Intimate partner violence and associated factors in an obstetric population in Jos, North-central Nigeria

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Stephen Ajen Anzaku

2017-01-01

Full Text Available Background: Intimate partner violence (IPV during pregnancy is a human right and public health concern, often life-threatening to both the mother and fetus. This study sought to ascertain the prevalence of IPV, pattern, and associated factors in a Nigerian obstetric population. Materials and Methods: This is a cross-sectional study among 338 pregnant women at term between January and July 2015 using pretested self-administered questionnaires to ascertain their sociodemographic and obstetric characteristics as well as partners' features. IPV was assessed using the hurt, insult, threaten, and scream validated screening tool. Data were analyzed using SPSS version 20 for windows (SPSS Inc., Chicago, IL, USA. Multivariate analysis was done to ascertain associated factors for IPV and P < 0.05 was considered statistically significant. Results: Prevalence of IPV among women was 14.8% (50/338. One hundred and twenty-seven respondents (37.6% suffered verbal abuse, 28.4% had physical violence, while 5.3% reported sexual abuse. Most of the women, i.e., 72.0% (36/50 did not report violence and 76.0% (38/50 disclosed that they still felt safe in their marital relationship. Independent risk factors for IPV were duration of marriage of 6.8 years (P = 0.04, odds ratio [OR] =8.8, 95% confidence interval [CI] =7.8–9.9, maternal primary educational status (P = 0.02, OR = 10.7, 95% CI = 1.1–103.1, and male partner cigarette smoking (P = 0.003, OR = 3.1, 95% CI = 3.0–316.0. Conclusion: IPV during pregnancy is common in this obstetric population. Screening for IPV should be a part of routine antenatal care, especially among women with long marriage duration, primary educational status, and those whose husbands smoking cigarettes is recommended.

Blood transfusion in obstetrics: attitude and perceptions of pregnant ...

African Journals Online (AJOL)

Background: Obstetrics haemorrhage is the leading cause of preventable maternal deaths worldwide. Blood transfusion is pivotal to death reduction, but are the women aware of its importance? Objectives: The study investigated the view of a population of pregnant women on obstetrics related blood transfusion. Methods: ...

Procedural modeling of urban layout: population, land use, and road network

NARCIS (Netherlands)

Lyu, X.; Han, Q.; de Vries, B.

2017-01-01

This paper introduces an urban simulation system generating urban layouts with population, road network and land use layers. The desired urban spatial structure is obtained by generating a population map based on population density models. The road network is generated at two spatial levels

External Validation Study of First Trimester Obstetric Prediction Models (Expect Study I): Research Protocol and Population Characteristics.

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Meertens, Linda Jacqueline Elisabeth; Scheepers, Hubertina Cj; De Vries, Raymond G; Dirksen, Carmen D; Korstjens, Irene; Mulder, Antonius Lm; Nieuwenhuijze, Marianne J; Nijhuis, Jan G; Spaanderman, Marc Ea; Smits, Luc Jm

2017-10-26

A number of first-trimester prediction models addressing important obstetric outcomes have been published. However, most models have not been externally validated. External validation is essential before implementing a prediction model in clinical practice. The objective of this paper is to describe the design of a study to externally validate existing first trimester obstetric prediction models, based upon maternal characteristics and standard measurements (eg, blood pressure), for the risk of pre-eclampsia (PE), gestational diabetes mellitus (GDM), spontaneous preterm birth (PTB), small-for-gestational-age (SGA) infants, and large-for-gestational-age (LGA) infants among Dutch pregnant women (Expect Study I). The results of a pilot study on the feasibility and acceptability of the recruitment process and the comprehensibility of the Pregnancy Questionnaire 1 are also reported. A multicenter prospective cohort study was performed in The Netherlands between July 1, 2013 and December 31, 2015. First trimester obstetric prediction models were systematically selected from the literature. Predictor variables were measured by the Web-based Pregnancy Questionnaire 1 and pregnancy outcomes were established using the Postpartum Questionnaire 1 and medical records. Information about maternal health-related quality of life, costs, and satisfaction with Dutch obstetric care was collected from a subsample of women. A pilot study was carried out before the official start of inclusion. External validity of the models will be evaluated by assessing discrimination and calibration. Based on the pilot study, minor improvements were made to the recruitment process and online Pregnancy Questionnaire 1. The validation cohort consists of 2614 women. Data analysis of the external validation study is in progress. This study will offer insight into the generalizability of existing, non-invasive first trimester prediction models for various obstetric outcomes in a Dutch obstetric population

Urban Ecology: Patterns of Population Growth and Ecological Effects

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Wayne C. Zipperer; Steward T.A. Pickett

2012-01-01

Currently, over 50% of the world’s population lives in urban areas. By 2050, this estimate is expected to be 70%. This urban growth, however, is not uniformly distributed around the world. The majority of it will occur in developing nations and create megacities whose populations exceed at least 10 million people. Not all urban areas, however, are growing. Some are...

Obstetric Risk Factors and Subsequent Mental Health Problems in a ...

African Journals Online (AJOL)

Background: Studies suggest that obstetric complications are associated with several child psychiatric conditions. In planning for child psychiatric services it is important to monitor patterns of morbidity and associated risk factors. Identifying obstetric risk factors in a newly opened child psychiatric clinic population with ...

Procedural modeling of urban layout: population, land use, and road network

OpenAIRE

Lyu, X.; Han, Q.; de Vries, B.

2017-01-01

This paper introduces an urban simulation system generating urban layouts with population, road network and land use layers. The desired urban spatial structure is obtained by generating a population map based on population density models. The road network is generated at two spatial levels corresponding to the road hierarchy. The land use allocation is based on the What If? allocation model. The expected results are urban layouts suitable for academic scenario analysis.

Obstetric complications and asthma in childhood.

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Xu, B; Pekkanen, J; Järvelin, M R

2000-01-01

Studies have shown that perinatal factors are associated with childhood asthma. The current analyses examined the association between obstetric complications and risk of asthma at the age of 7 years using a prospectively population-based birth cohort in northern Finland. Results indicated that obstetric complications were associated with a higher risk of asthma among children. Those children who were administered special procedures at birth, i.e., cesarean section, vacuum extraction, and other procedures, including use of forceps, manual auxiliary, and extraction breech, had an adjusted odds ratio (OR) for asthma of 1.38 (95% confidence interval [CI] 1.00-1.92), 1.32 (95% CI 0.80-2.19), and 2.14 (95% CI 1.06-4.33), respectively, as compared to children who were delivered normally. Children who had a lower Apgar score at the first and the fifth minute after birth also had a higher risk as compared to those who had an Apgar score of 9-10. The results encourage further evaluation of the association between obstetric complications and risk of asthma among children in other populations, and further exploration of possible mechanisms underlying the association.

Prevalence, detection and treatment of asymptomatic bacteriuria in a Turkish obstetric population.

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Kutlay, Sim; Kutlay, Baran; Karaahmetoglu, Ozgur; Ak, Cetin; Erkaya, Salim

2003-08-01

To prospectively determine the prevalence of asymptomatic bacteriuria (ASB) and urinary tract infection (UTI) and presenting symptoms of UTI as well as the most appropriate diagnostic test and success of single/combination drug treatment in a Turkish obstetric population. Between September and December 2000, 406 of 412 pregnant women admitted for an initial obstetric examination during the first trimester were evaluated. Results of clean-catch urine culture, microscopic urinalysis and dipstick urine tests were analyzed. The prevalence of ASB (n = 43) and symptomatic UTI (n = 19) were 10.6% and 4.7%, respectively. The sensitivity and specificity of microscopic urinalysis were 71.0% and 73.6%, respectively. The sensitivity and specificity of dipstick testing were 38.7% and 35.8%, respectively. Eighty-three percent of ASB/UTI cases were effectively treated with a course of a single antimicrobial (amoxicillin or a first-generation cephalosporin). If untreated, ASB can lead to acute, symptomatic UTI, including acute pyelonephritis, which in turn is associated with preterm labor and low birth weight. Therefore, screening for ASB early in pregnancy by methods with high sensitivity and treatment with appropriate antimicrobial regimens can decrease the risk of symptomatic UTI. In a Turkish clinical unit where culture is not available, the use of microscopic urinalysis was a clinically effective alternative method of detecting ASB. In this study, the sensitivity and specificity of dipstick testing were not high enough to recommend them as means of detecting ASB/UTI.

Migrants and obstetrics in Austria--applying a new questionnaire shows differences in obstetric care and outcome.

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Oberaigner, Willi; Leitner, Hermann; Oberaigner, Karin; Marth, Christian; Pinzger, Gerald; Concin, Hans; Steiner, Horst; Hofmann, Hannes; Wagner, Teresa; Mörtl, Manfred; Ramoni, Angela

2013-01-01

Immigration plays a major role in obstetrics in Austria, and about 18 % of the Austrian population are immigrants. Therefore, we aimed to (1) test the feasibility of a proposed questionnaire for assessment of migrant status in epidemiological research and (2) assess some important associations between procedures and outcomes in obstetrics and migration in selected departments in Austria. We adapted a standardized questionnaire to the main immigration groups in Austria. Information on country of origin, length of residence in Austria and German-language ability was collected from eight selected obstetrics departments. Of the 1,971 questionnaires, 1,873 questionnaires of singleton births were selected and included in the analysis. We analyzed a total of 1,873 parturients with singleton births, of which 35 % had migrant status, 12 % were from ex-Yugoslavia, 12 % were from Turkey, and 12 % were from other countries. The proportion of parturients having their first care visit after the 12th week of pregnancy was higher in migrant groups (19 %). Smoking was highest in the migrants from ex-Yugoslavia (21 %). Vaginal delivery was more frequent in migrants from ex-Yugoslavia (78 %) and Turkey (83 %) than in nonmigrants (71 %) and episiotomy was more frequently performed in migrants from other countries. All differences are statistically significant. Administration of a standardized questionnaire for assessment of migrant status in obstetric departments in Austria was shown to be feasible. We assessed differences in obstetric care and outcome and consequently recommend that action should be initiated in Austria toward harmonizing obstetric procedures among the migrant and the nonmigrant groups and toward minimizing risk factors.

Migration, urban population growth and regional disparity in China

OpenAIRE

Renard, Mary-Françoise; Xu, Zelai; Zhu, Nong

2011-01-01

The main objective of this paper is to study the determinants of city population growth in China during the 1990s', as well as the determinants of migrations towards cities, which constitutes the main source of urban population growth in this period. A second objective is to identify regional differences in the urban growth and migrations, that is, whether urban growth and migration patterns are different between coastal and inland provinces. Additionally, we are interested in the differences...

Capital, population and urban patterns.

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Zhang, W

1994-04-01

The author develops an approach to urban dynamics with endogenous capital and population growth, synthesizing the Alonso location model, the two-sector neoclassical growth model, and endogenous population theory. A dynamic model for an isolated island economy with endogenous capital, population, and residential structure is developed on the basis of Alonso's residential model and the two-sector neoclassical growth model. The model describes the interdependence between residential structure, economic growth, population growth, and economic structure over time and space. It has a unique long-run equilibrium, which may be either stable or unstable, depending upon the population dynamics. Applying the Hopf theorem, the author also shows that when the system is unstable, the economic geography exhibits permanent endogenous oscillations.

Genetic diversity and population structure in contemporary house sparrow populations along an urbanization gradient

OpenAIRE

Vangestel, C; Mergeay, Joachim; Dawson, D. A; Callens, T; Vandomme, V; Lens, L

2012-01-01

House sparrow (Passer domesticus) populations have suffered major declines in urban as well as rural areas, while remaining relatively stable in suburban ones. Yet, to date no exhaustive attempt has been made to examine how, and to what extent, spatial variation in population demography is reflected in genetic population structuring along contemporary urbanization gradients. Here we use putatively neutral microsatellite loci to study if and how genetic variation can be partitioned in a hierar...

Feasibility of screening and prevalence of prenatal depression in an obstetric setting in Spain.

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de la Fe Rodríguez-Muñoz, María; Le, Huynh-Nhu; de la Cruz, Ivette Vargas; Crespo, María Eugenia Olivares; Méndez, Nuria Izquierdo

2017-08-01

Prenatal depression is a significant public health problem and one of the main risk factors for postpartum depression. Limited research in perinatal depression has been conducted in Spain. The objectives of this study was to: (1) examine the feasibility of integrating a screening program for prenatal depression in an obstetrics setting in a large urban hospital in Spain; and (2) provide an initial estimate of the prevalence rate of the severity of depressive symptoms during pregnancy. Screening for prenatal depression was conducted during the first trimester in an obstetrics setting in an urban hospital in Madrid, Spain 2014-2015. The Patient Health Questionnaire (PHQ-9) was used as the main screener. Of the 730 women asked to complete the screening protocol, 445 (60.9%) completed the PHQ-9 during the first trimester. Those who did not complete the screening were more likely to be immigrants and did not read Spanish. The prevalence of moderate to high severity of prenatal depressive symptoms prenatal depressive is 14.8% (PHQ-9≥10). It is possible to integrate screening for prenatal depression in an urban obstetrics setting, but there are significant structural barriers to implementation. The prevalence of significant prenatal depressive symptoms is similar to previous research in Spain and adds to the limited research in this area. Copyright © 2017 Elsevier B.V. All rights reserved.

