian Women

    International Nuclear Information System (INIS)

    SALEM, D.S.; KAMAL, R.M.; HELAL, M.H.

    2008-01-01

    The global health community faces a challenge with breast cancer being the most common cause of cancer related death among women around the globe. Since breast cancer’s pathogenesis is poorly understood, primary prevention is still a distant goal. Thus secondary prevention through early detection is the only feasible approach at present. With this strong conviction, the launching o f the first Egyptian national screening program W omen Health Outreach Program ( WHOP), was announced on October 30 th 2007. This project is a government- funded program that offers free breast screening for all Egyptian women above the age of 45 years. In addition to free mammograms, the program gives the participants a chance to be screened for diabetes, hypertension and obesity as well. Positively detected cases are also offered the option of free management. During the period from October 30 th , 2007, up to February 9 th , 2009, 20, 098 women in Cairo, Alexandria and Suez governorates were screened for breast cancer, diabetes, hypertension and obesity through the program. In this article we will represent the achievements, challenges and services delivered by WHOP

  18. Oxytocin and dystocia as risk factors for adverse birth outcomes: a cohort of low-risk nulliparous women.

    Science.gov (United States)

    Bernitz, Stine; Øian, Pål; Rolland, Rune; Sandvik, Leiv; Blix, Ellen

    2014-03-01

    augmented and not augmented women without dystocia were compared to investigate associations between oxytocin and adverse birth outcomes. Augmented women with and without dystocia were compared, to investigate associations between dystocia and adverse birth outcomes. a cohort of low-risk nulliparous women originally included in a randomised controlled trial. the Department of Obstetrics and Gynaecology, Østfold Hospital Trust, Norway. the study population consists of 747 well defined low-risk women. incidence of oxytocin augmentation, and associations between dystocia and augmentation, and mode of delivery, transfer of newborns to the intensive care unit, episiotomy and postpartum haemorrhage. of all participants 327 (43.8%) were augmented with oxytocin of which 139 (42.5%) did not fulfil the criteria for dystocia. Analyses adjusted for possible confounders found that women without dystocia had an increased risk of instrumental vaginal birth (OR 3.73, CI 1.93-7.21) and episiotomy (OR 2.47, CI 1.38-4.39) if augmented with oxytocin. Augmented women had longer active phase if vaginally delivered and longer labours if delivered by caesarean section if having dystocia. Among women without dystocia, those augmented had higher body mass index, gave birth to heavier babies, had longer labours if vaginally delivered and had epidural analgesia more often compared to women not augmented. in low-risk nulliparous without dystocia, we found an association between the use of oxytocin and an increased risk of instrumental vaginal birth and episiotomy. careful attention should be paid to criteria for labour progression and guidelines for oxytocin augmentation to avoid unnecessary use. Copyright © 2013 Elsevier Ltd. All rights reserved.

  19. Implementing a Coach-Delivered Dating Violence Prevention Program with High School Athletes.

    Science.gov (United States)

    Jaime, Maria Catrina D; McCauley, Heather L; Tancredi, Daniel J; Decker, Michele R; Silverman, Jay G; O'Connor, Brian; Miller, Elizabeth

    2018-05-10

    Teen dating violence and sexual violence are severe public health problems. Abusive behaviors within the context of dating or romantic relationships are associated with adverse health outcomes. Promoting positive bystander intervention and increasing knowledge of abusive behaviors are promising strategies for preventing dating and sexual violence. Coaching Boys Into Men (CBIM) is an evidence-based, athletic coach-delivered dating violence prevention program that has been shown to increase positive bystander behaviors and reduce abuse perpetration among high school male athletes. Identifying specific barriers and facilitators based on the coaches' experiences with program delivery combined with the coaches' and athletes' program perceptions may help optimize future CBIM implementation and sustainability. Semi-structured interviews with coaches (n = 36) explored the implementers' perspectives on strategies that worked well and potential barriers to program implementation. Ten focus groups with male athletes (n = 39) assessed their experiences with CBIM and the suitability of having their coaches deliver this program. Coaches described using the CBIM training cards and integrating program delivery during practice. Athletes reported coaches routinely delivering the CBIM program and adding their own personal stories or examples to the discussions. Key facilitators to program implementation include support from the violence prevention advocate, the ease of integrating CBIM into the sports season, and using the program materials. Barriers to implementation included finding sufficient time for the program, dynamics of delivering sensitive program content, and participant constraints. Coaches and athletes alike found the program feasible and acceptable to implement within the sports setting. Both coaches and athletes offered insights on the implementation and the feasibility and acceptability of CBIM within school-based athletic programs. These experiences by

  20. Patients' Characteristics and Providers' Attitudes: Predictors of Screening Pregnant Women for Illicit Substance Use

    Science.gov (United States)

    Kerker, Bonnie D.; Horwitz, Sarah M.; Leventhal, John M.

    2004-01-01

    Objective: This study's aim was to determine how patients' and providers' characteristics affect hospital providers' decisions to screen pregnant and postpartum women for illicit substances. Methods: A retrospective design was used. Participants included all low-income women (N=1,100) who delivered at an urban teaching hospital over a 12-month…

  1. Determinants of institutional delivery among young married women in Nepal: Evidence from the Nepal Demographic and Health Survey, 2011

    Science.gov (United States)

    Shahabuddin, ASM; De Brouwere, Vincent; Adhikari, Ramesh; Delamou, Alexandre; Bardaj, Azucena; Delvaux, Therese

    2017-01-01

    Objectives To identify the determinants of institutional delivery among young married women in Nepal. Design Nepal Demographic and Health Survey (NDHS) data sets 2011 were analysed. Bivariate and multivariate logistic regression analyses were performed using a subset of 1662 ever-married young women (aged 15–24 years). Outcome measure Place of delivery. Results The rate of institutional delivery among young married women was 46%, which is higher than the national average (35%) among all women of reproductive age. Young women who had more than four antenatal care (ANC) visits were three times more likely to deliver in a health institution compared with women who had no antenatal care visit (OR: 3.05; 95% CI: 2.40 to 3.87). The probability of delivering in an institution was 69% higher among young urban women than among young women who lived in rural areas. Young women who had secondary or above secondary level education were 1.63 times more likely to choose institutional delivery than young women who had no formal education (OR: 1.626; 95% CI: 1.171 to 2.258). Lower use of a health institution for delivery was also observed among poor young women. Results showed that wealthy young women were 2.12 times more likely to deliver their child in an institution compared with poor young women (OR: 2.107; 95% CI: 1.53 to 2.898). Other factors such as the age of the young woman, religion, ethnicity, and ecological zone were also associated with institutional delivery. Conclusions Maternal health programs should be designed to encourage young women to receive adequate ANC (at least four visits). Moreover, health programs should target poor, less educated, rural, young women who live in mountain regions, are of Janajati ethnicity and have at least one child as such women are less likely to choose institutional delivery in Nepal. PMID:28408543

  2. A randomized controlled trial comparing parenteral normal saline with and without 5% dextrose on the course of labor in nulliparous women.

    Science.gov (United States)

    Sharma, Chanderdeep; Kalra, Jasvinder; Bagga, Rashmi; Kumar, Praveen

    2012-12-01

    The objective of this study was to compare intravenous normal saline with and without 5% dextrose on the course of labor in nulliparous women in active phase of spontaneous labor. In a randomized controlled trial, term, nulliparous women with singleton pregnancy in active labor were randomized into one of two groups receiving either normal saline or normal saline alternating with 5% dextrose at rate of 175 ml/h. The primary outcome was total length of labor from onset of study fluid in vaginally delivered women. Maternal and neonatal outcomes were also analyzed. Of 250 women enrolled, in vaginally delivered subjects, there was significant difference in the duration of labor (p=0.0) and prolonged labor (p=0.01), with favorable results for women in 5% dextrose alternating with normal saline. No statistically significant differences were observed in the cesarean section rates between the groups. The cord pH was significantly higher in neonates born to women in 5% dextrose alternating with normal saline infusion as compared to normal saline alone (p=0.01), however, no neonate in the study had acidemia. Administration of a 5% dextrose solution alternating with normal saline is a better parenteral fluid for significantly decreasing duration of labor in term vaginally delivered nulliparous women in spontaneous active labor as compared to normal saline alone.

  3. Mindfulness-based yoga intervention for women with depression.

    Science.gov (United States)

    Schuver, Katie J; Lewis, Beth A

    2016-06-01

    The purpose of this study was to examine the efficacy of a 12-week mindfulness-based yoga intervention on depressive symptoms and rumination among depressed women. Prospective, randomized, controlled 12 week intervention pilot study. Depressive symptoms were assessed at baseline, post-intervention (12 weeks), and one-month follow-up. Women with a history of diagnosed depression and currently depressed were randomized to a mindfulness-based yoga condition or a walking control. The mindfulness-based yoga intervention consisted of a home-based yoga asana, pranayama and meditation practice with mindfulness education sessions delivered over the telephone. The walking control condition consisted of home-based walking sessions and health education sessions delivered over the phone. The Beck Depression Inventory (BDI) and Ruminative Responses Scale (RRS). Both groups reported decreases in depressive symptoms from baseline to post-intervention, f(1,33)=34.83, pyoga condition reported significantly lower levels of rumination than the control condition at post-intervention, after controlling for baseline levels of rumination, f(1,31)=6.23, pyoga may provide tools to manage ruminative thoughts among women with elevated depressive symptoms. Future studies, with larger samples are needed to address the effect of yoga on depression and further explore the impact on rumination. Copyright © 2016 Elsevier Ltd. All rights reserved.

  4. Women's attitudes towards receiving family planning services from ...

    African Journals Online (AJOL)

    These are age, level of education, knowledge about family planning benefits and districts. Conclusion: Women's perception towards family planning services delivered by CHWs in Western region in Kenya is quite low. To improve the demand and supply for family planning services in this region, there is need to invest a ...

  5. Delivering high performance BWR fuel reliably

    International Nuclear Information System (INIS)

    Schardt, J.F.

    1998-01-01

    Utilities are under intense pressure to reduce their production costs in order to compete in the increasingly deregulated marketplace. They need fuel, which can deliver high performance to meet demanding operating strategies. GE's latest BWR fuel design, GE14, provides that high performance capability. GE's product introduction process assures that this performance will be delivered reliably, with little risk to the utility. (author)

  6. Delivering high performance BWR fuel reliably

    Energy Technology Data Exchange (ETDEWEB)

    Schardt, J.F. [GE Nuclear Energy, Wilmington, NC (United States)

    1998-07-01

    Utilities are under intense pressure to reduce their production costs in order to compete in the increasingly deregulated marketplace. They need fuel, which can deliver high performance to meet demanding operating strategies. GE's latest BWR fuel design, GE14, provides that high performance capability. GE's product introduction process assures that this performance will be delivered reliably, with little risk to the utility. (author)

  7. Is Male Involvement in ANC and PMTCT Associated with Increased Facility-Based Obstetric Delivery in Pregnant Women?

    Science.gov (United States)

    Kashitala, Joshua; Nyambe, Namakau; Mwalo, Stuart; Musamba, Josephine; Chishinga, Nathaniel; Kasonde, Prisca; Lilja, Anna M; Mwiche, Angel; Welsh, Michael

    2015-06-01

    Ensuring that pregnant women are delivering in a health facility and are attended to by skilled birth attendants is critical to reducing maternal and infant morbidity and mortality. This study sought to determine the associations between male involvement in antenatal care (ANC) services and pregnant women delivering at health facilities and being attended to by skilled birth attendants as well as attending postnatal care. This was a retrospective cohort study using secondary analysis of program data. We reviewed health records of all pregnant women who attended antenatal services irrespective of HIV status between March and December 2012 in 10 health facilities in three provinces of Zambia. An extraction questionnaire was used to collect sociodemographic and clinical information from registers used in services for maternal neonatal child health as well as delivery. Using logistic regression, we calculated the odds ratios (OR) and 95% confidence intervals (CI) of the association between (1) male involvement and delivery at a health facility by a skilled birth attendant and (2) male involvement and women's attendance at postnatal services. We found that more women who had been accompanied by their male partner during ANC delivered at a health facility than those who had not been accompanied (88/220 = 40% vs. 543/1787 = 30.4%, respectively; OR 1.53, 95% CI: 1.15-2.04). Also, we noted that a greater proportion of the women who returned for postnatal visits had been accompanied by their partner at ANC visits, compared to those women who came to ANC without their partner (106/220 = 48.2% vs. 661/1787 = 37.0%, respectively; OR 1.58, 95% CI: 1.20-2.10). Male involvement seems to be a key factor in women's health-seeking behaviours and could have a positive impact on maternal and infant morbidity and mortality.

  8. The risk of caesarean section in obese women analysed by parity.

    LENUS (Irish Health Repository)

    O'Dwyer, Vicky

    2012-02-01

    OBJECTIVE: This study looked at the association between caesarean section (CS) and Body Mass Index (BMI) in primigravidas compared with multigravidas. STUDY DESIGN: We enrolled women at their convenience, in the first trimester after an ultrasound examination confirmed an ongoing pregnancy. Weight and height were measured digitally and BMI calculated. After delivery, clinical details were again collected from the Hospital\\'s computerised database. RESULTS: Of the 2000 women enrolled, there were 50.4% (n=1008) primigravidas and 49.6% (n=992) multigravidas. Of the 2000 8.5% were delivered by elective CS and 13.4% were delivered by emergency CS giving an overall rate of 21.9%. The overall CS rate was 30.1% in obese women compared with 19.2% in the normal BMI category (p<0.001). In primigravidas the increase in CS rate in obese women was due to an increase in emergency CS (p<0.005) and in multigravidas the increase was due to an increase in elective CS (p<0.01). In obese primigravidas 20.6% had an emergency section for fetal distress. In obese multigravidas 17.2% had a repeat elective CS. CONCLUSION: The influence of maternal obesity on the increase in CS rates is different in primigravidas compared with multigravidas.

  9. Materials Delivered by Member States

    International Nuclear Information System (INIS)

    1966-01-01

    The information given in this document is divided into two parts. In part I the Director General is reporting to the Members of the Agency, under Article IX. G of the Statute, the quantities of materials delivered by Members up to 31 December 1965 in compliance with requests the Agency had made under Article IX. D. Part III contains information about materials which had not been delivered by 31 December but which had been allocated, in accordance with Article XI. F. 1 of the Statute, to approved Agency projects for which project arrangements were in force on that date

  10. Materials Delivered by Member States

    International Nuclear Information System (INIS)

    1965-01-01

    The information given in this document is divided into two parts. In part I the Director General is reporting to the Members of the Agency, under Article IX. G of the Statute, the quantities of materials delivered by Members up to 31 December 1964 in compliance with requests the Agency had made under Article IX. D. Part II contains information about materials which had not been delivered by 31 December but which had been allocated, in accordance with Article XI. F. 1 of the Statute, to approved Agency projects for which project arrangements were in force on that date

  11. Materials Delivered by Member States

    International Nuclear Information System (INIS)

    1968-01-01

    The information given in this document is divided into two parts. In part I the Director General is reporting to the Members of the Agency, under Article IX. G of the Statute, the quantities of materials delivered by Members up to 30 June 1968 in compliance with requests the Agency had made under Article IX,D. Part II contains information about materials which had not been delivered by 30 June 1968 but which had been allocated, in accordance with Article XI.F.I of the Statute, to approved Agency projects for which project arrangements were in force on that date

  12. '. . . if you bring the kit home, you [can] get time and test together with your partner': Pregnant women and male partners' perceptions regarding female partner-delivered HIV self-testing in Uganda - A qualitative study.

    Science.gov (United States)

    Matovu, Joseph Kb; Buregyeya, Esther; Arinaitwe, Jim; Wanyenze, Rhoda K

    2017-11-01

    In 2015, the World Health Organization reported that more than 60 million people were tested for HIV in 122 low- and middle-income countries between 2010 and 2014. Despite this level of progress, over 40% of people living with HIV remain unaware of their HIV status. This calls for innovative approaches to improve uptake of HIV testing services, including use of HIV self-test (HIVST) kits. We conducted a cross-sectional, qualitative study to assess pregnant women and their male partners' perceptions regarding female partner-delivered HIVST kits. This study was conducted at two health facilities in Central Uganda between November and December 2015. Data were collected on pregnant women's willingness to take HIVST kits to their male partners and other household members using eight focus group discussions and 30 in-depth interviews. Data were analyzed following a thematic framework approach. Overall, pregnant women were willing to take HIVST kits to their partners and other household members, with the exception of their cowives. Male partners were willing to use HIVST kits brought by their female partners. Our findings suggest that secondary distribution of HIVST kits through female partners is acceptable and has the potential to improve male partner and household-member HIV testing.

  13. The effect of inflatable obstetric belts in nulliparous pregnant women receiving patient-controlled epidural analgesia during the second stage of labor.

    Science.gov (United States)

    Kim, Jong-Woon; Kim, Yoon Ha; Cho, Hye Yon; Shin, Hee-Young; Shin, Jong Chul; Choi, Sea Kyung; Lee, Keun-Young; Song, Ji-Eun; Lee, Pil-Ryang

    2013-11-01

    The aim of this study was to evaluate the effect of inflatable obstetric belts on uterine fundal pressure in the management of the second stage of labor. Between July 2009 and December 2010, 188 nulliparous women with a singleton pregnancy at term were enrolled and only one dropped. The participants were randomized to receive either standard care (control group, n = 91) or uterine fundal pressure by the Labor Assister (Baidy M-520/Curexo, Inc., Seoul, Korea; active group, n = 97) during the second stage of labor in addition to standard care. The Labor Assister is an inflatable obstetric belt that is synchronized to apply constant fundal pressure during a uterine contraction. The primary endpoint was duration of the second stage of labor in women who delivered vaginally (control, n = 80 versus active, n = 93). It was not analyzed in women who delivered by cesarean section (n = 14) and delivered precipitously (n = 1). The secondary outcomes are perinatal outcomes and perineal laceration. Participants received patient-controlled epidural analgesia. The 93 women in the active group spent less time in the second stage of labor when compared to the 80 women in the control group (46.51 ± 28.01 min versus 75.02 ± 37.48 min, p labor without complications in nulliparous women who receive patient-controlled epidural analgesia.

  14. Alternative Fuels Data Center: Seattle Bakery Delivers With Biodiesel

    Science.gov (United States)

    Trucks Seattle Bakery Delivers With Biodiesel Trucks to someone by E-mail Share Alternative Fuels Data Center: Seattle Bakery Delivers With Biodiesel Trucks on Facebook Tweet about Alternative Fuels Data Center: Seattle Bakery Delivers With Biodiesel Trucks on Twitter Bookmark Alternative Fuels

  15. Anal incontinence in women with recurrent obstetric anal sphincter rupture

    DEFF Research Database (Denmark)

    Bøgeskov, Reneé; Nickelsen, Carsten Nahne Amtoft; Secher, Niels Jørgen

    2015-01-01

    UNLABELLED: Abstract Objectives: To determine the risk of recurrent anal sphincter rupture (ASR), and compare the risk of anal incontinence (AI) after recurrent ASR, with that seen in women with previous ASR who deliver by caesarean section or vaginally without sustaining a recurrent ASR. METHODS...

  16. Portrayal of caesarean section in Brazilian women's magazines: 20 year review.

    Science.gov (United States)

    Torloni, Maria Regina; Daher, Silvia; Betrán, Ana Pilar; Widmer, Mariana; Montilla, Pilar; Souza, Joao Paulo; Merialdi, Mario

    2011-01-25

    To assess the quality and comprehensiveness of the information on caesarean section provided in Brazilian women's magazines. Review of articles published during 1988-2008 in top selling women's magazines. Brazil, one of the countries with the highest caesarean section rates in the world. Women's magazines with the largest distribution during the study period, identified through the official national media indexing organisations. Articles with objective scientific information or advice, comments, opinions, or the experience of ordinary women or celebrities on delivery by caesarean section. Sources of information mentioned by the author of the article, the accuracy and completeness of data presented on caesarean section, and alleged reasons why women would prefer to deliver though caesarean section. 118 articles were included. The main cited sources of information were health professionals (78% (n=92) of the articles). 71% (n=84) of the articles reported at least one benefit of caesarean section, and 82% (n=97) reported at least one short term maternal risk of caesarean section. The benefits most often attributed to delivery by caesarean section were reduction of pain and convenience for family or health professionals. The most frequently reported short term maternal risks of caesarean section were increased time to recover and that it is a less natural way of giving birth. Only one third of the articles mentioned any long term maternal risks or perinatal complications associated with caesarean section. Fear of pain was the main reported reason why women would prefer to deliver by caesarean section. Most of the articles published in Brazilian women's magazines do not use optimal sources of information. The portrayal of caesarean section is mostly balanced, not explicitly in favour of one or another route of delivery, but incomplete and may be leading women to underestimate the maternal/perinatal risks associated with this route of delivery.

  17. Changing trends on the place of delivery: why do Nepali women give birth at home?

    Directory of Open Access Journals (Sweden)

    Shrestha Saraswoti

    2012-10-01

    Full Text Available Abstract Background Home delivery in unhygienic environment is common in Nepal. This study aimed to identify whether practice of delivery is changing over time and to explore the factors contributing to women’s decision for choice of place of delivery. Methods A community based cross sectional study was conducted among 732 married women of reproductive age (MWRA in Kavrepalanchok district of Nepal in 2011. Study wards were selected randomly and all MWRA residing in the selected wards were interviewed. Data were collected through pre-tested interviewer administered questionnaire. Chi-square and multivariate analysis was used to examine the association between socio-demographic factors and place of delivery. Results The study shows that there was almost 50% increasement in institutional delivery over the past ten years. The percentage of last birth delivered in health institution has increased from 33.7% before 10 years to 63.8% in the past 5 years. However, the place of delivery varied according to residence. In urban area, most women 72.3% delivered in health institutions while only 35% women in rural and 17.5% in remote parts delivered in health institutions. The key socio-demographic factors influencing choice of place of delivery included multi parity, teen-age pregnancy, less or no antenatal visits. Having a distant health center, difficult geographical terrain, lack of transportation, financial constraints and dominance of the mothers- in-law were the other main reasons for choosing a home delivery. Psychological vulnerability and insecurity of rural women also led to home delivery, as women were shy and embarrassed in visiting the health center. Conclusion The trend of delivery at health institution was remarkably increased but there were strong differentials in urban–rural residency and low social status of women. Shyness, dominance of mothers in law and ignorance was one of the main reasons contributing to home delivery.

  18. Risk perception of future cardiovascular disease in women diagnosed with a hypertensive disorder of pregnancy.

    Science.gov (United States)

    Traylor, Jessica; Chandrasekaran, Suchitra; Limaye, Meghana; Srinivas, Sindhu; Durnwald, Celeste P

    2016-01-01

    The objective of this study is to evaluate a woman's risk perception for future cardiovascular disease (CVD) after being diagnosed with a hypertensive disorder of pregnancy. A prospective cohort of women diagnosed with a hypertensive disorder of pregnancy (HDP) was studied. Each woman completed two surveys, one prior to hospital discharge and one 2 weeks later, designed to assess knowledge of and risk perception for future CVD based on their recent diagnosis of a HDP. Rates of postpartum depression were also assessed. Of the 146 subjects included, 28% were diagnosed with preeclampsia with severe features, 52.1% with preeclampsia with mild features, and 19.9% had chronic hypertension. Women with severe features and those delivering preterm were more likely to report a perception of increased risk of both recurrent HDP in a future pregnancy (p = 0.004 and 0.005, respectively) and hypertension later in life (p = 0.01 and 0.03, respectively). Women delivering preterm were more likely to report an accurate perception of increased risk of myocardial infarction and stroke compared to those delivering at term (p = 0.006 and 0.002, respectively). Disease severity and preterm delivery were associated with a higher likelihood of the perception of an increased risk for both recurrent HDP and hypertension in the future. Only preterm delivery was associated with a higher risk perception for stroke and myocardial infarction. Interventions targeted at improved health awareness in women diagnosed with HDP are warranted.

  19. Awareness of Cytomegalovirus Infection among Pregnant Women in Geneva, Switzerland: A Cross-sectional Study

    Directory of Open Access Journals (Sweden)

    Alexia Willame

    2015-12-01

    Full Text Available Background: Cytomegalovirus (CMV is the most frequent cause of congenital infection and commonly associated with sensorineural deficit. At present, there is neither prophylaxis nor treatment during pregnancy. The objective of this study was to evaluate the level of awareness regarding CMV infection and its consequences in women delivering at the University of Geneva Hospitals (Geneva, Switzerland. Methods: The study consisted of a validated questionnaire completed by women in the immediate postpartum period. Results: The questionnaire was completed by 59% (314/528 of delivering women. Only 39% (123/314 knew about CMV and 19.7% (62/314 had received information about preventive measures. Women were more aware about other congenital diseases, such as toxoplasmosis (87%; human immunodeficiency virus (99%; syphilis (85.5%; rubella (92.3%; and group B Streptococcus (63%. Factors associated with CMV awareness were Swiss nationality, high education level, employment in health care or with children, and being followed by an obstetrician. Regarding quality of information, few were aware of the main CMV complications (deafness, 25.2%; mental retardation, 34.5%. Among those informed about CMV, most (74.6% knew about preventive measures. Among these, 82.5% thought that these were easily applicable. Conclusions: Most women were unaware of CMV infection and its potential risks during pregnancy. It is crucial to improve CMV information given to pregnant women to prevent the risks for the fetus/newborn.

  20. Clinical impact of and contributing factors to urinary incontinence in women 5 years after first delivery.

    Science.gov (United States)

    Liang, Ching-Chung; Wu, Ming-Ping; Lin, Shu-Jen; Lin, Yu-Jr; Chang, Shuenn-Dhy; Wang, Hui-Hsuan

    2013-01-01

    This study was conducted to investigate the prevalence of and contributing factors to urinary incontinence (UI) in women 5 years after their first birth and to evaluate the associations of UI with delivery mode and quality of life. Between 2005 July and 2006 March, primiparous women who delivered at term in a tertiary hospital were recruited into this cohort study. Immediately postpartum, the women completed a structured urogynecological questionnaire regarding lower urinary tract symptoms. Then the same urogynecological questionnaire, the Incontinence Impact Questionnaire (IIQ-7), and the Urinary Distress Inventory (UDI-6) were mailed to them 5 years later to follow up on UI. Three hundred and twelve women responding to the mailed questionnaires were included in the analyses. The prevalence 5 years after first delivery of stress (SUI) and urge (UUI) UI were 43.6 % and 19.2 %, respectively. Women with UI during their first pregnancy were more likely to develop UI 5 years postpartum than those without it; women who delivered their first child vaginally had a greater incidence of UI than those having cesarean birth; UUI in women following cesarean delivery more negatively impacted emotional health than it did following vaginal birth, whereas the impact of SUI did not significantly differ between delivery groups. UI during the first pregnancy and vaginal delivery in primiparous women may predict an increased risk of having UI 5 years after delivery. UUI adversely affected women's emotional health, especially in those undergoing cesarean section.

  1. Implementation and evaluation of a harm-reduction model for clinical care of substance using pregnant women

    Directory of Open Access Journals (Sweden)

    Wright Tricia E

    2012-01-01

    Full Text Available Abstract Background Methamphetamine (MA use during pregnancy is associated with many pregnancy complications, including preterm birth, small for gestational age, preeclampsia, and abruption. Hawaii has lead the nation in MA use for many years, yet prior to 2007, did not have a comprehensive plan to care for pregnant substance-using women. In 2006, the Hawaii State Legislature funded a pilot perinatal addiction clinic. The Perinatal Addiction Treatment Clinic of Hawaii was built on a harm-reduction model, encompassing perinatal care, transportation, child-care, social services, family planning, motivational incentives, and addiction medicine. We present the implementation model and results from our first one hundred three infants (103 seen over 3 years of operation of the program. Methods Referrals came from community health centers, hospitals, addiction treatment facilities, private physician offices, homeless outreach services and self-referral through word-of-mouth and bus ads. Data to describe sample characteristics and outcome was obtained prospectively and retrospectively from chart abstraction and delivery data. Drug use data was obtained from the women's self-report and random urine toxicology during the pregnancy, as well as urine toxicology at the time of birth on mothers, and urine and meconium toxicology on the infants. Post-partum depression was measured in mothers with the Edinburgh Post-Partum depression scale. Data from Path clinic patients were compared with a representative cohort of women delivering at Kapiolani Medical Center for Women and Children during the same time frame, who were enrolled in another study of pregnancy outcomes. Ethical approval for this study was obtained through the University of Hawaii Committee for Human Studies. Results Between April 2007 and August 2010, 213 women with a past or present history of addiction were seen, 132 were pregnant and 97 delivered during that time. 103 live-born infants were

  2. Implementation and evaluation of a harm-reduction model for clinical care of substance using pregnant women.

    Science.gov (United States)

    Wright, Tricia E; Schuetter, Renee; Fombonne, Eric; Stephenson, Jessica; Haning, William F

    2012-01-19

    Methamphetamine (MA) use during pregnancy is associated with many pregnancy complications, including preterm birth, small for gestational age, preeclampsia, and abruption. Hawaii has lead the nation in MA use for many years, yet prior to 2007, did not have a comprehensive plan to care for pregnant substance-using women. In 2006, the Hawaii State Legislature funded a pilot perinatal addiction clinic. The Perinatal Addiction Treatment Clinic of Hawaii was built on a harm-reduction model, encompassing perinatal care, transportation, child-care, social services, family planning, motivational incentives, and addiction medicine. We present the implementation model and results from our first one hundred three infants (103) seen over 3 years of operation of the program. Referrals came from community health centers, hospitals, addiction treatment facilities, private physician offices, homeless outreach services and self-referral through word-of-mouth and bus ads. Data to describe sample characteristics and outcome was obtained prospectively and retrospectively from chart abstraction and delivery data. Drug use data was obtained from the women's self-report and random urine toxicology during the pregnancy, as well as urine toxicology at the time of birth on mothers, and urine and meconium toxicology on the infants. Post-partum depression was measured in mothers with the Edinburgh Post-Partum depression scale. Data from Path clinic patients were compared with a representative cohort of women delivering at Kapiolani Medical Center for Women and Children during the same time frame, who were enrolled in another study of pregnancy outcomes. Ethical approval for this study was obtained through the University of Hawaii Committee for Human Studies. Between April 2007 and August 2010, 213 women with a past or present history of addiction were seen, 132 were pregnant and 97 delivered during that time. 103 live-born infants were delivered. There were 3 first-trimester Spontaneous

  3. Urinary incontinence and vaginal squeeze pressure two years post-cesarean delivery in primiparous women with previous gestational diabetes mellitus

    OpenAIRE

    Barbosa, Angélica Mércia Pascon; Dias, Adriano; Marini, Gabriela; Calderon, Iracema Mattos Paranhos; Witkin, Steven; Rudge, Marilza Vieira Cunha

    2011-01-01

    OBJECTIVE: To assess the prevalence of urinary incontinence and associated vaginal squeeze pressure in primiparous women with and without previous gestational diabetes mellitus two years post-cesarean delivery. METHODS: Primiparous women who delivered by cesarean two years previously were interviewed about the delivery and the occurrence of incontinence. Incontinence was reported by the women and vaginal pressure evaluated by a Perina perineometer. Sixty-three women with gestational diabetes ...

  4. Determinants of prenatal health care utilisation by low-risk women: a prospective cohort study.

    Science.gov (United States)

    Feijen-de Jong, Esther I; Jansen, Danielle E M C; Baarveld, Frank; Boerleider, Agatha W; Spelten, Evelien; Schellevis, François; Reijneveld, Sijmen A

    2015-06-01

    Prenatal health care is pivotal in providing adequate prevention and care to pregnant women. We examined the determinants of inadequate prenatal health care utilisation by low-risk women in primary midwifery-led care in the Netherlands. We used longitudinal data from the population-based DELIVER study with 20 midwifery practices across the Netherlands in 2009 and 2010 as the experimental setting. The participants were 3070 pregnant women starting pregnancy care in primary midwifery care. We collected patient-reported data on potential determinants of prenatal care utilisation derived from the Andersen model. Prenatal health care utilisation was measured by a revised version of the Kotelchuck Index, which measures a combination of care entry and number of visits. Low-risk pregnant women (not referred during pregnancy) were more likely to use prenatal care inadequately if they intended to deliver at a hospital, if they did not use folic acid adequately periconceptionally, or if they were exposed to cigarette smoke during pregnancy. Among those who were referred to secondary care, women reporting a chronic illnesses or disabilities, and women who did not use folic acid periconceptionally were more likely to make inadequate use of prenatal care. Inadequate prenatal health care use in primary midwifery care is more likely in specific groups, and the risk groups differ when women are referred to secondary care. The findings suggest routes that can target interventions to women who are at risk of not adequately using prenatal prevention and care services. Copyright © 2015 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  5. Factors influencing place of delivery for women in Kenya: an analysis of the Kenya demographic and health survey, 2008/2009

    Directory of Open Access Journals (Sweden)

    Kitui John

    2013-02-01

    Full Text Available Abstract Background Maternal mortality in Kenya increased from 380/100000 live births to 530/100000 live births between 1990 and 2008. Skilled assistance during childbirth is central to reducing maternal mortality yet the proportion of deliveries taking place in health facilities where such assistance can reliably be provided has remained below 50% since the early 1990s. We use the 2008/2009 Kenya Demographic and Health Survey data to describe the factors that determine where women deliver in Kenya and to explore reasons given for home delivery. Methods Data on place of delivery, reasons for home delivery, and a range of potential explanatory factors were collected by interviewer-led questionnaire on 3977 women and augmented with distance from the nearest health facility estimated using health facility Global Positioning System (GPS co-ordinates. Predictors of whether the woman’s most recent delivery was in a health facility were explored in an exploratory risk factor analysis using multiple logistic regression. The main reasons given by the woman for home delivery were also examined. Results Living in urban areas, being wealthy, more educated, using antenatal care services optimally and lower parity strongly predicted where women delivered, and so did region, ethnicity, and type of facilities used. Wealth and rural/urban residence were independently related. The effect of distance from a health facility was not significant after controlling for other variables. Women most commonly cited distance and/or lack of transport as reasons for not delivering in a health facility but over 60% gave other reasons including 20.5% who considered health facility delivery unnecessary, 18% who cited abrupt delivery as the main reason and 11% who cited high cost. Conclusion Physical access to health facilities through distance and/or lack of transport, and economic considerations are important barriers for women to delivering in a health facility in Kenya

  6. Views of Women and Health Professionals on mHealth Lifestyle Interventions in Pregnancy: A Qualitative Investigation

    OpenAIRE

    Willcox, Jane C; van der Pligt, Paige; Ball, Kylie; Wilkinson, Shelley A; Lappas, Martha; McCarthy, Elizabeth A; Campbell, Karen J

    2015-01-01

    Background Evidence suggests that women are failing to meet guidelines for nutrition, physical activity, and weight gain during pregnancy. Interventions to promote a healthy lifestyle in pregnancy demonstrate mixed results and many are time and resource intensive. mHealth-delivered interventions offer an opportunity to provide trusted source information in a timely and cost-effective manner. Studies regarding women?s and health professionals? views of mHealth in antenatal care are limited. Ob...

  7. Increasing prevalence of group B streptococcal infection among pregnant women

    DEFF Research Database (Denmark)

    Petersen, Kathrine Birch; Johansen, Helle Krogh; Rosthoj, Susanne

    2014-01-01

    the Clinical Microbiology Database. Maternal data were obtained from a local database at the RH. RESULTS: In our cohort, a total of 638 (3.8%) women were diagnosed with GBS, 517 (81%) from urine, 92 (14%) from vaginal swabs and 29 (5%) from both. The overall rate of women colonised with GBS rose from 3......INTRODUCTION: Group B streptococci (GBS) can cause preterm delivery for women and sepsis and meningitis in infants younger than 90 days of age. The present retrospective cohort study determines the trend over time in the rates of GBS and in demographic risk factors for GBS among pregnant women...... delivering at Rigshospitalet (RH). MATERIAL AND METHODS: In the period from 2002 to 2010, a total of 33,616 women gave birth at the RH. Our cohort was defined as 16,587 (49%) women examined by 24,724 cultures. All microbiological requisitions from the Department of Obstetrics at RH were extracted from...

  8. Association between perfluorinated compound exposure and miscarriage in Danish pregnant women.

    Directory of Open Access Journals (Sweden)

    Tina Kold Jensen

    Full Text Available Perfluorinated alkylated substances (PFAS have been extensively used in consumer products and humans are widely exposed to these persistent compounds. A recent study found no association between exposure to perfluorooctanoic acid (PFOA and perfluorooctanesulfonic acid (PFOS and miscarriage, but no studies have examined adverse effect of the more recently introduced PFASs. We therefore conducted a case-control study within a population-based, prospective cohort during 2010-2012. Newly pregnant women residing in the Municipality of Odense, Denmark were invited to enroll in the Odense Child Cohort at their first antenatal visit before pregnancy week 12. Among a total of 2,874 participating women, 88 suffered a miscarriage and 59 had stored serum samples, of which 56 occurred before gestational week 12. They were compared to a random sample (N=336 of delivering women, who had also donated serum samples before week 12. Using a case-control design, 51 of the women suffering a miscarriage were matched on parity and gestational day of serum sampling with 204 delivering women. In a multiple logistic regression with adjustment for age, BMI, parity and gestational age at serum sampling, women with the highest tertile of exposure to perfluorononanoic acid (PFNA and perfluorodecanoic acid (PFDA in pregnancy had odds ratios for miscarriage of 16.5 (95% CI 7.4-36.6-36.5 and 2.67 (1.31-5.44, respectively, as compared to the lowest tertile. In the matched data set, the OR were 37.9 (9.9-145.2 and 3.71 (1.60-8.60, respectively. The association with perfluorohexane sulfonic acid (PFHxS was in the same direction, but not statistically significant, while no association was found with PFOA and PFOS. Our findings require confirmation due to the possible public health importance, given that all pregnant women are exposed to these widely used compounds.

  9. Association between Perfluorinated Compound Exposure and Miscarriage in Danish Pregnant Women

    Science.gov (United States)

    Jensen, Tina Kold; Andersen, Louise Bjørkholt; Kyhl, Henriette Boye; Nielsen, Flemming; Christesen, Henrik Thybo; Grandjean, Philippe

    2015-01-01

    Perfluorinated alkylated substances (PFAS) have been extensively used in consumer products and humans are widely exposed to these persistent compounds. A recent study found no association between exposure to perfluorooctanoic acid (PFOA) and perfluorooctanesulfonic acid (PFOS) and miscarriage, but no studies have examined adverse effect of the more recently introduced PFASs. We therefore conducted a case-control study within a population-based, prospective cohort during 2010-2012. Newly pregnant women residing in the Municipality of Odense, Denmark were invited to enroll in the Odense Child Cohort at their first antenatal visit before pregnancy week 12. Among a total of 2,874 participating women, 88 suffered a miscarriage and 59 had stored serum samples, of which 56 occurred before gestational week 12. They were compared to a random sample (N=336) of delivering women, who had also donated serum samples before week 12. Using a case-control design, 51 of the women suffering a miscarriage were matched on parity and gestational day of serum sampling with 204 delivering women. In a multiple logistic regression with adjustment for age, BMI, parity and gestational age at serum sampling, women with the highest tertile of exposure to perfluorononanoic acid (PFNA) and perfluorodecanoic acid (PFDA) in pregnancy had odds ratios for miscarriage of 16.5 (95% CI 7.4-36.6-36.5) and 2.67 (1.31-5.44), respectively, as compared to the lowest tertile. In the matched data set, the OR were 37.9 (9.9-145.2) and 3.71 (1.60-8.60), respectively. The association with perfluorohexane sulfonic acid (PFHxS) was in the same direction, but not statistically significant, while no association was found with PFOA and PFOS. Our findings require confirmation due to the possible public health importance, given that all pregnant women are exposed to these widely used compounds. PMID:25848775

  10. Pregnant Women's Intentions and Subsequent Behaviors Regarding Maternal and Neonatal Service Utilization: Results from a Cohort Study in Nyanza Province, Kenya.

    Directory of Open Access Journals (Sweden)

    Andreea A Creanga

    Full Text Available Higher use of maternal and neonatal health (MNH services may reduce maternal and neonatal mortality in Kenya. This study aims to: 1 prospectively explore women's intentions to use MNH services (antenatal care, delivery in a facility, postnatal care, neonatal care at 35 and high-school education were significant predictors of intention-behavior discordance regarding delivery in a facility; several delivery-related factors were significantly associated with intention-behavior discordance regarding use of postnatal and neonatal care. Delivery facilities were chosen based on proximity to women's residence, affordability, and service quality; among women who delivered outside a health facility, 16.3% could not afford going to a facility. Good/very good birth experiences were reported by 93.6% of women who delivered in a facility and 32.6% of women who did not. We found higher MNH service utilization than previously documented in Nyanza province. Further increasing the number of facility deliveries and use of postnatal care may improve MNH in Kenya.

  11. The dual influences of age and obstetric history on fecal continence in parous women.

    LENUS (Irish Health Repository)

    Eogan, Maeve

    2011-02-01

    To assess whether women who underwent forceps delivery were more likely than those who delivered either normally (spontaneous vaginal delivery [SVD]) or by cesarean to experience deterioration in fecal continence as they aged.

  12. An exploratory qualitative analysis of student midwives views of teaching methods that could build their confidence to deliver perinatal bereavement care.

    Science.gov (United States)

    Martin, Caroline J Hollins; Robb, Yvonne; Forrest, Eleanor

    2016-04-01

    Equipping student midwives with confidence to deliver bereavement care to childbearing women is a challenge for midwifery lecturers. To explore qualitative data provided by student midwives who evaluated the workbook Bereavement care for childbearing women and their families (Hollins Martin & Forrest, 2013) to explore their views of potential teaching strategies that could build their confidence to deliver real bereavement care. An exploratory qualitative thematic analysis was used to provide, analyse and report themes identified within data collected in a prior study. Participants were student midwives (n=179) in their second/third year of a midwifery degree program at 1 of 3 universities in the UK were included in the study. Data to evaluate effectiveness of the bereavement workbook as a teaching method was collected using a survey instrument. It was the comments written under questions by participants that were analysed in the present study. Three themes emerged: (1) increasing classroom interaction, (2) the importance of reflecting on emotions, and (3) need for experience. Although this study has addressed delivery of education that relates to midwives, the findings are cross transferable to other healthcare educators, practitioners, and students. Several solutions are proposed that could potentially build student confidence to deliver bereavement care: lecturers should (1) encourage group discussion in the classroom to help build student confidence to emotionally cope during real bereavement events; (2) ensure students gain exposure by encouraging qualified midwives to include them in real bereavement events early on in their training, and (3) develop packages of perinatal bereavement scenarios for simulation and rehearsal in the clinical skills laboratory. Post-implementation, it is recommended that these teaching strategies be evaluated. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. Postpartum women's perspectives of engaging with a dietitian and exercise physiologist via video consultations for weight managment: A qualitative evaluation

    Science.gov (United States)

    Optimising weight status after childbirth is important. Video consultations are an unexplored opportunity to deliver real-time support to postpartum women to improve lifestyle behaviours. This study aims to provide insight into postpartum women's perspectives of engaging with a dietitian and exercis...

  14. Postpartum womens perspectives of engaging with a dietitian and exercise physiologist via video consultations for weight management: A qualitative evaluation

    Science.gov (United States)

    Optimising weight status after childbirth is important. Video consultations are an unexplored opportunity to deliver real-time support to postpartum women to improve lifestyle behaviours. This study aims to provide insight into postpartum women's perspectives of engaging with a dietitian and exercis...

  15. The use of facilities for labor and delivery: the views of women in rural Uganda

    Directory of Open Access Journals (Sweden)

    Rebecca Newell

    2017-09-01

    Full Text Available The aim of the paper is to explore factors associated with home or hospital delivery in rural Uganda. Qualitative interviews with recently-delivered women in rural Uganda and statistical analysis of data from the 2011 Ugandan Demographic and Health Survey (DHS to assess the association between socio-demographic and cultural factors and delivery location in multivariable regression models. In the DHS, 61.7% (of 4907 women had a facility-based delivery (FBD; in adjusted analyses, FBD was associated with an urban setting [adjusted odds ratio (aOR 3.38, 95% confidence interval (CI 2.66 to 4.28], the upper wealth quintile (aOR: 3.69, 95%CI 2.79 to 3.87 and with secondary education (aOR: 3.07, 95%CI 2.37 to 3.96. In interviews women quoted costs and distance as barriers to FBD. Other factors reported in interviews to be associated with FBD included family influence, perceived necessity of care (weak women needed FBD, and the reputation of the facility (women bypassed local facilities to deliver at better hospitals. Choosing a FBD is a complex decision and education around the benefits of FBD should be combined with interventions designed to remove barriers to FBD.

  16. Materials Delivered by Member States

    International Nuclear Information System (INIS)

    1962-01-01

    The information given in this document is divided into two parts. In part I the Director General is reporting to the Members of the Agency, under Article IX. G of the Statute, the quantities of materials delivered up to 30 September 1962 by Member States in compliance with requests the Agency has made under Article IX. D. Part II contains information about materials which have not yet been delivered but which have been allocated, in accordance with Article XI. F. 1 of the Statute, to approved Agency projects for which project agreements were in force on 30 September 1962. Reports on subsequent deliveries of materials and revised information about allocated but undelivered materials will be issued from time to time

  17. Smartphone application for women with gestational diabetes mellitus: a study protocol for a multicentre randomised controlled trial.

    Science.gov (United States)

    Borgen, Iren; Garnweidner-Holme, Lisa Maria; Jacobsen, Anne Flem; Bjerkan, Kirsti; Fayyad, Seraj; Joranger, Pål; Lilleengen, Anne Marie; Mosdøl, Annhild; Noll, Josef; Småstuen, Milada Cvancarova; Terragni, Laura; Torheim, Liv Elin; Lukasse, Mirjam

    2017-03-27

    The promotion of a healthy diet, physical activity and measurement of blood glucose levels are essential components in the care for women with gestational diabetes mellitus (GDM). Smartphones offer a new way to promote health behaviour. The main aim is to investigate if the use of the Pregnant+ app, in addition to standard care, results in better blood glucose levels compared with current standard care only, for women with GDM. This randomised controlled trial will include 230 pregnant women with GDM followed up at 5 outpatient departments (OPD) in the greater Oslo Region. Women with a 2-hour oral glucose tolerance test (OGTT) ≥9 mmol/L, who own a smartphone, understand Norwegian, Urdu or Somali and are <33 weeks pregnant, are invited. The intervention group receives the Pregnant+ app and standard care. The control group receives standard care only. Block randomisation is performed electronically. Data are collected using self-reported questionnaires and hospital records. Data will be analysed according to the intention-to-treat principle. Groups will be compared using linear regression for the main outcome and χ 2 test for categorical data and Student's t-test or Mann-Whitney-Wilcoxon test for skewed distribution. The main outcome is the glucose level measured at the 2-hour OGTT 3 months postpartum. Secondary outcomes are a change in health behaviour and knowledge about GDM, quality of life, birth weight, mode of delivery and complications for mother and child. The study is exempt from regional ethics review due to its nature of quality improvement in patient care. Our study has been approved by the Norwegian Social Science Data Services and the patient privacy protections boards governing over the recruitment sites. Findings will be presented in peer-reviewed journals and at conferences. NCT02588729, Post-results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  18. The power of women on April 27.

    Science.gov (United States)

    Khumalo, B

    1994-04-01

    Women make up 54% of voters in South Africa. A delegation of 80 groups representing 2 million women under the Women' National Coalition delivered many research reports on women's issues (e.g., rape, violence, women's status, women workers' rights) to the Transitional Executive Council. If political parties want women to support them, they need to address the inequalities and discrimination women encounter at work, in their homes, and in society. The research findings were a result of 23 focus groups and will be used to draft a Women's Charter. The Coalition will use the Charter to bring about maximum equality within the constitutional framework. The research revealed that sexual harassment at work was more common than was recognized. Black women reported that men of all races in responsible positions seek sex for jobs or for promotion. 50% of women are raped. 1 of 6 women are beaten by their partner. In the past, women's groups were not well supported because White women tended to be satisfied with the status quo. Specifically, they had a servant, leisure time, and a high standard of living. Women are starting to understand that they can be forces of change. A common thread among the diversity of women in the research was a desire for control of their lives. Other issues emerging from the research were women and law, women at work, women and violence, and political awareness among women. The women call for changes in marital law to make sure that women are considered as majors. For example, they should be able to buy property and sign contracts. Women want equal pay for work of equal value, equal treatment when applying for a job. Women want society, including family members, not to ignore domestic violence. They also call on authorities and police to respond more vigorously to domestic violence. Women are becoming more involved in politics, locally, regionally, and nationally.

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

    Science.gov (United States)

    Asrese, Kerebih; Adamek, Margaret E

    2017-12-28

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

  20. Promoting Early Presentation of Breast Cancer in Older Women: Implementing an Evidence-Based Intervention in Routine Clinical Practice

    International Nuclear Information System (INIS)

    Forbes, L. J. L.; Forster, A. S.; Dodd, R. H.; Tucker, L.; Laming, R.; Ramirez, A. J.; Sellars, S.; Patnick, J.

    2012-01-01

    Women over 70 with breast cancer have poorer one-year survival and present at a more advanced stage than younger women. Promoting early symptomatic presentation in older women may reduce stage cost effectively and is unlikely to lead to overdiagnosis. After examining efficacy in a randomised controlled trial, we piloted a brief health professional-delivered intervention to equip women to present promptly with breast symptoms, as an integral part of the final invited mammogram at age ∼70, in the English National Health Service Breast Screening Programme. Methods. We trained mammographers, who then offered the intervention to older women in four breast screening services. We examined breast cancer awareness at baseline and one month in women receiving the intervention, and also in a service where the intervention was not offered. Results. We trained 27 mammographers to deliver the intervention confidently to a high standard. Breast cancer awareness increased 7-fold at one month in women receiving the intervention compared with 2-fold in the comparison service (odds ratio 15.2, 95% confidence interval 10.0 to 23.2). Conclusions. The PEP Intervention can be implemented in routine clinical practice with a potency similar to that achieved in a randomised controlled trial. It has the potential to reduce delay in diagnosis for breast cancer in older women.

  1. Promoting Early Presentation of Breast Cancer in Older Women: Implementing an Evidence-Based Intervention in Routine Clinical Practice

    Science.gov (United States)

    Forbes, Lindsay J. L.; Forster, Alice S.; Dodd, Rachael H.; Tucker, Lorraine; Laming, Rachel; Sellars, Sarah; Patnick, Julietta; Ramirez, Amanda J.

    2012-01-01

    Background. Women over 70 with breast cancer have poorer one-year survival and present at a more advanced stage than younger women. Promoting early symptomatic presentation in older women may reduce stage cost effectively and is unlikely to lead to overdiagnosis. After examining efficacy in a randomised controlled trial, we piloted a brief health professional-delivered intervention to equip women to present promptly with breast symptoms, as an integral part of the final invited mammogram at age ~70, in the English National Health Service Breast Screening Programme. Methods. We trained mammographers, who then offered the intervention to older women in four breast screening services. We examined breast cancer awareness at baseline and one month in women receiving the intervention, and also in a service where the intervention was not offered. Results. We trained 27 mammographers to deliver the intervention confidently to a high standard. Breast cancer awareness increased 7-fold at one month in women receiving the intervention compared with 2-fold in the comparison service (odds ratio 15.2, 95% confidence interval 10.0 to 23.2). Conclusions. The PEP Intervention can be implemented in routine clinical practice with a potency similar to that achieved in a randomised controlled trial. It has the potential to reduce delay in diagnosis for breast cancer in older women. PMID:23213334

  2. Women's experiences of factors affecting treatment engagement and adherence in internet delivered Behavioural Activation for Postnatal Depression

    Directory of Open Access Journals (Sweden)

    Heather A. O'Mahen

    2015-03-01

    Discussion: Open access, self-help internet interventions are acceptable to women with postnatal depression, but it is critical to provide tailoring and support to help overcome barriers and improve treatment adherence.

  3. Mediators and Moderators of the Effectiveness of a Community Health Worker Intervention That Improved Dietary Outcomes in Pregnant Latino Women

    Science.gov (United States)

    Shah, Megha K.; Kieffer, Edith C.; Choi, Hwajung; Schumann, Christina; Heisler, Michele

    2015-01-01

    Background. Pregnancy is an opportune time to initiate diabetes prevention strategies for minority and underserved women, using culturally tailored interventions delivered by community health workers. A community-partnered randomized controlled trial (RCT) with pregnant Latino women resulted in significantly improved vegetable, fiber, added sugar,…

  4. Development of an intervention delivered by mobile phone aimed at decreasing unintended pregnancy among young people in three lower middle income countries.

    Science.gov (United States)

    McCarthy, Ona L; Wazwaz, Ola; Osorio Calderon, Veronica; Jado, Iman; Saibov, Salokhiddin; Stavridis, Amina; López Gallardo, Jhonny; Tokhirov, Ravshan; Adada, Samia; Huaynoca, Silvia; Makleff, Shelly; Vandewiele, Marieka; Standaert, Sarah; Free, Caroline

    2018-05-02

    Unintended pregnancies can result in poorer health outcomes for women, children and families. Young people in low and middle income countries are at particular risk of unintended pregnancies and could benefit from innovative contraceptive interventions. There is growing evidence that interventions delivered by mobile phone can be effective in improving a range of health behaviours. This paper describes the development of a contraceptive behavioural intervention delivered by mobile phone for young people in Tajikistan, Bolivia and Palestine, where unmet need for contraception is high among this group. Guided by Intervention Mapping, the following steps contributed to the development of the interventions: (1) needs assessment; (2) specifying behavioural change to result from the intervention; (3) selecting behaviour change methods to include in the intervention; (4) producing and refining the intervention content. The results of the needs assessment produced similar interventions across the countries. The interventions consist of short daily messages delivered over 4 months (delivered by text messaging in Palestine and mobile phone application instant messages in Bolivia and Tajikistan). The messages provide information about contraception, target attitudes that are barriers to contraceptive uptake and support young people in feeling that they can influence their reproductive health. The interventions each contain the same ten behaviour change methods, adapted for delivery by mobile phone. The development resulted in a well-specified, theory-based intervention, tailored to each country. It is feasible to develop an intervention delivered by mobile phone for young people in resource-limited settings.

  5. The health of women and girls: how can we address gender equality and gender equity?

    Science.gov (United States)

    Payne, Sarah

    2015-01-01

    This article focuses on the health of women and girls, and the role of addressing gender inequalities experienced by women and girls. The health of both males and females is influenced by sex, or biological factors, and gender, or socially constructed influences, including gender differences in the distribution and impact of social determinants of health, access to health promoting resources, health behaviors and gender discourse, and the ways in which health systems are organized and financed, and how they deliver care. Various strategies to address the health of women and girls have been developed at intergovernmental, regional, and national level, and by international nongovernmental organizations. These include vertical programs which aim to target specific health risks and deliver services to meet women and girl's needs, and more cross-cutting approaches which aim at "gender" policy making. Much of this work has developed following the adoption of gender mainstreaming principles across different policy arenas and scales of policy making, and this article reviews some of these strategies and the evidence for their success, before concluding with a consideration of future directions in global policy. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  6. Cultural considerations for South Asian women with breast cancer.

    Science.gov (United States)

    Bedi, Manveen; Devins, Gerald M

    2016-02-01

    Cultural values shape a woman's experience of disease and introduce novel stressors that influence psychosocial needs and adaptation. This literature review examines the psychosocial impact of breast cancer in South Asian women, a large group that has received little attention in this regard. We conducted a comprehensive review of the literature published before April 2014 using Ovid MEDLINE, PsychINFO, PubMED, CINHAL, EMBASE, and Sociological Abstracts. We searched for articles about the psychosocial impact of breast cancer in South Asian women. We retained 23 studies for review. The literature concerning South Asian women's experiences identified culturally linked themes that play significant roles in shaping the illness experience; e.g., stigma and breast cancer, low priority of women's health, collective experience of disease, and religion and spirituality. There is a growing need for culturally sensitive care for South Asian women. By understanding the core cultural values and integrating them into clinical practice, Western healthcare providers may improve the quality of care they deliver and help women to extract the maximum benefit. Developing culturally competent support services may enhance effectiveness in addressing the healthcare needs of South Asian women and may serve other ethnic minorities in North America.

  7. Breastmilk Sharing: Awareness and Participation Among Women in the Moms2Moms Study

    Science.gov (United States)

    McNamara, Kelly A.; Dillon, Chelsea E.; Strafford, Katherine; Ronau, Rachel; McKenzie, Lara B.; Geraghty, Sheela R.

    2014-01-01

    Abstract Background: Feeding infants unscreened, raw human milk from a source other than the mother may pose health risks. The objectives of the Moms2Moms Study were to estimate the proportions of mothers who were aware of breastmilk sharing, considered sharing, and shared milk and to identify associated maternal and child characteristics. Subjects and Methods: All eligible women (n=813) who delivered at The Ohio State University Wexner Medical Center (Columbus, OH) and did not indicate an intention to exclusively “bottle feed” were asked to participate in this cohort by completing a postal questionnaire at 12 months postpartum (499 [61%] responded). Women who shared milk participated in a follow-up interview. Results: Awareness of milk sharing was high (77%) and positively associated with socioeconomic status, age, non-Hispanic white race, having fed one's infant at the breast, and reporting no difficulty making enough milk. Twenty-five percent considered sharing. Primiparous women (odds ratio [OR]=2.12; 95% confidence interval [CI] 1.02, 4.62) and those who delivered preterm (OR=3.27; 95% CI 1.38, 7.30) were more likely to consider feeding milk from another mother. Women with public/no insurance (OR=0.52; 95% CI 0.27, 0.97) were less likely to consider providing milk for someone else; highly educated women were more likely (OR=1.90; 95% CI 1.12, 3.32). Almost 4% of women shared milk and did so among friends or relatives or had a preterm infant who received screened and pasteurized donor milk. Conclusions: Sharing milk among friends and relatives is occurring. Many women are aware of milk sharing and have considered it. PMID:25007386

  8. Factors associated with HIV infection among delivered women in Sergipe, Brazil

    Directory of Open Access Journals (Sweden)

    Lemos Lígia

    2009-08-01

    Full Text Available Abstract Background In Brazil, the number of HIV cases has increased mostly amongst poor less educated women in the northeast region. This combination increased the risk for vertical transmission. This study aims to identify risk factors associated with HIV infection at delivery in Sergipe-NE Brazil. Findings This was a case-control study, with 39 cases and 117 controls that gave birth at the official health system hospitals. All patients were tested for HIV at hospital admission, using a rapid test and were interviewed about socioeconomic conditions and health attitudes and practices. Univariate and multivariate logistic analysis were performed to evaluate the factors associated with HIV infection. In the univariate analysis, association with HIV positivity was found for the variables "antenatal HIV test" (OR: 4.44; CI: 1.93 – 10.29 and "intravenous drug use" (OR = 12.08; 95% CI 1.28 – 8. Three patients were intravenous drug users, all HIV+. After logistic multivariate regression, not being tested for HIV during antenatal care (OR = 4.98; 95% CI: 2.13–12.22; p Conclusion Drug use, limited knowledge about how to prevent AIDS, and lack of HIV testing during pregnancy were risk factors for infection with HIV. Although it was not conceived to evaluate effectiveness of procedures to prevent vertical transmission, the risk factors here detected may corroborate official recommendation for rapid HIV testing at delivery as an effective procedure to prevent vertical transmission.

  9. Equivalent weight loss for weight management programs delivered by phone and clinic

    Science.gov (United States)

    Donnelly, Joseph E.; Goetz, Jeannine; Gibson, Cheryl; Sullivan, Debra K.; Lee, Robert; Smith, Bryan K.; Lambourne, Kate; Mayo, Matthew S.; Hunt, Suzanne; Lee, Jae Hoon; Honas, Jeffrey J.; Washburn, Richard A.