Contemporary Obstetric Triage.

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Sandy, Edward Allen; Kaminski, Robert; Simhan, Hygriv; Beigi, Richard

2016-03-01

The role of obstetric triage in the care of pregnant women has expanded significantly. Factors driving this change include the Emergency Medical Treatment and Active Labor Act, improved methods of testing for fetal well-being, increasing litigation risk, and changes in resident duty hour guidelines. The contemporary obstetric triage facility must have processes in place to provide a medical screening examination that complies with regulatory statues while considering both the facility's maternal level of care and available resources. This review examines the history of the development of obstetric triage, current considerations in a contemporary obstetric triage paradigm, and future areas for consideration. An example of a contemporary obstetric triage program at an academic medical center is presented. A successful contemporary obstetric triage paradigm is one that addresses the questions of "sick or not sick" and "labor or no labor," for every obstetric patient that presents for care. Failure to do so risks poor patient outcome, poor patient satisfaction, adverse litigation outcome, regulatory scrutiny, and exclusion from federal payment programs. Understanding the role of contemporary obstetric triage in the current health care environment is important for both providers and health care leadership. This study is for obstetricians and gynecologists as well as family physicians. After completing this activity, the learner should be better able to understand the scope of a medical screening examination within the context of contemporary obstetric triage; understand how a facility's level of maternal care influences clinical decision making in a contemporary obstetric triage setting; and understand the considerations necessary for the systematic evaluation of the 2 basic contemporary obstetric questions, "sick or not sick?" and "labor or no labor?"

The less healthy urban population: income-related health inequality in China

Science.gov (United States)

2012-01-01

Background Health inequality has been recognized as a problem all over the world. In China, the poor usually have less access to healthcare than the better-off, despite having higher levels of need. Since the proportion of the Chinese population living in urban areas increased tremendously with the urbanization movements, attention has been paid to the association between urban/rural residence and population health. It is important to understand the variation in health across income groups, and in particular to take into account the effects of urban/rural residence on the degree of income-related health inequalities. Methods This paper empirically assesses the magnitude of rural/urban disparities in income-related adult health status, i.e., self-assessed health (SAH) and physical activity limitation, using Concentration Indices. It then uses decomposition methods to unravel the causes of inequalities and their variations across urban and rural populations. Data from the China Health and Nutrition Survey (CHNS) 2006 are used. Results The study finds that the poor are less likely to report their health status as “excellent or good” and are more likely to have physical activity limitation. Such inequality is more pronounced for the urban population than for the rural population. Results from the decomposition analysis suggest that, for the urban population, 76.47 per cent to 79.07 per cent of inequalities are driven by non-demographic/socioeconomic-related factors, among which income, job status and educational level are the most important factors. For the rural population, 48.19 per cent to 77.78 per cent of inequalities are driven by non-demographic factors. Income and educational attainment appear to have a prominent influence on inequality. Conclusion The findings suggest that policy targeting the poor, especially the urban poor, is needed in order to reduce health inequality. PMID:22989200

The less healthy urban population: income-related health inequality in China.

Science.gov (United States)

Yang, Wei; Kanavos, Panos

2012-09-18

Health inequality has been recognized as a problem all over the world. In China, the poor usually have less access to healthcare than the better-off, despite having higher levels of need. Since the proportion of the Chinese population living in urban areas increased tremendously with the urbanization movements, attention has been paid to the association between urban/rural residence and population health. It is important to understand the variation in health across income groups, and in particular to take into account the effects of urban/rural residence on the degree of income-related health inequalities. This paper empirically assesses the magnitude of rural/urban disparities in income-related adult health status, i.e., self-assessed health (SAH) and physical activity limitation, using Concentration Indices. It then uses decomposition methods to unravel the causes of inequalities and their variations across urban and rural populations. Data from the China Health and Nutrition Survey (CHNS) 2006 are used. The study finds that the poor are less likely to report their health status as "excellent or good" and are more likely to have physical activity limitation. Such inequality is more pronounced for the urban population than for the rural population. Results from the decomposition analysis suggest that, for the urban population, 76.47 per cent to 79.07 per cent of inequalities are driven by non-demographic/socioeconomic-related factors, among which income, job status and educational level are the most important factors. For the rural population, 48.19 per cent to 77.78 per cent of inequalities are driven by non-demographic factors. Income and educational attainment appear to have a prominent influence on inequality. The findings suggest that policy targeting the poor, especially the urban poor, is needed in order to reduce health inequality.

The less healthy urban population: income-related health inequality in China

Directory of Open Access Journals (Sweden)

Yang Wei

2012-09-01

Full Text Available Abstract Background Health inequality has been recognized as a problem all over the world. In China, the poor usually have less access to healthcare than the better-off, despite having higher levels of need. Since the proportion of the Chinese population living in urban areas increased tremendously with the urbanization movements, attention has been paid to the association between urban/rural residence and population health. It is important to understand the variation in health across income groups, and in particular to take into account the effects of urban/rural residence on the degree of income-related health inequalities. Methods This paper empirically assesses the magnitude of rural/urban disparities in income-related adult health status, i.e., self-assessed health (SAH and physical activity limitation, using Concentration Indices. It then uses decomposition methods to unravel the causes of inequalities and their variations across urban and rural populations. Data from the China Health and Nutrition Survey (CHNS 2006 are used. Results The study finds that the poor are less likely to report their health status as “excellent or good” and are more likely to have physical activity limitation. Such inequality is more pronounced for the urban population than for the rural population. Results from the decomposition analysis suggest that, for the urban population, 76.47 per cent to 79.07 per cent of inequalities are driven by non-demographic/socioeconomic-related factors, among which income, job status and educational level are the most important factors. For the rural population, 48.19 per cent to 77.78 per cent of inequalities are driven by non-demographic factors. Income and educational attainment appear to have a prominent influence on inequality. Conclusion The findings suggest that policy targeting the poor, especially the urban poor, is needed in order to reduce health inequality.

Retrospective cohort study of the effects of obesity in early pregnancy on maternal weight gain and obstetric outcomes in an obstetric population in Africa

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Iyoke CA

2013-08-01

.63, abnormal Apgar scores (OR 2.67, 95% CI 1.46–4.93, and newborn special care admissions (OR 1.18, 95% CI 1.0–3.29.Conclusion: Early pregnancy obesity was associated with a wide range of adverse fetomaternal outcomes, and could be a genuine risk factor for increased pregnancy-related morbidity and/or mortality in this population. Interventions to reduce prepregnancy obesity could therefore be useful in this low-resource African setting.Keywords: obesity, early pregnancy, maternal weight gain, obstetric outcomes

Urban population and economic growth: South Asia perspective

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Sandip Sarker

2016-07-01

Full Text Available Previously economic growth was generally discussed in terms of foreign direct investment (FDI, educational growth, savings, investments, inflation as well as trade openness of a nation. Very recently it has been identified that population is one of the major determinants of economic growth of a nation. In the recent years, the study of urbanization has gained a matter of concern in developing countries as it has been recognized as part of a larger process of economic development which is affecting developing countries. South Asian countries are one of the emerging economics and growing at a faster rate over the past few years. At the same time, population of South Asia is growing at a significant rate. Therefore the study has attempted to identify the causal relationship between urban population and economic growth in South Asia using a panel data analysis. The study makes use of the Augmented Dickey-Fuller (ADF and Phillips-Perron (PP, Pesaran as well as Fisher methods for panel unit root test. The panel Pedroni cointegration test suggests that there is long run relationship between the variables. The further panel Vector Error Correction Model (VECM suggests that there is long run causality running from urban population growth to economic growth in South Asia. The study concludes that the growth of urban population can have significant impact on economic growth in South Asia in the long run.

Human population, urban settlement patterns and their impact on Plasmodium falciparum malaria endemicity

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Kabaria Caroline W

2008-10-01

Full Text Available Abstract Background The efficient allocation of financial resources for malaria control and the optimal distribution of appropriate interventions require accurate information on the geographic distribution of malaria risk and of the human populations it affects. Low population densities in rural areas and high population densities in urban areas can influence malaria transmission substantially. Here, the Malaria Atlas Project (MAP global database of Plasmodium falciparum parasite rate (PfPR surveys, medical intelligence and contemporary population surfaces are utilized to explore these relationships and other issues involved in combining malaria risk maps with those of human population distribution in order to define populations at risk more accurately. Methods First, an existing population surface was examined to determine if it was sufficiently detailed to be used reliably as a mask to identify areas of very low and very high population density as malaria free regions. Second, the potential of international travel and health guidelines (ITHGs for identifying malaria free cities was examined. Third, the differences in PfPR values between surveys conducted in author-defined rural and urban areas were examined. Fourth, the ability of various global urban extent maps to reliably discriminate these author-based classifications of urban and rural in the PfPR database was investigated. Finally, the urban map that most accurately replicated the author-based classifications was analysed to examine the effects of urban classifications on PfPR values across the entire MAP database. Results Masks of zero population density excluded many non-zero PfPR surveys, indicating that the population surface was not detailed enough to define areas of zero transmission resulting from low population densities. In contrast, the ITHGs enabled the identification and mapping of 53 malaria free urban areas within endemic countries. Comparison of PfPR survey results showed

Domestic violence screening of obstetric triage patients in a military population.

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Lutgendorf, M A; Thagard, A; Rockswold, P D; Busch, J M; Magann, E F

2012-10-01

The objective was to estimate the self-reported prevalence of domestic violence in a pregnant military population presenting for emergency care, and to determine the acceptability of domestic violence screening. A prospective observational survey of patients presenting for obstetric emergency care. Women were anonymously screened for domestic violence using the Abuse Assessment Screen. A total of 499 surveys were distributed, with 26 duplicate surveys. After excluding the 12 blank surveys, a total of 461 surveys were included in the final analysis. The lifetime prevalence of domestic violence (including physical, emotional and sexual abuse) was 22.6% (95% CI=19.0 to 26.4) with 4.1% (95% CI=2.3-6.0) of women reporting physical abuse in the past year and 2.8% (95% CI=1.3-4.3) reporting abuse since becoming pregnant. The majority of women 91.8% (95% CI=88.7-94.2) were not offended by domestic violence screening and 88.8% (95% CI=82.0-88.9) felt that patients should be routinely screened. The self-reported prevalence of domestic violence in a pregnant military population presenting for emergency care was 22.6%. Most women are not offended by domestic violence screening and support routine screening.

Seasonal associations with urban light pollution for nocturnally migrating bird populations.

Science.gov (United States)

La Sorte, Frank A; Fink, Daniel; Buler, Jeffrey J; Farnsworth, Andrew; Cabrera-Cruz, Sergio A

2017-11-01

The spatial extent and intensity of artificial light at night (ALAN) has increased worldwide through the growth of urban environments. There is evidence that nocturnally migrating birds are attracted to ALAN, and there is evidence that nocturnally migrating bird populations are more likely to occur in urban areas during migration, especially in the autumn. Here, we test if urban sources of ALAN are responsible, at least in part, for these observed urban associations. We use weekly estimates of diurnal occurrence and relative abundance for 40 nocturnally migrating bird species that breed in forested environments in North America to assess how associations with distance to urban areas and ALAN are defined across the annual cycle. Migratory bird populations presented stronger than expected associations with shorter distances to urban areas during migration, and stronger than expected association with higher levels of ALAN outside and especially within urban areas during migration. These patterns were more pronounced during autumn migration, especially within urban areas. Outside of the two migration periods, migratory bird populations presented stronger than expected associations with longer distances to urban areas, especially during the nonbreeding season, and weaker than expected associations with the highest levels of ALAN outside and especially within urban areas. These findings suggest that ALAN is associated with higher levels of diurnal abundance along the boundaries and within the interior of urban areas during migration, especially in the autumn when juveniles are undertaking their first migration journey. These findings support the conclusion that urban sources of ALAN can broadly effect migratory behavior, emphasizing the need to better understand the implications of ALAN for migratory bird populations. © 2017 John Wiley & Sons Ltd.

Is Demography Destiny? Urban Population Change and Economic Vitality of Future Cities

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Jacques Poot

Full Text Available ABSTRACT: The growth of cities has attracted considerable scholarly attention during the last decade as it is becoming clear that powerful agglomeration forces are reinforcing the role of cities as the engines of economic growth. Close to 4 billion people live in cities, about 55 per cent of the world's population. While population growth rates are declining and the world's population is likely to level off from the middle of the 21st century, probably ending up around 10 billion, further urbanization is expected to continue. Another 3 billion people will become urban citizens this century. At the same time no corner of the world will be sheltered from sweeping demographic changes due to population ageing and increasing migration. Such changes will be amplified in cities. In this paper we combine UN population projections and migration data with our own assumptions to derive projections of age composition and birthplace composition of urban populations by continent. We also briefly address the consequences of these demographic trends for future urban economic vitality. Particular attention is paid to the impacts of demographic changes on urban creativity and innovation. We conclude that, with the right policies in place, such demographic changes enhance rather than impede the future prosperity of the urban world. KEYWORDS: World population projections, urbanization, ageing, migration, ethnic diversity

Trends in mortality and biological stress in a medieval polish urban population.

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Betsinger, Tracy K; DeWitte, Sharon

2017-12-01

Urbanization in pre-modern populations may have had a variety of consequences related to population crowding. However, research on the effects of urbanization have provided inconsistent results regarding the biological impact of this transition on human populations. The purpose of this study is to test the hypothesis that urbanization caused an increase in overall biological stress in a medieval (10th-13th centuries AD) Polish population. A human skeletal sample (n=164) was examined for the presence of porotic hyperostosis, cribra orbitalia, linear enamel hypoplasia, periosteal reaction, and specific infectious diseases. Prevalence rates were compared among three temporal samples: initial urbanization, early urbanization, and later urbanization. Results indicate no significant trends for any of the pathological conditions. Cox proportional hazards analyses, however, revealed a significant increase in the risk of death over time, which supports the hypothesis. These results reflect the necessity of using multiple analyses to address bioarchaeological questions. The lack of significant results from skeletal indicators may be due to an earlier urbanization trend in the population. This study illustrates that the association of urbanization with elevated biological stress is complicated and dependent on various factors, including culture and time period. Copyright © 2017 Elsevier Inc. All rights reserved.

knowledge about obstetric danger signs among preg

African Journals Online (AJOL)

user

about knowledge level of pregnant women on obstetric danger signs. The objective of this .... ple size formula for estimating a single population proportion with the ..... subjects mentioned vaginal bleeding as danger sign during pregnancy ...

[Urbanization mechanisms in bird species: population systems transformations or adaptations at the individual level?].

Science.gov (United States)

Fridman, V S; Eremkin, G S; Zakharova-Kubareva, N Iu

2008-01-01

The present research deals with urbanization of wild bird and mammal species. Forms and mechanisms of population steadiness in the urban landscape have been examined. The urbanization process turned out to be a directed change of the population system forming de novo in the urbolandscape leading to a sustainable organization peculiar for the particular environment. The population organization of different types in urbolandscape is found to provide its stability under conditions of directed and fast changes accompanied with instability and heterogenous structure of habitats. It is shown that the same type of population organization meets the corresponding demands among different species settling in the urban environment. Its features are "openness" and "flowage" of the groups, far order of settlement levels and other units of population system, constant movements of the individuals between the groups as a respond to the signals of urboenvironment significant changes. The "urban" variant of the population system organization turns out to be opposite to that of the same species in the non-urban habitats. After formation of the urban types by the species and successful developing of the town, the urban population becomes separated from the maternal local population and begins to exist independently in the urban landscape. The variety of adaptation aberrations in ecology, behavior, and mode of life of urban birds is the population system stability function in the urban landscape and is not a results of individual selection. It is shown that the urbanization process of the species goes firstly on the population level being the system structure transformation developed by the species towards the most stable state in the town (city) territory. Only after the appearance of stable urban population, the urban individuals show the rapid growth of different changes in ecology, behavior, mode of life that was traditionally described by naturalists as species adaptation to the

Population genetics, community of parasites, and resistance to rodenticides in an urban brown rat (Rattus norvegicus) population.

Science.gov (United States)

Desvars-Larrive, Amélie; Pascal, Michel; Gasqui, Patrick; Cosson, Jean-François; Benoît, Etienne; Lattard, Virginie; Crespin, Laurent; Lorvelec, Olivier; Pisanu, Benoît; Teynié, Alexandre; Vayssier-Taussat, Muriel; Bonnet, Sarah; Marianneau, Philippe; Lacôte, Sandra; Bourhy, Pascale; Berny, Philippe; Pavio, Nicole; Le Poder, Sophie; Gilot-Fromont, Emmanuelle; Jourdain, Elsa; Hammed, Abdessalem; Fourel, Isabelle; Chikh, Farid; Vourc'h, Gwenaël

2017-01-01

Brown rats are one of the most widespread urban species worldwide. Despite the nuisances they induce and their potential role as a zoonotic reservoir, knowledge on urban rat populations remains scarce. The main purpose of this study was to characterize an urban brown rat population from Chanteraines park (Hauts-de-Seine, France), with regards to haematology, population genetics, immunogenic diversity, resistance to anticoagulant rodenticides, and community of parasites. Haematological parameters were measured. Population genetics was investigated using 13 unlinked microsatellite loci. Immunogenic diversity was assessed for Mhc-Drb. Frequency of the Y139F mutation (conferring resistance to rodenticides) and two linked microsatellites were studied, concurrently with the presence of anticoagulant residues in the liver. Combination of microscopy and molecular methods were used to investigate the occurrence of 25 parasites. Statistical approaches were used to explore multiple parasite relationships and model parasite occurrence. Eighty-six rats were caught. The first haematological data for a wild urban R. norvegicus population was reported. Genetic results suggested high genetic diversity and connectivity between Chanteraines rats and surrounding population(s). We found a high prevalence (55.8%) of the mutation Y139F and presence of rodenticide residues in 47.7% of the sampled individuals. The parasite species richness was high (16). Seven potential zoonotic pathogens were identified, together with a surprisingly high diversity of Leptospira species (4). Chanteraines rat population is not closed, allowing gene flow and making eradication programs challenging, particularly because rodenticide resistance is highly prevalent. Parasitological results showed that co-infection is more a rule than an exception. Furthermore, the presence of several potential zoonotic pathogens, of which four Leptospira species, in this urban rat population raised its role in the maintenance

Population in urban development and the practical problems of urban planning policy in Africa

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Joseph Uyanga

2013-07-01

Full Text Available The paper analyses the pattern of recent growth in African towns, examines the population component in this growth process and discusses the attendant urban planning problems. The contention in the study is that there are problems of definition. policy enunciation, and organisational co-ordination in the conceptualization. planning. orchestration and implementation of urban development and service systems. The magnitude of African urban developmental problems, and its multi-faceted nature demands that the latest in scientific knowledge and technological innovations should be integrated and incorporated into the urban planning and implementation processes.

Thermodynamics of urban population flows.

Science.gov (United States)

Hernando, A; Plastino, A

2012-12-01

Orderliness, reflected via mathematical laws, is encountered in different frameworks involving social groups. Here we show that a thermodynamics can be constructed that macroscopically describes urban population flows. Microscopic dynamic equations and simulations with random walkers underlie the macroscopic approach. Our results might be regarded, via suitable analogies, as a step towards building an explicit social thermodynamics.

Obstetric antiphospholipid syndrome.

Science.gov (United States)

Esteve-Valverde, E; Ferrer-Oliveras, R; Alijotas-Reig, J

2016-04-01

Obstetric antiphospholipid syndrome is an acquired autoimmune disorder that is associated with various obstetric complications and, in the absence of prior history of thrombosis, with the presence of antiphospholipid antibodies directed against other phospholipids, proteins called cofactors or PL-cofactor complexes. Although the obstetric complications have been related to the procoagulant properties of antiphospholipid antibodies, pathological studies of human placenta have shown the proinflammatory capacity of antiphospholipid antibodies via the complement system and proinflammatory cytokines. There is no general agreement on which antiphospholipid antibodies profile (laboratory) confers the greatest obstetric risk, but the best candidates are categories I and IIa. Combined treatment with low doses of aspirin and heparin achieves good obstetric and maternal outcomes. In this study, we also review the therapeutic possibilities in refractory cases, although the likelihood of progressing to other autoimmune diseases is low. We briefly comment on incomplete obstetric antiphospholipid syndrome, also known as antiphospholipid antibody-mediated pregnancy morbidity syndrome. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Medicina Interna (SEMI). All rights reserved.

Obstetric violence according to obstetric nurses

OpenAIRE

Michelle Gonçalves da Silva; Michelle Carreira Marcelino; Lívia Shélida Pinheiro Rodrigues; Rosário Carcaman Toro; Antonieta Keiko Kakuda Shimo

2014-01-01

The objective was to report the experience of obstetric nurses on the obstetric violence experienced, witnessed and observed during their professional careers. This study is based on an account of experience of working in several health institutions such as basic health units, private and public hospitals, located in São Paulo, Brazil, in a period 5-36 years of technical training and professional experience from 1977 to 2013. The technique to expose the professional experiences was brainstorm...

The impact of motorcycle accidents on the obstetric population in ...

African Journals Online (AJOL)

Contexts: Motorcycle accidents are very common in most cities in Nigeria since the introduction of motorcycle for public commercial transportation in the early 1980s and because most pregnant women use this popular means of transport it may contribute to non-obstetric causes of maternal and perinatal morbidity and ...

Population growth and rural-urban migration, with special reference to Ghana.

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De Graft-johnson, K T

1974-01-01

While the population of Ghana is expected to double in 25 years at the current rate of increase (approximately 2.5% per annum), the population of urban centers is increasing even faster. The 1970 census shows the urban population growing by 4.8% per annum. This is mainly the result of rural to urban migration and, to a smaller extent, the increase in the number of urban centers from 39 in 1948 to 98 in 1960 to 135 in 1970. In the 1970 census only 57.1% of the population were enumerated in their locality of birth and only 20.9% in a locality other than their place of birth but in the same region. 4.1% were born outside Ghana, mostly in another West African country. 1 striking difference between urban and rural areas is the differing sex ratio of the working population. In rural areas there are 91.0 males aged 15-64 years for every 100 females while in urban areas there are 107.1. Most migration in Africa is for employment and those most likely to migrate are working-age males. Because secondary schools are scarce in rural areas, urban dwellers generally have a higher education level. There are no significant differences between overall labor force participation rates for females. The nationwide participation rate was 38.9% for both males and females (males 43.8%, females 34.1%); in urban areas the total was 40.0% (males 46.3%, females 33.7%) and in rural areas 38.5% (males 42.7%, females 34.3%). Ghanaian women have traditionally occupied a prominent place in the labor force. The theory that urban migration is due to urban-rural income disparities is not confirmed by figures. Considering the high amount of unemployment in urban areas, a rural dweller can average as much as a city dweller. In fact, poorly educated migrants are the ones most affected by urban unemployment. A recent study by Kodwo Ewusi considered the impact of many variables on migration; he found depressed social conditions at the place of origin are more compelling motivations than economic factors

Population development in Ljubljana urban region

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Dejan Rebernik

2004-12-01

Full Text Available The paper presents the main characteristic of population development and urbanisation processes in Ljubljana and Ljubljana urban region. Up to the end of the seventies fast population growth was a consequence of strong immigration from rural parts of Slovenia and the rest of Yugoslavia. In the eighties and nineties deconcentration of population within the region with intense suburbanisation and depopulation of inner city and older residential neighbourhoods were the main urbanisation processes. In the second half of the nineties the highest population growth was recorded in dispersed rural settlements in the periphery of the region. In some parts of the inner city reurbanisation and gentrification occurred.

How safe is GP obstetrics? An assessment of antenatal risk factors and perinatal outcomes in one rural practice.

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Kirke, Andrew B

2010-01-01

complicated patients to specialist services either in Kalgoorlie or to Perth, there remained a significant number of women who developed antenatal risk factors. There was a high rate of induction of labour, which reflected the high rates of hypertension and diabetes, both relative indicators for induction at term. There was a reassuringly high rate of spontaneous vaginal delivery and low rates of elective and non-elective caesarian section. Post-partum clinically significant events still occurred for mother and baby, although not at rates higher than expected elsewhere. The results of this audit show that in a rural setting where options for referral may be less than in an urban setting, it is still possible to practice obstetrics safely. These results support the hypothesis that it is safe to practice GP obstetrics particularly in a rural setting. An unexpected result in this audit was the high rate of gestational diabetes, which is significantly greater than the average published for Western Australia. Further investigation of rates of gestational diabetes in other rural populations is warranted to explore this further.

Computer simulation of population dynamics inside the urban environment

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Andreev, A. S.; Inovenkov, I. N.; Echkina, E. Yu.; Nefedov, V. V.; Ponomarenko, L. S.; Tikhomirov, V. V.

2017-12-01

In this paper using a mathematical model of the so-called “space-dynamic” approach we investigate the problem of development and temporal dynamics of different urban population groups. For simplicity we consider an interaction of only two population groups inside a single urban area with axial symmetry. This problem can be described qualitatively by a system of two non-stationary nonlinear differential equations of the diffusion type with boundary conditions of the third type. The results of numerical simulations show that with a suitable choice of the diffusion coefficients and interaction functions between different population groups we can receive different scenarios of population dynamics: from complete displacement of one population group by another (originally more “aggressive”) to the “peaceful” situation of co-existence of them together.

Population Density and AIDS-Related Stigma in Large-Urban, Small-Urban, and Rural Communities of the Southeastern USA.

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Kalichman, Seth; Katner, Harold; Banas, Ellen; Kalichman, Moira

2017-07-01

AIDS stigmas delay HIV diagnosis, interfere with health care, and contribute to mental health problems among people living with HIV. While there are few studies of the geographical distribution of AIDS stigma, research suggests that AIDS stigmas are differentially experienced in rural and urban areas. We conducted computerized interviews with 696 men and women living with HIV in 113 different zip code areas that were classified as large-urban, small-urban, and rural areas in a southeast US state with high-HIV prevalence. Analyses conducted at the individual level (N = 696) accounting for clustering at the zip code level showed that internalized AIDS-related stigma (e.g., the sense of being inferior to others because of HIV) was experienced with greater magnitude in less densely populated communities. Multilevel models indicated that after adjusting for potential confounding factors, rural communities reported greater internalized AIDS-related stigma compared to large-urban areas and that small-urban areas indicated greater experiences of enacted stigma (e.g., discrimination) than large-urban areas. The associations between anticipated AIDS-related stigma (e.g., expecting discrimination) and population density at the community-level were not significant. Results suggest that people living in rural and small-urban settings experience greater AIDS-related internalized and enacted stigma than their counterparts living in large-urban centers. Research is needed to determine whether low-density population areas contribute to or are sought out by people who experienced greater AIDS-related stigma. Regardless of causal directions, interventions are needed to address AIDS-related stigma, especially among people in sparsely populated areas with limited resources.