    2013-01-01

    Objective Face-to-face weight management is costly and presents barriers for individuals seeking treatment; thus, alternate delivery systems are needed. The objective of this study was to compare weight management delivered by face-to-face (FTF) clinic or group conference calls (phone). Design and Methods Randomized equivalency trial in 295 overweight/obese men/women (BMI = 35.1±4.9, Age = 43.8±10.2, Minority = 39.8%). Weight loss (0–6 months) was achieved by reducing energy intake between 1,200– 1,500 kcal/day and progressing physical activity to 300 minutes/week. Weight maintenance (7–18 months) provided adequate energy to maintain weight and continued 300 minutes/week of physical activity. Behavioral weight management strategies were delivered weekly for 6 months and gradually reduced during months 7–18. A cost analysis provided a comparison of expenses between groups. Results Weight change from baseline to 6 months was −13.4 ± 6.7% and −12.3 ± 7.0% for FTF clinic and phone, respectively. Weight change from 6 months to 18 months was 6.4 ± 7.0% and 6.4 ± 5.2%, for FTF clinic and phone, respectively. The cost to FTF participants was $789.58 more person. Conclusions Phone delivery provided equivalent weight loss and maintenance and reduced program cost. Ubiquitous access to phones provides a vast reach for this approach. PMID:23408579

  10. Genital HSV Detection among HIV-1-Infected Pregnant Women in Labor

    Directory of Open Access Journals (Sweden)

    Janna Patterson

    2011-01-01

    Full Text Available Objective. To compare genital HSV shedding among HIV-positive and HIV-negative women. Methods. Women with and without known HIV infection who delivered at the University of Washington Medical Center between 1989–1996 had HSV serologies done as part of clinical care. Genital swabs from HSV-2-seropositive women were evaluated by real-time quantitative HSV DNA PCR. Results. HSV-2 seroprevalence was 71% and 30% among 75 HIV-positive and 3051 HIV-negative women, respectively, (P<.001. HSV was detected at delivery in the genital tract of 30.8% of HIV-seropositive versus 9.5% of HIV-negative women (RR=3.2, 95% CI 1.6 to 6.5, P=.001. The number of virion copies shed per mL was similar (log 3.54 for HIV positive versus 3.90 for HIV negative, P=.99. Conclusions. Our study demonstrated that HIV-, HSV-2-coinfected women are more likely to shed HSV at delivery.

  11. Counseling middle-aged women about physical activity using the stages of change.

    Science.gov (United States)

    Dearden, Jennifer S; Sheahan, Sharon L

    2002-11-01

    To discuss application of the Stages of Change theoretical framework and provide clinical tips on exercise adherence among midlife women. Included is a checklist to assist the nurse practitioner (NP) in effectively delivering the message. Review of the current scientific literature on exercise adherence and the Stages of Change model. Middle-aged women comprise a unique population. Determining the woman's readiness for change using the Stages of Change model, NPs can routinely include appropriate exercise recommendations in their practices. Nurse practitioners are in a unique position to promote healthy behaviors by counseling women in midlife about adopting an active lifestyle. Exercise counseling is an essential component of healthcare, especially among middle-aged women who are experiencing physical, emotional, and social changes.

  12. Oral microflora in infants delivered vaginally and by caesarean section

    DEFF Research Database (Denmark)

    Nelun Barfod, Mette; Magnusson, Kerstin; Lexner, Michala Oron

    2011-01-01

    International Journal of Paediatric Dentistry 2011 Background. Early in life, vaginally delivered infants exhibit a different composition of the gut flora compared with infants delivered by caesarean section (C-section); however, it is unclear whether this also applies to the oral cavity. Aim....... To investigate and compare the oral microbial profile between infants delivered vaginally and by C-section. Design. This is a cross-sectional case-control study. Eighty-four infants delivered either vaginally (n = 42) or by C-section (n = 42) were randomly selected from the 2009 birth cohort at the County...

  13. How a Strong Government Backed an African Language: The Lessons of Somalia

    Science.gov (United States)

    Warsame, Ali A.

    2001-07-01

    Although Somali is the mother tongue of over 95 per cent of the population of Somalia, when the country received independence in 1960 it took English, Italian, and Arabic as its official languages. Because of controversy involving technical, religious and political questions, no script for the Somali language could be agreed upon, either in the colonial era or in parliamentary years, 1960-1969. The consequences of this non-decision were considerable for Somali society. However, when the authoritarian military rulers came to the power in the early 1970s, they made a final decision in regard to script. They also issued a decree to the effect that Somali was to be the language of political and administrative discourse in the Somali Republic. That act marked the beginning of the restoration of cultural and linguistic rights for Somali society. This article examines how Somalia, under a strong and totalitarian regime, was able to promote its language. The article also presents an overview of the organisation and the implementation of the literacy campaigns carried out in Somalia, as well as some notes on planning and the theoretical framework behind the campaigns.

  14. An Elective Course in Women's Health Issues

    Directory of Open Access Journals (Sweden)

    Natalie A. DiPietro

    2013-01-01

    Full Text Available Purpose: To develop, implement, and evaluate an elective course for the Doctor of Pharmacy (PharmD curriculum that provides students with a comprehensive overview of women's health across the lifespan and exposes them to social and economic issues that impact women's health. Case Study: At the time of this writing, the class has been delivered 3 times to a total of 56 students. Students read and discussed (both in-class and online timely articles in women's health issues on topics including sex-based biology; women in clinical trials; maternal and child health; women's health coverage and access to care in the United States; gender and health communication; abuse and the role of healthcare professionals; and international issues in women's health and women's rights. Students completed a pre- and post-test; developed seminar presentations regarding women's health issues; wrote reflective essays about the course; and designed and implemented health promotion projects for National Women's Health Week (NWHW. At the end of the course, the number of correct answers on the post-test significantly improved from the pre-test (p<0.001. Through anonymous course evaluations, students indicated that the assignments fulfilled the learning objectives (mean 4.68 on a 5-point Likert scale and the exercises were useful in helping their understanding of the material (mean 4.66 on a 5-point Likert scale. Over 500 women from the campus and community participated in the NWHW projects. Implications: An elective course was designed to educate pharmacy students regarding women's health issues and to provide students with an opportunity to perform community outreach.   Type: Case Study

  15. Reducing the Salt Added to Takeaway Food: Within-Subjects Comparison of Salt Delivered by Five and 17 Holed Salt Shakers in Controlled Conditions.

    Directory of Open Access Journals (Sweden)

    Louis Goffe

    Full Text Available To determine if the amount of salt delivered by standard salt shakers commonly used in English independent takeaways varies between those with five and 17 holes; and to determine if any differences are robust to variations in: the amount of salt in the shaker, the length of time spent shaking, and the person serving.Four laboratory experiments comparing the amount of salt delivered by shakers. Independent variables considered were: type of shaker used (five or 17 holes, amount of salt in the shaker before shaking commences (shaker full, half full or nearly empty, time spent shaking (3s, 5s or 10s, and individual serving.Controlled, laboratory, conditions.A quota-based convenience sample of 10 participants (five women aged 18-59 years.Amount of salt delivered by salt shakers.Across all trials, the 17 holed shaker delivered a mean (SD of 7.86g (4.54 per trial, whilst the five holed shaker delivered 2.65g (1.22. The five holed shaker delivered a mean of 33.7% of the salt of the 17 holed shaker. There was a significant difference in salt delivered between the five and 17 holed salt shakers when time spent shaking, amount of salt in the shaker and participant were all kept constant (p<0.001. This difference was robust to variations in the starting weight of shakers, time spent shaking and participant shaking (ps

  16. Effectiveness of U.S. Policies for Al Shabaab

    Science.gov (United States)

    2014-06-13

    Police in Middle Shabelle,” http://allafrica.com/stories/201404181389.html (accessed 1 May 2014). 35 interview between Hamdi Salad (a reporter for...gains 34Hamdi Salad , “Somali Minister of Defence: Government committed to re- building army...Jane. “Bush Sees Victims of Somali Famine.” The New York Times, 1 January 1993. Salad , Hamdi. “Somali Minister of Defence: Government committed to

  17. Rhesus negative pregnant women in a traditional birth home in ...

    African Journals Online (AJOL)

    In a survey of 200 pregnant women (mean age 24 years) attending a traditional birth home (TBH) in Abeokuta, Nigeria, 19 (9.5%) were found to be rhesus negative, 8 (42.1%) of which were primigravidae while 11 (57.9%) were multigravidae. 87.5% of the Rhesus negative primigravidae delivered at the TBH without being ...

  18. Pregnancy Outcome of Multiparous Women Aged over 40 Years

    Science.gov (United States)

    Ates, Seda; Batmaz, Gonca; Sevket, Osman; Molla, Taner; Dane, Cem; Dane, Banu

    2013-01-01

    Objective. The aim of this study was to evaluate the effect of maternal age on prenatal and obstetric outcome in multiparaous women. Materials and Methods. A retrospective case control study was conducted, including women aged 40 years and over (study group, n = 97) who delivered at 20 week's gestation or beyond and women aged 20–29 years (control group, n = 97). Results. The mean age of women in the study group was 41.2 ± 1.7 years versus 25.4 ± 2.3 years in the control group. Advanced maternal age was associated with a significantly higher rate of hypertension, diabetes mellitus, fetal complication, and 5-minute Apgar scores <7 (P < 0.05). Caeserean section rate, incidence of placental abruption, preterm delivery, and neonatal intensive care unit admission were more common in the older group, but the differences were not statistically significant. Conclusions. Advanced maternal age is related to maternal and neonatal complications. PMID:25954770

  19. Health issues of incarcerated women in the United States

    Directory of Open Access Journals (Sweden)

    Sylvia Mignon

    2016-07-01

    Full Text Available Abstract Health care within jails and prisons in the United States is typically insufficient to meet the medical and psychological needs of female inmates. Health services are often of low quality, especially in the areas of reproductive medicine. Mental illness, substance abuse, a trauma history, and sexual victimization while incarcerated can predict a more difficult adjustment to a correctional environment. Incarcerated women who are able to maintain contact with family members, especially children, can have a better prison adjustment. Recommendations are made to improve the types and quality of health care delivered to women in jails and prisons in countries around the world.

  20. Peptidome analysis of human milk from women delivering macrosomic fetuses reveals multiple means of protection for infants.

    Science.gov (United States)

    Cui, Xianwei; Li, Yun; Yang, Lei; You, Lianghui; Wang, Xing; Shi, Chunmei; Ji, Chenbo; Guo, Xirong

    2016-09-27

    Breastfeeding is associated with a lower incidence of obesity, diabetes, and cardiovascular disease later in life. While macrosomic infants have a higher risk of developing obesity and other metabolic disorders. Breast milk may contain special nutrients to meet the different growth needs of different infants. Whether mothers make breast milk different to meet the requirement of macrosomic infants is still unknown. Here, we conducted a comparison between mothers delivering macrosomic and non-macrosomic infants in colostrum endogenous peptides. More than 400 peptides, originating from at least 34 protein precursors, were identified by Liquid Chromatography/Mass Spectrometry (LC/MS). Out of these, 29 peptides found to be significant differently expressed (|fold change| ≥ 3, P milk peptide physiological action.

  1. Living well after breast cancer randomized controlled trial protocol: evaluating a telephone-delivered weight loss intervention versus usual care in women following treatment for breast cancer.

    Science.gov (United States)

    Reeves, Marina M; Terranova, Caroline O; Erickson, Jane M; Job, Jennifer R; Brookes, Denise S K; McCarthy, Nicole; Hickman, Ingrid J; Lawler, Sheleigh P; Fjeldsoe, Brianna S; Healy, Genevieve N; Winkler, Elisabeth A H; Janda, Monika; Veerman, J Lennert; Ware, Robert S; Prins, Johannes B; Vos, Theo; Demark-Wahnefried, Wendy; Eakin, Elizabeth G

    2016-10-28

    Obesity, physical inactivity and poor diet quality have been associated with increased risk of breast cancer-specific and all-cause mortality as well as treatment-related side-effects in breast cancer survivors. Weight loss intervention trials in breast cancer survivors have shown that weight loss is safe and achievable; however, few studies have examined the benefits of such interventions on a broad range of outcomes and few have examined factors important to translation (e.g. feasible delivery method for scaling up, assessment of sustained changes, cost-effectiveness). The Living Well after Breast Cancer randomized controlled trial aims to evaluate a 12-month telephone-delivered weight loss intervention (versus usual care) on weight change and a range of secondary outcomes including cost-effectiveness. Women (18-75 years; body mass index 25-45 kg/m 2 ) diagnosed with stage I-III breast cancer in the previous 2 years are recruited from public and private hospitals and through the state-based cancer registry (target n = 156). Following baseline assessment, participants are randomized 1:1 to either a 12-month telephone-delivered weight loss intervention (targeting diet and physical activity) or usual care. Data are collected at baseline, 6-months (mid-intervention), 12-months (end-of-intervention) and 18-months (maintenance). The primary outcome is change in weight at 12-months. Secondary outcomes are changes in body composition, bone mineral density, cardio-metabolic and cancer-related biomarkers, metabolic health and chronic disease risk, physical function, patient-reported outcomes (quality of life, fatigue, menopausal symptoms, body image, fear of cancer recurrence) and behaviors (dietary intake, physical activity, sitting time). Data collected at 18-months will be used to assess whether outcomes achieved at end-of-intervention are sustained six months after intervention completion. Cost-effectiveness will be assessed, as will mediators and moderators of

  2. Delivered volumes of enteral nutrition exceed prescribed volumes.

    Science.gov (United States)

    Walker, Renee Nichole; Utech, Anne; Velez, Maria Eugenia; Schwartz, Katie

    2014-10-01

    Enteral nutrition (EN) provisions are typically calculated based on a 24-hour infusion period. However, feedings are often interrupted for daily activities, procedures, or gastrointestinal intolerance. The study's objective was to determine the delivered EN quantities provided to stable hospitalized patients, using cellular time and measured volumes to verify our EN calculation adjustment. A supply of consecutively numbered ready-to-hang (RTH) EN product was delivered to the bedside of 26 inpatients with established EN tolerance at goal rates on various types of nursing units. The dietitian weighed the volume remaining in the infusing product and recorded the measurement time. On the following days, the dietitian continued to weigh the infusing RTH product and the empty RTH bottles saved by nursing. The primary outcome was the difference between the prescribed and delivered EN provisions, which was calculated with a paired t test. Patients received significantly more calories in the delivered enteral feeding (mean [SD], 1678 [385] kcal) than prescribed calories in the EN order (1489 [246 kcal]; t = 3.736, P = .001), adjusting for observed time. No significant differences were found between nursing units, product, and rate. EN delivered may actually exceed ordered amounts by 5%–21% (mean, 12%) with feeding pump inaccuracy as the primary contributing factor. This differs from what others have found. Our findings support using a volume-based ordering system vs a rate-based ordering system for more accurate EN delivery.

  3. Women?s status and experiences of mistreatment during childbirth in Uttar Pradesh: a mixed methods study using cultural health capital theory

    OpenAIRE

    Sudhinaraset, May; Treleaven, Emily; Melo, Jason; Singh, Kanksha; Diamond-Smith, Nadia

    2016-01-01

    Background Mistreatment of women in healthcare settings during childbirth has been gaining attention globally. Mistreatment during childbirth directly and indirectly affects health outcomes, patient satisfaction, and the likelihood of delivering in a facility currently or in the future. It is important that we study patients? reports of mistreatment and abuse to develop a deeper understanding of how it is perpetrated, its consequences, and to identify potential points of intervention. Patient...

  4. Helping rural women in Pakistan to prevent postpartum hemorrhage: A quasi experimental study

    Directory of Open Access Journals (Sweden)

    Mir Ali

    2012-10-01

    Full Text Available Abstract Background According to the Pakistan Demographic and Health Survey from 2006–2007, the maternal mortality ratio in rural areas is 319 per 100,000 live births. Postpartum hemorrhage is the leading cause of maternal deaths in Pakistan. The objectives of the study were to document the feasibility of distribution of misoprostol tablets by community-based providers mainly traditional birth attendants and acceptability and use of misoprostol by women who gave birth at home. Methods A quasi-experimental design, comprising intervention and comparison areas, was used to document the acceptability of providing misoprostol tablets to pregnant women to prevent postpartum hemorrhage in the rural community setting in Pakistan. Data were collected using structured questionnaires administered to women before and after delivery at home and their birth attendants. Results Out of 770 women who delivered at home, 678 (88% ingested misoprostol tablets and 647 (84% ingested the tablets after the birth of the neonate but prior to the delivery of the placenta. The remaining women took misoprostol tablets after delivery of the placenta. Side effects were experienced by 40% of women and were transitory in nature. Among women who delivered at home, 80% said that they would use misoprostol tablets in the future and 74% were willing to purchase them in the future. Conclusions Self-administration of misoprostol in the home setting is feasible. Community-based providers, such as traditional birth attendants and community midwives with proper training and counseling, play an important role in reducing postpartum hemorrhage. Proper counseling and information exchange are helpful for introducing new practices in resource-constrained rural communities. Until such a time that skilled birth attendance is made more universally available in the rural setting, alternative strategies, such as training and using the services of traditional birth attendants to provide safe

  5. Women's right to health and Ireland's abortion laws.

    Science.gov (United States)

    Taylor, Maeve

    2015-07-01

    The provision of the Irish Constitution that guarantees "the unborn" a right to life equal to that of a pregnant woman has consequences for access to abortion and the care of women in pregnancy generally. Long-awaited legislation to give effect to the narrow constitutional right to abortion was enacted into law in 2013. In 2014, a guidance document for health professionals' implementation of the legislation was published. However, the legislation and guidance document fall far short of international human rights bodies' recommendations: they fail to deliver effective procedural rights to all of the women eligible for lawful abortion within the state and create new legal barriers to women's reproductive rights. At the same time, cases continue to highlight that the Irish Constitution imposes an unethical and rights-violating legal regime in non-abortion-related contexts. Recent developments suggest that both the failure to put guidelines in place and the development of guidelines that are not centered on women or based on rights further reduce women's access to rights and set unacceptable limitations on women's reproductive autonomy. Nevertheless, public and parliamentary scrutiny of cases involving Ireland's abortion laws is increasingly focusing on the need for reform. Copyright © 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  6. Effect of Women's autonomy on maternal health service utilization in Nepal: a cross sectional study.

    Science.gov (United States)

    Adhikari, Ramesh

    2016-05-13

    Women's role has been a priority area not only for sustainable development, but also in reproductive health since ICPD 1994. However, very little empirical evidence is available about women's role on maternal health service utilization in Nepal. This paper explores dimensions of women's autonomy and their relationship to utilization of maternal health services. The analysis uses data from the Nepal Demographic and Health Survey, 2011. The analysis is confined to women who had given birth in the 5 years preceding the survey (n = 4,148). Women's autonomy related variables are taken from the standard DHS questionnaire and measured based on decision in household about obtaining health care, large household purchases and visit to family or relative. The net effect of women's autonomy on utilization of maternal health services after controlling for the effect of other predictors has been measured through multivariate logistic regression analysis. The findings indicate only about a half of the women who had given birth in the past 5 years preceding the survey had 4 or more ANC check up for their last birth. Similarly, 40 % of the women had delivered their last child in the health facilities. Furthermore, slightly higher than two-fifth women (43 %) had postnatal check up for their last child. Only slightly higher than a fourth woman (27 %) had utilized all the services (adequate ANC visit, delivered at health institution and post natal check up) for their last child. This study found that many socio-demographic variables such as age of women, number of children born, level of education, ethnicity, place of residence and wealth index are predicators of utilizing the maternal health services of recent child. Notably, higher level autonomy was associated with higher use of maternal health services [adjusted odds ratio (aOR) =1.40; CI 1.18-1.65]. Utilization of maternal health services for the recent child among women is very low. The study results suggest that policy

  7. The Florence Bird Lecture: "From Strength to Strength: The Interrelated Rights of Women and Children over the Life Cycle"

    Science.gov (United States)

    Pearson, Landon

    2012-01-01

    This article presents the author's Florence Bird lecture, which was delivered at Carleton University in Ottawa, Canada on International Women's Day, March 8, 2012. In the lecture, the author focuses on the interrelated rights of women and children over the life cycle. The author explores this linkage and offers a caveat. The author shares a…

  8. Rapid fetal fibronectin testing to predict preterm birth in women with symptoms of premature labour : a systematic review and cost analysis

    NARCIS (Netherlands)

    Deshpande, S N; van Asselt, A D I; Tomini, F; Armstrong, N; Allen, A; Noake, C; Khan, K; Severens, J L; Kleijnen, J; Westwood, M E

    2013-01-01

    BACKGROUND: Premature birth is defined as birth of before 37 completed weeks' gestation. Not all pregnant women showing symptoms of preterm labour will go on to deliver before 37 weeks' gestation. Hence, addition of fetal fibronectin (fFN) testing to the diagnostic workup of women with suspected

  9. Women referred for occupational risk assessment in pregnancy have no increased risk of adverse obstetric outcomes

    DEFF Research Database (Denmark)

    Bidstrup, Signe Brøker; Kaerlev, Linda; Thulstrup, Ane Marie

    2015-01-01

    .72-1.17). CONCLUSION: The women who are referred for occupational risk assessment at two large occupational university departments are not at an increased risk of preterm birth or of delivering low birth weight children. This may reflect that reproductive hazards in Danish workplaces are limited and......INTRODUCTION: Our aim was to study the association between pregnant women's referral status for occupational risk assessment, and their risk of preterm delivery (... pregnant women referred to two Danish clinics of occupational medicine (Copenhagen and Aarhus) from 1984 to 2010 were compared with the referred women's 1,077 non-referred pregnancy outcomes and with the pregnancy outcomes of 345,467 gainfully employed women from the same geographical areas and time period...

  10. Skilled care at birth among rural women in Nepal: practice and challenges.

    Science.gov (United States)

    Dhakal, Sulochana; van Teijlingen, Edwin; Raja, Edwin Amalraj; Dhakal, Keshar Bahadur

    2011-08-01

    In Nepal, most births take place at home, and many, particularly in rural areas, are not attended by a skilled birth attendant. The main objectives of the study were to assess the use of skilled delivery care and barriers to access such care in a rural community and to assess health problems during delivery and seeking care. This cross-sectional study was carried out in two Village Development Committees in Nepal in 2006. In total, 150 women who had a live birth in the 24 months preceding the survey were interviewed using a structured questionnaire. The sample population included married women aged 15-49 years. Forty-six (31%) women delivered their babies at hospital, and 104 (69%) delivered at home. The cost of delivery at hospital was significantly (p home. Results of univariate analysis showed that women from Brahmin-Chhetri ethnicity, women with higher education or who were more skilled, whose husbands had higher education and more skilled jobs, had first or second childbirth, and having adverse previous obstetric history were associated with institutional delivery while women with higher education and having an adverse history of pregnancy outcome predicted the uptake of skilled delivery care in Nepal. The main perceived problems to access skilled delivery care were: distance to hospital, lack of transportation, lack of awareness on delivery care, and cost. The main reasons for seeking intrapartum care were long labour, retained placenta, and excessive bleeding. Only a quarter of women sought care immediately after problems occurred. The main reasons seeking care late were: the woman or her family not perceiving that there was a serious problem, distance to health facility, and lack of transport. The use of skilled birth attendants at delivery among rural women in Nepal is very poor. Home delivery by unskilled birth attendants is still a common practice among them. Many associated factors relating to the use of skilled delivery care that were identified

  11. Materials Delivered by Member States

    International Nuclear Information System (INIS)

    1969-01-01

    In this document the Director General is reporting to the Members of the Agency, under Article IX. G of the Statute, the quantities of materials delivered by Members up to 30 June 1969 in compliance with requests the Agency had made under Article IX. D

  12. Contractor firm strategies in delivering green project: A review

    Science.gov (United States)

    Powmya, Ayisha; Abidin, Nazirah Zainul; Azizi, Nurul Sakina Mokhtar

    2017-10-01

    Building green requires effort from various parties, from those who plan, design, manage and construct the building. Contractors are responsible for converting the design on paper into a real building and their role at the construction site support environmental sustainability by implementing responsible construction practices. Inefficient or inexperienced contractor in green construction project may find that delivering this type of project is not an easy task due to added requirement in design, stringent practices at site and the use of green technology and materials. Adopting suitable strategies at firm level will assist in preparatory process and readiness of delivering the green project. This paper reviews the strategies at firm level to deliver green construction project. From extensive literature review, it was discovered that there are six strategies to be adopted by the contractor. Understanding these strategies is expected to promote more contractors to be proactive in delivering green projects.

  13. Contribution of overweight and obesity to adverse pregnancy outcomes among immigrant and non-immigrant women in Berlin, Germany.

    Science.gov (United States)

    Reiss, Katharina; Breckenkamp, Jürgen; Borde, Theda; Brenne, Silke; David, Matthias; Razum, Oliver

    2015-10-01

    Maternal excessive weight and smoking are associated with an increased risk of pregnancy complications and adverse pregnancy outcomes. In Germany, immigrant women have a higher prevalence of pre-pregnancy overweight/obesity compared with autochthonous women. We compared the contribution of pre-pregnancy overweight/obesity to adverse pregnancy outcomes among immigrant and autochthonous women in Berlin/Germany. Data from 2586 immigrant women (from Turkey, Lebanon, other countries of origin) and 2676 autochthonous women delivering in three maternity hospitals of Berlin within 12 months (2011/2012) was used. Cox regression models were applied to estimate the association between overweight/obesity and smoking with the outcomes large-for-gestational-age (LGA), small-for-gestational-age (SGA), preterm birth (PTB) and extreme preterm-birth (E-PTB). Population attributive fractions (PAF) were calculated to quantify the proportion of the outcomes attributable to overweight/obesity and smoking, respectively. Prevalence of overweight and obesity was 33.4% among autochthonous and 53.6% among Turkish women. Prevalence risk ratios of excessive weight were highest for LGA infants among immigrant and autochthonous women. The PAFs were -11.8% (SGA), +16.3% (LGA), +3.6% (PTB) and +16.5% (E-PTB) for the total study population. Overweight/obesity is strongly associated with an increased risk of delivering an LGA infant among both immigrant and autochthonous women. Compared with autochthonous women, the contribution of excessive weight to LGA is even higher among immigrant women, in whom PAFs of overweight/obesity even exceed those of smoking for some outcomes. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  14. Materials Delivered by Member States

    International Nuclear Information System (INIS)

    1975-01-01

    In this document the Director General is reporting to the Members of the Agency, under Article IX. G of the Statute, the quantities of materials which Members had delivered up to 30 June 1975, in compliance with requests the Agency had made under Article IX. D

  15. Materials Delivered by Member States

    International Nuclear Information System (INIS)

    1974-01-01

    In this document the Director General is reporting to the Members of the Agency, under Article IX. G of the Statute, the quantities of materials which Members had delivered up to 31 March 1974, in compliance with requests the Agency had made under Article IX. D

  16. Materials Delivered by Member States

    International Nuclear Information System (INIS)

    1971-01-01

    In this document the Director General is reporting to the Members of the Agency, under Article IX. G of the Statute, the quantities of materials which Members had delivered up to the end of 1970, in compliance with requests the Agency had made under Article IX. D

  17. Materials Delivered by Member States

    International Nuclear Information System (INIS)

    1973-01-01

    In this document the Director General is reporting to the Members of the Agency, under Article IX. G of the Statute, the quantities of materials which Members had delivered up to the end of 1972, in compliance with requests the Agency had made under Article IX. D

  18. Materials Delivered by Member States

    International Nuclear Information System (INIS)

    1972-01-01

    In this document the Director General is reporting to the Members of the Agency, under Article IX. G of the Statute, the quantities of materials which Members had delivered up to the end of 1971, in compliance with requests the Agency had made under Article IX. D

  19. Urinary incontinence during pregnancy and 1 year after delivery in primiparous women compared with a control group of nulliparous women

    DEFF Research Database (Denmark)

    Hansen, Bent Brandt; Svare, Jens; Viktrup, Lars

    2012-01-01

    , the prevalence of any type of urinary incontinence in the primiparous group was 32.1%, compared to 13.8% in the control group. Adjusted OR¿=¿3.3 (95%CI¿=¿2.4-4.4). One year after delivery, the prevalence in the primiparous group was 29.3%, compared to 16.6% in the control group. Adjusted OR¿=¿2.5 (95%CI¿=¿1......AIMS: To investigate the impact of the first pregnancy and delivery on the prevalence and types of urinary incontinence during pregnancy and 1 year after delivery. METHODS: The study was a prospective cohort study with a control group. Primiparous women, who delivered in our department from June...... 2003 to July 2005, participated. The women filled out a questionnaire 2-3 days after the delivery and a new questionnaire after 1 year. The questionnaires comprised basic characteristics and symptoms of urinary incontinence. An attempted age-matched control group of nulliparous women was included...

  20. Leadership styles of service professionals aiding women of abuse: enhancing service delivery.

    Science.gov (United States)

    Haeseler, Lisa Ann

    2013-01-01

    Leadership styles of service professionals--including social workers and teachers--in the area of family abuse were investigated. Leadership characteristics of the professionals were measured by their responses to a survey. Results indicated that the interviewed service professionals demonstrated productive leadership traits. Study findings are congruent with leadership styles described in the research. Holistic and collaborative services are required to enhance care for women of abuse, as their needs are multifaceted and complex. Specific leadership styles promote better care for women; leaders need to collaboratively initiate and deliver more interdisciplinary and unified service.

  1. A Social Media-Based Mindful Yoga Program for Pregnant Women in Taiwan.

    Science.gov (United States)

    Guo, Sophie Huey-Ming; Lee, Chia-Wen; Tsao, Chien-Ming; Hsing, Hung-Chun

    2016-01-01

    Social media, a communication tool, is increasingly used to facilitate the engagement of experts (such as a health provider) and other participants in a wide range of programs. However, social media requires study to elucidate its applications under women health-related conditions. This work develops a social media-based mindful yoga program for pregnant women, and delivers media content by ways of Facebook platform and DVD. The results of pilot testing revealed users' preference of using Facebook platform. Developing experience and uses' responses can provide valuable information for further implement socialmedia based interventions.

  2. Alternative Fuels Data Center: Golden Eagle Delivers Beer With Natural Gas

    Science.gov (United States)

    Trucks Golden Eagle Delivers Beer With Natural Gas Trucks to someone by E-mail Share Alternative Fuels Data Center: Golden Eagle Delivers Beer With Natural Gas Trucks on Facebook Tweet about Alternative Fuels Data Center: Golden Eagle Delivers Beer With Natural Gas Trucks on Twitter Bookmark

  3. Plasma homocyst(e)ine concentrations in eclamptic and preeclamptic African women postpartum.

    Science.gov (United States)

    Rajkovic, A; Mahomed, K; Malinow, M R; Sorenson, T K; Woelk, G B; Williams, M A

    1999-09-01

    To examine the relationship between plasma homocyst(e)ine and risk of eclampsia and preeclampsia among sub-Saharan African women who delivered at Harare Maternity Hospital in Zimbabwe. We ran a hospital-based, case-control study at Harare Maternity Hospital, University of Zimbabwe, Harare, Zimbabwe comprising 33 pregnant women with eclampsia and 138 with preeclampsia. Controls were 185 normotensive pregnant women. Plasma was collected postpartum and homocyst(e)ine levels were measured by high-performance liquid chromatography and electrochemical detection. Women with eclampsia or preeclampsia had significantly higher mean homocyst(e)ine levels than normotensive controls (12.54 or 12.77 micromol/L versus 9.93 micromol/L, respectively, Pine distribution (median 13.9 micromol/L) compared with women in the lowest quartile (median 6.2 micromol/L). The corresponding OR for preeclampsia was 4.57. Nulliparas with elevated homocyst(e)ine had a 12.90 times higher risk of preeclampsia compared with multiparas without elevated homocyst(e)ine. Postpartum plasma homocyst(e)ine concentrations are higher among Zimbabwean women with eclampsia and preeclampsia compared with normotensive women.

  4. Bacteriological quality of raw camel milk along the market value chain in Fafen zone, Ethiopian Somali regional state.

    Science.gov (United States)

    Abera, Tsegalem; Legesse, Yoseph; Mummed, Behar; Urga, Befekadu

    2016-05-26

    The camel is a multipurpose animal with a huge productive potential. Camel milk is a key food in arid and semi-arid areas of the African and Asian countries. The quality of milk is influenced by different bacteria present in milk. This study was conducted to evaluate total bacterial content in raw camel milk along the market chain in Fafen zone, Ethiopian Somali Regional State. One hundred twenty-six raw camel milk samples were collected from Gursum (47.1 %) and Babile (52.9 %) districts. The three sampling levels included were udder (14.7 %), milking bucket (29.4 %) and market (55.9 %). Milk samples were analyzed for total bacterial counts (TBC) and coliform counts (CC). Furthermore, major pathogens were isolated and identified. 108 (85.7 %) of raw camel milk samples demonstrated bacterial contamination. The overall mean TBC and CC of contaminated raw camel milk samples was 4.75 ± 0.17 and 4.03 ± 0.26 log CFU/ml, respectively. TBC increased from udder to market level and was higher in Gursum compared to Babile district (P < 0.05). Around 38.9 % of TBCs and 88.2 % CCs in contaminated raw camel milk samples were in the range considered unsafe for human utility. Staphylococcus spp. (89.8 %), Streptococcus spp. (53.7 %), E. coli (31.5 %), Salmonella spp. (17.6 %), Klebsiella spp. (5.6 %) and Enterobacter spp. (5.6 %) were the major bacterial microorganisms isolated. The majority of the bacterial isolates in this study showed high incidence in market as compared to production level. These results indicate a lack of compliance with good production practices and hygiene at milking, transportation and market of raw camel milk.

  5. Internet delivered cognitive behavior therapy for antenatal depression: A randomised controlled trial.

    Science.gov (United States)

    Forsell, Erik; Bendix, Marie; Holländare, Fredrik; Szymanska von Schultz, Barbara; Nasiell, Josefine; Blomdahl-Wetterholm, Margareta; Eriksson, Caroline; Kvarned, Sara; Lindau van der Linden, Johanna; Söderberg, Elin; Jokinen, Jussi; Wide, Katarina; Kaldo, Viktor

    2017-10-15

    Major depression occurs in 5-10% of pregnancies and is associated with many negative effects for mother and child, yet treatment options are scarce. To our knowledge, this is the first published randomised controlled trial on Internet delivered Cognitive Behavior Therapy (ICBT) for this group. To test the efficacy of a pregnancy adapted version of an existing 10-week ICBT-program for depression as well as assessing acceptability and adherence DESIGN: Randomised controlled trial. Online and telephone. Self-referred pregnant women (gestational week 10-28 at intake) currently suffering from major depressive disorder. 42 pregnant women (gestational week 12-28) with major depression were randomised to either treatment as usual (TAU) provided at their antenatal clinic or to ICBT as an add-on to usual care. The primary outcome was depressive symptoms measured with the Montgomery-Åsberg depression rating scale-self report (MADRS-S). The Edinburgh Postnatal Depression Scale and measures of anxiety and sleep were used. Credibility, satisfaction, adherence and utilization were also assessed. The ICBT group had significantly lower levels of depressive symptoms post treatment (p treatment credibility, satisfaction, utilization, and adherence were comparable to implemented ICBT for depression. Small sample size and no long-term evaluation. Pregnancy adapted ICBT for antenatal depression is feasible, acceptable and efficacious. These results need to be replicated in larger trials to validate these promising findings. Copyright © 2017. Published by Elsevier B.V.

  6. What's wrong with female circumcision?

    Science.gov (United States)

    Nelson, D

    1994-03-16

    Why should the multicultural society of Canada outlaw female genital mutilation (FGM) as proposed by federal Justice Minister Allan Rock or allow avoidance of the procedure to be a legitimate reason for gaining refugee status? Is this anti-FGM position simply an ethnocentric stance that would be called racism in other circumstances? Canadian objections to FGM can not arise from objections about mutilation of a child's sexual organs because male circumcision is legal in Canada, although it, too, is medically questionable. Perhaps Rock is being patriarchal in reserving his concern for females. In Somali culture, women determine the nature and extent of FGM, so Rock may simply be exhibiting his inability to understand other cultures. On the other hand, it is politically incorrect for Canadian government workers to criticize other cultures, and immigrants are assured that their values and beliefs will be accommodated in Canada. Thus, polygamy among Somali immigrants is ignored. The question is why should FGM be a major exception and invoke efforts at repression instead of a respect for diversity.

  7. Standardised Chinese herbal treatment delivered by GPs compared with individualised treatment administered by practitioners of Chinese herbal medicine for women with recurrent urinary tract infections (RUTI): study protocol for a randomised controlled trial.

    Science.gov (United States)

    Flower, Andrew; Harman, Kim; Lewith, George; Moore, Michael; Bishop, Felicity L; Stuart, Beth; Lampert, Nicholas

    2016-07-27

    In the UK, urinary tract infections (UTIs) are the most common bacterial infection presented by women in primary care. Recurrent urinary tract infections (RUTIs) are defined as three episodes of UTI in the last 12 months, or two episodes in the last 6 months. Between 20 and 30 % of women who have had one episode of UTI will have an RUTI, and approximately 25 % of these will develop subsequent recurrent episodes. RUTIs can have a significant negative effect on the quality of life, and have a high impact on health care costs as a result of outpatient visits, diagnostic tests and prescriptions. Chinese herbal medicine (CHM) has a recorded history of treatments for the symptoms of UTIs for more than 2000 years. More recent clinical research in China has provided some preliminary evidence that CHM can alleviate the symptoms of UTIs and reduce the rate of recurrence, but more rigorous investigation is required. The RUTI trial is a double-blind, randomised, placebo-controlled, feasibility trial. A total of 80 women will be randomised to 'individualised' herbs prescribed by a Chinese herbal practitioner or to 'standardised' herbs provided by primary care clinicians. Both arms will have herbs for prevention of UTIs and treatment of acute episodes. Treatment duration is for 16 weeks. The primary outcomes are the number of episodes of recurrent UTIs during the trial period and in the 6 months of follow-up, and the number of days of symptoms rated moderately bad or worse based on patient diaries. Secondary outcomes will assess participant expectations and beliefs, adherence to the treatment, adverse events and health economics and provide quantitative and qualitative assessments of the impact of recurrent infections on the lives of women. The RUTI trial is the first instance of CHM delivered as a clinical trial of an investigatory medicinal product in the UK. This study provides important information regarding the feasibility and acceptability of researching and using

  8. Life cycle assessment perspectives on delivering an infant in the US

    International Nuclear Information System (INIS)

    Campion, Nicole; Thiel, Cassandra L.; DeBlois, Justin; Woods, Noe C.; Landis, Amy E.; Bilec, Melissa M.

    2012-01-01

    This study introduces life cycle assessment as a tool to analyze one aspect of sustainability in healthcare: the birth of a baby. The process life cycle assessment case study presented evaluates two common procedures in a hospital, a cesarean section and a vaginal birth. This case study was conducted at Magee-Womens Hospital of the University of Pittsburgh Medical Center, which delivers over 10,000 infants per year. The results show that heating, ventilation, and air conditioning (HVAC), waste disposal, and the production of the disposable custom packs comprise a large percentage of the environmental impacts. Applying the life cycle assessment tool to medical procedures allows hospital decision makers to target and guide efforts to reduce the environmental impacts of healthcare procedures. - Highlights: ► Life cycle assessment helps identify the environmental impacts of medical procedures. ► Disposable custom packs represent a large portion of environmental impacts of births. ► Electricity loading contributes to global warming potential and respiratory effects. ► Impact improvements should focus on heating, ventilation, and air conditioning and disposable custom packs.

  9. Impact of peer delivered wellness coaching.

    Science.gov (United States)

    Swarbrick, Margaret; Gill, Kenneth J; Pratt, Carlos W

    2016-09-01

    People receiving publicly funded behavioral health services for severe mental disorders have shorter lifespans and significantly impaired health-related quality of life compared to the general population. The aim of this article was to explore how peer wellness coaching (PWC), a manualized approach to pursue specific physical wellness goals, impacted goal attainment and overall health related quality of life. Deidentified archival program evaluation data were examined to explore whether peer delivered wellness coaching had an impact on 33 service recipients with regard to goal attainment and health-related quality of life. Participants were served by 1 of 12 wellness coach trainees from a transformation transfer initiative grant who had been trained in the manualized approach. Coaching participants and their coaches reported significant progress toward the attainment of individually chosen goals, 2 to 4 weeks after establishing their goals. After 8 to 10 weeks of peer delivered wellness coaching, improvements were evident in the self-report of physical health, general health, and perceived health. These improvements were sustained 90 days later. PWC is potentially a promising practice for helping people choose and pursue individual goals and facilitating positive health and wellness changes. Rigorous controlled research with larger samples is needed to evaluate the benefits of peer delivered wellness coaching. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  10. Trends in gynecologic cancer among elderly women in Denmark, 1980-2012

    DEFF Research Database (Denmark)

    Ør Knudsen, Anja; Schledermann, Doris; Nyvang, Gitte-Bettina

    2016-01-01

    (cancer of the cervix uteri), C54 (corpus uteri cancer), C56 (ovarian cancer) and C57 (Fallopian tube cancer). Data derived from the NORDCAN database with comparable data on cancer incidence, mortality, prevalence and relative survival in the Nordic countries, where the Danish data are delivered from......Background The aim of this analysis was to describe trends in incidence, mortality, prevalence, and survival in Danish women with gynecologic cancer from 1980-2012 comparing women aged 70 years or more with younger women. Material and methods Gynecologic cancers included were ICD-10 codes C53...... the Danish Cancer Registry and the Danish Cause of Death Registry with follow-up for death or emigration until the end of 2013. Results For cervical cancer the incidence decreased among women aged less than 70 years and remained stable among the elderly. The mortality rates were clearly separated by age...

  11. Smoking habits in Italian pregnant women: any changes after the ban?

    Science.gov (United States)

    Charrier, Lorena; Serafini, Paola; Giordano, Livia; Zotti, Carla Maria

    2010-04-01

    A reduction in the prevalence of smoking and tobacco consumption was noted after the enactment in 2005 of new smoking regulations in Italy. To determine the impact of the smoking ban on pregnant women, we compared the results of two retrospective studies on two samples of 300 women, who recently delivered, conducted before and after the regulations went into effect. The comparison showed a marked drop in passive exposure to smoke in the workplace but not in the family environment; however, passive exposure and smoking were associated before and during pregnancy. Nearly all women agreed that the ban on smoking in public was reasonable and stated it had influenced their smoking habit or exposure. Despite this lip service, both studies highlighted that smoking in pregnancy remains a problem for many women, as about 10 per cent did not quit and over 50 per cent relapsed after delivery.

  12. Feasibility and acceptability of shared decision-making to promote alcohol behavior change among women Veterans: Results from focus groups.

    Science.gov (United States)

    Abraham, Traci H; Wright, Patricia; White, Penny; Booth, Brenda M; Cucciare, Michael A

    2017-01-01

    Although rates of unhealthy drinking are high among women Veterans with mental health comorbidities, most women Veterans with mental comorbidities who present to primary care with unhealthy drinking do not receive alcohol-related care. Barriers to alcohol-related treatment could be reduced through patient-centered approaches to care, such as shared decision-making. We assessed the feasibility and acceptability of a telephone-delivered shared decision-making intervention for promoting alcohol behavior change in women Veterans with unhealthy drinking and co-morbid depression and/or probable post-traumatic stress disorder. We used 3, 2-hour focus group discussions with 19 women Veterans to identify barriers and solicit recommendations for using the intervention with women Veterans who present to primary care with unhealthy drinking and mental health comorbidities. Transcripts from the focus groups were qualitatively analyzed using template analysis. Although participants perceived that the intervention was feasible and acceptable for the targeted patient population, they identified the treatment delivery modality, length of telephone sessions, and some of the option grid content as potential barriers. Facilitators included strategies for enhancing the telephone-delivered shared decision-making sessions and diversifying the treatment options contained in the option grids. Focus group feedback resulted in preliminary adaptations to the intervention that are mindful of women Veterans' individual preferences for care and realistic in the everyday context of their busy lives.

  13. Minimal Impact by Antenatal Subpatent Plasmodium falciparum Infections on Delivery Outcomes in Malawian Women: A Cohort Study.

    Science.gov (United States)

    Taylor, Steve M; Madanitsa, Mwayiwawo; Thwai, Kyaw-Lay; Khairallah, Carole; Kalilani-Phiri, Linda; van Eijk, Anna M; Mwapasa, Victor; Ter Kuile, Feiko O; Meshnick, Steven R

    2017-08-01

    Antenatal malaria screening with a rapid diagnostic test (RDT) and treatment only of women with positive RDT findings may potentially prevent low birth weight resulting from malaria. The consequences of subpatent antenatal infections below the detection limit of RDTs are incompletely understood. In Malawi, pregnant women of any gravidity status were tested at each antenatal visit for Plasmodium falciparum, using an RDT and polymerase chain reaction analysis, and were followed until delivery. Associations between antenatal infections and delivery outcomes were assessed with Poisson regression or analysis of variance. Compared with women with no detected antenatal P. falciparum infection, women with positive RDT findings delivered babies with a lower mean birth weight (2960 vs 2867 g; mean difference, -93 g [95% confidence interval {CI}, -27 to -159]; P = .006); this was not observed among women with only subpatent infections (mean birth weight, 3013 g; mean difference, 54 [95% CI, -33-140]; P = .2268). These differences were apparent early in pregnancy, during the second trimester: compared with uninfected women, women with positive RDT findings delivered babies with a lower mean birth weight (mean difference, -94 g [95% CI, -31 to -156]; P = .003), but women with subpatent infections did not (mean difference, 36 g [95% CI, -49-122]; P = .409). Subpatent antenatal P. falciparum infections were not associated with adverse delivery outcomes. The association of patent infections at enrollment with low birth weight suggests the importance of preventing P. falciparum infection early in pregnancy. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

  14. Women's perceptions and experiences of fetal macrosomia.

    Science.gov (United States)

    Reid, Esther W; McNeill, Jenny A; Holmes, Valerie A; Alderdice, Fiona A

    2014-04-01

    to explore women's perceptions and experiences of pregnancy and childbirth following birth of a macrosomic infant (birth weight ≥4000g). a qualitative design utilising interviews conducted 13-19 weeks post partum in women's homes. The study was conducted in one Health and Social Care Trust in Northern Ireland between January and September 2010. Participants were identified from a larger cohort of women recruited to a prospective study exploring the impact of physical activity and nutrition on macrosomia. Eleven women who delivered macrosomic infants participated in this phase of the study. four overarching themes emerged: preparation for delivery; physical and emotional impact of macrosomia; professional relations and perceptions of macrosomia. Findings highlighted the importance of communication with health professionals in relation to both prediction of macrosomia and decision making about childbirth, and offers further understanding into the physical and emotional impact of having a macrosomic infant on women. Furthermore, there was evidence that beliefs and perceptions relating to macrosomia may influence birth experiences and uptake of health promotion messages. this study provides important insight into women's experiences of macrosomia throughout the perinatal period and how they were influenced by previous birth experiences, professional relations and personal perceptions and beliefs about macrosomia. Pregnant women at risk of having a macrosomic infant may require extra support throughout the antenatal period continuing into the postnatal period. Support needs to be tailored to the woman's information needs, with time allocated to explore previous birth experiences, beliefs about macrosomia and options for childbirth. Copyright © 2013 Elsevier Ltd. All rights reserved.

  15. Development and Pilot Testing of 24-Hour Multiple-Pass Recall to Assess Dietary Intake of Toddlers of Somali- and Iraqi-Born Mothers Living in Norway

    Directory of Open Access Journals (Sweden)

    Navnit Kaur Grewal

    2014-06-01

    Full Text Available The aim of this study was to develop, test, and evaluate a 24-h recall procedure to assess the dietary intake of toddlers of Somali- and Iraqi-born mothers living in Norway. A protocol for a 24-h multiple-pass recall procedure, registration forms, and visual tools (a picture library for food identification and portion size estimation was developed and tested in 12 mothers from Somalia and Iraq with children aged 10–21 months. Five female field workers were recruited and trained to conduct the interviews. Evaluation data for the 24-h recall procedure were collected from both the mothers and the field workers. Nutrient intake was calculated using a Norwegian dietary calculation system. Each child’s estimated energy intake was compared with its estimated energy requirement. Both the mothers and the field workers found the method feasible and the visual tools useful. The estimated energy intake corresponded well with the estimated energy requirement for most of the children (within mean ± 2 SD, except for three. The pilot study identified the need for additional foods in the picture library and some crucial aspects in training and supervising the field workers to reduce sources of error in the data collection.

  16. Experiences of and responses to disrespectful maternity care and abuse during childbirth; a qualitative study with women and men in Morogoro Region, Tanzania.

    Science.gov (United States)

    McMahon, Shannon A; George, Asha S; Chebet, Joy J; Mosha, Idda H; Mpembeni, Rose N M; Winch, Peter J

    2014-08-12

    Interventions to reduce maternal mortality have focused on delivery in facilities, yet in many low-resource settings rates of facility-based birth have remained persistently low. In Tanzania, rates of facility delivery have remained static for more than 20 years. With an aim to advance research and inform policy changes, this paper builds on a growing body of work that explores dimensions of and responses to disrespectful maternity care and abuse during childbirth in facilities across Morogoro Region, Tanzania. This research drew on in-depth interviews with 112 respondents including women who delivered in the preceding 14 months, their male partners, public opinion leaders and community health workers to understand experiences with and responses to abuse during childbirth. All interviews were recorded, transcribed, translated and coded using Atlas.ti. Analysis drew on the principles of Grounded Theory. When initially describing birth experiences, women portrayed encounters with providers in a neutral or satisfactory light. Upon probing, women recounted events or circumstances that are described as abusive in maternal health literature: feeling ignored or neglected; monetary demands or discriminatory treatment; verbal abuse; and in rare instances physical abuse. Findings were consistent across respondent groups and districts. As a response to abuse, women described acquiescence or non-confrontational strategies: resigning oneself to abuse, returning home, or bypassing certain facilities or providers. Male respondents described more assertive approaches: requesting better care, paying a bribe, lodging a complaint and in one case assaulting a provider. Many Tanzanian women included in this study experienced unfavorable conditions when delivering in facilities. Providers, women and their families must be made aware of women's rights to respectful care. Recommendations for further research include investigations of the prevalence and dimensions of disrespectful care and

  17. Factors associated with lack of postnatal care among Palestinian women: A cross-sectional study of three clinics in the West Bank

    Directory of Open Access Journals (Sweden)

    Maxwell Annette E

    2008-07-01

    Full Text Available Abstract Background Only about one-third of women in Palestine (West Bank and Gaza obtain postpartum care. Therefore, the goal of this study was to assess factors associated with lack of postnatal care, women's reasons for not obtaining postnatal care, and their attitudes towards its importance. Methods In early 2006, a cross-sectional survey was conducted at three clinics run by the Ministry of Health providing Mother and Child Health Care in West Bank, Palestine. A total of 264 postpartum women attending the clinics were interviewed face-to-face, using a structured questionnaire. Results Although the majority of women considered postnatal care necessary (66.1%, only 36.6% of women obtained postnatal care. The most frequent reason for not obtaining postnatal care was that women did not feel sick and therefore did not need postnatal care (85%, followed by not having been told by their doctor to come back for postnatal care (15.5%. Based on a multivariable analysis, use of postnatal care was higher among women who had experienced problems during their delivery, had a cesarean section, or had an instrumental vaginal delivery than among women who had a spontaneous vaginal delivery. Use of postnatal care was also higher among women who delivered in a private hospital as compared to those who delivered in a public hospital. In addition, we found regional differences. Conclusion The higher use of postnatal care among high-risk women is appropriate, but some clinically dangerous conditions can also occur in low-risk women. Future efforts should therefore focus on providing postnatal care to a larger number of low-risk women.

  18. How to design and deliver a local teaching program

    OpenAIRE

    Limb, Christopher; Whitehurst, Katharine; Gundogan, Buket; Koshy, Kiron; Agha, Riaz

    2017-01-01

    Teaching is an invaluable aspect of any medical or surgical career. Many trainees will find themselves delivering teaching at several stages in their career and in this “How to” article we explain how to design, set up, and deliver a successful teaching program, as well as how to evidence this in your portfolio.

  19. Maternal obesity and postpartum haemorrhage after vaginal and caesarean delivery among nulliparous women at term: a retrospective cohort study

    Directory of Open Access Journals (Sweden)

    Fyfe Elaine M

    2012-10-01

    Full Text Available Abstract Background Increasing rates of postpartum haemorrhage in developed countries over the past two decades are not explained by corresponding changes in risk factors and conjecture has been raised that maternal obesity may be responsible. Few studies investigating risk factors for PPH have included BMI or investigated PPH risk among nulliparous women. The aim of this study was to determine in a cohort of nulliparous women delivering at term whether overweight and obesity are independent risk factors for major postpartum haemorrhage (PPH ≥1000ml after vaginal and caesarean section delivery. Methods The study population was nulliparous singleton pregnancies delivered at term at National Women’s Hospital, Auckland, New Zealand from 2006 to 2009 (N=11,363. Multivariable logistic regression was adjusted for risk factors for major PPH. Results There were 7238 (63.7% women of normal BMI, 2631 (23.2% overweight and 1494 (13.1% obese. Overall, PPH rates were increased in overweight and obese compared with normal-weight women (n=255 [9.7%], n=233 [15.6%], n=524 [7.2%], p Conclusion Nulliparous obese women have a twofold increase in risk of major PPH compared to women with normal BMI regardless of mode of delivery. Higher rates of PPH among obese women are not attributable to their higher rates of caesarean delivery. Obesity is an important high risk factor for PPH, and the risk following vaginal delivery is emphasised. We recommend in addition to standard practice of active management of third stage of labour, there should be increased vigilance and preparation for PPH management in obese women.

  20. Pregnancy outcome in women with cystic fibrosis-related diabetes.

    Science.gov (United States)

    Reynaud, Quitterie; Poupon-Bourdy, Stéphanie; Rabilloud, Muriel; Al Mufti, Lina; Rousset Jablonski, Christine; Lemonnier, Lydie; Nove-Josserand, Raphaële; Touzet, Sandrine; Durieu, Isabelle

    2017-10-01

    With increasing life expectancy, more women with cystic fibrosis and diabetes mellitus become pregnant. We investigated how pre-gestational diabetes (cystic fibrosis-related diabetes) influenced pregnancy outcome and the clinical status of these women. We analyzed all pregnancies reported to the French cystic fibrosis registry between 2001 and 2012, and compared forced expiratory volume (FEV 1 ) and body mass index before and after pregnancy in women with and without pre-gestational diabetes having a first delivery. A total 249 women delivered 314 infants. Among these, 189 women had a first delivery and 29 of these had pre-gestational diabetes. There was a trend towards a higher rate of assisted conception among diabetic women (53.8%) than non-diabetic women (34.5%, p = 0.06), and the rate of cesarean section was significantly higher in diabetic women (48% vs. 21.4%, p = 0.005). The rate of preterm birth and mean infant birthweight did not differ significantly between diabetic and non-diabetic women. Forced expiratory volume before pregnancy was significantly lower in the diabetic group. The decline in forced expiratory volume and body mass index following pregnancy did not differ between the women with and those without pre-gestational diabetes. Pre-gestational diabetes in women with cystic fibrosis is associated with a higher rate of cesarean section but does not seem to have a clinically significant impact on fetal growth or preterm delivery. The changes in maternal pulmonary and nutritional status following pregnancy in women with cystic fibrosis were not influenced by pre-gestational diabetes. © 2017 Nordic Federation of Societies of Obstetrics and Gynecology.

  1. RELATIONSHIP BETWEEN PERIODONTAL DISEASE INDEX AND LOW BIRTH WEIGHT BABIES IN PREGNANT WOMEN WITH PERIODONTITIS

    Directory of Open Access Journals (Sweden)

    Ira Komara

    2016-03-01

    Full Text Available Objective: To identify the relationship between periodontitis in pregnant women through the periodontal disease index (PDI and low birth weight babies. Methods: A case-control study was conducted to determine the relationship between periodontitis in pregnant women through the periodontal disease index (PDI and the low birth weight babies (LBW. The participants were mothers with periodontitis and non-periodontitis mothers aged 20–35 years who gave birth in the Department of Obstetrics and Gynecology-Dr. Hasan Sadikin General Hospital, Bandung in the period of December to January 2005. Results: Based on the chisquare test results a highly significant relationship between periodontitis and low birth weight (p=0.002 was found. The Odd’s ratio showed that the risk of low birth weight in pregnant women with periodontitis was 15.58 times higher compared to those who did not suffer from periodontitis. The periodontal disease index has an accuracy of 88.6% in predicting the incidence of LBW. It strongly influenced the incidence of LBW with a high Odd’s ratio of 28.0. Pregnant women who suffer from periodontitis with a PDI > 3.25, have 19.2 times higher risk for delivering babies with LBW compared to the non-periodontitis mothers. Conclusions: The loss of attachment affects the possibility of delivering LBW babies.

  2. Particle tracker system delivered to CERN

    CERN Multimedia

    Pitcher, Graham

    2006-01-01

    "The CCLRC Rutherford Appleton Laboratory (RAL) has delivered a system to CERN that will help to process the vast amounts of data generated by the silicon tracking detector within the Compact Muon Solenoid experiment." (1/2 page)

  3. Counseling postpartum women about contraception.

    Science.gov (United States)

    Kennedy, K

    1992-10-01

    Only 5 studies have examines resumption of intercourse after childbirth and coital frequency. These studies conducted in Chile, England, the Philippines, Scotland, and Thailand found that 4 to almost 8 weeks is the average duration between childbirth and resumption of intercourse. Yet, they also showed sizable variation in this duration. In Thailand, the first postpartum intercourse occurred between 3 and 21 weeks. Further, during this study, one mother had not yet resumed intercourse. A study in metropolitan Cebu, in the Philippines, included 3080 women. The mean intercourse resumption interval was 4-6 weeks, yet at 2 years 80 women still had not had postpartum intercourse. This study found 10 factors predicting resumption of intercourse: husband present, not breast feeding, resumption of menstruation, young age, some education, children younger than 7 years old, uncrowded home, nuclear family, urba residence, and trained health worker delivering baby. Mean coital frequency among the Thai women was once per week, but this does not indicate typical frequency. In fact, one woman averaged intercourse 3 times/week, while another had her first postpartum intercourse 6 weeks after delivery and not gain until 8 weeks later. Family planning counselors can use coital frequency studies to guide them when advising postpartum women. For example, a women who does not have intercourse frequently and is at 6-12 months postpartum could use the lactational amenorrhea method and condoms. More frequent intercourse and resumption of menstruation requires a more reliable family planning method. A 1988 study found that for the first 6 months postpartum women who breast feed have a lower coital frequency, longer delay before intercourse resumption, reduced sexual interest and enjoyment, more pain during intercourse, and are somewhat more depressed than those who bottle feed.

  4. A dynamic allocation mechanism of delivering capacity in coupled networks

    International Nuclear Information System (INIS)

    Du, Wen-Bo; Zhou, Xing-Lian; Zhu, Yan-Bo; Zheng, Zheng

    2015-01-01

    Traffic process is ubiquitous in many critical infrastructures. In this paper, we introduce a mechanism to dynamically allocate the delivering capacity into the data-packet traffic model on the coupled Internet autonomous-system-level network of South Korea and Japan, and focus on its effect on the transport efficiency. In this mechanism, the total delivering capacity is constant and the lowest-load node will give one unit delivering capacity to the highest-load node at each time step. It is found that the delivering capacity of busy nodes and non-busy nodes can be well balanced and the effective betweenness of busy nodes with interconnections is significantly reduced. Consequently, the transport efficiency such as average traveling time and packet arrival rate is remarkably improved. Our work may shed some light on the traffic dynamics in coupled networks.