Dynamics of urban population growth in Nigeria: The role of repeated migration.

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Adepoju, A

1976-02-01

The paper examines the direct contribution of migration to the growth of the urban population both in terms of its mobility and stability components with special reference to Western Nigeria. The basis of the paper is a survey of urban migration conducted by the author in 1971-1972; the findings are supplemented where necessary by the 1952-1953 and 1963 census figures. Migration is a major factor in the growth of the urban population. The direct contribution by migrants to such growth can be traced to the following groups: the initial streams of migrants, the follow-up migrants and the potentially mobile migrants attracted from the migrants' communities of origin to the towns. Repeated migration by some migrants, particularly the young, the educated and the white collar-workers, are also major factors in the urban population growth. Such repeated migrations are predominantly urban to urban or turnover moves. The high mobility rate among a group of migrants tends to conceal the relative stability among the migrant population as a whole. Repeated migrants usually stay between 3 and 5 years at each destination, before moving on. A substantial proportion of migrants, mainly farmers, the less educated and the old, are relatively stable in the survey towns (Ife and Oshogho). The urban residence ration indices also indicate an increase in the rate of immigration, mainly of young persons, to the towns. The youthful age structure, the age selectivity in migration and the marital status of the young migrants tend to exacerbate the masculinity in the form of unbalanced sex ratio prevailing in most urban centers. The urban population is unlikely to be stable. The tendency for old migrants of rural origin to return to their villages at the end of their migration career and for contemporary migrants to consist predominantly of youths, will for the next generation or 2 lead to a young and unstable urban population.

Urban habitat fragmentation and genetic population structure of bobcats in coastal southern California

Science.gov (United States)

Ruell, E.W.; Riley, S.P.D.; Douglas, M.R.; Antolin, M.F.; Pollinger, J.R.; Tracey, J.A.; Lyren, L.M.; Boydston, E.E.; Fisher, R.N.; Crooks, K.R.

2012-01-01

Although habitat fragmentation is recognized as a primary threat to biodiversity, the effects of urban development on genetic population structure vary among species and landscapes and are not yet well understood. Here we use non-invasive genetic sampling to compare the effects of fragmentation by major roads and urban development on levels of dispersal, genetic diversity, and relatedness between paired bobcat populations in replicate landscapes in coastal southern California. We hypothesized that bobcat populations in sites surrounded by urbanization would experience reduced functional connectivity relative to less isolated nearby populations. Our results show that bobcat genetic population structure is affected by roads and development but not always as predicted by the degree that these landscape features surround fragments. Instead, we suggest that urban development may affect functional connectivity between bobcat populations more by limiting the number and genetic diversity of source populations of migrants than by creating impermeable barriers to dispersal.

Shrinking population and the urban hierarchy

OpenAIRE

Kim, Ho Yeon

2012-01-01

This paper examines whether population shrinkage leads to changes in the urban hierarchy in terms of relative sizes of cities and their functions onomic geography. We work backwards in a racetrack economy with eight cities in a long-run equilibrium. Initial distribution of population is chosen to satisfy both the rank-size rule and central place hierarchy. We have a short-run equilibrium in which firms choose prices and consumers choose consumption taking the number of workers in each region ...

The impact of urbanization and population density on childhood Plasmodium falciparum parasite prevalence rates in Africa.

Science.gov (United States)

Kabaria, Caroline W; Gilbert, Marius; Noor, Abdisalan M; Snow, Robert W; Linard, Catherine

2017-01-26

Although malaria has been traditionally regarded as less of a problem in urban areas compared to neighbouring rural areas, the risk of malaria infection continues to exist in densely populated, urban areas of Africa. Despite the recognition that urbanization influences the epidemiology of malaria, there is little consensus on urbanization relevant for malaria parasite mapping. Previous studies examining the relationship between urbanization and malaria transmission have used products defining urbanization at global/continental scales developed in the early 2000s, that overestimate actual urban extents while the population estimates are over 15 years old and estimated at administrative unit level. This study sought to discriminate an urbanization definition that is most relevant for malaria parasite mapping using individual level malaria infection data obtained from nationally representative household-based surveys. Boosted regression tree (BRT) modelling was used to determine the effect of urbanization on malaria transmission and if this effect varied with urbanization definition. In addition, the most recent high resolution population distribution data was used to determine whether population density had significant effect on malaria parasite prevalence and if so, could population density replace urban classifications in modelling malaria transmission patterns. The risk of malaria infection was shown to decline from rural areas through peri-urban settlements to urban central areas. Population density was found to be an important predictor of malaria risk. The final boosted regression trees (BRT) model with urbanization and population density gave the best model fit (Tukey test p value <0.05) compared to the models with urbanization only. Given the challenges in uniformly classifying urban areas across different countries, population density provides a reliable metric to adjust for the patterns of malaria risk in densely populated urban areas. Future malaria risk

[Study on the first translated obstetrics book Tai chan ju yao (Essentials in Obstetrics)].

Science.gov (United States)

Wu, M

2018-01-28

In 1893, Wan Tsun-mo translated and published Tai chan ju yao ( Essentials in Obstetrics ), the first monograph of western obstetrics in modern China, symbolizing the independence of obstetrics from such maternal and child books as Fu ying xin shuo and Fu ke jing yun tu shuo , which occupies an important position in the history of the development of modern Chinese obstetrics. The book introduced anatomy, physiology, pathology, embryology, diagnostics, surgery, pharmacology and other knowledge of obstetrics in a catechismal form, and had a detailed discussion of such advanced obstetrical technologies as antiseptic, anesthesia, forceps and cesarean section for the first time.Judging from the content and translation of Tai chan ju yao , this book has already possessed the basic knowledge system of modern obstetrics, though the translation appeared to be somewhat jerky and not elegant and the terminology needing to be further improved, it was not only used as an important medium for the introduction of obstetrical knowledge, but also of great clinical value.However, its influence was so weak that later researchers seldom mentioned this book.

Population health and urban form : a review of the literature

International Nuclear Information System (INIS)

2004-11-01

A review examining the links between public health and living spaces was presented. The aim of the review was to explore whether different urban forms created communities that encouraged healthy living and resulted in a healthier population as well as to suggest avenues and approaches for further research of the subject in British Columbia. The historical links between public health and community planning were examined. A conceptual model of the linkages of urban form and population health was developed and used to identify ways in which urban form and population health are linked. Areas of concern include vehicle emissions, water quality and heat build-up as well as noise pollution. Issues concerning health inequalities related to income and access to health services were examined, as well as the role that urban form plays as a barrier to physical activity. Findings indicated that there is a strong correlation between urban form and health. Lower density urban forms that require a vehicle generated more miles travelled by car with more traffic crashes and higher risks to pedestrians and cyclists. A growing body of evidence has indicated that community contacts are scarcer in low density areas. In addition, low density dwellers seemed to have higher stress levels. Car dependent lifestyles had negative impacts on children's play, growth and development. Urban forms which promoted a range of housing options in terms of affordability, tenure and type allowed people to remain within their neighbourhoods. Disadvantaged groups fared better in denser areas where there were more public facilities. 62 refs. 1 tab., 2 figs

Low Elevation Coastal Zone (LECZ) Urban-Rural Population Estimates, Global Rural-Urban Mapping Project (GRUMP), Alpha Version

Data.gov (United States)

National Aeronautics and Space Administration — The Low Elevation Coastal Zone (LECZ) Urban-Rural Estimates consists of country-level estimates of urban, rural and total population and land area country-wide and...

An investigation of the role of China's urban population on coal consumption

International Nuclear Information System (INIS)

Michieka, Nyakundi M.; Fletcher, Jerald J.

2012-01-01

This paper investigates the causal relationship between urban population, real GDP, electricity production and coal consumption in China for the period 1971–2009. Using a vector autoregression framework and a modified version of the Granger (1969) causality test proposed by Toda and Yamamoto (J. Econ. 66 (1995) 225), the results suggest that there is causality running from GDP to coal consumption. The variance decomposition analysis report that urban population and coal affect electricity production variability over the forecast period. We also find that increasing urban population may negatively affect China's GDP over time. Policy measures aimed at influencing GDP could ultimately affect coal consumption. - Highlights: ► We find Granger Causality running from GDP to coal consumption. ► China can mitigate the adverse environmental effects of coal by altering GDP path. ► We find Granger Causality running from urbanization to electricity production. ► China needs to find other sources of energy to cater for growing electricity demand. ► Increasing urban population may slow economic growth due to overcrowding in cities.

Social Profile Of The Aged In An Urban Population

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J A Khan

1997-08-01

Full Text Available Research Problem: What is the socio-demographic profile of urban aged population in Aligarh city.Objectives: i To describe the socio-demographic profile of the aged population in an urban area, ii To describe the attitude of these people.Design:Cross-sectional study.Setting : Urban areas of Aligarh city.Participants : 3951 persons aged 60 years and aboveStudy Variables: Socio-demographic characteristics, attitudes.Statistical Analysis : By proportions.Result: 15% of the total estimated elderly population covering all 10 sectors of Aligarh city was studied. The majority ofthe elderly (72.4% belonged to 60-70 years age group. Most of them (77.2% were illiterate, 61.6% belonged to lower socio-economic classes (IV & V, 78.1 % lived in joint families. 39.6% of the aged felt that they were not being given due respect by family members. Nearly half of them had an indifferent or unhappy attitude towards life.Conclusion: The socio-demographic characteristics of the aged are important and must be kept in mind for developing programs to assist them in living as respectful senior citizens.

Fine-Scale Population Estimation by 3D Reconstruction of Urban Residential Buildings

Science.gov (United States)

Wang, Shixin; Tian, Ye; Zhou, Yi; Liu, Wenliang; Lin, Chenxi

2016-01-01

Fine-scale population estimation is essential in emergency response and epidemiological applications as well as urban planning and management. However, representing populations in heterogeneous urban regions with a finer resolution is a challenge. This study aims to obtain fine-scale population distribution based on 3D reconstruction of urban residential buildings with morphological operations using optical high-resolution (HR) images from the Chinese No. 3 Resources Satellite (ZY-3). Specifically, the research area was first divided into three categories when dasymetric mapping was taken into consideration. The results demonstrate that the morphological building index (MBI) yielded better results than built-up presence index (PanTex) in building detection, and the morphological shadow index (MSI) outperformed color invariant indices (CIIT) in shadow extraction and height retrieval. Building extraction and height retrieval were then combined to reconstruct 3D models and to estimate population. Final results show that this approach is effective in fine-scale population estimation, with a mean relative error of 16.46% and an overall Relative Total Absolute Error (RATE) of 0.158. This study gives significant insights into fine-scale population estimation in complicated urban landscapes, when detailed 3D information of buildings is unavailable. PMID:27775670

Microgeographic differentiation in thermal performance curves between rural and urban populations of an aquatic insect.

Science.gov (United States)

Tüzün, Nedim; Op de Beeck, Lin; Brans, Kristien I; Janssens, Lizanne; Stoks, Robby

2017-12-01

The rapidly increasing rate of urbanization has a major impact on the ecology and evolution of species. While increased temperatures are a key aspect of urbanization ("urban heat islands"), we have very limited knowledge whether this generates differentiation in thermal responses between rural and urban populations. In a common garden experiment, we compared the thermal performance curves (TPCs) for growth rate and mortality in larvae of the damselfly Coenagrion puella from three urban and three rural populations. TPCs for growth rate shifted vertically, consistent with the faster-slower theoretical model whereby the cold-adapted rural larvae grew faster than the warm-adapted urban larvae across temperatures. In line with costs of rapid growth, rural larvae showed lower survival than urban larvae across temperatures. The relatively lower temperatures hence expected shorter growing seasons in rural populations compared to the populations in the urban heat islands likely impose stronger time constraints to reach a certain developmental stage before winter, thereby selecting for faster growth rates. In addition, higher predation rates at higher temperature may have contributed to the growth rate differences between urban and rural ponds. A faster-slower differentiation in TPCs may be a widespread pattern along the urbanization gradient. The observed microgeographic differentiation in TPCs supports the view that urbanization may drive life-history evolution. Moreover, because of the urban heat island effect, urban environments have the potential to aid in developing predictions on the impact of climate change on rural populations.