  5. Contingent use of fetal fibronectin testing and cervical length measurement in women with preterm labour.

    Science.gov (United States)

    Audibert, François; Fortin, Suzanne; Delvin, Edgard; Djemli, Anissa; Brunet, Suzanne; Dubé, Johanne; Fraser, William D

    2010-04-01

    To evaluate the contingent use of fetal fibronectin (fFN) testing and cervical length (CL) measurement to predict preterm delivery, and to validate the use of phosphorylated IGFBP-1 as a predictor of preterm delivery. We recruited 71 women with a clinical diagnosis of preterm labour between 24 and 34 weeks, and tested for the presence of fFN and IGFBP-1 in the cervicovaginal secretions of all women immediately before CL measurement. Among the 66 women with complete outcome, four were excluded from the final analysis as two had assessment for fFN but no CL measurement, and another two had CL measured but no screening for fFN. Among 62 women with complete results, the mean gestational age at recruitment was 29.4 +/- 2.5 weeks. Six women (9.6%) delivered within two weeks of assessment, and 14 (22.5%) delivered before 34 weeks. A positive fFN test resulted in a sensitivity of 83%, a specificity of 84%, a positive predictive value of 36%, and a negative predictive value of 98% for delivery within two weeks; for CL contingent use of fFN (in which the test was assumed to be positive if CL contingent use protocol, only one third of women needed fFN screening after CL measurement. In this study, IGFBP-1 screening did not predict preterm delivery and fFN screening provided the best predictive capacity. A policy of contingent use of testing for fFN after CL measurement, or contingent use of CL measurement after fFN screening (depending on available resources) is a promising approach to limit use of resources.

  6. Delivering migrant workers' remittances

    OpenAIRE

    Ballard, Roger

    2004-01-01

    As globalization has led to ever higher levels of labour mobility, so the volume of funds remitted to their families by workers employed in countries far distant from their homes has increased by leaps and bounds. The total volume of such transfers currently amounts to over $100 billion per annum, the greater part of which flows from economically advanced regions in the West and North to developing countries in the East and South. Delivering those funds swiftly, reliably and cheaply to relati...

  7. Evaluation of primary care midwifery in The Netherlands: design and rationale of a dynamic cohort study (DELIVER).

    Science.gov (United States)

    Manniën, Judith; Klomp, Trudy; Wiegers, Therese; Pereboom, Monique; Brug, Johannes; de Jonge, Ank; van der Meijde, Margreeth; Hutton, Eileen; Schellevis, Francois; Spelten, Evelien

    2012-03-20

    In the Netherlands, midwives are autonomous medical practitioners and 78% of pregnant women start their maternity care with a primary care midwife. Scientific research to support evidence-based practice in primary care midwifery in the Netherlands has been sparse. This paper describes the research design and methodology of the multicenter multidisciplinary prospective DELIVER study which is the first large-scale study evaluating the quality and provision of primary midwifery care. Between September 2009 and April 2011, data were collected from clients and their partners, midwives and other healthcare professionals across the Netherlands. Clients from twenty midwifery practices received up to three questionnaires to assess the expectations and experiences of clients (e.g. quality of care, prenatal screening, emotions, health, and lifestyle). These client data were linked to data from the Netherlands Perinatal Register and electronic client records kept by midwives. Midwives and practice assistants from the twenty participating practices recorded work-related activities in a diary for one week, to assess workload. Besides, the midwives were asked to complete a questionnaire, to gain insight into collaboration of midwives with other care providers, their tasks and attitude towards their job, and the quality of the care they provide. Another questionnaire was sent to all Dutch midwifery practices which reveals information regarding the organisation of midwifery practices, provision of preconception care, collaboration with other care providers, and provision of care to ethnic minorities. Data at client, midwife and practice level can be linked. Additionally, partners of pregnant women and other care providers were asked about their expectations and experiences regarding the care delivered by midwives and in six practices client consults were videotaped to objectively assess daily practice. In total, 7685 clients completed at least one questionnaire, 136 midwives and

  8. Evaluation of primary care midwifery in the Netherlands: design and rationale of a dynamic cohort study (DELIVER

    Directory of Open Access Journals (Sweden)

    Manniën Judith

    2012-03-01

    Full Text Available Abstract Background In the Netherlands, midwives are autonomous medical practitioners and 78% of pregnant women start their maternity care with a primary care midwife. Scientific research to support evidence-based practice in primary care midwifery in the Netherlands has been sparse. This paper describes the research design and methodology of the multicenter multidisciplinary prospective DELIVER study which is the first large-scale study evaluating the quality and provision of primary midwifery care. Methods/Design Between September 2009 and April 2011, data were collected from clients and their partners, midwives and other healthcare professionals across the Netherlands. Clients from twenty midwifery practices received up to three questionnaires to assess the expectations and experiences of clients (e.g. quality of care, prenatal screening, emotions, health, and lifestyle. These client data were linked to data from the Netherlands Perinatal Register and electronic client records kept by midwives. Midwives and practice assistants from the twenty participating practices recorded work-related activities in a diary for one week, to assess workload. Besides, the midwives were asked to complete a questionnaire, to gain insight into collaboration of midwives with other care providers, their tasks and attitude towards their job, and the quality of the care they provide. Another questionnaire was sent to all Dutch midwifery practices which reveals information regarding the organisation of midwifery practices, provision of preconception care, collaboration with other care providers, and provision of care to ethnic minorities. Data at client, midwife and practice level can be linked. Additionally, partners of pregnant women and other care providers were asked about their expectations and experiences regarding the care delivered by midwives and in six practices client consults were videotaped to objectively assess daily practice. Discussion In total, 7685

  9. Access to HIV Care and Resilience in a Long-Term Conflict Setting: A Qualitative Assessment of the Experiences of Living with Diagnosed HIV in Mogadishu, Somali.

    Science.gov (United States)

    Kulane, Asli; Owuor, John O A; Sematimba, Douglas; Abdulahi, Sacdia Abdisamad; Yusuf, Hamdi Moalim; Mohamed, Lul M

    2017-07-05

    Human Immunodeficiency Virus (HIV) continues to take a heavy toll on the lives of many people, with the worst impact on health and wellbeing for the affected individuals in fragile states. The HIV situation in Somalia is not clearly known and experiences of the people living with HIV in this war-torn region are often unexpressed. This pilot qualitative study sought to explore the experiences of people diagnosed with HIV living in Mogadishu, and their resilience in access to care and social support. Participants were recruited through drug dispensers at the HIV clinic in Banadir Hospital. Face-to-face in-depth interviews were conducted in Somali in May 2013 among patients who were receiving antiretroviral therapy (ART) from the HIV clinic in Mogadishu. These were tape-recorded, transcribed, and translated for content analysis. Three women and four men who were living with HIV shared the following narratives. Their perception was that they had either got HIV from their spouses or through health care contamination. They were very knowledgeable about the realities of HIV, how the medication works, nutritional requirements, and drug adherence. They were always willing to go an extra mile to secure a good life for themselves. However, the external HIV stigma impacted their access to care. They faced challenges in their homes and at work which compelled them to seek support from non-governmental organizations (NGOs) or close family members. This stigma often affected their disclosure to the wider community due to the uncertainty of the repercussions, leading to a life of extreme loneliness and financial difficulties. The participants' coping mechanisms included living together and starting their own NGO for support with very strong optimism about their prognosis. The people diagnosed with HIV living in Mogadishu are highly knowledgeable about HIV transmission, the realities of living with a diagnosed HIV infection, and the efficacy of HIV treatment. Our small sample

  10. Access to HIV Care and Resilience in a Long-Term Conflict Setting: A Qualitative Assessment of the Experiences of Living with Diagnosed HIV in Mogadishu, Somali

    Science.gov (United States)

    Kulane, Asli; Owuor, John O. A.; Abdulahi, Sacdia Abdisamad; Yusuf, Hamdi Moalim; Mohamed, Lul M.

    2017-01-01

    Background: Human Immunodeficiency Virus (HIV) continues to take a heavy toll on the lives of many people, with the worst impact on health and wellbeing for the affected individuals in fragile states. The HIV situation in Somalia is not clearly known and experiences of the people living with HIV in this war-torn region are often unexpressed. This pilot qualitative study sought to explore the experiences of people diagnosed with HIV living in Mogadishu, and their resilience in access to care and social support. Methods: Participants were recruited through drug dispensers at the HIV clinic in Banadir Hospital. Face-to-face in-depth interviews were conducted in Somali in May 2013 among patients who were receiving antiretroviral therapy (ART) from the HIV clinic in Mogadishu. These were tape-recorded, transcribed, and translated for content analysis. Results: Three women and four men who were living with HIV shared the following narratives. Their perception was that they had either got HIV from their spouses or through health care contamination. They were very knowledgeable about the realities of HIV, how the medication works, nutritional requirements, and drug adherence. They were always willing to go an extra mile to secure a good life for themselves. However, the external HIV stigma impacted their access to care. They faced challenges in their homes and at work which compelled them to seek support from non-governmental organizations (NGOs) or close family members. This stigma often affected their disclosure to the wider community due to the uncertainty of the repercussions, leading to a life of extreme loneliness and financial difficulties. The participants’ coping mechanisms included living together and starting their own NGO for support with very strong optimism about their prognosis. Conclusions: The people diagnosed with HIV living in Mogadishu are highly knowledgeable about HIV transmission, the realities of living with a diagnosed HIV infection, and the

  11. What models of maternity care do pregnant women in Ireland want?

    LENUS (Irish Health Repository)

    Byrne, C

    2012-02-01

    The introduction of new models of care in the Irish maternity services has been recommended by both advocacy groups and strategic reports. Yet there is a dearth of information about what models of care pregnant women want. We surveyed women in early pregnancy who were attending a large Dublin maternity hospital. Demographic and clinical details were recorded from the hospital chart. Of the 501 women, 351 (70%) (352 (70.3%) of women wanted shared antenatal care between their family doctor and either a hospital doctor or midwife. 228 (45.5%) preferred to have their baby delivered in a doctor-led unit, while 215 (42.9%) preferred a midwifery-led unit. Of those 215 (42.9%), 118 (55%) met criteria for suitability. There was minimal demand (1.6%) for home births. Choice was influenced by whether the woman was attending for private care or not. Safety is the most important factor for women when choosing the type of maternity care they want. Pregnant women want a wide range of choices when it comes to models of maternity care. Their choice is strongly influenced by safety considerations, and will be determined in part by risk assessment.

  12. Metropol Health Day Women's Health in a Global Perspective 11 May 2016

    DEFF Research Database (Denmark)

    Robertson, Aileen

    food is key and most food is produced by subsistence farmers in developing countries. Over 80% of these farmers are women. Women are discriminated against and if they had the same rights as men they would be able to produce around 30% more food of nutritious quality. •There is a lack of intersectoral......KEY CHALLENGES There is a political lack of awareness that women can help to deliver prosperous economic development along with achievement of the SDGs by 2030...........women can do this by addressing 3 key challenges: •chronic undernutrition (low height for age), measured by stunting of failure...... to meet optimum height by 2 years of age, remains persistently high (over 50% in young children) and results in irreversible cognitive brain damage before age of 1-2 years which is directly linked to national economic development (this irreversible damage is measured indirectly by stunting) •Nutritious...

  13. Association between women veterans' experiences with VA outpatient health care and designation as a women's health provider in primary care clinics.

    Science.gov (United States)

    Bastian, Lori A; Trentalange, Mark; Murphy, Terrence E; Brandt, Cynthia; Bean-Mayberry, Bevanne; Maisel, Natalya C; Wright, Steven M; Gaetano, Vera S; Allore, Heather; Skanderson, Melissa; Reyes-Harvey, Evelyn; Yano, Elizabeth M; Rose, Danielle; Haskell, Sally

    2014-01-01

    Women veterans comprise a small percentage of Department of Veterans Affairs (VA) health care users. Prior research on women veterans' experiences with primary care has focused on VA site differences and not individual provider characteristics. In 2010, the VA established policy requiring the provision of comprehensive women's health care by designated women's health providers (DWHPs). Little is known about the quality of health care delivered by DWHPs and women veterans' experience with care from these providers. Secondary data were obtained from the VA Survey of Healthcare Experience of Patients (SHEP) using the Consumer Assessment of Healthcare Providers and Systems (CAHPS) patient-centered medical home (PCMH) survey from March 2012 through February 2013, a survey designed to measure patient experience with care and the DWHPs Assessment of Workforce Capacity that discerns between DWHPs versus non-DWHPs. Of the 28,994 surveys mailed to women veterans, 24,789 were seen by primary care providers and 8,151 women responded to the survey (response rate, 32%). A total of 3,147 providers were evaluated by the SHEP-CAHPS-PCMH survey (40%; n = 1,267 were DWHPs). In a multivariable model, patients seen by DWHPs (relative risk, 1.02; 95% CI, 1.01-1.04) reported higher overall experiences with care compared with patients seen by non-DWHPs. The main finding is that women veterans' overall experiences with outpatient health care are slightly better for those receiving care from DWHPs compared with those receiving care from non-DWHPs. Our findings have important policy implications for how to continue to improve women veterans' experiences. Our work provides support to increase access to DWHPs at VA primary care clinics. Published by Elsevier Inc.

  14. Somalis

    DEFF Research Database (Denmark)

    Farah, Abdulkadir Osman

    Contemporary scholarship characterizes Somalia as a nation in search of statehood. The approach presupposes a homogenous cohesive nation and society- with considerable traditional democratic pastoralism. This book portrays a complex nation with multiple heterogeneous characteristics. This alterna...

  15. Effect of Maternal and Pregnancy Risk Factors on Early Neonatal Death in Planned Home Births Delivering at Home.

    Science.gov (United States)

    Bachilova, Sophia; Czuzoj-Shulman, Nicholas; Abenhaim, Haim Arie

    2018-05-01

    The prevalence of home birth in the United States is increasing, although its safety is undetermined. The objective of this study was to investigate the effects of obstetrical risk factors on early neonatal death in planned home births delivering at home. The authors conducted a retrospective 3-year cohort study consisting of planned home births that delivered at home in the United States between 2011 and 2013. The study excluded infants with congenital and chromosomal anomalies and infants born at ≤34 weeks' gestation. Multivariate logistic regression models were used to estimate the adjusted effects of individual obstetrical variables on early neonatal deaths within 7 days of delivery. During the study period, there were 71 704 planned and delivered home births. The overall early neonatal death rate was 1.5 deaths per 1000 planned home births. The risks of early neonatal death were significantly higher in nulliparous births (OR 2.71; 95% CI 1.71-4.31), women with a previous CS (OR 2.62, 95% CI 1.25-5.52), non-vertex presentations (OR 4.27; 95% CI 1.33-13.75), plural births (OR 9.79; 95% CI 4.25-22.57), preterm births (OR 4.68; 95% CI 2.30-9.51), and births at ≥41 weeks of gestation (OR 1.76; 95% CI 1.09-2.84). Early neonatal deaths occur more commonly in certain obstetrical contexts. Patient selection may reduce adverse neonatal outcomes among planned home births. Copyright © 2018 Society of Obstetricians and Gynaecologists of Canada. Published by Elsevier Inc. All rights reserved.

  16. What women want? A scoping survey on women's knowledge, attitudes and behaviours towards ovarian reserve testing and egg freezing.

    Science.gov (United States)

    O'Brien, Yvonne; Martyn, Fiona; Glover, Louise E; Wingfield, Mary B

    2017-10-01

    We aimed to investigate women's knowledge, attitudes and behaviours towards ovarian reserve testing and egg freezing for non-medical reasons in the general population. This was a cross-sectional survey study of 663 women aged 18-44 years which assessed female perception of ovarian reserve testing and oocyte cryopreservation. An online forum was used to deliver the survey through the use of two social media sites. Participants were recruited through the technique of "snowballing", whereby existing study subjects recruited others from among their acquaintances. The data collected was analyzed using SPSS to explore descriptive statistics and frequencies relating to the participants' knowledge, attitudes and behaviour towards the practices of ovarian reserve testing and oocyte cryopreservation. Categorical variables were analyzed using Chi-squared; a p-value of women surveyed had knowledge of ovarian reserve testing. 64.8% would be interested in having testing performed. Younger women (women were also more likely to be interested, (73.6% v's 62.1%, p=0.022). 89.7% of women surveyed were aware of oocyte cryopreservation. 72.2% agreed that they would consider freezing their eggs to preserve fertility. There was no significant difference in the numbers of single women compared to women in a relationship who would consider egg freezing to preserve fertility (75.7% v's 71.2%, p=0.347, or in younger (women, (74.7% v's 71.1%, p=0.387). A majority (62.1%) of study participants believed that it is a woman's right to postpone pregnancy for social reasons and to freeze her eggs, with no significant difference in options noted between younger and older women. Knowledge of ovarian reserve testing and oocyte cryopreservation for non-medical reasons were higher than in previous studies, possibly reflecting increasing awareness of these issues among the general public. Additionally, we demonstrated that the women, in our study, were very open to the use of these modern technologies in

  17. How natural capital delivers ecosystem services

    NARCIS (Netherlands)

    Smith, A.C.; Harrison, P.A.; Pérez Soba, M.; Archaux, F.; Blicharska, M.; Egoh, B.N.; Erős, T.; Fabrega Domenech, N.; György, I.; Haines-Young, R.; Li, S.; Lommelen, E.; Meiresonne, L.; Miguel Ayala, L.; Mononen, L.; Simpson, G.; Stange, E.; Turkelboom, F.; Uiterwijk, M.; Veerkamp, C.J.; Wyllie de Echeverria, V.

    2017-01-01

    There is no unified evidence base to help decision-makers understand how the multiple components of natural capital interact to deliver ecosystem services. We systematically reviewed 780 papers, recording how natural capital attributes (29 biotic attributes and 11 abiotic factors) affect the

  18. Gender and Women's Reproductive Health

    Directory of Open Access Journals (Sweden)

    Aygul Akyuz

    2010-08-01

    Full Text Available AIM: According to the “rights to equality” in reproductive and sexual rights, “no persons should be discriminated against their sexual and reproductive lives, in their access to health care and/or services on the grounds of race, sex, sexual orientation, marital status, family position, age, language, religion, political, or other opinion; national or social origin, property, birth, or other status” In this context, health professionals devoted to reproductive health are responsible for the provision of services to individuals equally and should maintain equality rights. The aim of this study is to determine the effects of gender on the reproductive health of women and utilization of reproductive health services. METHODS: The study population consisted of 250 married women at their reproductive ages of 15 to 49, who applied to the obstetrics and gynecology service of a university hospital and a gynecology clinic of a training hospital dedicated to obstetrics and gynecology between 1 February 2007 and 30 April 2007. The data collection form was developed by researchers after evaluation of the relevant literature which relevance of gender discrimination could show where the questions. RESULTS: 52% of Women’ have graduated from primary school. Education levels of women with men (her husband between level of education is statistically significant difference, and women were receive less education than men (her husband (²=34.231, p<0.001. The study was determined that women who received training secondary school and above, worked and decision maker to domestic that they get prenatal care of a high percentage and deliver their babies in the hospital with the aid of a health care professional, and they go to medical center from gynecological problems and they need to obtain permission from their husbands in order to seek aid at a medical center of a low percentage (p<0.05. CONCLUSION: Women's reproductive health, gender discrimination status

  19. Where Do Poor Women in Developing Countries Give Birth? A Multi-Country Analysis of Demographic and Health Survey Data

    OpenAIRE

    Montagu, Dominic; Yamey, Gavin; Visconti, Adam; Harding, April; Yoong, Joanne

    2011-01-01

    Background In 2008, over 300,000 women died during pregnancy or childbirth, mostly in poor countries. While there are proven interventions to make childbirth safer, there is uncertainty about the best way to deliver these at large scale. In particular, there is currently a debate about whether maternal deaths are more likely to be prevented by delivering effective interventions through scaled up facilities or via community-based services. To inform this debate, we examined delivery location a...

  20. Prevalence, reasons and predictors for home births among pregnant women attending antenatal care in Birnin Kudu, North-west Nigeria.

    Science.gov (United States)

    Ashimi, Adewale Olufemi; Amole, Taiwo Gboluwaga

    2015-10-01

    To determine the prevalence, reasons and predictors for home birth in a rural community. Descriptive cross sectional study which utilised a pretested interviewer administered semi-structured questionnaire to assess the place of delivery in their last childbirth among 410 pregnant women attending antenatal care in Birnin Kudu, Nigeria. Logistic regression analysis was used to assess the relative effect of determinants. Of the 410 women, 248 (60.5%) delivered at home in their last childbirth. Self reported reasons: Home birth was opted for because of: lack of transportation 113 (45.6%), onset of labour was at night 104 (41.9 %), preferred birthing position 72 (29.0%), tradition 60 (24.2%), fear of surgery 42 (16.9%) and poor attitude of health workers 32 (12.9%). The odds of giving birth at home was 3.88 times higher in women with informal education (adjusted OR 3.88; 95% CI: 2.51, 6.00) and the odds of giving birth at home was 0.27 for women with less than 5 deliveries compared with women with 5 or more deliveries (adjusted OR 0.27; 95% CI: 0.15, 0.49) after controlling for confounders. The prevalence of home birth is high in Birnin Kudu and according to our respondents the main reasons for this practice are onset of labour late at night with lack of transportation and a limited choice of birthing positions. Provision of training and retraining of skilled birth attendants to assist women birthing in squatting positions would encourage women to deliver in the hospitals. Copyright © 2015 Elsevier B.V. All rights reserved.

  1. Preconception health: awareness, planning, and communication among a sample of US men and women.

    Science.gov (United States)

    Mitchell, Elizabeth W; Levis, Denise M; Prue, Christine E

    2012-01-01

    It is important to educate both men and women about preconception health (PCH), but limited research exists in this area. This paper examines men's and women's awareness of exposure to PCH information and of specific PCH behaviors, PCH planning, and PCH discussions with their partners. Data from Porter Novelli's 2007 Healthstyles survey were used. Women and men of reproductive age were included in the analysis (n = 2,736) to understand their awareness, planning, and conversations around PCH. Only 27.9% of women and men reported consistently using an effective birth control method. The majority of men (52%) and women (43%) were unaware of any exposure to PCH messages; few received information from their health care provider. Women were more aware than men of specific pre-pregnancy health behaviors. Women in the sample reported having more PCH conversations with their partners than did men. PCH education should focus on both women and men. Communication about PCH is lacking, both between couples and among men and women and their health care providers. PCH education might benefit from brand development so that consumers know what to ask for and providers know what to deliver.

  2. Pregnant Women's Intentions and Subsequent Behaviors Regarding Maternal and Neonatal Service Utilization: Results from a Cohort Study in Nyanza Province, Kenya.

    Science.gov (United States)

    Creanga, Andreea A; Odhiambo, George Awino; Odera, Benjamin; Odhiambo, Frank O; Desai, Meghna; Goodwin, Mary; Laserson, Kayla; Goldberg, Howard

    2016-01-01

    Higher use of maternal and neonatal health (MNH) services may reduce maternal and neonatal mortality in Kenya. This study aims to: 1) prospectively explore women's intentions to use MNH services (antenatal care, delivery in a facility, postnatal care, neonatal care) at MNH services (≥93.9% and ≥87.5%, respectively, for all services assessed). Actual service use was high for antenatal (98.1%) and neonatal (88.5%) care, but lower for delivery in a facility (76.9%) and postnatal care (51.8%). Woman's age >35 and high-school education were significant predictors of intention-behavior discordance regarding delivery in a facility; several delivery-related factors were significantly associated with intention-behavior discordance regarding use of postnatal and neonatal care. Delivery facilities were chosen based on proximity to women's residence, affordability, and service quality; among women who delivered outside a health facility, 16.3% could not afford going to a facility. Good/very good birth experiences were reported by 93.6% of women who delivered in a facility and 32.6% of women who did not. We found higher MNH service utilization than previously documented in Nyanza province. Further increasing the number of facility deliveries and use of postnatal care may improve MNH in Kenya.

  3. Geochemistry of sediment cores of the western equatorial Indian Ocean

    Digital Repository Service at National Institute of Oceanography (India)

    Murty, P.S.N.; Cronan, D.S.; Rao, Ch.M.; Paropkari, A.L.; Topgi, R.S.; Guptha, M.V.S.; Colley, N.

    the Somali Basin, and that among the Somali Basin cores depth appears to influence the variable distributions of metals in them. Iron, aluminium and titanium appear to be mainly supplied from terrigenous sources, manganese from authigenic sources...

  4. Why some women fail to give birth at health facilities: A comparative study between Ethiopia and Nigeria.

    Directory of Open Access Journals (Sweden)

    Sanni Yaya

    Full Text Available Obstetric complications and maternal deaths can be prevented through safe delivery process. Facility based delivery significantly reduces maternal mortality by increasing women's access to skilled personnel attendance. However, in sub-Saharan Africa, most deliveries take place without skilled attendants and outside health facilities. Utilization of facility-based delivery is affected by socio-cultural norms and several other factors including cost, long distance, accessibility and availability of quality services. This study examined country-level variations of the self-reported causes of not choosing to deliver at a health facility.Cross-sectional data on 37,086 community dwelling women aged between 15-49 years were collected from DHS surveys in Ethiopia (n = 13,053 and Nigeria (n = 24,033. Outcome variables were the self-reported causes of not delivering at health facilities which were regressed against selected sociodemographic and community level determinants. In total eight items complaints were identified for non-use of facility delivery: 1 Cost too much 2 Facility not open, 3 Too far/no transport, 4 don't trust facility/poor service, 5 No female provider, 6 Husband/family didn't allow, 7 Not necessary, 8 Not customary. Multivariable regression methods were used for measuring the associations.In both countries a large proportion of the women mentioned facility delivery as not necessary, 54.9% (52.3-57.9 in Nigeria and 45.4% (42.0-47.5 in Ethiopia. Significant urban-rural variations were observed in the prevalence of the self-reported causes of non-utilisation. Women in the rural areas are more likely to report delivering at health facility as not customary/not necessary and healthy facility too far/no transport. However, urban women were more likely to complain that husband/family did not allow and that the costs were too high.Women in the rural were more likely to regard facility delivery as unnecessary and complain about transportation

  5. Why some women fail to give birth at health facilities: A comparative study between Ethiopia and Nigeria.

    Science.gov (United States)

    Yaya, Sanni; Bishwajit, Ghose; Uthman, Olalekan A; Amouzou, Agbessi

    2018-01-01

    Obstetric complications and maternal deaths can be prevented through safe delivery process. Facility based delivery significantly reduces maternal mortality by increasing women's access to skilled personnel attendance. However, in sub-Saharan Africa, most deliveries take place without skilled attendants and outside health facilities. Utilization of facility-based delivery is affected by socio-cultural norms and several other factors including cost, long distance, accessibility and availability of quality services. This study examined country-level variations of the self-reported causes of not choosing to deliver at a health facility. Cross-sectional data on 37,086 community dwelling women aged between 15-49 years were collected from DHS surveys in Ethiopia (n = 13,053) and Nigeria (n = 24,033). Outcome variables were the self-reported causes of not delivering at health facilities which were regressed against selected sociodemographic and community level determinants. In total eight items complaints were identified for non-use of facility delivery: 1) Cost too much 2) Facility not open, 3) Too far/no transport, 4) don't trust facility/poor service, 5) No female provider, 6) Husband/family didn't allow, 7) Not necessary, 8) Not customary. Multivariable regression methods were used for measuring the associations. In both countries a large proportion of the women mentioned facility delivery as not necessary, 54.9% (52.3-57.9) in Nigeria and 45.4% (42.0-47.5) in Ethiopia. Significant urban-rural variations were observed in the prevalence of the self-reported causes of non-utilisation. Women in the rural areas are more likely to report delivering at health facility as not customary/not necessary and healthy facility too far/no transport. However, urban women were more likely to complain that husband/family did not allow and that the costs were too high. Women in the rural were more likely to regard facility delivery as unnecessary and complain about transportation and

  6. Women veterans' preferences for intimate partner violence screening and response procedures within the Veterans Health Administration.

    Science.gov (United States)

    Iverson, Katherine M; Huang, Kristin; Wells, Stephanie Y; Wright, Jason D; Gerber, Megan R; Wiltsey-Stirman, Shannon

    2014-08-01

    Intimate partner violence (IPV) is a significant health issue faced by women veterans, but little is known about their preferences for IPV-related care. Five focus groups were conducted with 24 women Veterans Health Administration (VHA) patients with and without a lifetime history of IPV to understand their attitudes and preferences regarding IPV screening and responses within VHA. Women veterans wanted disclosure options, follow-up support, transparency in documentation, and VHA and community resources. They supported routine screening for IPV and articulated preferences for procedural aspects of screening. Women suggested that these procedures could be provided most effectively when delivered with sensitivity and connectedness. Findings can inform the development of IPV screening and response programs within VHA and other healthcare settings. © 2014 Wiley Periodicals, Inc.

  7. The effect of caesarean section on self-esteem amongst primiparous women in South-Western Nigeria: a case-control study.

    Science.gov (United States)

    Loto, Olabisi M; Adewuya, Abiodun O; Ajenifuja, Olusegun K; Orji, Ernest O; Owolabi, Alexander T; Ogunniyi, Solomon O

    2009-09-01

    This study aims to assess the level of self-esteem of newly delivered mothers who had caesarean section (CS) and evaluate the sociodemographic and obstetrics correlates of low self-esteem in them. Newly delivered mothers who had CS (n = 109) and who had spontaneous vaginal delivery (SVD) (n = 97) completed questionnaires on sociodemographic and obstetrics variables within 1 week of delivery. They also completed the Rosenberg self-esteem scale. RESULTS. Women with CS had statistically significant lower scores on the self-esteem scale than women with SVD (p = 0.006). Thirty (27.5%) of the CS group were classified as having low self-esteem compared with 11 (11.3%) of the SVD group (p = 004). The correlates of low self-esteem in the CS group included polygamy (odd ratio (OR) 4.99, 95% confidence interval (95% CI) 1.62-15.33) and emergency CS (OR 4.66, 95% CI 1.55-16.75). CS in South-Western Nigerian women is associated with lowered self-esteem in the mothers.

  8. HIV, violence and women: unmet mental health care needs.

    Science.gov (United States)

    Zunner, Brian; Dworkin, Shari L; Neylan, Thomas C; Bukusi, Elizabeth A; Oyaro, Patrick; Cohen, Craig R; Abwok, Matilda; Meffert, Susan M

    2015-03-15

    HIV-infected (HIV+) women have high rates of Gender Based Violence (GBV). Studies of GBV find that approximately 50-90% of survivors develop mood and anxiety disorders. Given that women in sub-Saharan African constitute the largest population of HIV+ individuals in the world and the region׳s high GBV prevalence, mental health research with HIV+ women affected by GBV (HIV+GBV+) in this region is urgently needed. Qualitative methods were used to evaluate the mental health care needs of HIV+GBV+ female patients at an HIV clinic in the Kisumu County, Kenya. Thirty in-depth interviews and four focus groups were conducted with patients, healthcare providers and community leaders. Interviews were transcribed, translated and analyzed using qualitative data software. Respondents stated that physical, sexual and emotional violence against HIV+ women was widely prevalent and perpetrated primarily by untested husbands accusing a wife of marital infidelity following her positive HIV test result. Mental health problems among HIV+GBV+ women included depressive, anxiety, traumatic stress symptoms and suicidal thoughts. Participants opined that emotional distress from GBV not only caused HIV treatment default, but also led to poor HIV health even if adherent. Respondents agreed that mental health treatment was needed for HIV+GBV+ women; most agreed that the best treatment modality was individual counseling delivered weekly at the HIV clinic. Emotional distress may be higher and/or more varied among HIV+GBV+ women who are not engaged in HIV care. Mental health care is needed and desired by HIV+GBV+ women in Kisumu County, Kenya. Copyright © 2014 Elsevier B.V. All rights reserved.