The population conundrums and some implications for urban development in Serbia

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Petrić Jasna

2012-01-01

Full Text Available Population development may reveal either a potential or constraint on functional labour markets and spatial development of the territory in concern. The first results of the 2011 Census in Serbia depict a rather bleak demographic situation, which is only the continuation of population trends from the late 20th and beginning of the 21st century, substantially fuelled by dynamic political and socioeconomic processes featuring Serbia in the past few decades. The focus is on demographic changes in relation to three correlated aspects: 1 intensive ageing process; 2 depopulation and negative natural growth; and 3 migratory movements - population exodus. This paper addresses in particular the spatial consequences and institutional aspects of recent demographic changes and their reflection on urban areas in Serbia. In the past, population movements from rural to urban areas used to colour much of the migratory balance map of the country, however this situation changed due to exhaustion of the ‘traditional’ demographic reservoirs. Still, urban primacy of the capital city Belgrade has been even intensified with the recent demographic movements, or more precisely, a tissue of the two largest cities in relative proximity - Belgrade and Novi Sad is hypertrophied in a demographic sense. Other urban settlements in Serbia, especially the smaller towns, which are numerous but demographically shrinking, have not been empowered enough to substantiate better links with smaller and larger settlements within urban-rural interface, and their role has been challenged in that respect. Demographic changes, which affect urban growth or decline, are largely to do with border effects, economic and social gaps, educational opportunities, and search of certain ‘urban lifestyles’. The latter is particularly stressed regarding the process of ‘second demographic transition’ which encompassed Serbia and is manifested by changes in the family domain, viz. partnership

Predicting Intra-Urban Population Densities in Africa using SAR and Optical Remote Sensing Data

Science.gov (United States)

Linard, C.; Steele, J.; Forget, Y.; Lopez, J.; Shimoni, M.

2017-12-01

The population of Africa is predicted to double over the next 40 years, driving profound social, environmental and epidemiological changes within rapidly growing cities. Estimations of within-city variations in population density must be improved in order to take urban heterogeneities into account and better help urban research and decision making, especially for vulnerability and health assessments. Satellite remote sensing offers an effective solution for mapping settlements and monitoring urbanization at different spatial and temporal scales. In Africa, the urban landscape is covered by slums and small houses, where the heterogeneity is high and where the man-made materials are natural. Innovative methods that combine optical and SAR data are therefore necessary for improving settlement mapping and population density predictions. An automatic method was developed to estimate built-up densities using recent and archived optical and SAR data and a multi-temporal database of built-up densities was produced for 48 African cities. Geo-statistical methods were then used to study the relationships between census-derived population densities and satellite-derived built-up attributes. Best predictors were combined in a Random Forest framework in order to predict intra-urban variations in population density in any large African city. Models show significant improvement of our spatial understanding of urbanization and urban population distribution in Africa in comparison to the state of the art.

Intimate Partner Violence among General and Urban Poor Populations in Kathmandu, Nepal

Science.gov (United States)

Oshiro, Azusa; Poudyal, Amod K.; Poudel, Krishna C.; Jimba, Masamine; Hokama, Tomiko

2011-01-01

Comparative studies are lacking on intimate partner violence (IPV) between urban poor and general populations. The objective of this study is to identify the prevalence and risk factors of physical IPV among the general and poor populations in urban Nepal. A cross-sectional study was conducted by structured questionnaire interview. Participants…

Training in Emergency Obstetrics: A Needs Assessment of U.S. Emergency Medicine Program Directors

Directory of Open Access Journals (Sweden)

Daniel W. Robinson

2017-12-01

Full Text Available Introduction Obstetrical emergencies are a high-risk yet infrequent occurrence in the emergency department. While U.S. emergency medicine (EM residency graduates are required to perform 10 low-risk normal spontaneous vaginal deliveries, little is known about how residencies prepare residents to manage obstetrical emergencies. We sought to profile the current obstetrical training curricula through a survey of U.S. training programs. Methods We sent a web-based survey covering the four most common obstetrical emergencies (pre-eclampsia/eclampsia, postpartum hemorrhage (PPH, shoulder dystocia, and breech presentation through email invitations to all program directors (PD of U.S. EM residency programs. The survey focused on curricular details as well as the comfort level of the PDs in the preparation of their graduating residents to treat obstetrical emergencies and normal vaginal deliveries. Results Our survey had a 55% return rate (n=105/191. Of the residencies responding, 75% were in the academic setting, 20.2% community, 65% urban, and 29.8% suburban, and the obstetrical curricula were 2–4 weeks long occurring in post-graduate year one. The most common teaching method was didactics (84.1–98.1%, followed by oral cases for pre-eclampsia (48% and PPH (37.2%, and homemade simulation for shoulder dystocia (37.5% and breech delivery (33.3%. The PDs’ comfort about residency graduate skills was highest for normal spontaneous vaginal delivery, pre-eclampsia, and PPH. PDs were not as comfortable about their graduates’ skill in handling shoulder dystocia or breech delivery. Conclusion Our survey found that PDs are less comfortable in their graduates’ ability to perform non-routine emergency obstetrical procedures.

Fine-Scale Population Estimation by 3D Reconstruction of Urban Residential Buildings

Directory of Open Access Journals (Sweden)

Shixin Wang

2016-10-01

Full Text Available Fine-scale population estimation is essential in emergency response and epidemiological applications as well as urban planning and management. However, representing populations in heterogeneous urban regions with a finer resolution is a challenge. This study aims to obtain fine-scale population distribution based on 3D reconstruction of urban residential buildings with morphological operations using optical high-resolution (HR images from the Chinese No. 3 Resources Satellite (ZY-3. Specifically, the research area was first divided into three categories when dasymetric mapping was taken into consideration. The results demonstrate that the morphological building index (MBI yielded better results than built-up presence index (PanTex in building detection, and the morphological shadow index (MSI outperformed color invariant indices (CIIT in shadow extraction and height retrieval. Building extraction and height retrieval were then combined to reconstruct 3D models and to estimate population. Final results show that this approach is effective in fine-scale population estimation, with a mean relative error of 16.46% and an overall Relative Total Absolute Error (RATE of 0.158. This study gives significant insights into fine-scale population estimation in complicated urban landscapes, when detailed 3D information of buildings is unavailable.

Dynamic assessments of population exposure to urban greenspace using multi-source big data.

Science.gov (United States)

Song, Yimeng; Huang, Bo; Cai, Jixuan; Chen, Bin

2018-09-01

A growing body of evidence has proven that urban greenspace is beneficial to improve people's physical and mental health. However, knowledge of population exposure to urban greenspace across different spatiotemporal scales remains unclear. Moreover, the majority of existing environmental assessments are unable to quantify how residents enjoy their ambient greenspace during their daily life. To deal with this challenge, we proposed a dynamic method to assess urban greenspace exposure with the integration of mobile-phone locating-request (MPL) data and high-spatial-resolution remote sensing images. This method was further applied to 30 major cities in China by assessing cities' dynamic greenspace exposure levels based on residents' surrounding areas with different buffer scales (0.5km, 1km, and 1.5km). Results showed that regarding residents' 0.5-km surrounding environment, Wenzhou and Hangzhou were found to be with the greenest exposure experience, whereas Zhengzhou and Tangshan were the least ones. The obvious diurnal and daily variations of population exposure to their surrounding greenspace were also identified to be highly correlated with the distribution pattern of urban greenspace and the dynamics of human mobility. Compared with two common measurements of urban greenspace (green coverage rate and green area per capita), the developed method integrated the dynamics of population distribution and geographic locations of urban greenspace into the exposure assessment, thereby presenting a more reasonable way to assess population exposure to urban greenspace. Additionally, this dynamic framework could hold potential utilities in supporting urban planning studies and environmental health studies and advancing our understanding of the magnitude of population exposure to greenspace at different spatiotemporal scales. Copyright © 2018 Elsevier B.V. All rights reserved.

Modification of Heat-Related Mortality in an Elderly Urban Population by Vegetation (Urban Green) and Proximity to Water (Urban Blue): Evidence from Lisbon, Portugal.

Science.gov (United States)

Burkart, Katrin; Meier, Fred; Schneider, Alexandra; Breitner, Susanne; Canário, Paulo; Alcoforado, Maria João; Scherer, Dieter; Endlicher, Wilfried

2016-07-01

Urban populations are highly vulnerable to the adverse effects of heat, with heat-related mortality showing intra-urban variations that are likely due to differences in urban characteristics and socioeconomic status. We investigated the influence of urban green and urban blue, that is, urban vegetation and water bodies, on heat-related excess mortality in the elderly > 65 years old in Lisbon, Portugal, between 1998 and 2008. We used remotely sensed data and geographic information to determine the amount of urban vegetation and the distance to bodies of water (the Atlantic Ocean and the Tagus Estuary). Poisson generalized additive models were fitted, allowing for the interaction between equivalent temperature [universal thermal climate index (UTCI)] and quartiles of urban greenness [classified using the Normalized Difference Vegetation Index (NDVI)] and proximity to water (≤ 4 km vs. > 4 km), while adjusting for potential confounders. The association between mortality and a 1°C increase in UTCI above the 99th percentile (24.8°C) was stronger for areas in the lowest NDVI quartile (14.7% higher; 95% CI: 1.9, 17.5%) than for areas in the highest quartile (3.0%; 95% CI: 2.0, 4.0%). In areas > 4 km from water, a 1°C increase in UTCI above the 99th percentile was associated with a 7.1% increase in mortality (95% CI: 6.2, 8.1%), whereas in areas ≤ 4 km from water, the estimated increase in mortality was only 2.1% (95% CI: 1.2, 3.0%). Urban green and blue appeared to have a mitigating effect on heat-related mortality in the elderly population in Lisbon. Increasing the amount of vegetation may be a good strategy to counteract the adverse effects of heat in urban areas. Our findings also suggest potential benefits of urban blue that may be present several kilometers from a body of water. Burkart K, Meier F, Schneider A, Breitner S, Canário P, Alcoforado MJ, Scherer D, Endlicher W. 2016. Modification of heat-related mortality in an elderly urban population by

The effects of ageing and urbanisation on China's future rural and urban populations

NARCIS (Netherlands)

Chen, Quanrun; Dietzenbacher, Erik; Los, Bart

2017-01-01

This paper estimates China's future population and labour force by developing a novel forecasting model for population. It combines information about age-specific parameters on fertility and mortality for both rural and urban areas using information about rural-urban migration and the transformation

Low Elevation Coastal Zone (LECZ) Urban-Rural Population and Land Area Estimates, Version 2

Data.gov (United States)

National Aeronautics and Space Administration — The Low Elevation Coastal Zone (LECZ) Urban-Rural Population and Land Area Estimates, Version 2 data set consists of country-level estimates of urban population,...

More than 500 million Chinese urban residents (14% of the global urban population) are imperiled by fine particulate hazard.

Science.gov (United States)

He, Chunyang; Han, Lijian; Zhang, Robin Q

2016-11-01

China's urbanization and the subsequent public vulnerability to degenerated environment is important to global public health. Among the environmental problems, fine particulate (PM 2.5 ) pollution has become a serious hazard in rapidly urbanizing China. However, quantitative information remains inadequate. We thus collected PM 2.5 concentrations and population census records, to illustrate the spatial patterns and changes in the PM 2.5 hazard levels in China, and to quantify public vulnerability to the hazard during 2000-2010, following the air quality standards of World Health Organization. We found that 28% (2.72 million km 2 ) of China's territory, including 78% of cities (154 cities) with a population of >1 million, was exposed to PM 2.5 hazard in 2010; a 15% increase (1.47 million km 2 ) from 2000 to 2010. The hazards potentially impacted the health of 72% of the total population (942 million) in 2010, including 70% of the young (206 million) and 76% of the old (71 million). This was a significant increase from the 42% of total the population (279 million) exposed in 2000. Of the total urban residents, 76% (501 million) were affected in 2010. Along with PM 2.5 concentration increase, massive number of rural to urban migration also contributed greatly to China's urban public health vulnerability. Copyright © 2016 Elsevier Ltd. All rights reserved.

Myocardial infarction in Québec rural and urban populations between 1995 and 1997.

Science.gov (United States)

Loslier, Julie; Vanasse, Alain; Niyonsenga, Théophile; Courteau, Josiane; Orzanco, Gabriela; Hemiari, Abbas

2007-01-01

There is abundant evidence of health inequities between urban and rural populations. The purpose of this paper is to describe the socioeconomic characteristics of Québec urban and rural populations and the relation between rurality and incidence of myocardial infarction (MI), care management and outcomes. Socioeconomic data by census subdivisions were available from the 1996 Canadian census, representing 7,137,245 individuals. Data on patients with MI were taken from the provincial administrative health database (MED-ECHO), which is managed by the Ministry of Health and contains clinical and demographic information collected when patients are released from acute care hospitals in Québec. We included a total of 37,678 cases compiled over the 3 years of follow-up in the analyses. Residents of rural areas with low urban influence have higher MI incidence rates than all of the other populations in the study. In comparison with urban populations, their observed rural counterparts are at a disadvantage with regard to education, employment and income. Although angioplasty and coronary artery bypass graft surgery rates were higher in more urban areas, the survival rate was lower than in rural areas. This study revealed geographic heterogeneity of MI incidence, revascularization rates and survival rates among urban and rural populations.

Comparison of patterns of substance abuse disorders in urban and rural population

Directory of Open Access Journals (Sweden)

Morad Rasouli-Azad

2011-03-01

Full Text Available Background: Studies of the prevalence of substance abuse in rural and urban population in different countries revealed variable results regarding to the study method, study population, age group and measuring tools. The purpose of this research is to compare the patterns of substance abuse disorders in urban and rural population in Mashhad.Materials and Method: Two groups consecutively admitted patients who referred to substance treatment clinics of Mashhad, were selected (110 urban and 100 rural patients. Samples were evaluated with structured demographic questionnaire and Structured Clinical Interview (SCID for DSM-IV. Data were analyzed by χ2 and independent t-test.Results: This study showed statistically significant differences between two groups in marital status, education level, monthly income and job. Also the samples were differed in substance type, history of injection and quit, abuse of nicotine, cannabis and alcohol in long life. Conclusion: Rural and urban societies have differences in patterns of substance abuse that can be originated from social-context differences

The relationship between quality of work life and location of cross-training among obstetric nurses in urban northeastern Ontario, Canada: A population-based cross sectional study.