  9. Life cycle assessment perspectives on delivering an infant in the US

    Energy Technology Data Exchange (ETDEWEB)

    Campion, Nicole [University of Pittsburgh, 949 Benedum Hall, Pittsburgh, PA 15261 (United States); Thiel, Cassandra L., E-mail: clt31@pitt.edu [University of Pittsburgh, 949 Benedum Hall, Pittsburgh, PA 15261 (United States); DeBlois, Justin [University of Pittsburgh, 949 Benedum Hall, Pittsburgh, PA 15261 (United States); Woods, Noe C. [Magee-Womens Hospital of UPMC, 300 Halket Street, Pittsburgh, PA 15235 (United States); Landis, Amy E. [Arizona State University, P.O. Box 875306, Tempe, AZ 85287-5306 (United States); Bilec, Melissa M. [University of Pittsburgh, 949 Benedum Hall, Pittsburgh, PA 15261 (United States)

    2012-05-15

    This study introduces life cycle assessment as a tool to analyze one aspect of sustainability in healthcare: the birth of a baby. The process life cycle assessment case study presented evaluates two common procedures in a hospital, a cesarean section and a vaginal birth. This case study was conducted at Magee-Womens Hospital of the University of Pittsburgh Medical Center, which delivers over 10,000 infants per year. The results show that heating, ventilation, and air conditioning (HVAC), waste disposal, and the production of the disposable custom packs comprise a large percentage of the environmental impacts. Applying the life cycle assessment tool to medical procedures allows hospital decision makers to target and guide efforts to reduce the environmental impacts of healthcare procedures. - Highlights: Black-Right-Pointing-Pointer Life cycle assessment helps identify the environmental impacts of medical procedures. Black-Right-Pointing-Pointer Disposable custom packs represent a large portion of environmental impacts of births. Black-Right-Pointing-Pointer Electricity loading contributes to global warming potential and respiratory effects. Black-Right-Pointing-Pointer Impact improvements should focus on heating, ventilation, and air conditioning and disposable custom packs.

  10. Magnitude of institutional delivery service utilization and associated factors among women in pastoral community of Awash Fentale district Afar Regional State, Ethiopia.

    Science.gov (United States)

    Assefa, Luelseged; Alemayehu, Mussie; Debie, Ayal

    2018-03-02

    Reduction of maternal mortality is a global priority particularly in developing countries like Ethiopia where maternal mortality ratio is one of the highest in the world. Most deliveries in developing countries occur at home without skilled birth attendants. Therefore, the objective of this study was to assess institutional delivery service utilization and associated factors among women in pastoral community of Awash Fentale district, Ethiopia. Overall, 35.2% of women delivered at health facilities. Women who had good knowledge AOR = 2.1, 95% CI 1.32, 4.87), Ante Natal Care (ANC) follow up (AOR = 3.2, 95% CI 1.55, 6.63), resided in a place where distance to reach at the nearby health facilities takes delivery place (AOR = 1.9; 95% CI 1.49, 5.07) were more likely to deliver at health facility. Therefore, strengthening ANC services, improving maternal knowledge, involving husbands in decision of delivery place and expanding health facilities in the community would enhance institutional delivery.

  11. Mental health in early pregnancy is associated with pregnancy outcome in women with pregestational diabetes

    DEFF Research Database (Denmark)

    Callesen, N F; Secher, A L; Cramon, P

    2015-01-01

    -related quality of life, anxiety, depression and locus of control were seen in women delivering large or appropriate for gestational age infants. CONCLUSIONS: Poor mental quality of life and the presence of depressive symptoms in early pregnancy were associated with preterm delivery in women with pregestational......AIM: To explore the role of early pregnancy health-related quality of life, anxiety, depression and locus of control for pregnancy outcome in women with pregestational diabetes. METHODS: This was a cohort study of 148 pregnant women with pregestational diabetes (118 with Type 1 diabetes and 30...... with Type 2 diabetes), who completed three internationally validated questionnaires: the 36-item Short-Form Health Survey, the Hospital Anxiety and Depression Scale and the Multidimensional Health Locus of Control survey at 8 weeks. Selected pregnancy outcomes were preterm delivery (

  12. Birthing experiences of Ghanaian women in 37th Military Hospital, Accra, Ghana

    Directory of Open Access Journals (Sweden)

    R.S. Mensah

    2014-01-01

    Full Text Available The purpose of the study was to explore the expectations of women relating to their labor and delivery needs at the 37th Military Hospital, in Ghana. Using a generic or non-categorical qualitative research design women who delivered at the 37th Military Hospital were interviewed. Data was collected by using semi-structured individual interviews. Emerging themes from the data were: the importance of environmental serenity in childbirth, the need to confirm true labor, being in control during labor, the importance of midwives, and childbirth as a sacred and euphoric journey. The findings revealed that not only were the environment serene and devoid of noise but the nurse-midwives were friendly and supportive for the women and were competent in diagnosing the progression of labor. The competencies and attributes that the nurse-midwives possessed at this hospital offered the women with an element of ownership regarding their laboring processes.

  13. Room temperature stable carbetocin for the prevention of postpartum haemorrhage during the third stage of labour in women delivering vaginally: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Widmer, Mariana; Piaggio, Gilda; Abdel-Aleem, Hany; Carroli, Guillermo; Chong, Yap-Seng; Coomarasamy, Arri; Fawole, Bukola; Goudar, Shivaprasad; Hofmeyr, G Justus; Lumbiganon, Pisake; Mugerwa, Kidza; Nguyen, Thi My Huong; Qureshi, Zahida; Souza, Joao Paulo; Gülmezoglu, A Metin

    2016-03-17

    Postpartum haemorrhage (PPH) is the leading cause of maternal mortality in low-income countries and contributes to nearly a quarter of maternal deaths globally. The current available interventions for prevention of postpartum haemorrhage, oxytocin and carbetocin, are limited by their need for refrigeration to maintain potency, as the ability to maintain a cold chain across the drug distribution and storage network is inconsistent, thus restricting their use in countries with the highest burden of maternal mortality. We describe a randomized, double-blind non-inferiority trial comparing a newly developed room temperature stable formulation of carbetocin to the standard intervention (oxytocin) for the prevention of PPH after vaginal birth. Approximately 30,000 women delivering vaginally will be recruited across 22 centres in 10 countries. The primary objectives are to evaluate the non-inferiority of room temperature stable carbetocin (100 μg intramuscular) versus oxytocin (10 IU intramuscular) in the prevention of PPH and severe PPH after vaginal birth. The primary endpoints are blood loss ≥500 mL or the use of additional uterotonics (composite endpoint required by drug regulatory authorities) and blood loss ≥1,000 mL (WHO requirement). Non-inferiority will be assessed using a two-sided 95 % confidence interval for the relative risk of the above endpoints for room temperature stable carbetocin versus oxytocin. The upper limit of the two-sided 95 % confidence interval for the relative risk for the composite endpoint of blood loss ≥500 mL or the use of additional uterotonics, and for the endpoint of blood loss ≥1,000 mL, will be compared to a non-inferiority margin of 1.16 and 1.23, respectively. If the upper limit is below the corresponding margin, non-inferiority will have been demonstrated. The safety analysis will include all women receiving treatment. Safety and tolerability will be assessed by a review of adverse events, by conducting inferential testing

  14. Inefficient charging for delivered gas by local gas distributors

    Directory of Open Access Journals (Sweden)

    Siniša Bikić

    2005-10-01

    Full Text Available In this region, especially in Serbia, common belief is that local distributors of gas used by households don’t charge for gas properly. It is suspected that there are two sources for improper ways of gas charging. Local distributors charge for delivered gas only, according to flow rat but not according to gas quality. It is usual that local distributors deliver gas of different quality than one signed in contract. In this work will be considered only one of aspects inefficient charging for delivered gas by local gas distributors, which is connected to variable atmospheric pressure. There is doubt, that local distributors make mistakes during accounting for delivered gas to costumers in regard atmospheric pressure. At the beginning of every investigation, problem has to be located and recognized. Authors are going to collect as much as possible available data, to elaborate and analyze data by scientific methods and to represent conclusions. So, the aim of this work is to diagnose current state and to approve or disapprove above mentioned suspicions. In our region this theme is very interesting, both because of energy efficiency and air pollution control. In this way both consumer and distributor will know, how mush energy they have really spent.

  15. Women referred for occupational risk assessment in pregnancy have no increased risk of adverse obstetric outcomes

    DEFF Research Database (Denmark)

    Bidstrup, Signe Brøker; Kaerlev, Linda; Thulstrup, Ane Marie

    2015-01-01

    pregnant women referred to two Danish clinics of occupational medicine (Copenhagen and Aarhus) from 1984 to 2010 were compared with the referred women's 1,077 non-referred pregnancy outcomes and with the pregnancy outcomes of 345,467 gainfully employed women from the same geographical areas and time period.......72-1.17). CONCLUSION: The women who are referred for occupational risk assessment at two large occupational university departments are not at an increased risk of preterm birth or of delivering low birth weight children. This may reflect that reproductive hazards in Danish workplaces are limited and....../or that the occupational risk assessment and counselling of pregnant women are preventing these selected adverse pregnancy outcomes. FUNDING: The Research Unit at Department of Occupational and Environmental Medicine at Bispebjerg Hospital supported the study financially. TRIAL REGISTRATION: not relevant. The study...

  16. Group versus individual sessions delivered by a physiotherapist for female urinary incontinence: an interview study with women attending group sessions nested within a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Smith Jan

    2009-09-01

    Full Text Available Abstract Background The aim was to explore the concerns and expectations of women invited to attend group physiotherapy sessions for the management of female urinary incontinence and whether the experience changed their views; and to gather recommendations from women attending group sessions on the design and delivery of these sessions Methods An interview study nested within a randomised controlled trial in five British NHS physiotherapy departments, including 22 women who had expressed a preference for an individual physiotherapy session but were randomised to, and attended, group sessions. Results Embarrassment was woven throughout women's accounts of experiencing urinary incontinence and seeking health care. Uncertainty about the nature of group sessions was a source of concern. Attending the first session was seen as a big hurdle by many women. However, a sense of relief was common once the session started, with most women describing some benefit from attendance. Recommendations for design and delivery of the sessions from women focused on reducing embarrassment and uncertainty prior to attendance. Conclusion Taking account of women's embarrassment and providing detailed information about the content of group sessions will enable women to benefit from group physiotherapy sessions for the management of female urinary incontinence. Trial Registration Trial registration number: ISRCTN 16772662

  17. Delivered Pricing, FOB Pricing, and Collusion in Spatial Markets

    OpenAIRE

    Maria Paz Espinosa

    1992-01-01

    This article examines price discrimination and collusion in spatial markets. The problem is analyzed in the context of a repeated duopoly game. I conclude that the prevailing pricing systems depend on the structural elements of the market. Delivered pricing systems emerge in equilibrium in highly monopolistic and highly competitive industries, while FOB is used in intermediate market structures. The fact driving this result is that delivered pricing policies allow spatial price discrimination...

  18. Circulating Angiogenic Factors and the Risk of Adverse Outcomes among Haitian Women with Preeclampsia.

    Directory of Open Access Journals (Sweden)

    Melissa I March

    Full Text Available Angiogenic factors are strongly associated with adverse maternal and fetal outcomes among women with preterm preeclampsia (PE in developed countries. We evaluated the role of angiogenic factors and their relationship to adverse outcomes among Haitian women with PE.We measured plasma antiangiogenic soluble fms-like tyrosine kinase 1 (sFlt1 and proangiogenic placental growth factor (PlGF levels in women with PE (n=35 compared to controls with no hypertensive disorders (NHD (n=43 among subjects with singleton pregnancies that delivered at Hospital Albert Schweitzer (HAS in Haiti. We divided the preeclamptic women into two groups, early onset (≤ 34 weeks and late onset (>34 weeks and examined relationships between sFlt1/PlGF ratios on admission and adverse outcomes (abruption, respiratory complications, stroke, renal insufficiency, eclampsia, maternal death, birth weight 34 weeks with no adverse outcome.PE-related adverse outcomes are common in women in Haiti and are associated with profound angiogenic imbalance regardless of gestational age at presentation.

  19. The nutritional status of women in the first trimester of pregnancy attending an inner-city antenatal department in the UK.

    Science.gov (United States)

    Rees, Gail; Brooke, Zoe; Doyle, Wendy; Costeloe, Kate

    2005-09-01

    We have previously found high rates of poor iron and folate status in women who had delivered a low birthweight baby (LBW) in an ethnically diverse inner-city area of the UK. However, little was known of the nutritional status in the local general obstetric population. We therefore investigated biochemical measures of nutritional status in the first trimester of the first pregnancy. Routine blood samples collected at the antenatal booking clinic were analysed for haemoglobin (Hb), serum ferritin, red cell folate (RCF) (n = 100) and erythrocyte transketolase activation coefficient (ETKAC) for thiamin status (n = 90). We found 9% of women in our sample had a low Hb level, 10% had a low serum ferritin and only one had a low RCF. This is a substantially lower number of women with biochemical deficiencies than we found previously in women three months after delivering a LBW baby. However, 34% had low thiamin status. Thiamin status was negatively correlated with gestational age at birth (r = -0.407, p nutritional status were observed between ethnic and socio-economic groups. Hb levels differed between ethnic (p = 0.001) and socio-economic groups (p = 0.02), with Africans and women in manual occupations/unwaged having the lowest Hb levels. RCF levels also differed between groups (p nutrition particularly in ethnic minorities and low income groups who are most at risk of adverse birth outcomes such as LBW.

  20. Utilization of maternal health-care services by tribal women in Kerala.

    Science.gov (United States)

    Jose, Jinu Annie; Sarkar, Sonali; Kumar, S Ganesh; Kar, Sitanshu Sekhar

    2014-01-01

    The coverage of maternal care services among the tribal women in Kerala is better as compared to other states in India. This study was done to identify the factors contributing to better coverage of maternal care services among the tribal women in Kerala and to study the reasons for remaining differences that exists in utilization of services between tribal and non-tribal pregnant women. This was a descriptive cum qualitative study conducted in Thariode Gramapanchayat in the Wayanad district of Kerala. Among all women who had registered their pregnancies in the 5 sub-centres under CHC Thariode and had delivered between September 2009 and October 2010, equal numbers of tribal and non-tribal ante-natal women, 35 each were interviewed in-depth using a semi-structured questionnaire. Quantitative data was analysed using SPSS Version 16.0. Content analysis was done for qualitative data. The determinants of utilization in tribal women were general awareness, affordability, accessibility and quality of services along with motivation by health workers. Among tribal antenatal women, 85% utilized maternal health care facilities fully compared to 100% among non-tribal women. Lower levels of education and lack of transport facilities were prime factors contributing to under utilization by tribal women. Affordable, accessible and good quality of services in the public health system in Kerala and motivation by health workers were important contributing factors for better utilization of maternal care services.

  1. Trends in contraceptive use and distribution of births with demographic risk factors in Ethiopia: a sub-national analysis.

    Science.gov (United States)

    Shiferaw, Solomon; Abdullah, Muna; Mekonnen, Yared; Maïga, Abdoulaye; Akinyemi, Akanni; Amouzou, Agbessi; Friedman, Howard; Barros, Aluisio J D; Hounton, Sennen

    2015-01-01

    Gambela to 72% in the Somali region. The multivariate analysis showed women living in the Somali, Afar and Benishangul-Gumuz regions had significantly higher odds of having avoidable birth risk compared to those in Addis Ababa after controlling for observed covariates. The trend analysis showed there was a significant drop in the proportion of births from women above 34 years between 2000 and 2011. There was no significant decline in births to women less than 18 years between 2000 and 2011. A majority of births in Ethiopia fall in one of the risk categories, with substantial region-to-region variation in the percentage of births with avoidable risk factors, Somali and Afar having the highest burden. The analysis indicated that births in the three regions had significantly higher odds of having one of the avoidable risk factors compared to Addis Ababa, and we suggest family planning programmes need to identify differentials of modern contraceptive use at the sub-national level in order to better address coverage and equity issues.

  2. Trends in contraceptive use and distribution of births with demographic risk factors in Ethiopia: a sub-national analysis

    Directory of Open Access Journals (Sweden)

    Solomon Shiferaw

    2015-11-01

    births, with wide regional variation from 55% in Gambela to 72% in the Somali region. The multivariate analysis showed women living in the Somali, Afar and Benishangul-Gumuz regions had significantly higher odds of having avoidable birth risk compared to those in Addis Ababa after controlling for observed covariates. The trend analysis showed there was a significant drop in the proportion of births from women above 34 years between 2000 and 2011. There was no significant decline in births to women less than 18 years between 2000 and 2011. Conclusions: A majority of births in Ethiopia fall in one of the risk categories, with substantial region-to-region variation in the percentage of births with avoidable risk factors, Somali and Afar having the highest burden. The analysis indicated that births in the three regions had significantly higher odds of having one of the avoidable risk factors compared to Addis Ababa, and we suggest family planning programmes need to identify differentials of modern contraceptive use at the sub-national level in order to better address coverage and equity issues.

  3. The peculiarities of pregnancy and parturition, of fetus and newborn states in women exposed to the radioactive influence

    International Nuclear Information System (INIS)

    Didenko, L.V.; Kolamijtseva, A.G.; Dashkevich, V.E.; Gun'kov, S.V.

    1992-01-01

    The clinico-statistical study of pregnancy and parturition course in 753 women pregnant during the ChNPP accident, living in the controlled contaminated Chernobyl regions, has been conducted. The decrease of the growth in the fetus biometric indices has been detected in 30% of the patients examined. The fetoplacental deficiency has been found out in 50% of the patients. The hormonal disbalance during pregnancy has been determined 78 of the women examinated delivered. Two newborns had congenital anomalies

  4. [Health effects and psychological stress in pregnant women engaged in work outside the home].

    Science.gov (United States)

    Anan, Ayumi; Shiiba, Michiyo; Sibata, Eiji; Kawamoto, Rieko

    2010-12-01

    Modern society demands working conditions in which pregnant women can successfully deliver children and maintain a professional position. The aim of this study is to investigate the effects of work on the health and psychological stress in working women and their newborns. We reviewed twenty-eight publications and found that health problems in working women occur at high rates. However, there is no report investigating the mechanism by which health problems occur, or describing the precise working conditions and symptoms in pregnant women who are engaged in work outside the home. In addition, the literature uses subjective evaluations, including psychological tests, to quantify stress and anxiety, but no biochemical analyses of stress-related substances were conducted. We suggest that a standard index to represent working conditions and job category, as well as an investigation of the workload of house-keeping, is needed to understand the total work effort by pregnant women in modern times. Finally, measurement of stress-related biological markers may be effective in the investigation from various perspectives of occupational stress in pregnant women.

  5. Potential, Distribution, Ethno-Botany and Tapping Procedures of ...

    African Journals Online (AJOL)

    Potential, Distribution, Ethno-Botany and Tapping Procedures of Gum Producing Acacia Species in the Somali Region, Southeastern Ethiopia. ... Therefore, promotion of gum extraction in the Somali Region both for economic benefit of the community and sustainable management of the fragile ecosystem is recommended.

  6. Greater Somalia, the never-ending dream?

    DEFF Research Database (Denmark)

    Zoppi, Marco

    2015-01-01

    This paper provides an historical analysis of the concept of Greater Somalia, the nationalist project that advocates the political union of all Somali-speaking people, including those inhabiting areas in current Djibouti, Ethiopia and Kenya. The Somali territorial unification project of “lost...

  7. Culture and postpartum mood problems: similarities and differences in the experiences of first- and second-generation Canadian women.

    Science.gov (United States)

    Mamisachvili, Lana; Ardiles, Paola; Mancewicz, Grazyna; Thompson, Sherry; Rabin, Kapri; Ross, Lori E

    2013-04-01

    Few studies have examined the role of culture in a woman's experience of postpartum mood problems (PPMP). This study explored differences and similarities in experiences of PPMP between first- and second-generation Canadian women. In this exploratory qualitative study, we interviewed nine first-generation and eight second-generation women who were clients of the Women's Health Centre at St. Joseph's Health Centre in Toronto, Canada. Using semistructured interviews, we explored how women perceived and experienced PPMP. Four themes reflected cultural issues: PPMP stigma, relationship with parents/in-laws, internalization of society's expectations of motherhood, and identity issues/relationship with self. The results of this study contribute to a limited literature on possible contributing factors to PPMP and can inform development of resources for delivering culturally appropriate mental health care for women dealing with PPMP.

  8. No perinatal HIV-1 transmission from women with effective antiretroviral therapy starting before conception.

    Science.gov (United States)

    Mandelbrot, Laurent; Tubiana, Roland; Le Chenadec, Jerome; Dollfus, Catherine; Faye, Albert; Pannier, Emmanuelle; Matheron, Sophie; Khuong, Marie-Aude; Garrait, Valerie; Reliquet, Veronique; Devidas, Alain; Berrebi, Alain; Allisy, Christine; Elleau, Christophe; Arvieux, Cedric; Rouzioux, Christine; Warszawski, Josiane; Blanche, Stéphane

    2015-12-01

    The efficacy of preventing perinatal transmission (PT) of human immunodeficiency virus type 1 (HIV-1) depends on both viral load (VL) and treatment duration. The objective of this study was to determine whether initiating highly active antiretroviral therapy (ART) before conception has the potential to eliminate PT. A total of 8075 HIV-infected mother/infant pairs included from 2000 to 2011 in the national prospective multicenter French Perinatal Cohort (ANRS-EPF) received ART, delivered live-born children with determined HIV infection status, and did not breastfeed. PT was analyzed according to maternal VL at delivery and timing of ART initiation. The overall rate of PT was 0.7% (56 of 8075). No transmission occurred among 2651 infants born to women who were receiving ART before conception, continued ART throughout the pregnancy, and delivered with a plasma VL women starting ART before conception to 0.4% (3 of 709), 0.9% (24 of 2810), and 2.2% (23 of 1051) for those starting during the first, second, or third trimester (P women with VLs of 50-400 copies/mL near delivery than for those with suppression of plasma VL. © The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  9. Delivering construction projects using innovative building technologies

    CSIR Research Space (South Africa)

    Ampofo-Anti, Naalamkai

    2017-07-01

    Full Text Available . Figure 1: IBT delivery flowchart Proceedings 11th Built Environment Conference 6 th August – 8 th August 2017 Delivering construction projects using innovative building technologies Durban, South Africa 5. REFERENCES Ampofo-Anti, N...

  10. Women's Perceptions of Participation in an Extended Contact Text Message-Based Weight Loss Intervention: An Explorative Study.

    Science.gov (United States)

    Job, Jennifer R; Spark, Lauren C; Fjeldsoe, Brianna S; Eakin, Elizabeth G; Reeves, Marina M

    2017-02-27

    Extending contact with participants after the end of an initial weight loss intervention has been shown to lead to maintained weight loss and related behavioral change. Mobile phone text messaging (short message service, SMS) offers a low-cost and efficacious method to deliver extended contact. In this rapidly developing area, formative work is required to understand user perspectives of text message technology. An extended contact intervention delivered by text messages following an initial telephone-delivered weight loss intervention in breast cancer survivors provided this opportunity. The aim of this study was to qualitatively explore women's perceptions of participation in an extended contact intervention using text messaging to support long-term weight loss, physical activity, and dietary behavioral change. Following the end of an initial 6-month randomized controlled trial of a telephone-delivered weight loss intervention (versus usual care), participants received a 6-month extended contact intervention via tailored text messages. Participant perceptions of the different types of text messages, the content, tailoring, timing, and frequency of the text messages, and the length of the intervention were assessed through semistructured interviews conducted after the extended contact intervention. The interviews were transcribed verbatim and analyzed with key themes identified. Participants (n=27) were a mean age of 56.0 years (SD 7.8) and mean body mass index of 30.4 kg/m2 (SD 4.2) and were at a mean of 16.1 months (SD 3.1) postdiagnosis at study baseline. Participants perceived the text messages to be useful behavioral prompts and felt the messages kept them accountable to their behavioral change goals. The individual tailoring of the text message content and schedules was a key to the acceptability of the messages; however, some women preferred the support and real-time discussion via telephone calls (during the initial intervention) compared with the text

  11. The FL/AC ratio for prediction of shoulder dystocia in women with gestational diabetes.

    Science.gov (United States)

    Duryea, Elaine L; Casey, Brian M; McIntire, Donald D; Twickler, Diane M

    2017-10-01

    To determine if sonographic variables, including fetal femur length to abdominal circumference (FL/AC) ratio, are associated with shoulder dystocia in women with gestational diabetes. This was a retrospective cohort study of women with gestational diabetes who delivered singleton infants at Parkland Hospital from 1997 to 2015. Diagnosis and treatment of gestational diabetes were uniform including sonography at 32-36 weeks. Biometric calculations were evaluated for correlation with shoulder dystocia. During the study period, 6952 women with gestational diabetes underwent a sonogram at a mean gestation of 34.8 ± 1.8 weeks. Of 4183 vaginal deliveries, 66 experienced shoulder dystocia (16/1000). The FL/AC was associated with shoulder dystocia (p dystocia in women with gestational diabetes. Additionally, it is a simple ratio that is independent of the reference used and remains stable, unlike age-adjusted AC and HC/AC ratio.

  12. Place of Delivery Associated With Postnatal Care Utilization Among Childbearing Women in Zambia.

    Science.gov (United States)

    Chungu, Charles; Makasa, Mpundu; Chola, Mumbi; Jacobs, Choolwe Nkwemu

    2018-01-01

    Postnatal care (PNC) utilization is critical to the prevention of maternal morbidity and mortality. Despite its importance, the proportion of women utilizing this service is still low in Zambia. We investigated if place of delivery was associated with PNC utilization in the first 48 h among childbearing women in Zambia. Data from the 2013/14 Zambia Demographic and Health Survey for women, aged 15-49 years, who reported giving birth in the 2 years preceding the survey was used. The data comprised of sociodemographic and other obstetric data, which were cleaned, recoded, and analyzed using STATA version 13 (Stata Corporation, College Station, TX, USA). Multivariate logistic regression was used to examine the association of place of delivery and other background variables. Women who delivered in a health facility were more likely to utilize PNC in the first 48 h compared to those who did not deliver in a health facility: government hospital (AOR 7.24, 95% CI 4.92-11.84), government health center/clinic (AOR 7.15 95% CI 4.79-10.66), other public sector (AOR 23.2 95% CI 3.69-145.91), private hospital/clinic (AOR 10.08 95% CI 3.35-30.35), and Mission hospital/clinic (AOR 8.56 95% CI 4.71-15.53). Additionally, women who were attended to by a skilled personnel during delivery of the baby were more likely to utilize PNC (AOR 2.30, 95% CI 1.57-3.37). Women from rural areas were less likely to utilize PNC in the first 48 h (AOR 0.70, 95% CI 0.53-0.90). Place of delivery was found to be linked with PNC utilization in this population although access to health care is still driven by inequity-related dynamics and imbalances. Given that inequity stresses are heaviest in the rural and poor groups, interventions should aim to reach this group. The study results will help program managers to increase access to health facility delivery and direct interventional efforts toward the affected subpopulations, such as the young and rural women. Furthermore, results will help

  13. Women referred for occupational risk assessment in pregnancy have no increased risk of adverse obstetric outcomes

    DEFF Research Database (Denmark)

    Bidstrup, Signe Brøker; Kaerlev, Linda; Thulstrup, Ane Marie

    2015-01-01

    .72-1.17). CONCLUSION: The women who are referred for occupational risk assessment at two large occupational university departments are not at an increased risk of preterm birth or of delivering low birth weight children. This may reflect that reproductive hazards in Danish workplaces are limited and....../or that the occupational risk assessment and counselling of pregnant women are preventing these selected adverse pregnancy outcomes. FUNDING: The Research Unit at Department of Occupational and Environmental Medicine at Bispebjerg Hospital supported the study financially. TRIAL REGISTRATION: not relevant. The study......INTRODUCTION: Our aim was to study the association between pregnant women's referral status for occupational risk assessment, and their risk of preterm delivery (

  14. Evidence to suggest that copulatory vocalizations in women are not a reflexive consequence of orgasm.

    Science.gov (United States)

    Brewer, Gayle; Hendrie, Colin A

    2011-06-01

    The current studies were conducted in order to investigate the phenomenon of copulatory vocalizations and their relationship to orgasm in women. Data were collected from 71 sexually active heterosexual women (M age = 21.68 years ± .52) recruited from the local community through opportunity sampling. The studies revealed that orgasm was most frequently reported by women following self-manipulation of the clitoris, manipulation by the partner, oral sex delivered to the woman by a man, and least frequently during vaginal penetration. More detailed examination of responses during intercourse revealed that, while female orgasms were most commonly experienced during foreplay, copulatory vocalizations were reported to be made most often before and simultaneously with male ejaculation. These data together clearly demonstrate a dissociation of the timing of women experiencing orgasm and making copulatory vocalizations and indicate that there is at least an element of these responses that are under conscious control, providing women with an opportunity to manipulate male behavior to their advantage.