Science.gov (United States)

Nowrouzi, Behdin; Lightfoot, Nancy; Carter, Lorraine; Larivière, Michel; Rukholm, Ellen; Schinke, Robert; Belanger-Gardner, Diane

2015-01-01

The purpose of this mixed methods study was to examine the quality of work life of registered nurses working in obstetrics at 4 hospitals in northeastern Ontario and explore demographic and occupational factors related to nurses' quality of work life (QWL). A stratified random sample of registered nurses (N = 111) selected from the 138 eligible registered nurses (80.4%) of staff in the labor, delivery, recovery, and postpartum areas at the 4 hospitals participated. Logistic regression analyses were used to consider QWL in relation to the following: 1) demographic factors, and 2) stress, employment status and educational attainment. In the logistic regression model, the odds of a higher quality of work life for nurses who were cross trained (nurses who can work across all areas of obstetrical care) were estimated to be 3.82 (odds ratio = 3.82, 95% confidence interval: 1.01-14.5) times the odds of a higher quality of work life for nurses who were not cross trained. This study highlights a relationship between quality of work life and associated factors including location of cross-training among obstetrical nurses in northeastern Ontario. These findings are supported by the qualitative interviews that examine in depth their relationship to QWL. Given the limited number of employment opportunities in the rural and remote regions, it is paramount that employers and employees work closely together in creating positive environments that promote nurses' QWL. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

The role of population density on the impact of urbaniza-tion on GHG emissions in China

Science.gov (United States)

Liu, Yonghong; Gao, Chaochao; Lu, Yingying

2017-04-01

Urbanization directly drives rural to urban population migration and indirectly causes west to east migration in China, two phenomena that may significantly impact China's greenhouse gas emissions given its huge population and vast difference between the western rural and eastern urban areas. These two phenomena were analyzed by using emissions as a per capita term, and extending the impact from the traditional urbanization rate effect to include population density effect. The results show that population density has actually been the dominant demographic player in changing per capita emissions for the past two decades in China, and its elasticity changed from positive in economically less-developed provinces to negative for the developed provinces. This study provides a new perspective in the study of the relationship between urbanization and greenhouse gas emissions, and the results indicate that population density change should be taken into account to accurately assess the impact of urbanization.

Population genetics of the olive-winged bulbul (Pycnonotus plumosus) in a tropical urban-fragmented landscape.

Science.gov (United States)

Tang, Grace S Y; Sadanandan, Keren R; Rheindt, Frank E

2016-01-01

With increasing urbanization, urban-fragmented landscapes are becoming more and more prevalent worldwide. Such fragmentation may lead to small, isolated populations that face great threats from genetic factors that affect even avian species with high dispersal propensities. Yet few studies have investigated the population genetics of species living within urban-fragmented landscapes in the Old World tropics, in spite of the high levels of deforestation and fragmentation within this region. We investigated the evolutionary history and population genetics of the olive-winged bulbul (Pycnonotus plumosus) in Singapore, a highly urbanized island which retains landscape.

Obstetric airway management

African Journals Online (AJOL)

of stomach contents into the lungs during obstetric anesthesia.8 ... Both of the mortalities occurred secondary to solid ... The large number of deaths ... subcategories of patients as a first-line airway device, and are increasingly being ... outline the problems with obstetric airway management, and then focus on a few of the ...

[Urban and rural population of the state of Sao Paulo: results of the census of 1980].

Science.gov (United States)

Saad, P M

1981-01-01

The accelerated urban growth of Sao Paulo between 1940-70 has continued during the period 1970-80, according to the 1980 censes. During 1970-80 the urban population increased 55.47%, while the rural population decreased 18.67%, bringing the percentage of the urban population to 88.6% of the total population of the state. This phenomenon has been common to all the 11 administrative regions of the state. The highest percentage of the urban population in 1980 was in the region of Greater Sao Paulo, followed by Litoral and Vale do Paraiba. The largest increases in urban population were in the regions of Sorocaba, Campinas, and Vale do Paraiba, while the highest decreases in rural population were in the regions of Sao Jose do Rio Preto, Aracatuba, Presidente Prudente, and Marilia. The document presents detailed data for each of the 11 administrative regions of the state, and for each municipality within a region.

The obstetric performance of United Kingdom asylum seekers from Somalia: a case-control study and literature review.

Science.gov (United States)

Yoong, W; Kolhe, S; Karoshi, Mahantesh; Ullah, M; Nauta, M

2005-01-01

Little published research exists regarding obstetric performance of immigrant women in the United Kingdom. The aim of this study was to evaluate the obstetric performance and fetal outcomes of Somalian women who received prenatal care and requested to deliver at a teaching hospital in North London. This is a case-control study in which consecutive Somalian women were identified as index cases and the subsequent British-born Caucasian women listed in the delivery book served as controls. 69 index and 69 control cases were analyzed. Fifty-five percent of the Somalian women spoke little or no English. Half (50%) had undergone circumcision, the majority being type I WHO classification of female genital circumcision, which did not require significant surgical intervention prior to labor; 13% had cesarean sections, 13% instrumental vaginal deliveries, and 74% had vaginal deliveries. The Somalian women had higher parity (2.35 vs. 1.18) and were more likely to be grand multiparous (9/69 vs. 1/69) compared to controls. Epidural use was less frequent in Somalian women, but otherwise there were no significant differences between the two groups with regard to maternal age, rates of induction of labor, cesarean sections, duration of labor, premature deliveries, instrumental deliveries, and birth weights. The demographic characteristics of the Somalian female population appear to exert minimal effect on obstetric and fetal outcomes. This may be due to the increased vigilance exercised by health professionals as well as to the fact that recent arrivals are from more urban and westernized areas in Somalia.

Analysis of Urban Growth in Edwardsville Illinois Using Remote Sensing and Population Change

Science.gov (United States)

Onuoha, Hilda U.

Rapid urbanization is one of the many critical, global issues. This very significant social and economic phenomenon has brought about much debate in the past twenty years and has become a very important policy issue. Understanding its dynamics and patterns is important to develop appropriate policies and make more informed planning decisions. Many dimensions to the urban land growth have been identified in related literature including drivers, relationship with other factors like population, impacts, and methods of measurement. In this study, urban growth in the Edwardsville area (composed of Edwardsville and Glen Carbon, Illinois) is analyzed spatio-temporally using remote sensing and population change from 1990 to 2015. The objectives of this study are (a) identifying the major land use changes in the Edwardsville area from 1990 to 2015, (b) analyzing the rate of urban growth and its relationship to population change in the area from 1990 to 2015, (c) identifying the general pattern and direction of urban growth in the study area. Using multi-temporal satellite images to classify and derive changes in land cover classes during the study period, results showed that the land cover classes with major changes are the urban/built-up land and agricultural/grassland, with a steady increase in the former and steady decrease in the later. Results also show the highest rate of increase in urban land was between 2000 and 2010. In comparison to population, the both show increase over the study years but urban land shows a higher rate of increase indicating dispersion. To analyze urban growth pattern in the area, the study area was divided into three zones: NE, SE, and W. The SE zone showed the highest amount of the growth and from the results, the infill type of growth was inferred.

Constructing an Urban Population Model for Medical Insurance Scheme Using Microsimulation Techniques

Directory of Open Access Journals (Sweden)

Linping Xiong

2012-01-01

Full Text Available China launched a pilot project of medical insurance reform in 79 cities in 2007 to cover urban nonworking residents. An urban population model was created in this paper for China’s medical insurance scheme using microsimulation model techniques. The model made it clear for the policy makers the population distributions of different groups of people, the potential urban residents entering the medical insurance scheme. The income trends of units of individuals and families were also obtained. These factors are essential in making the challenging policy decisions when considering to balance the long-term financial sustainability of the medical insurance scheme.

The influence of travel time on emergency obstetric care seeking behavior in the urban poor of Bangladesh: a GIS study.

Science.gov (United States)

Panciera, Rocco; Khan, Akib; Rizvi, Syed Jafar Raza; Ahmed, Shakil; Ahmed, Tanvir; Islam, Rubana; Adams, Alayne M

2016-08-22

Availability of Emergency Obstetric Care (EmOC) is crucial to avert maternal death due to life-threatening complications potentially arising during delivery. Research on the determinants of utilization of EmOC has neglected urban settings, where traffic congestion can pose a significant barrier to the access of EmOC facilities, particularly for the urban poor due to costly and limited transportation options. This study investigates the impact of travel time to EmOC facilities on the utilization of facility-based delivery services among mothers living in urban poor settlements in Sylhet, Bangladesh. A cross-sectional EmOC health-seeking behavior survey from 39 poor urban clusters was geo-spatially linked to a comprehensive geo-referenced dataset of EmOC facility locations. Geo-spatial techniques and logistic regression were then applied to quantify the impact of travel time on place of delivery (EmOC facility or home), while controlling for confounding socio-cultural and economic factors. Increasing travel time to the nearest EmOC facility is found to act as a strong deterrent to seeking care for the urban poor in Sylhet. Logistic regression results indicate that a 5-min increase in travel time to the nearest EmOC facility is associated with a 30 % decrease (0.655 odds ratio, 95 % CI: 0.529-0.811) in the likelihood of delivery at an EmOC facility rather than at home. Moreover, the impact of travel time varies substantially between public, NGO and private facilities. A 5-min increase in travel time from a private EmOC facility is associated with a 32.9 % decrease in the likelihood of delivering at a private facility, while for public and Non-Government Organizations (NGO) EmOC facilities, the impact is lower (28.2 and 28.6 % decrease respectively). Other strong determinants of delivery at an EmOC facility are the use of antenatal care and mother's formal education, while Muslim mothers are found to be more likely to deliver at home. Geospatial evidence points to

Personality Traits and Behavioral Syndromes in Differently Urbanized Populations of House Sparrows (Passer domesticus)

Science.gov (United States)

Bókony, Veronika; Kulcsár, Anna; Tóth, Zoltán; Liker, András

2012-01-01

Urbanization creates novel environments for wild animals where selection pressures may differ drastically from those in natural habitats. Adaptation to urban life involves changes in various traits, including behavior. Behavioral traits often vary consistently among individuals, and these so-called personality traits can be correlated with each other, forming behavioral syndromes. Despite their adaptive significance and potential to act as constraints, little is known about the role of animal personality and behavioral syndromes in animals' adaptation to urban habitats. In this study we tested whether differently urbanized habitats select for different personalities and behavioral syndromes by altering the population mean, inter-individual variability, and correlations of personality traits. We captured house sparrows (Passer domesticus) from four different populations along the gradient of urbanization and assessed their behavior in standardized test situations. We found individual consistency in neophobia, risk taking, and activity, constituting three personality axes. On the one hand, urbanization did not consistently affect the mean and variance of these traits, although there were significant differences between some of the populations in food neophobia and risk taking (both in means and variances). On the other hand, both urban and rural birds exhibited a behavioral syndrome including object neophobia, risk taking and activity, whereas food neophobia was part of the syndrome only in rural birds. These results indicate that there are population differences in certain aspects of personality in house sparrows, some of which may be related to habitat urbanization. Our findings suggest that urbanization and/or other population-level habitat differences may not only influence the expression of personality traits but also alter their inter-individual variability and the relationships among them, changing the structure of behavioral syndromes. PMID:22574204

Maternal infibulation and obstetrical outcome in Djibouti.

Science.gov (United States)

Minsart, Anne-Frederique; N'guyen, Thai-Son; Ali Hadji, Rachid; Caillet, Martin

2015-01-01

The objective of the present study was to assess the relation between female genital mutilation and obstetric outcome in an East African urban clinic with a standardized care, taking into account medical and socioeconomic status. This was a cohort study conducted in Djibouti between October 1, 2012 and April 30, 2014. Overall 643 mothers were interviewed and clinically assessed for the presence of female genital mutilation. The prevalence of obstetric complications by infibulation status was included in a multivariate stepwise regression model. Overall, 29 of 643 women did not have any form of mutilation (4.5%), as opposed to 238 of 643 women with infibulation (37.0%), 369 with type 2 (57.4%), and 7 with type 1 mutilation (1.1%).Women with a severe type of mutilation were more likely to have socio-economic and medical risk factors. After adjustment, the only outcome that was significantly related with infibulation was the presence of meconium-stained amniotic fluid with an odds ratio of 1.58 (1.10-2.27), p value=0.014. Infibulation was not related with excess perinatal morbidity in this setting with a very high prevalence of female genital mutilation, but future research should concentrate on the relation between infibulation and meconium.

Opinions regarding neonatal resuscitation training for the obstetric physician: a survey of neonatal and obstetric training program directors.