  15. Maternal height and length of gestation: does this impact on preterm labour in Asian women?

    Science.gov (United States)

    Chan, Ben Chong-Pun; Lao, Terence Tzu-Hsi

    2009-08-01

    Both maternal height and ethnicity may influence the gestation length, but their independent effect is unclear. This study was performed to examine the relationship between maternal height and gestational length in women with singleton pregnancies in a Chinese and southeast Asian population. A retrospective cohort study was performed on women carrying singleton pregnancies with spontaneous labour in a 48-month period managed under our department to determine the relationship between maternal height, expressed in quartiles, with the mean gestational age and incidence of preterm labour. Of the 16 384 women who delivered within this period, the 25th, 50th and 75th percentile values of maternal height were 153 cm, 156 cm and 160 cm respectively. Excluded from analysis were 6597 women because of multifetal pregnancy, teenage pregnancy (maternal age women with shorter stature. In our population, maternal height has an influence on gestational length, and the lower three quartiles was associated with increased odds of labour at > 32 to management and intervention.

  16. Husbandry, breeding practices, and production constraints of camel in the pastoral communities of Afar and Somali, Ethiopia

    Directory of Open Access Journals (Sweden)

    Yosef Tadesse

    2014-12-01

    Full Text Available The objectives of this paper were to identify and describe husbandry practices, herd structure, owners’ trait preferences, breeding practices, and production constraints of camel in the two major camel rearing pastoral communities, viz. Afar and Somali, to generate baseline information that would help to plan possible breed improvement strategies and options for the different camel populations. The study sites were selected purposively while households from each of the sites randomly. Data were collected using formal questionnaires and focus group discussion. Results showed that average camel population per household was higher in Mille (28.06±2.27, Gode (27.51±2.02, and Moyale (24.07±2.13 districts. Female camel populations with age of >1 year contributes 78-83% of the total camel herd population in all the study districts. Higher number of female animals in the herd in the arid environment means providing continuous supply of milk and allows a rapid recovery of herd numbers after a disease outbreak or drought occurrence. This shows that pastoralists breeding objectives are in relation to the arid environment and female population in the herd. Most of the pastoral communities utilize a single breeding male camel per 40-50 female camels and this will affect productivity and heterogeneity of camel population. With regard to trait preference, all pastoral communities ranked milk yield as the first trait of choice, except Liben district in which adaptation trait was the primary preference. Growth trait ranked second in Mille, Gode, Liben, and Jijiga pastoral communities where as adaptation trait ranked second in Amibara and Shinille pastoral communities. The major camel production constraints were feed, diseases, and lack of water in that order and the major cause of the constraints was the recurrent drought occurred during the past 2-3 decades in the two regions. Therefore, in planning and implementation of the breeding strategies for small

  17. Utah Delivers Opportunities for Career Exploration

    Science.gov (United States)

    Dobson, Kristine; Fischio, Shannon

    2006-01-01

    Providing information and resources to support career exploration is key to the mission of career and technical education (CTE) in Utah. Utah CTE has responded in a variety of ways to meet the career exploration needs of students of all ages. This article discusses how the career and technical education in Utah delivers opportunities for career…

  18. Women in water management: the need for local planning.

    Science.gov (United States)

    Bhatt, M R

    1995-08-01

    This article on women's role in water resource management is based on a paper delivered at a seminar organized at the Water and Land Management Institute in Anand, India, in 1994. The article reflects Family Planning International's (FPI) experience in community-based water resource development. Most analyses of village and household water management data exclude women's role. The reasons are identified as the lack of inclusion of women's thinking in land-development research and planning, the dominance of males in planning and consequent male assumptions made about women's work and use of water, the lack of valuation of the nonmonetary nature of women's relationship to water, and the ease of ignoring women. Women's roles that are obstacles to inclusion in research and planning are identified as the lack of effective women's lobbies, the undervaluation by women of their work, and the lack of professional recognition of women as potential users of water or spokespersons for more than their own self-interests as women. National water policies are shifting to community-based management because local authorities are in daily contact with users, of whom about 50% are women. Historically national policy shifted from attention to distribution of investments in the water sector to reorganization of water agencies and to building up the capacity of private or voluntary agencies. The local context allows for more efficient and effective responses to local conditions. Local institutions and groups are better equipped to solicit local participation. One primary lesson learned by FPI is that local water resource planning is very important in strengthening the economic and individual capacity of poor people in underdeveloped areas. FPI's experience in Mahesana, Banaskantha, and Sabarkantha in Gujarat state supports this lesson learned. Water resource development policies resulted in mixed outcomes, and national control has been inefficient and disrespectful to local authorities

  19. An Examination of Peer-Delivered Parenting Skills Programs Across New York State.

    Science.gov (United States)

    Acri, Mary C; Craig, Nancy; Adler, Josh

    2018-03-24

    Peers are an important adjunct to the public mental health service system, and are being increasingly utilized across the country as a cost-effective solution to workforce shortages. Despite the tremendous growth of peer-delivered support over the past two decades, it has only been within the past few years that peer programs have been the subject of empirical inquiry. The purpose of this study was to examine the prevalence and characteristics of peer-delivered parenting programs across the New York State public mental health service system. We surveyed 46 family peer organizations across New York State regarding their delivery of structured peer-delivered parenting programs. Thirty-four (76%) completed the questionnaire, and of them, 18 (53%) delivered a parenting program. Subsequent interviews with seven of the 18 organizations revealed peer organizations had been delivering eight unique parenting programs for upwards of two decades. Additionally, organizations offered multiple supports to families to participate. Training, supervision, and issues around fidelity are discussed, as well as the implications of this study for states utilizing a peer workforce.

  20. Long-term Clinical Outcomes of Whole-Breast Irradiation Delivered in the Prone Position

    International Nuclear Information System (INIS)

    Stegman, Lauren D.; Beal, Katherine P.; Hunt, Margie A.; Fornier, Monica N.; McCormick, Beryl

    2007-01-01

    Purpose: The aim of this study was to evaluate retrospectively the effectiveness and toxicity of post-lumpectomy whole-breast radiation therapy delivered with prone positioning. Methods and Materials: Between September 1992 and August 2004, 245 women with 248 early-stage invasive or in situ breast cancers were treated using a prone breast board. Photon fields treated the whole breast to 46 to 50.4 Gy with standard fractionation. The target volume was clinically palpable breast tissue; no attempt was made to irradiate chest wall lymphatics. Tumor bed boosts were delivered in 85% of cases. Adjuvant chemotherapy and hormonal therapy were administered to 42% and 62% of patients, respectively. Results: After a median follow-up of 4.9 years, the 5 year actuarial true local and elsewhere ipsilateral breast tumor recurrence rates were 4.8% and 1.3%, respectively. The 5-year actuarial rates of regional nodal recurrence and distant metastases were 1.6% and 7.4%. Actuarial disease-free, disease-specific, and overall survival rates at 5 years were 89.4%, 97.3%, and 93%, respectively. Treatment breaks were required by 2.4% of patients. Grade 3 acute dermatitis and edema were each limited to 2% of patients. Only 4.9% of patients complained of acute chest wall discomfort. Chronic Grade 2 to 3 skin and subcutaneous tissue toxicities were reported in 4.4% and 13.7% of patients, respectively. Conclusions: Prone position breast radiation results in similar long-term disease control with a favorable toxicity profile compared with standard supine tangents. The anatomic advantages of prone positioning may contribute to improving the therapeutic ratio of post-lumpectomy radiation by improving dose homogeneity and minimizing incidental cardiac and lung dose

  1. Women: A Developmental Perspective. Proceedings of a Research Conference Sponsored by the National Institute of Child Health and Human Development in Cooperation with the National Institute of Mental Health and the National Institute on Aging (Bethesda, Maryland, November 20-21, 1980).

    Science.gov (United States)

    Berman, Phyllis W., Ed.; Ramey, Estelle R., Ed.

    These proceedings consist of 26 papers delivered at a conference devoted to research on the health and development of women. The focus of the conference was on women's health concerns, female development from infancy to womanhood, women and work, reproduction and giving birth, women and the family, sexuality, and the middle and later years.…

  2. SU-E-J-21: Advantages of Ultra Fast Radiation Dose Delivering

    International Nuclear Information System (INIS)

    Feng, Y

    2014-01-01

    Purpose: For delivering conformed dose to a moving tumor and sparing normal tissue, we presented an innovation that was combined a linear accelerator and a storage ring to generate ultra high dose rate. This innovation allows delivering prescribed dose to a moving target in such a short time period, for an example 0.1 second, during which the displacement of the target could be ignored. Methods: The advantages of this approach were evaluated based on normal tissue sparing, feasibility, accuracy, and time saving in clinical treatment. The target volume reduction with this innovation approach was demonstrated by analyzing the values of GTVs, ITVs, and PTVs obtained from 15 patients who had been diagnosed with malignant neoplasm of lung and treated with SBRT. The processes of SBRT treatment were investigated and advantages of this innovation in improving SBRT lung treatment were evaluated. Results: With the ultra-high dose rate, the target volumes could be reduced by ∼30% to 50%. The innovation combining with IGRT technique could deliver prescribed dose to moving target accurately with simpler procedures than that of adaptive approach. This new approach could reduce the time of guiding treatment by many times. The new technique make a new strategy became feasible that was to deliver the dose to a target when it moved to a desirable location, such as away from critical organs. Conclusion: Combining with IGRT technique, this innovation could significantly improve the accuracy to deliver dose to moving targets with a shorter time than conventional techniques. The innovation opens a door for new strategies to deliver dose to moving targets

  3. Delivering Bad News: Attitudes, Feelings, and Practice Characteristics Among Speech-Language Pathologists.

    Science.gov (United States)

    Gold, Rinat; Gold, Azgad

    2018-02-06

    The purpose of this study was to examine the attitudes, feelings, and practice characteristics of speech-language pathologists (SLPs) in Israel regarding the subject of delivering bad news. One hundred and seventy-three Israeli SLPs answered an online survey. Respondents represented SLPs in Israel in all stages of vocational experience, with varying academic degrees, from a variety of employment settings. The survey addressed emotions involved in the process of delivering bad news, training on this subject, and background information of the respondents. Frequency distributions of the responses of the participants were determined, and Pearson correlations were computed to determine the relation between years of occupational experience and the following variables: frequency of delivering bad news, opinions regarding training, and emotions experienced during the process of bad news delivery. Our survey showed that bad news delivery is a task that most participants are confronted with from the very beginning of their careers. Participants regarded training in the subject of delivering bad news as important but, at the same time, reported receiving relatively little training on this subject. In addition, our survey showed that negative emotions are involved in the process of delivering bad news. Training SLPs on specific techniques is required for successfully delivering bad news. The emotional burden associated with breaking bad news in the field of speech-language pathology should be noticed and addressed.

  4. Delivering service adaptation with 3G technology

    NARCIS (Netherlands)

    Liotta, A.; Yew, A.; Bohoris, C.; Pavlou, G.; Feridun, M.; Kropf, P.G.; Babin, G.

    2002-01-01

    Now that 3G technologies have reached their maturity, newly advanced services can be delivered to the mobile user. These include context- aware services, adaptable services and Virtual Home Environment (VHE)-like services. Important research issues relate, however, to managing such services through

  5. Factors associated with delivery at or after 28 weeks gestation in women with bulging fetal membranes before 26 weeks gestation.

    Science.gov (United States)

    Ito, Akiko; Maseki, Yoshiaki; Ikeda, Sayako; Tezuka, Atsuko; Kuribayashi, Momoko; Furuhashi, Madoka

    2017-09-01

    To elucidate the factors that contribute to prolonged pregnancy and promote neonate survival in women with bulging fetal membranes. A database was reviewed to identify women with singleton pregnancies who underwent amniocentesis on admission to determine amniotic fluid neutrophil elastase levels before 26 + 0 weeks gestation between July 2001 and January 2015. Following delivery, the placentas of these patients were examined for histologic chorioamnionitis. Ninety-seven women delivered before 28 weeks gestation, and 117 women delivered at or after 28 weeks gestation. Rescue cerclage performed via the McDonald procedure (adjusted odds ratio [aOR]: 3.78; 95% confidence interval [CI]: 1.35-11.80) was associated with a higher likelihood of reaching at least 28 weeks gestation before delivery, whereas protruding membranes (aOR: 0.38; 95% CI: 0.18-0.78), elevated amniotic neutrophil elastase levels (≥0.15 μg/ml) (aOR, 0.41; 95% CI: 0.20-0.82) and elevated peripheral C-reactive protein levels (≥0.4 mg/dl) (aOR: 0.34; 95% CI: 0.180.65) were associated with a significantly reduced likelihood of reaching this gestational age before delivery. Among women who underwent rescue cerclage, amniorrhexis was associated with a negative prognosis (aOR: 0.18; 95% CI: 0.05-0.51). Intra-amniotic inflammation, protrusion of fetal membranes and amniorrhexis are factors that may prevent pregnancy prolongation. Rescue cerclage improves pregnancy outcomes.

  6. Factors determining choice of delivery place among women of child bearing age in Dega Damot District, North West of Ethiopia: a community based cross- sectional study.

    Science.gov (United States)

    Belay, AlemayehuSayih; Sendo, EndalewGemechu

    2016-08-17

    In the latest report of Ethiopia Demography and Health Survey (EDHS) 2011, the Maternal Mortality Ratio was estimated at 676/100,000 live births. Most of these deaths are preventable. Increasing the proportion of women who deliver in a health facility can be an important means in reducing maternal mortality in low-income settings including Ethiopia. We aimed to identify factors determining choice of delivery place among child bearing age women. A community based cross sectional survey was conducted in Dega Damot District from April- May, 2014. Mixed methods were employed in the study. Multistage sampling method was used. The primary outcome variable for this study was women who delivered their most recent baby in a health facility. Three hundred sixty one women who gave birth in the past 1 year were included in the study. The mean age of the respondents was 30.9 [SD ±6.006]. One hundred seven (29.6 %) of the respondents were in the age range of 25-29 years. In our study, the proportion of women assisted by skilled health workers during institutional delivery was 89.1 % followed by Health extension workers (8.0 %). Most women (87.4 %) who did not deliver in health facilities were assisted by families, friends or neighbors followed by Health extension workers (7.2 %), and traditional birth attendants (5.4 %), respectively. The qualitative data has described and gave an insight of the contributing factors that influence the women using the health institutions for delivery. These included: ANC attendance, Positive attitude of Health workers and complications during labor and delivery. The preference for a health facility delivery was largely due to the understanding that if complications occurred either during labor or delivery, this was the only place where they could be managed. The study revealed that women's institutional delivery service utilization in the study area is low. Based on these findings, improving the utilization of health facility for delivery

  7. Empowerment, intimate partner violence and skilled birth attendance among women in rural Uganda.

    Science.gov (United States)

    Kwagala, Betty; Nankinga, Olivia; Wandera, Stephen Ojiambo; Ndugga, Patricia; Kabagenyi, Allen

    2016-05-04

    There is limited research on how the empowerment of women and intimate partner violence (IPV) are associated with skilled birth attendance (SBA) among rural women in Uganda. Therefore, the aim of this paper was to investigate the association between women's empowerment, their experience of IPV and SBA in rural Uganda. Using data from the Uganda Demographic and Health Survey (UDHS), we selected 857 rural women who were in union, had given birth in the last 5 years preceding the survey and were selected for the domestic violence (DV) module. Frequency distributions were used to describe the background characteristics of the women and their partners. Pearson's chi-squared (χ (2)) tests were used to investigate the associations between SBA and women's empowerment; and partners' and women's socio-demographic factors including sexual violence. Multivariable logistic regression analyses were used to examine the association between SBA and explanatory variables. More than half (55 %) of the women delivered under the supervision of skilled birth attendant. Women's empowerment with respect to participation in household decision-making, property (land and house) (co)ownership, IPV, and sexual empowerment did not positively predict SBA among rural women in Uganda. Key predictors of SBA were household wealth status, partners' education, ANC attendance and parity. For enhancement of SBA in rural areas, there is a need to encourage a more comprehensive ANC attendance irrespective of number of children a woman has; and design interventions to enhance household wealth and promote men's education.

  8. Utilization of fetal fibronectin testing and pregnancy outcomes among women with symptoms of preterm labor

    Directory of Open Access Journals (Sweden)

    Blackwell SC

    2017-10-01

    Full Text Available Sean C Blackwell,1 Erin M Sullivan,2 Allison A Petrilla,2 Xian Shen,2 Kathleen A Troeger,3 James D Byrne4 1Department of Obstetrics, Gynecology and Reproductive Sciences, University of Texas Health Sciences Center, Houston, TX, USA; 2Avalere Health, LLC, Health Economics and Outcomes Research, Washington, DC, USA; 3Hologic, Inc., Outcomes Research, Marlborough, MA, USA; 4Department of Obstetrics and Gynecology, Santa Clara Valley Medical Center, San Jose, CA, USA Objectives: To identify pregnant health plan members triaged through the emergency department (ED, including labor and delivery (ELD units, with symptoms of preterm labor (PTL, and evaluate the use of fetal fibronectin (fFN testing; and to calculate the rate of hospitalization and timing of delivery in relation to the ED visit. Methods: Retrospective cohort study using Medical Outcomes Research for Effectiveness and Economics Registry®, a national multipayer claims database. A cohort of pregnant women evaluated in an ELD with a diagnosis of PTL from June 2012 through November 2015 was identified. The proportion of women with PTL who received fFN testing was calculated.Results: A total of 23,062 patients met the criteria for inclusion in the study. The rate of fFN testing prior to delivery was 12.0%. Of the 23,062 patients included in the analysis, 75.9% were discharged home. Of those who were discharged from the emergency room, one in five went on to deliver within 3 days and almost 96% of this group was not screened for the presence of fFN. Of the remaining 24.1% of patients admitted to the hospital, 91.3% delivered during their stay. In a sensitivity analysis, the percentage of women who delivered within 3 days of the ELD encounter was lower for women who received fFN testing only (6.6% versus those who had a history of transvaginal ultrasound (TVUS only (21.6%. Furthermore, the rate of delivery within 3 days was lowest among patients who had both fFN testing and TVUS (4

  9. High levels of mortality, malnutrition, and measles, among recently-displaced Somali refugees in Dagahaley camp, Dadaab refugee camp complex, Kenya, 2011.

    Science.gov (United States)

    Polonsky, Jonathan A; Ronsse, Axelle; Ciglenecki, Iza; Rull, Monica; Porten, Klaudia

    2013-01-22

    Following a rapid influx of over 200,000 displaced Somalis into the Dadaab refugee camp complex in Kenya, Médecins Sans Frontières conducted a mortality and nutrition survey of the population living in Bulo Bacte, a self-settled area surrounding Dagahaley camp (part of this complex). The survey was conducted between 31st July and 10th August 2011. We exhaustively interviewed representatives from all households in Bulo Bacte, collecting information on deaths, births, and population movements during the recall period (15th February 2011 to survey date), in order to provide estimates of retrospective death rates. We recorded the mid-upper arm circumference and presence or absence of bipedal oedema of all children of height 67-global and severe acute malnutrition. The surveyed population included 26,583 individuals, of whom 6,488 (24.4%) were children aged under 5 years. There were 360 deaths reported during the 177 days of the recall period, of which 186 (52%) were among children aged under 5 years. The crude death rate for the entire recall period was 0.8 per 10,000 person-days. The under-5 death rate was 1.8 per 10,000 person-days. More than two-thirds of all deaths were reported to have been associated with diarrhoea (25%), cough or other breathing difficulties (24%), or with fever (19%). Measles accounted for a reported 17% of all deaths; this was due to a measles outbreak that occurred between June and October 2011.Global acute malnutrition was observed in 13.4%, and severe acute malnutrition in 3.0%, of children measuring 67-crisis-affected populations should be revised to take into account the epidemiologic context. Organisations must be sensitive and reactive to changes in the health status of the populations they assist.

  10. Characteristics of HIV-infected childbearing women in Barbados Características de las mujeres con infección por VIH que dan a luz en Barbados

    OpenAIRE

    Alok Kumar; Valmay Bent

    2003-01-01

    OBJECTIVE: To describe the demographic profile, social and family characteristics, and life style traits of HIV-infected childbearing women in the Caribbean nation of Barbados in comparison to a control group of HIV-negative women. METHODS: Data for this report were drawn from the Pediatrics HIV Surveillance Program of the Queen Elizabeth Hospital in Barbados. The data covered all HIV-infected women in the country who delivered between 1986-2000, with similar data coming from a control group ...

  11. Perinatal outcomes of women with a prior history of unexplained recurrent miscarriage.

    LENUS (Irish Health Repository)

    Dempsey, Mark

    2014-05-14

    Abstract Objective: We sought to determine subsequent pregnancy outcomes in a cohort of women with a history of unexplained RM who were not receiving medical treatment. Study Design: This was a prospective cohort study, of women with a history of three unexplained consecutive first trimester losses, who were recruited and followed in their subsequent pregnancy. Control patients were healthy pregnant patients with no previous adverse perinatal outcome. Results: A total of 42 patients with a history of unexplained RM were recruited to the study. 9 (21.4%) experienced a further first trimester miscarriage, 1 case of ectopic and 1 case of partial molar pregnancy. 74% (23\\/31) of the RM cohort had a vaginal delivery. There was one case of severe pre-eclampsia. The RM group delivered at a mean gestational age of 38+2 weeks and with a mean birth-weight of 3.23kg. None of the neonates were under the 10(th) centile for gestational age. Overall, there was no significant difference in pregnancy outcomes between the two cohorts. Conclusion: Our study confirms the reassuring prognosis for achieving a live birth in the unexplained RM population with a very low incidence of adverse events with the majority delivering appropriately grown fetuses at term.

  12. Internet-delivered interpersonal psychotherapy versus internet-delivered cognitive behavioral therapy for adults with depressive symptoms: randomized controlled noninferiority trial.

    Science.gov (United States)

    Donker, Tara; Bennett, Kylie; Bennett, Anthony; Mackinnon, Andrew; van Straten, Annemieke; Cuijpers, Pim; Christensen, Helen; Griffiths, Kathleen M

    2013-05-13

    Face-to-face cognitive behavioral therapy (CBT) and interpersonal psychotherapy (IPT) are both effective treatments for depressive disorders, but access is limited. Online CBT interventions have demonstrated efficacy in decreasing depressive symptoms and can facilitate the dissemination of therapies among the public. However, the efficacy of Internet-delivered IPT is as yet unknown. This study examines whether IPT is effective, noninferior to, and as feasible as CBT when delivered online to spontaneous visitors of an online therapy website. An automated, 3-arm, fully self-guided, online noninferiority trial compared 2 new treatments (IPT: n=620; CBT: n=610) to an active control treatment (MoodGYM: n=613) over a 4-week period in the general population. Outcomes were assessed using online self-report questionnaires, the Center for Epidemiological Studies Depression scale (CES-D) and the Client Satisfaction Questionnaire (CSQ-8) completed immediately following treatment (posttest) and at 6-month follow-up. Completers analyses showed a significant reduction in depressive symptoms at posttest and follow-up for both CBT and IPT, and were noninferior to MoodGYM. Within-group effect sizes were medium to large for all groups. There were no differences in clinical significant change between the programs. Reliable change was shown at posttest and follow-up for all programs, with consistently higher rates for CBT. Participants allocated to IPT showed significantly lower treatment satisfaction compared to CBT and MoodGYM. There was a dropout rate of 1294/1843 (70%) at posttest, highest for MoodGYM. Intention-to-treat analyses confirmed these findings. Despite a high dropout rate and lower satisfaction scores, this study suggests that Internet-delivered self-guided IPT is effective in reducing depressive symptoms, and may be noninferior to MoodGYM. The completion rates of IPT and CBT were higher than MoodGYM, indicating some progress in refining Internet-based self

  13. 20 CFR 669.330 - How are services delivered to the customer?

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false How are services delivered to the customer... Farmworker Jobs Program Customers and Available Program Services § 669.330 How are services delivered to the customer? To ensure that all services are focused on the customer's needs, services are provided through a...

  14. Midwives׳ experiences of caring for women with learning disabilities - A qualitative study.

    Science.gov (United States)

    Castell, Emma; Stenfert Kroese, Biza

    2016-05-01

    people with learning disabilities (LD) are increasingly likely to become parents and are entitled to have access to the right support to be able to be suitable parents. However, access to such support is affected by limited resources, attitudes towards people with LD becoming parents, and lack of training regarding caring for parents with learning disabilities for midwives. A learning disability (LD) is defined as a significantly reduced ability to understand new or complex information, to learn new skills (impaired intelligence), reduced skills to cope independently with everyday life, has an impact on most areas of a person's life and the difficulties started in early childhood. Little research has explored health professionals' experiences of their support of people with LD during their journey to become parents. Midwives are often the first professionals pregnant women come into contact with and therefore are key professionals in the support system for parents with LD. The principle objective of the current research is to develop an understanding of midwives' experiences of caring for women with a LD. the study explored midwives׳ experiences of caring for women with LD using an Interpretative Phenomenological Approach (IPA). nine qualified midwives employed by a single NHS trust participated in the study. a semi-structured interview schedule was utilised during one-to-one interviews with the midwives. The interview transcripts were analysed using IPA stages. Four superordinate themes were identified. The midwives reported receiving a lack of LD training and faced significant time constraints, which left them feeling that they could not spend the necessary time with the women to meet their pregnancy needs. The midwives felt unsupported in their attempts to deliver adequate midwifery care, speaking about a lack of accessible support for pregnant women with LD. They were left feeling responsible to fill the gaps in service provision. The midwives were dedicated

  15. Development of a Health System-Based Nurse-Delivered Aromatherapy Program.

    Science.gov (United States)

    Joswiak, Denise; Kinney, Mary Ellen; Johnson, Jill R; Kolste, Alison K; Griffin, Kristen H; Rivard, Rachael L; Dusek, Jeffery A

    2016-04-01

    Healthcare systems are increasingly looking to integrate aromatherapy (essential oils) as a safe, low-cost, and nonpharmacologic option for patient care to reduce pain, nausea, and anxiety and to improve sleep. This article describes the development and implementation of a healthcare system-wide program of nurse-delivered essential oil therapeutic interventions to inpatients throughout an acute care setting. In addition, we provide lessons learned for nursing administrators interested in developing similar nurse-delivered aromatherapy programs.

  16. Using mobile phone technology to provide recovery support for women offenders.

    Science.gov (United States)

    Scott, Christy K; Johnson, Kimberly; Dennis, Michael L

    2013-10-01

    Mobile technology holds promise as a recovery tool for people with substance use disorders. However, some populations who may benefit the most may not have access to or experience with mobile phones. Incarcerated women represent a group at high risk for recidivism and relapse to substance abuse. Cost-effective mechanisms must be in place to support their recovery upon release. This study explores using mobile technology as a recovery management tool for women offenders residing in the community following release from jail. This study surveyed 325 minority women offenders with substance use disorders to determine whether or not they use cell phones, their comfort with texting and search features, and the social networks that they access from mobile phones. We found that 83% of survey subjects had cell phones; 30% of those were smartphones. Seventy-seven percent of the women reported access to supportive friends, and 88% had close family members they contacted regularly using mobile technology. Results indicated that most of the women were comfortable using a mobile phone, although the majority of them had prepaid minutes rather than plans, and most did currently use smartphones or have the capability to download applications or access social networks via their phones. Most women reported that they would be comfortable using a mobile phone to text, e-mail, and answer surveys. The high rate of adoption of mobile technology by women offenders makes them a promising target for recovery support delivered via mobile phone.

  17. Testing the Feasibility of a Culturally Tailored Breast Cancer Screening Intervention with Native Hawaiian Women in Rural Churches

    Science.gov (United States)

    Ka'opua, Lana Sue I.; Park, Soon H.; Ward, Margaret E.; Braun, Kathryn L.

    2011-01-01

    The authors report on the feasibility of delivering a church-based breast cancer screening intervention tailored on the cultural strengths of rural-dwelling Hawaiians. Native Hawaiian women are burdened by disproportionately high mortality from breast cancer, which is attributed to low participation in routine mammography. Mammography is proven to…

  18. A longitudinal study of women's memories of their childbirth experiences at five years postpartum.

    Science.gov (United States)

    Takehara, Kenji; Noguchi, Makiko; Shimane, Takuya; Misago, Chizuru

    2014-07-05

    Few studies have investigated whether women can accurately recall their birthing experiences after a long period. We investigated the consistency of women's memories of their childbirth experiences between those at a few days postpartum and 5 years later. This prospective cohort study comprised 1,168 women who delivered at a maternity hospital and four maternity homes in Japan between May 2002 and August 2003. Data were collected using structured interviews and transcriptions from medical records. The childbirth experience was assessed using the Childbirth Experience Scale (CBE-Scale) at a few days postpartum and 5 years later. We obtained 584 (50.0%) valid responses from women who completed the survey at a few days postpartum and 5 years later. Significant differences were observed in 16 out of 18 items on the CBE-Scale when responses were compared at both time points. Women who answered "yes" to any item on the CBE-Scale at the baseline survey tended to demonstrate a more precise recollection for that item 5 years after childbirth than those who answered "no" for the corresponding item. We conclude that women remember their childbirth experience clearly at 5 years after the childbirth.

  19. Factors Associated With Increased Cesarean Risk Among African American Women: Evidence From California, 2010

    Science.gov (United States)

    Doctor, Jason N.

    2015-01-01

    Objectives. We studied if both observed and unobserved maternal health in African American women in hospitals or communities were associated with cesarean delivery of infants. Methods. We examined the relationship between African American race and cesarean delivery among 493 433 women discharged from 255 Californian hospitals in 2010 using administrative data; we adjusted for patient comorbidities and maternal, fetal, and placental risk factors, as well as clustering of patients within hospitals. Results. Cesarean rates were significantly higher overall for African American women than other women (unadjusted rate 36.8% vs 32.7%), as were both elective and emergency primary cesarean rates. Elevated risks persisted after risk adjustment (odds ratio generally > 1.27), but the prevalence of particular risk factors varied. Although African American women were clustered in some hospitals, the proportion of African Americans among all women delivering in a hospital was not related to its overall cesarean rate. Conclusions. To address the higher likelihood of elective cesarean delivery, attention needs to be given to currently unmeasured patient-level health factors, to the quality of provider–physician interactions, as well as to patient preferences. PMID:25790391

  20. 1000th magnet delivered!

    CERN Multimedia

    2006-01-01

    On Monday 20 February members of the AT Department marked the delivery of the 1000th superconducting dipole magnet to CERN. Only 232 more of the dipole magnets are needed for the LHC. The 35 tonne-dipoles are 15 meters long and are being manufactured by three companies: Babcock Noell Nuclear in Germany (which finished its contract in November 2005), Ansaldo Superconduttori in Italy and Alstom-Jeumont in France. "The production is proceeding well and we expect to be complete in October as previously foreseen," said Lucio Rossi, Head of the Magnets and Superconductors Group (AT-MAS). In total, 1650 main magnets are needed for the LHC, of which 1300 have been delivered.

  1. 1000th magnet delivered!

    CERN Multimedia

    2006-01-01

    On Monday 20 February members of the AT Department marked the delivery of the 1000th superconducting dipole magnet to CERN. Only 232 more of the dipole magnets are needed for the LHC. The 35-tonne-dipoles are 15 meters long and are being manufactured by three companies: Babcock Noell Nuclear in Germany (which completed its contract in November 2005), Ansaldo Superconduttori in Italy and Alstom-Jeumont in France. 'The production is proceeding well and we expect to be complete in October as foreseen,' said Lucio Rossi, Head of the Magnets and Superconductors Group (AT-MAS). In total, 1650 main magnets are needed for the LHC, of which 1300 have already been delivered.

  2. Nosocomial infections of ocular conjunctiva in newborns delivered by cesarian section.

    Science.gov (United States)

    Bezirtzoglou, E; Romond, C

    1991-01-01

    Colonization of the ocular conjunctiva in newborns delivered by cesarian section occurs usually within the first day of life. We have studied the flora of the ocular conjunctiva at birth, from 19 newborns delivered by cesarian section, coming from two different maternity hospitals. Ocular conjunctiva cultures yielded the main predominant flora in both maternity hospitals considered. The most common genus of this flora are: Staphylococcus, Corynebacterium and Propionibacterium acnes. Peptostreptococcus productus, Neisseria, Eubacterium and Clostridium perfringens are isolated occasionally. In newborns delivered by cesarian section, this flora principally acquired may be the consequence of the presence of bacteria in the ambient air, as well as differences in care provided by the nosocomial personnel.

  3. Women referred for occupational risk assessment in pregnancy have no increased risk of adverse obstetric outcomes

    DEFF Research Database (Denmark)

    Bidstrup, Signe Brøker; Kaerlev, Linda; Thulstrup, Ane Marie

    2015-01-01

    INTRODUCTION: Our aim was to study the association between pregnant women's referral status for occupational risk assessment, and their risk of preterm delivery (METHODS: In a cohort study, 1,202 deliveries among....../or that the occupational risk assessment and counselling of pregnant women are preventing these selected adverse pregnancy outcomes. FUNDING: The Research Unit at Department of Occupational and Environmental Medicine at Bispebjerg Hospital supported the study financially. TRIAL REGISTRATION: not relevant. The study.......72-1.17). CONCLUSION: The women who are referred for occupational risk assessment at two large occupational university departments are not at an increased risk of preterm birth or of delivering low birth weight children. This may reflect that reproductive hazards in Danish workplaces are limited and...

  4. School Nurse-Delivered Adolescent Relationship Abuse Prevention

    Science.gov (United States)

    Raible, Claire A.; Dick, Rebecca; Gilkerson, Fern; Mattern, Cheryl S.; James, Lisa; Miller, Elizabeth

    2017-01-01

    Background: Project Connect is a national program to build partnerships among public health agencies and domestic violence services to improve the health care sector response to partner and sexual violence. Pennsylvania piloted the first school nurse-delivered adolescent relationship abuse intervention in the certified school nurses' office…

  5. Linking functional and relational service quality to customer satisfaction and loyalty: differences between men and women.

    Science.gov (United States)

    Sánchez-Hernández, Rosa M; Martínez-Tur, Vicente; Peiró, José M; Moliner, Carolina

    2010-04-01

    This study assessed differences between men and women in the association of perceptions of service quality with customer evaluations. Functional (efficiency with which the service is delivered) and relational (customers' emotional benefits, beyond the core performance, related to the social interaction of customers with employees) dimensions of service quality were measured as well as customer satisfaction and loyalty. The sample of 277 customers (191 men, 86 women), surveyed in 29 Mexican hotels, had a mean age of 38.1 yr. (SD=9.7) for men and 34.5 yr. (SD=11.0) for women. To be eligible for survey, customers had to have spent at least one night in the hotel in question. Analysis indicated that the women and men differed in the association of functional and relational dimensions of service quality with their satisfaction and loyalty. Functional service quality was higher for the men than the women, while relational service quality showed greater predictive power for women than for men, although these accounted for only 4% of the customers' satisfaction variance and 6% of the loyalty variance.

  6. The role of Veterinarians in areas with persistent failure of rain ...

    African Journals Online (AJOL)

    The drought stricken areas are usually the marginal areas where livestock production system is the main farming system. Large parts of Somali fall under this category and the NE Somali (Puntland) being no exception. Apart from livestock being kept for nomadic livelihood and, the unregulated export of animals to Arabian ...

  7. Islam en politiek in de Hoorn van Afrika

    NARCIS (Netherlands)

    Abbink, J.

    1991-01-01

    In de Hoorn van Afrika - Ethiopië, Djibouti, Somalië - heerst een relatieve staat van interreligieuze harmonie. Voor Somalië en Djibouti is dit makkelijk te begrijpen, omdat hier bijna de gehele bevolking al vele eeuwen islamitisch is en bovendien tot één richting behoort, de soennitische. Maar ook

  8. Is International Accounting Education Delivering Pedagogical Value?

    Science.gov (United States)

    Patel, Chris; Millanta, Brian; Tweedie, Dale

    2016-01-01

    This paper examines whether universities are delivering pedagogical value to international accounting students commensurate with the costs of studying abroad. The paper uses survey and interview methods to explore the extent to which Chinese Learners (CLs) in an Australian postgraduate accounting subject have distinct learning needs. The paper…

  9. Labor Patterns in Women Attempting Vaginal Birth After Cesarean With Normal Neonatal Outcomes

    Science.gov (United States)

    GRANTZ, Katherine L.; GONZALEZ-QUINTERO, Victor; TROENDLE, James; REDDY, Uma M.; HINKLE, Stefanie N.; KOMINIAREK, Michelle A.; LU, Zhaohui; ZHANG, Jun

    2015-01-01

    Objective To describe labor patterns in women with a trial of labor after cesarean (TOLAC) with normal neonatal outcomes. Study Design In a retrospective observational study at 12 U.S. centers (2002–2008), we examined time interval for each centimeter of cervical dilation and compared labor progression stratified by spontaneous or induced labor in 2,892 multiparous women with TOLAC (second delivery) and 56,301 nulliparous women at 37 0/7 to 41 6/7 weeks of gestation. Analyses were performed including women with intrapartum cesarean delivery, and then repeated limiting only to women who delivered vaginally. Results Labor was induced in 23.4% of TOLAC and 44.1% of nulliparous women (Plabor (Plabor (P=.099); however, TOLAC had lower maximum doses of oxytocin compared to nulliparous women: median (90th percentile): 6 (18) mU/min versus 12 (28) mU/min, respectively (Plabor duration for TOLAC versus nulliparous women with spontaneous labor from 4–10cm was 0.9 (2.2) hours longer (P=.007). For women who entered labor spontaneously and achieved vaginal delivery, labor patterns for TOLAC were similar to nulliparous women. For induced labor, labor duration for TOLAC versus nulliparous women from 4–10cm was 1.5 (4.6) hours longer (Plabor patterns were slower for induced TOLAC compared to nulliparous women. Conclusions Labor duration for TOLAC was slower compared to nulliparous labor, particularly for induced labor. By improved understanding of the rates of progress at different points in labor, this new information on labor curves in women undergoing TOLAC, particularly for induction, should help physicians when managing labor. PMID:25935774

  10. Predictors of women's utilization of primary health care for skilled pregnancy care in rural Nigeria.

    Science.gov (United States)

    Okonofua, Friday; Ntoimo, Lorretta; Ogungbangbe, Julius; Anjorin, Seun; Imongan, Wilson; Yaya, Sanni

    2018-04-18

    Although Primary Health Care (PHC) was designed to provide universal access to skilled pregnancy care for the prevention of maternal deaths, very little is known of the factors that predict the use of PHC for skilled maternity care in rural parts of Nigeria - where its use is likely to have a greater positive impact on maternal health care. The objective of this study was to identify the factors that lead pregnant women to use or not use existing primary health care facilities for antenatal and delivery care. The study was a cross-sectional community-based study conducted in Esan South East and Etsako East LGAs of Edo State, Nigeria. A total of 1408 randomly selected women of reproductive age were interviewed in their households using a pre-tested structured questionnaire. The data were analyzed with descriptive and multivariate statistical methods. The results showed antenatal care attendance rate by currently pregnant women of 62.1%, and a skilled delivery of 46.6% by recently delivered women at PHCs, while 25% of women delivered at home or with traditional birth attendants. Reasons for use and non-use of PHCs for antenatal and delivery care given by women were related to perceptions about long distances to PHCs, high costs of services and poor quality of PHC service delivery. Chi-square test of association revealed that level of education and marital status were significantly related to use of PHCs for antenatal care. The results of logistic regression for delivery care showed that women with primary (OR 3.10, CI 1.16-8.28) and secondary (OR 2.37, CI 1.19-4.71) levels education were more likely to receive delivery care in PHCs than the highly educated. Being a Muslim (OR 1.56, CI 1.00-2.42), having a partner who is employed in Estako East (OR 2.78, CI 1.04-7.44) and having more than five children in Esan South East (OR 2.00, CI 1.19-3.35) significantly increased the odds of delivery in PHCs. The likelihood of using a PHC facility was less for women who had more

  11. The impact of medically indicated and spontaneous preterm birth among hypertensive women.

    Science.gov (United States)

    Kase, Benjamin A; Carreno, Carlos A; Blackwell, Sean C; Sibai, Baha M

    2013-11-01

    To (1) describe the frequency of spontaneous preterm birth (SPTB) and medically indicated preterm birth (PTB) among women with chronic hypertension (CHTN) and (2) to evaluate differences in neonatal outcomes according to SPTB or medically indicated PTB. Retrospective analysis of a previously conducted multicenter randomized trial. Deliveries were categorized as SPTB or medically indicated and stratified by gestational ages (PTBs occurred in the late preterm period (n = 146). SGA was significantly more frequent among those with medically indicated PTB at 0.05). Nearly one-third of women with CHTN delivered preterm. The majority of PTBs were medically indicated and late preterm, but approximately one-third were due to SPTB. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  12. Experiences of non-adherence to Internet-delivered cognitive behavior therapy: A qualitative study

    OpenAIRE

    Johansson, Olof; Michel, Teresa; Andersson, Gerhard; Paxling, Björn

    2015-01-01

    Many trials on Internet-delivered psychological treatments have had problems with nonadherence, but not much is known about the subjective reasons for non-adhering. The aim of this study was to explore participants' experiences of non-adherence to Internet-delivered psychological treatment. Grounded theory was used to analyze data from seven in-depth interviews with persons who had non-adhered to a study on Internet-delivered cognitive behavioral therapy for generalized anxiety disorder. The ...

  13. Victoria's dirty secret: how sociocultural norms influence adolescent girls and women.

    Science.gov (United States)

    Strahan, Erin J; Lafrance, Adèle; Wilson, Anne E; Ethier, Nicole; Spencer, Steven J; Zanna, Mark P

    2008-02-01

    The present studies tested whether the salience of sociocultural norms for ideal appearance leads women to base their self-worth more strongly on appearance, which in turn leads them to feel more concerned with others' perceptions and less satisfied with their bodies. Study 1 tested this model by manipulating the salience of the sociocultural norm among female university students. The model was supported. In Study 2 an intervention challenging the legitimacy of the sociocultural norm was delivered to female and male adolescents. Compared to controls, females who received this intervention were less accepting of the sociocultural norms for appearance, based their self-worth less strongly on appearance, and in turn were less concerned with others' perceptions and were more satisfied with their bodies. The implications for women are discussed.

  14. Opinions of women towards cesarean delivery and priority issues of care in the postpartum period.

    Science.gov (United States)

    Kisa, Sezer; Zeyneloğlu, Simge

    2016-05-01

    This study was conducted, in order to determine the opinions of women who had a cesarean delivery and the problems that they faced in the postpartum period. This descriptive study was conducted with 337 women who delivered babies by cesarean section. The data were collected using a semi-structured questionnaire. The results of the study showed that 53.4% of women underwent cesarean delivery for the first time, and 83.1% said that it was the obstetrician's decision to have a cesarean delivery. More than half of the women (61.1%) had a negative experience with cesarean delivery due to postpartum pain (44.7%) and inability to care for their infant (35.9%). The most common problems associated with cesarean delivery were postpartum pain (96.1%), back pain (68.2%), problems passing gas (62.0%), bleeding (56.1%), breastfeeding problems (49.6%) and limitation of movement (43.6%) respectively. Understanding the the opinions and problems of women towards cesarean delivery assists healthcare professionals in identifying better ways to provide appropriate care and support. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. Pregnancy Outcomes in HIV-Infected Women: Experience from a Tertiary Care Center in India.

    Science.gov (United States)

    Dadhwal, Vatsla; Sharma, Aparna; Khoiwal, Kavita; Deka, Dipika; Sarkar, Plaboni; Vanamail, P

    2017-01-01

    There is conflicting data on the effect of HIV infection as well as antiretroviral therapy (ART) on pregnancy outcome. The objectives of this study were to compare pregnancy outcomes in women with and without HIV infection, and to evaluate the effect of HAART on pregnancy in HIV-infected women. This is a prospective case record analysis of 212 HIV-infected women delivering between 2002 and 2015, in a tertiary health care center in India. The pregnancy outcome in HIV-infected women was compared to 238 HIV-uninfected controls. Women received ART for prevention of mother to child transmission as per protocol which varied during the period of study. Effect of use of ART on preterm birth (PTB) and intrauterine growth restriction (IUGR) was analyzed. HIV-infected women were more likely to have PTB, IUGR, and anemia (9.4%, 9.9%, 5.2%) compared to uninfected women (7.6%, 5%, 3.8%), this did not reach statistical significance (P-value = >0.05). The incidence of PIH, diabetes mellitus and intrahepatic cholestasis of pregnancy was similar in both groups. Mean birth weight was significantly lower in neonates of HIV-infected women (2593.60±499g) than HIV-uninfected women (2919±459g) [P-value=0.001]. neonatal intensive care unit admissions were also significantly higher in infants born to HIV-infected women (P-value=0.002). HIV-infected women on ART had decreased incidence of PTB and IUGR. Good antenatal care and multidisciplinary team approach can optimize pregnancy outcomes in HIV-infected women.

  16. I have no peace of mind-psychosocial distress expressed by rural women living with HIV in India as part of a mobile health intervention-a qualitative study.

    Science.gov (United States)

    Chandra, Prabha S; Parameshwaran, Soumya; Satyanarayana, Veena A; Varghese, Meiya; Liberti, Lauren; Duggal, Mona; Singh, Pushpendra; Jeon, Sangchoon; Reynolds, Nancy R

    2018-03-17

    This qualitative study assessed psychosocial concerns that rural women with HIV who had multiple psychosocial vulnerabilities were able to express and communicate during a mobile phone intervention delivered by nurses. The study is part of a pilot randomised controlled trial of an mHealth self-care intervention by nurses for women living with HIV in rural India. For the trial, 60 women were randomised to receive the mHealth intervention. All calls were recorded and call logs were maintained. Call logs of 59 women based on 1186 calls were scanned for psychosocial themes. Audio recordings of 400 calls rich in content were then transcribed and translated for analysis. Themes and subthemes were identified by two independent raters. Majority of the women had low literacy and more than half were widowed. Clinical depression was found in 18.6%. Of the 1186 call logs analysed, 932 calls had a record of at least one psychosocial concern and 493 calls recorded two psychosocial concerns. Some of the major themes that women discussed with nurses included worries about their own and their children's future; loneliness; stigma; inadvertent disclosure; death and dying; abandonment by partner; financial difficulties; body image; poor social support; emotions such as sadness, guilt, and anger; and need for social services. Almost all expressed appreciation for the intervention. Findings indicate the usefulness of mHealth-based self-care interventions delivered by nurses in hard to reach women in low- and middle-income countries, especially those with multiple psychosocial vulnerabilities.

  17. Place of Delivery Associated With Postnatal Care Utilization Among Childbearing Women in Zambia

    Directory of Open Access Journals (Sweden)

    Charles Chungu

    2018-04-01

    Full Text Available ObjectivePostnatal care (PNC utilization is critical to the prevention of maternal morbidity and mortality. Despite its importance, the proportion of women utilizing this service is still low in Zambia. We investigated if place of delivery was associated with PNC utilization in the first 48 h among childbearing women in Zambia.MethodsData from the 2013/14 Zambia Demographic and Health Survey for women, aged 15–49 years, who reported giving birth in the 2 years preceding the survey was used. The data comprised of sociodemographic and other obstetric data, which were cleaned, recoded, and analyzed using STATA version 13 (Stata Corporation, College Station, TX, USA. Multivariate logistic regression was used to examine the association of place of delivery and other background variables.ResultsWomen who delivered in a health facility were more likely to utilize PNC in the first 48 h compared to those who did not deliver in a health facility: government hospital (AOR 7.24, 95% CI 4.92–11.84, government health center/clinic (AOR 7.15 95% CI 4.79–10.66, other public sector (AOR 23.2 95% CI 3.69–145.91, private hospital/clinic (AOR 10.08 95% CI 3.35–30.35, and Mission hospital/clinic (AOR 8.56 95% CI 4.71–15.53. Additionally, women who were attended to by a skilled personnel during delivery of the baby were more likely to utilize PNC (AOR 2.30, 95% CI 1.57–3.37. Women from rural areas were less likely to utilize PNC in the first 48 h (AOR 0.70, 95% CI 0.53–0.90.ConclusionPlace of delivery was found to be linked with PNC utilization in this population although access to health care is still driven by inequity-related dynamics and imbalances. Given that inequity stresses are heaviest in the rural and poor groups, interventions should aim to reach this group.SignificanceThe study results will help program managers to increase access to health facility delivery and direct interventional efforts toward the affected subpopulations

  18. Trial of Labor Compared With Cesarean Delivery in Superobese Women.

    Science.gov (United States)

    Grasch, Jennifer L; Thompson, Jennifer L; Newton, J Michael; Zhai, Amy W; Osmundson, Sarah S

    2017-11-01

    To examine whether labor compared with planned cesarean delivery is associated with increased maternal and neonatal morbidity. We conducted a retrospective cohort study of all women with body mass indexes (BMIs) at delivery of 50 or greater delivering a live fetus at 34 weeks of gestation of greater between January 1, 2008, and December 31, 2015. Pregnancies with multiple gestations and major fetal anomalies were excluded. The primary outcome was a composite of maternal and neonatal morbidity and was estimated to be 50% in superobese women based on institutional data. A sample size of 338 women determined the study period and was selected to show a 30% difference in the incidence of the primary outcome between the two groups. Multivariate logistic regression adjusted for potential confounders. There were 344 women with BMIs of 50 or greater who met eligibility criteria, of whom 201 (58%) labored and 143 (42%) underwent planned cesarean delivery. Women who labored were younger, more likely to be nulliparous, and less likely to have pre-existing diabetes. Among women who labored, 45% underwent a cesarean delivery, most commonly for labor arrest (61%) or nonreassuring fetal status (28%). Composite maternal and neonatal morbidity was reduced among women who labored even after adjusting for age, parity, pre-existing diabetes, and prior cesarean delivery (adjusted odds ratio 0.42, 95% CI 0.24-0.75). In the subgroup of women (n=234) who underwent a cesarean delivery, whether planned (n=143) or after labor (n=91), there were no differences in maternal and neonatal morbidity except that severe maternal morbidity was increased in women (n=12) who labored (8.8% compared with 2.1%, relative risk 4.2, 95% CI 1.14-15.4). Despite high rates of cesarean delivery in women with superobesity, labor is associated with lower composite maternal and neonatal morbidity. Severe maternal morbidity may be higher in women who require a cesarean delivery after labor.

  19. Perinatal Outcomes in HIV Positive Pregnant Women with Concomitant Sexually Transmitted Infections

    Directory of Open Access Journals (Sweden)

    Erin Burnett

    2015-01-01

    Full Text Available Objective. To evaluate whether HIV infected pregnant women with concomitant sexually transmitted infection (STIs are at increased risk of adverse perinatal and neonatal outcomes. Methods. We conducted a cohort study of HIV positive women who delivered at an inner-city hospital in Atlanta, Georgia, from 2003 to 2013. Demographics, presence of concomitant STIs, prenatal care information, and maternal and neonatal outcomes were collected. The outcomes examined were the association of the presence of concomitant STIs on the risk of preterm birth (PTB, postpartum hemorrhage, chorioamnionitis, preeclampsia, intrauterine growth restriction, small for gestational age, low Apgar scores, and neonatal intensive care admission. Multiple logistic regression was performed to adjust for potential confounders. Results. HIV positive pregnant women with concomitant STIs had an increased risk of spontaneous PTB (odds ratio (OR 2.11, 95% confidence interval [CI] 1.12–3.97. After adjusting for a history of preterm birth, maternal age, and low CD4+ count at prenatal care entry the association between concomitant STIs and spontaneous PTB persisted (adjusted OR 1.96, 95% CI 1.01–3.78. Conclusions. HIV infected pregnant women with concomitant STIs relative to HIV positive pregnant women without a concomitant STI are at increased risk of spontaneous PTB.

  20. Reaching Perinatal Women Online: The Healthy You, Healthy Baby Website and App

    Directory of Open Access Journals (Sweden)

    Lydia Hearn

    2014-01-01

    Full Text Available Overwhelming evidence reveals the close link between unwarranted weight gain among childbearing women and childhood adiposity. Yet current barriers limit the capacity of perinatal health care providers (PHCPs to offer healthy lifestyle counselling. In response, today’s Internet savvy women are turning to online resources to access health information, with the potential of revolutionising health services by enabling PHCPs to guide women to appropriate online resources. This paper presents the findings of a project designed to develop an online resource to promote healthy lifestyles during the perinatal period. The methodology involved focus groups and interviews with perinatal women and PHCPs to determine what online information was needed, in what form, and how best it should be presented. The outcome was the development of the Healthy You, Healthy Baby website and smartphone app. This clinically-endorsed, interactive online resource provides perinatal women with a personalised tool to track their weight, diet, physical activity, emotional wellbeing, and sleep patterns based on the developmental stage of their child with links to quality-assured information. One year since the launch of the online resource, data indicates it provides a low-cost intervention delivered across most geographic and socioeconomic strata without additional demands on health service staff.

  1. How do Locals in Finland Identify Resident Foreigners

    Directory of Open Access Journals (Sweden)

    Minna Säävälä

    2008-01-01

    Full Text Available This study examines the identi? cation by Finns of foreign residents in Finland by analyzing data from a representative sample survey carried out in 2002. When people were asked to name a group of foreigners residing in Finland, the majority ?rst mentioned Somalis, despite the fact that only 4 percent of foreign residents are Somali and 6 percent of foreign-language speakers speak Somali. The general tendency when identifying resident foreigners is to refer primarily to ethnic or national groups; references to status (e.g. refugee, return migrant, guest worker or religion (e.g. Muslim are rare in the survey. In terms of ethnicity, identifying foreign residents in Finland is inconsistent, particularly as Russians and Estonians, the two largest groups, are not readily seen as foreign residents. The prevalence of answering Somalis could be considered an outcome of the maximally visible difference between Finns and Somalis. A logistic regression analysis is used to examine whether identifying resident foreigners differs according to socio-economic and educational characteristics, age, gender, region, and attitude towards the number of resident foreigners in Finland. The variables that signi? cantly in? uence the probability of answering Somalis and Russians are the respondents region, age, attitude towards the number of foreign residents in Finland, and to some extent, gender and higher education. Respondents occupational status, vocational education or income does not have a signi? cant impact on the answers. Regional differences appear to be a major factor affecting how foreigners are identi? ed, which shows that although the need to consider resident foreigners as visibly, culturally and linguistically maximally different may be a nearly universal base line for creating difference and identity, identifying foreign residents in Finland is not entirely independent of demographic realities.

  2. Birth preparedness and complication readiness (BPCR) among pregnant women in hard-to-reach areas in Bangladesh.

    Science.gov (United States)

    Moinuddin, Md; Christou, Aliki; Hoque, Dewan Md Emdadul; Tahsina, Tazeen; Salam, Shumona Sharmin; Billah, Sk Masum; Kuppens, Lianne; Matin, Md Ziaul; Arifeen, Shams El

    2017-01-01

    Birth preparedness and complication readiness aims to reduce delays in care seeking, promote skilled birth attendance, and facility deliveries. Little is known about birth preparedness practices among populations living in hard-to-reach areas in Bangladesh. To describe levels of birth preparedness and complication readiness among recently delivered women, identify determinants of being better prepared for birth, and assess the impact of greater birth preparedness on maternal and neonatal health practices. A cross-sectional survey with 2,897 recently delivered women was undertaken in 2012 as part of an evaluation trial done in five hard-to-reach districts in rural Bangladesh. Mothers were considered well prepared for birth if they adopted two or more of the four birth preparedness components. Descriptive statistics and multivariable logistic regression were used for analysis. Less than a quarter (24.5%) of women were considered well prepared for birth. Predictors of being well-prepared included: husband's education (OR = 1.3; CI: 1.1-1.7), district of residence, exposure to media in the form of reading a newspaper (OR = 2.2; CI: 1.2-3.9), receiving home visit by a health worker during pregnancy (OR = 1.5; CI: 1.2-1.8), and receiving at least 3 antenatal care visits from a qualified provider (OR = 1.4; CI: 1.0-1.9). Well-prepared women were more likely to deliver at a health facility (OR = 2.4; CI: 1.9-3.1), use a skilled birth attendant (OR = 2.4, CI: 1.9-3.1), practice clean cord care (OR = 1.3, CI: 1.0-1.5), receive post-natal care from a trained provider within two days of birth for themselves (OR = 2.6, CI: 2.0-3.2) or their newborn (OR = 2.6, CI: 2.1-3.3), and seek care for delivery complications (OR = 1.8, CI: 1.3-2.6). Greater emphasis on BPCR interventions tailored for hard to reach areas is needed to improve skilled birth attendance, care seeking for complications and essential newborn care and facilitate reductions in maternal and neonatal mortality in low

  3. Birth preparedness and complication readiness (BPCR among pregnant women in hard-to-reach areas in Bangladesh.

    Directory of Open Access Journals (Sweden)

    Md Moinuddin

    Full Text Available Birth preparedness and complication readiness aims to reduce delays in care seeking, promote skilled birth attendance, and facility deliveries. Little is known about birth preparedness practices among populations living in hard-to-reach areas in Bangladesh.To describe levels of birth preparedness and complication readiness among recently delivered women, identify determinants of being better prepared for birth, and assess the impact of greater birth preparedness on maternal and neonatal health practices.A cross-sectional survey with 2,897 recently delivered women was undertaken in 2012 as part of an evaluation trial done in five hard-to-reach districts in rural Bangladesh. Mothers were considered well prepared for birth if they adopted two or more of the four birth preparedness components. Descriptive statistics and multivariable logistic regression were used for analysis.Less than a quarter (24.5% of women were considered well prepared for birth. Predictors of being well-prepared included: husband's education (OR = 1.3; CI: 1.1-1.7, district of residence, exposure to media in the form of reading a newspaper (OR = 2.2; CI: 1.2-3.9, receiving home visit by a health worker during pregnancy (OR = 1.5; CI: 1.2-1.8, and receiving at least 3 antenatal care visits from a qualified provider (OR = 1.4; CI: 1.0-1.9. Well-prepared women were more likely to deliver at a health facility (OR = 2.4; CI: 1.9-3.1, use a skilled birth attendant (OR = 2.4, CI: 1.9-3.1, practice clean cord care (OR = 1.3, CI: 1.0-1.5, receive post-natal care from a trained provider within two days of birth for themselves (OR = 2.6, CI: 2.0-3.2 or their newborn (OR = 2.6, CI: 2.1-3.3, and seek care for delivery complications (OR = 1.8, CI: 1.3-2.6.Greater emphasis on BPCR interventions tailored for hard to reach areas is needed to improve skilled birth attendance, care seeking for complications and essential newborn care and facilitate reductions in maternal and neonatal mortality

  4. Modeling patients' acceptance of provider-delivered e-health.

    Science.gov (United States)

    Wilson, E Vance; Lankton, Nancy K

    2004-01-01

    Health care providers are beginning to deliver a range of Internet-based services to patients; however, it is not clear which of these e-health services patients need or desire. The authors propose that patients' acceptance of provider-delivered e-health can be modeled in advance of application development by measuring the effects of several key antecedents to e-health use and applying models of acceptance developed in the information technology (IT) field. This study tested three theoretical models of IT acceptance among patients who had recently registered for access to provider-delivered e-health. An online questionnaire administered items measuring perceptual constructs from the IT acceptance models (intrinsic motivation, perceived ease of use, perceived usefulness/extrinsic motivation, and behavioral intention to use e-health) and five hypothesized antecedents (satisfaction with medical care, health care knowledge, Internet dependence, information-seeking preference, and health care need). Responses were collected and stored in a central database. All tested IT acceptance models performed well in predicting patients' behavioral intention to use e-health. Antecedent factors of satisfaction with provider, information-seeking preference, and Internet dependence uniquely predicted constructs in the models. Information technology acceptance models provide a means to understand which aspects of e-health are valued by patients and how this may affect future use. In addition, antecedents to the models can be used to predict e-health acceptance in advance of system development.

  5. A better way to deliver bad news.

    Science.gov (United States)

    Manzoni, Jean-François

    2002-09-01

    In an ideal world, a subordinate would accept critical feedback from a manager with an open mind. He or she would ask a few clarifying questions, promise to work on certain performance areas, and show signs of improvement over time. But things don't always turn out that way. Such conversations can be unpleasant. Emotions can run high; tempers can flare. Fearing that the employee will become angry and defensive, the boss all too often inadvertently sabotages the meeting by preparing for it in a way that stifles honest discussion. This unintentional--indeed, unconscious--stress-induced habit makes it difficult to deliver corrective feedback effectively. Insead professor Jean-François Manzoni says that by changing the mind-set with which they develop and deliver negative feedback, managers can increase their odds of having productive conversations without damaging relationships. Manzoni describes two behavioral phenomena that color the feedback process--the fundament