Science.gov (United States)

Bruno, C J; Johnston, L; Lee, C; Bernstein, P S; Goffman, D

2018-04-01

Our goal was to garner opinions regarding neonatal resuscitation training for obstetric physicians. We sought to evaluate obstacles to neonatal resuscitation training for obstetric physicians and possible solutions for implementation challenges. We distributed a national survey via email to all neonatal-perinatal medicine fellowship directors and obstetrics & gynecology residency program directors in the United States. This survey was designed by a consensus method. Ninety-eight (53%) obstetric and fifty-seven (51%) neonatal program directors responded to our surveys. Eighty-eight percent of neonatologists surveyed believe that obstetricians should be neonatal resuscitation program (NRP) certified. The majority of surveyed obstetricians (>89%) believe that obstetricians should have some neonatal resuscitation training. Eighty-six percent of obstetric residents have completed training in NRP, but only 19% of obstetric attendings are NRP certified. Major barriers to NRP training that were identified include time, lack of national requirement, lack of belief it is helpful, and cost. Most obstetric attendings are not NRP certified, but the majority of respondents believe that obstetric providers should have some neonatal resuscitation training. Our study demonstrates that most respondents support a modified neonatal resuscitation course for obstetric physicians.

Urbanization is Associated with Increased Trends in Cardiovascular Mortality Among Indigenous Populations: the PAI Study

Directory of Open Access Journals (Sweden)

Anderson da Costa Armstrong

2018-02-01

Full Text Available Abstract Background: The cardiovascular risk burden among diverse indigenous populations is not totally known and may be influenced by lifestyle changes related to the urbanization process. Objectives: To investigate the cardiovascular (CV mortality profile of indigenous populations during a rapid urbanization process largely influenced by governmental infrastructure interventions in Northeast Brazil. Methods: We assessed the mortality of indigenous populations (≥ 30 y/o from 2007 to 2011 in Northeast Brazil (Bahia and Pernambuco states. Cardiovascular mortality was considered if the cause of death was in the ICD-10 CV disease group or if registered as sudden death. The indigenous populations were then divided into two groups according to the degree of urbanization based on anthropological criteria:9,10 Group 1 - less urbanized tribes (Funi-ô, Pankararu, Kiriri, and Pankararé; and Group 2 - more urbanized tribes (Tuxá, Truká, and Tumbalalá. Mortality rates of highly urbanized cities (Petrolina and Juazeiro in the proximity of indigenous areas were also evaluated. The analysis explored trends in the percentage of CV mortality for each studied population. Statistical significance was established for p value < 0.05. Results: There were 1,333 indigenous deaths in tribes of Bahia and Pernambuco (2007-2011: 281 in Group 1 (1.8% of the 2012 group population and 73 in Group 2 (3.7% of the 2012 group population, CV mortality of 24% and 37%, respectively (p = 0.02. In 2007-2009, there were 133 deaths in Group 1 and 44 in Group 2, CV mortality of 23% and 34%, respectively. In 2009-2010, there were 148 deaths in Group 1 and 29 in Group 2, CV mortality of 25% and 41%, respectively. Conclusions: Urbanization appears to influence increases in CV mortality of indigenous peoples living in traditional tribes. Lifestyle and environmental changes due to urbanization added to suboptimal health care may increase CV risk in this population.

Suicide risk in relation to level of urbanicity - a population-based linkage study

DEFF Research Database (Denmark)

Qin, Ping

2005-01-01

BACKGROUND: The extent to which the high suicide rate in urban areas is influenced by exposures to risk factors for suicide other than urbanicity remains unknown. This population-based study aims to investigate suicide risk in relation to the level of urbanicity in the context of other factors...

Obstetrical and perinatal outcomes in patients with or without obstetric analgesia during labor

Directory of Open Access Journals (Sweden)

Piedrahíta-Gutiérrez, Dany Leandro

2016-07-01

Full Text Available Objective: To describe and compare the obstetric and perinatal outcomes in patients with or without obstetric analgesia during labor, and to determine whether such analgesia is associated with adverse maternal or perinatal outcomes. Methodology: Comparative, retrospective, descriptive study, between January and November 2014, that included 502 healthy patients with normal pregnancies, out of which 250 received obstetric analgesia. The groups were compared as to maternal and perinatal outcomes. Results: Young, single and nulliparous mothers predominated; delivery was vaginal in 86 % of the cases, and by caesarean section in 14 %. Obstetric analgesia was associated with longer duration of the second stage of labor, instrumental delivery and cesarean section due to arrest of dilatation or fetal bradycardia; however, it was not related with higher incidence of postpartum hemorrhage or adverse perinatal outcomes such as meconium-stained amniotic fluid, Apgar under 5 at one minute or under 7 at 5 minutes, the need for neonatal resuscitation or for admission to NICU. Conclusion: Obstetric analgesia increases the duration of the second stage of labor and can increase the rate of caesarean sections and instrumental delivery, but it is not associated with adverse maternal or perinatal outcomes. Therefore, its use in labor is justified.

An optimum city size? The scaling relationship for urban population and fine particulate (PM_2_._5) concentration

International Nuclear Information System (INIS)

Han, Lijian; Zhou, Weiqi; Pickett, Steward T.A.; Li, Weifeng; Li, Li

2016-01-01

We utilize the distribution of PM_2_._5 concentration and population in large cities at the global scale to illustrate the relationship between urbanization and urban air quality. We found: 1) The relationship varies greatly among continents and countries. Large cities in North America, Europe, and Latin America have better air quality than those in other continents, while those in China and India have the worst air quality. 2) The relationships between urban population size and PM_2_._5 concentration in large cities of different continents or countries were different. PM_2_._5 concentration in large cities in North America, Europe, and Latin America showed little fluctuation or a small increasing trend, but those in Africa and India represent a “U” type relationship and in China represent an inverse “U” type relationship. 3) The potential contribution of population to PM_2_._5 concentration was higher in the large cities in China and India, but lower in other large cities. - Highlights: • Urban population and PM_2_._5 concentration varies greatly among regions. • Urban population size increase does not always enhances PM_2_._5 concentration. • Population's potential contribution to PM_2_._5 concentration higher in China. - We utilize the distribution of PM_2_._5 concentration and population in large cities at the global scale to illustrate the relationship between urbanization and urban air quality.

Cardiovascular Morbidity Profile Of Population Aged 60 Years And Above In Rural And Urban Areas Of Kanpur

Directory of Open Access Journals (Sweden)

Saurabh Goel

2009-06-01

Full Text Available Background: Cardiovascular morbidity is a major contributor towards old age health problems which requires specialized care and if left unattended can deteriorate the quality of life and also lead to mortality. Therefore a study was planned to find out the prevalence of cardiovascular morbidity among geriatric population living in rural and urban areas ofKanpur.Objective: To find out the prevalence of cardiovascular morbidity in geriatric population in rural and urban area of Kanpur and also to study the pattern of cardiovascular morbidity in two areas.Material and methods: a cross sectional study was carried out in a randomly selected rural and urban area of Kanpur. 443 geriatrics in rural and 401 in urban area were interviewed and physically examined.Results: Geriatrics constituted 8.2% and 7.7% of total population in rural and urban area respectively. Majority ofpopulation in both areas belonged to 60-70years age group i.e. 78.8% and 75.8% respectively. 12.2% of rural geriatric and 12.5% of urban geriatric were suffering from some or other kind of cardiovascular morbidity. In rural area 39.1%>of geriatric population is hypertensive while in urban area hypertension is prevalent in 41.6%> of geriatric population. 98. l%>of morbid in rural and 86.0% in urban area were not doing any kind of exercise. A majority of population suffering from cardiovascular morbidity were not smoking currently. Majority i.e. 72.2% of geriatric population suffering from cardiovascular morbidity in rural area were having BMJ between 18.5-24.99 while in urban area 57.4% of them were having BMl>-25. Hypertensives consitiuted 57.4% in rural and 66.0% in urban area towards those who are suffering from cardiovascular morbidity.

Cardiovascular Morbidity Profile Of Population Aged 60 Years And Above In Rural And Urban Areas Of Kanpur

Directory of Open Access Journals (Sweden)

Saurabh Goel

2009-06-01

Full Text Available Background: Cardiovascular morbidity is a major contributor towards old age health problems which requires specialized care and if left unattended can deteriorate the quality of life and also lead to mortality. Therefore a study was planned to find out the prevalence of cardiovascular morbidity among geriatric population living in rural and urban areas ofKanpur. Objective: To find out the prevalence of cardiovascular morbidity in geriatric population in rural and urban area of Kanpur and also to study the pattern of cardiovascular morbidity in two areas. Material and methods: a cross sectional study was carried out in a randomly selected rural and urban area of Kanpur. 443 geriatrics in rural and 401 in urban area were interviewed and physically examined. Results: Geriatrics constituted 8.2% and 7.7% of total population in rural and urban area respectively. Majority ofpopulation in both areas belonged to 60-70years age group i.e. 78.8% and 75.8% respectively. 12.2% of rural geriatric and 12.5% of urban geriatric were suffering from some or other kind of cardiovascular morbidity. In rural area 39.1%>of geriatric population is hypertensive while in urban area hypertension is prevalent in 41.6%> of geriatric population. 98. l%>of morbid in rural and 86.0% in urban area were not doing any kind of exercise. A majority of population suffering from cardiovascular morbidity were not smoking currently. Majority i.e. 72.2% of geriatric population suffering from cardiovascular morbidity in rural area were having BMJ between 18.5-24.99 while in urban area 57.4% of them were having BMl>-25. Hypertensives consitiuted 57.4% in rural and 66.0% in urban area towards those who are suffering from cardiovascular morbidity.

[Cities and oil. Historical and prospective aspects of the urban population of Venezuela].

Science.gov (United States)

Papail, J; Picquet, M

1989-01-01

The authors present a historical overview of urbanization in Venezuela. The impact of the oil economy on population change and spatial distribution is emphasized. A typology of cities based on socioeconomic function and on a demographic classification of urban centers is devised. Future trends in urbanization are also considered. (SUMMARY IN ENG)

Urban and rural population growth in a spatial panel of municipalities

NARCIS (Netherlands)

Costa da Silva, Diego Firmino; Elhorst, J. Paul; Silveira Neto, Raul da Mota

2017-01-01

Urban and rural population growth in a spatial panel of municipalities. Regional Studies. Using Bayesian posterior model probabilities and data pertaining to 3659 Brazilian minimum comparable areas (MCAs) over the period 1970-2010, two theoretical settings of population growth dynamics resulting in

Hepatitis C in haemorrhagic obstetrical emergencies

International Nuclear Information System (INIS)

Khaskheli, M.; Baloch, S.

2014-01-01

Objective: To determine the maternal health and fetal outcome in hepatitis C with obstetrical haemorrhagic emergencies. Study Design: An observational study. Place and Duration of Study: Department of Obstetrics and Gynaecology Unit-I, Liaquat University of Medical and Health Sciences Hospital, Hyderabad, Sindh, from January 2009 to December 2010. Methodology: All the women admitted during the study period with different obstetrical haemorrhagic emergencies were included. On virology screening, hepatitis C screening was done on all. The women with non-haemorrhagic obstetrical emergencies were excluded. Studied variables included demographic characteristics, the nature of obstetrical emergency, haemorrhagic conditions and maternal and fetal morbidity and mortality. The data was analyzed on SPSS version 20. Results: More frequent obstetrical haemorrhagic emergencies were observed with hepatitis C positive in comparison with hepatitis C negative cases including post-partum haemorrhage in 292 (80.88%) and ante-partum haemorrhage in 69 (19.11%) cases. Associated morbidities seen were disseminated intravascular coagulation in 43 (11.91%) and shock in 29 (8.03%) cases with hepatitis C positive. Fetal still birth rate was 37 (10.24%) in hepatitis C positive cases. Conclusion: Frequency of maternal morbidity and mortality and perinatal mortality was high in obstetrical haemorrhagic emergencies with hepatitis C positive cases. (author)

Patient satisfaction with community pharmacy: comparing urban and suburban chain-pharmacy populations.

Science.gov (United States)

Malewski, David F; Ream, Aimrie; Gaither, Caroline A

2015-01-01

Patient satisfaction with pharmaceutical care can be a strong predictor of medication and other health-related outcomes. Less understood is the role that location of pharmacies in urban or suburban environments plays in patient satisfaction with pharmacy and pharmacist services. The purpose of this study was to serve as a pilot examining urban and suburban community pharmacy populations for similarities and differences in patient satisfaction. Community pharmacy patients were asked to self-administer a 30-question patient satisfaction survey. Fifteen questions addressed their relationship with the pharmacist, 10 questions addressed satisfaction and accessibility of the pharmacy, and five questions addressed financial concerns. Five urban and five suburban pharmacies agreed to participate. Data analysis included descriptive statistics and chi-square analysis. Most patients reported high levels of satisfaction. Satisfaction with pharmacist relationship and service was 70% or higher with no significant differences between locations. There were significant differences between the urban and suburban patients regarding accessibility of pharmacy services, customer service and some patient/pharmacist trust issues. The significant differences between patient satisfaction in the suburban and urban populations warrant a larger study with more community pharmacies in other urban, suburban and rural locations to better understand and validate study findings. Copyright © 2015 Elsevier Inc. All rights reserved.

Simulation-based team training for multi-professional obstetric care teams to improve patient outcome : a multicentre, cluster randomised controlled trial

NARCIS (Netherlands)

Fransen, A F; van de Ven, J; Schuit, E; van Tetering, Aac; Mol, B W; Oei, S G

OBJECTIVE: To investigate whether simulation-based obstetric team training in a simulation centre improves patient outcome. DESIGN: Multicentre, open, cluster randomised controlled trial. SETTING: Obstetric units in the Netherlands. POPULATION: Women with a singleton pregnancy beyond 24 weeks of

Strategies to reduce exclusion among populations living in urban slum settlements in Bangladesh.

Science.gov (United States)

Rashid, Sabina Faiz

2009-08-01

The health and rights of populations living in informal or slum settlements are key development issues of the twenty-first century. As of 2007, the majority of the world's population lives in urban areas. More than one billion of these people, or one in three city-dwellers, live in inadequate housing with no or a few basic resources. In Bangladesh, urban slum settlements tend to be located in low-lying, flood-prone, poorly-drained areas, having limited formal garbage disposal and minimal access to safe water and sanitation. These areas are severely crowded, with 4-5 people living in houses of just over 100 sq feet. These conditions of high density of population and poor sanitation exacerbate the spread of diseases. People living in these areas experience social, economic and political exclusion, which bars them from society's basic resources. This paper overviews policies and actions that impact the level of exclusion of people living in urban slum settlements in Bangladesh, with a focus on improving the health and rights of the urban poor. Despite some strategies adopted to ensure better access to water and health, overall, the country does not have a comprehensive policy for urban slum residents, and the situation remains bleak.

Strategies to Reduce Exclusion among Populations Living in Urban Slum Settlements in Bangladesh

Science.gov (United States)

2009-01-01

The health and rights of populations living in informal or slum settlements are key development issues of the twenty-first century. As of 2007, the majority of the world's population lives in urban areas. More than one billion of these people, or one in three city-dwellers, live in inadequate housing with no or a few basic resources. In Bangladesh, urban slum settlements tend to be located in low-lying, flood-prone, poorly-drained areas, having limited formal garbage disposal and minimal access to safe water and sanitation. These areas are severely crowded, with 4–5 people living in houses of just over 100 sq feet. These conditions of high density of population and poor sanitation exacerbate the spread of diseases. People living in these areas experience social, economic and political exclusion, which bars them from society's basic resources. This paper overviews policies and actions that impact the level of exclusion of people living in urban slum settlements in Bangladesh, with a focus on improving the health and rights of the urban poor. Despite some strategies adopted to ensure better access to water and health, overall, the country does not have a comprehensive policy for urban slum residents, and the situation remains bleak. PMID:19761090

Obstetric and vascular APS: same autoantibodies but different diseases?

Science.gov (United States)

Meroni, P L; Raschi, E; Grossi, C; Pregnolato, F; Trespidi, L; Acaia, B; Borghi, M O

2012-06-01

Beta2 glycoprotein I (β2GPI)-dependent antiphospholipid antibodies (aPLs) are the main pathogenic autoantibody population and at the same time the laboratory diagnostic tool for the antiphospholipid syndrome (APS). These antibodies are responsible for both the vascular and the obstetric manifestations of the syndrome but the pathogenic mechanisms behind these manifestations are not the same. For example, thrombotic events do not appear to play a major role in APS miscarriages and a direct reactivity of β2GPI-dependent aPLs on decidual and trophoblast cells was reported. A local expression of β2GPI on these tissues was reported both in physiological conditions and in APS women, thus explaining the local tropism of the autoantibodies. The two hit hypothesis was suggested to explain why the vascular manifestations of APS may occur only occasionally in spite of the persistent presence of aPLs. This is not apparently the case for the obstetric variant of the syndrome, making the difference even more striking. A different pathogenesis may also provide the rationale for the well-known fact that the vascular and the obstetric manifestations may occur independently although in a minority of cases.

[Urban and population development of the city of Puebla and its metropolitan area].

Science.gov (United States)

Barbosa Prieto, A

1991-12-01

Metropolitanization has been considered an important problem of regional development in developing countries. Attitudes toward the metropolis have been ambivalent in Latin America. On the 1 hand the metropolis is viewed as an obstacle to development that absorbs resources from the zone of influence and incurs high social costs of urbanization, but on the hand it is also viewed as a form of achieving levels of economic efficiency comparable to those of developed countries. Metropolitan areas should not be viewed as isolated, but rather as important points of demographic and manpower attraction, poles of economic growth and technological and cultural innovation. "Urban areas" and "metropolitan zones" are distinct ways of defining and delimiting urban phenomena. Although there is no consensus as to the exact definitions of these 2 urban units, it is generally accepted that the urban area is the city itself as well as the contiguous built up area reaching in all directions to the onset of nonurban land uses such as forests territorial extension that includes the politico-administrative units with urban characteristics such as work places and residences for nonagricultural workers, and that maintain constant and intense socioeconomic interrelations with the central city. The process of urban planning in the metropolitan zone of Puebla, Mexico, began in institutional form in 1980 with master plans for the population centers of Puebla, Amozoc, San Andres and San Pedro Cholula, and Zacatelco in the state of Tlaxcala. In 1987., an attempt was made by the governments of the states of Puebla and Tlaxcala to develop a plan for the metropolitan zone as a single unit. Population growth was greater within the city of Puebla than in the metropolitan zone from 1960-80, but after 1980 growth in the outlying areas exceeded that in the center city. The population density of the city of Puebla declined from 160/hectare in 1950 to 76/hectare in 1990, the result of progressive dispersion

“Population Invasion” versus Urban Exclusion in the Tibetan Areas of Western China

OpenAIRE

Fischer, Andrew Martín

2008-01-01

textabstractThis article examines the confluence of local population transitions (demographic transition and urbanization) with non-local in-migration in the Tibetan areas of western China. The objective is to assess the validity of Tibetan perceptions of "population invasion" by Han Chinese and Chinese Muslims. The article argues that migration to Tibet from other regions in China has been concentrated in urban areas and has been counterbalanced by more rapid rates of natural increase in the...

Obstetric and gynecologic imaging

International Nuclear Information System (INIS)

Wicks, J.D.

1987-01-01

Obstetric and gynecologic imaging has undergone marked changes in the past 10 years, primarily because of the influence of new imaging modalities. The single modality that has most significantly changed the diagnostic approach to obstetric and gynecologic problems is diagnostic ultrasound. The remarkable ability of this technique to display the anatomy of the gravid and nongravid female pelvis without the use of ionizing radiation motivated the development of techniques and instrumentation that have supplanted but not totally replaced many x-ray based examinations. The use of diagnostic ultrasound for the evaluation of obstetric and gynecologic problems is the dominant theme of this chapter. Areas of patient diagnosis and management in which additional imaging techniques, x-rays, or magnetic resonance are used are presented where appropriate

Obstetrical ultrasound

International Nuclear Information System (INIS)

Bundy, A.L.

1988-01-01

The use of diagnostic ultrasound in obstetrics may provide fuel for legal action. While most legal implications of this relatively new imaging modality are purely speculative, some have already given rise to legal action. Several situations will likely provide a basis for the courts to find against the physician. The failure to perform a sonogram when clinically indicated will most likely be the strongest plaintiff argument. Other major concerns include the use and availability of state-of-the-art equipment, as well as interpretation of the scans by a trained physician. Obstetrical ultrasound is usually performed by a radiologist or obstetrician. However, many physicians performing these examinations have had little or no formal training in the field. While this is now being remedied by the respective board examines who require a certain amount of training, it may not be enough. When ultrasound-related cases reach the courts, the involved physicians will most likely be regarded as experts in the field and, therefore, will be held to a very high standard of care. This would be difficult to achieve without formal training. At the present time, the American Board of Radiology requires more training time in ultrasound than the American Board of Obstetrics and Gynecology

Population, behavioural and physiological responses of an urban population of black swans to an intense annual noise event.

Science.gov (United States)

Payne, Catherine J; Jessop, Tim S; Guay, Patrick-Jean; Johnstone, Michele; Feore, Megan; Mulder, Raoul A

2012-01-01

Wild animals in urban environments are exposed to a broad range of human activities that have the potential to disturb their life history and behaviour. Wildlife responses to disturbance can range from emigration to modified behaviour, or elevated stress, but these responses are rarely evaluated in concert. We simultaneously examined population, behavioural and hormonal responses of an urban population of black swans Cygnus atratus before, during and after an annual disturbance event involving large crowds and intense noise, the Australian Formula One Grand Prix. Black swan population numbers were lowest one week before the event and rose gradually over the course of the study, peaking after the event, suggesting that the disturbance does not trigger mass emigration. We also found no difference in the proportion of time spent on key behaviours such as locomotion, foraging, resting or self-maintenance over the course of the study. However, basal and capture stress-induced corticosterone levels showed significant variation, consistent with a modest physiological response. Basal plasma corticosterone levels were highest before the event and decreased over the course of the study. Capture-induced stress levels peaked during the Grand Prix and then also declined over the remainder of the study. Our results suggest that even intensely noisy and apparently disruptive events may have relatively low measurable short-term impact on population numbers, behaviour or physiology in urban populations with apparently high tolerance to anthropogenic disturbance. Nevertheless, the potential long-term impact of such disturbance on reproductive success, individual fitness and population health will need to be carefully evaluated.

Population, behavioural and physiological responses of an urban population of black swans to an intense annual noise event.

Directory of Open Access Journals (Sweden)

Catherine J Payne

Full Text Available Wild animals in urban environments are exposed to a broad range of human activities that have the potential to disturb their life history and behaviour. Wildlife responses to disturbance can range from emigration to modified behaviour, or elevated stress, but these responses are rarely evaluated in concert. We simultaneously examined population, behavioural and hormonal responses of an urban population of black swans Cygnus atratus before, during and after an annual disturbance event involving large crowds and intense noise, the Australian Formula One Grand Prix. Black swan population numbers were lowest one week before the event and rose gradually over the course of the study, peaking after the event, suggesting that the disturbance does not trigger mass emigration. We also found no difference in the proportion of time spent on key behaviours such as locomotion, foraging, resting or self-maintenance over the course of the study. However, basal and capture stress-induced corticosterone levels showed significant variation, consistent with a modest physiological response. Basal plasma corticosterone levels were highest before the event and decreased over the course of the study. Capture-induced stress levels peaked during the Grand Prix and then also declined over the remainder of the study. Our results suggest that even intensely noisy and apparently disruptive events may have relatively low measurable short-term impact on population numbers, behaviour or physiology in urban populations with apparently high tolerance to anthropogenic disturbance. Nevertheless, the potential long-term impact of such disturbance on reproductive success, individual fitness and population health will need to be carefully evaluated.

Urban Optimum Population Size and Development Pattern Based on Ecological Footprint Model: Case of Zhoushan, China

Directory of Open Access Journals (Sweden)

Yuan LU

2016-09-01

Full Text Available The agglomeration of population in the city can reflect the prosperity in the economy, society and culture. However, it has also brought a series of problems like environmental pollution, traffic congestion, housing shortage and jobs crisis. The results can be shown as the failure of urban comprehensive function, the decline of city benefits, and the contradiction between socioeconomic circumstance and ecosystem. Therefore, a reasonable population capacity, which is influenced by ecological resources, urban environment, geographical elements, social and economic factors, etc., is objectively needed. How to deal with the relationship between the utilization of natural capital and development of the city is extremely essential. This paper takes Zhoushan Island as an example, which is the fourth largest island off the coast of China. Firstly, the interactively influencing factors of urban optimal population are illustrated. And method is chosen to study the optimal population size. Secondly, based on the model of ecological footprint (EP, the paper calculates and analyzes the ecological footprint and ecological capacity of the Zhoushan Island, in order to explore the optimal population size of the city. Thirdly, analysis and evaluation of the resources and urban environment carrying capacity is made. Finally, the solution of the existing population problems and the suggestion for the future development pattern of the city are proposed in the urban eco-planning of Zhoushan Island. The main strategies can be summarized in two aspects: one is to reduce the ecological footprint, the other is to increase the ecological supply. The conclusion is that the current population of Zhoushan Island is far beyond the optimum population size calculated by the ecological footprint model. Therefore, sustainable development should be the guidance for urban planning in Zhoushan Island, and a low-carbon development pattern for the city is advocated.

Obstetric medicine: Interlinking obstetrics and internal medicine

African Journals Online (AJOL)

1 Mayo Clinic Hospitals, Division of Hospital Internal Medicine, Rochester, Minn, USA ... Obstetric physicians have a specific role in managing pregnant and postpartum women with ... problems may also affect pregnancy outcomes, with increased risk of ... greatly benefited from good control of her diabetes and hypertension.

Urban population genetics of slum-dwelling rats (Rattus norvegicus) in Salvador, Brazil

Science.gov (United States)

Kajdacsi, Brittney; Costa, Federico; Hyseni, Chaz; Porter, Fleur; Brown, Julia; Rodrigues, Gorete; Farias, Helena; Reis, Mitermeyer G.; Childs, James E.; Ko, Albert I.; Caccone, Adalgisa

2013-01-01

Throughout the developing world, urban centers with sprawling slum settlements are rapidly expanding and invading previously forested ecosystems. Slum communities are characterized by untended refuse, open sewers, and overgrown vegetation, which promote rodent infestation. Norway rats (Rattus norvegicus), are reservoirs for epidemic transmission of many zoonotic pathogens of public health importance. Understanding the population ecology of R. norvegicus is essential to formulate effective rodent control strategies, as this knowledge aids estimation of the temporal stability and spatial connectivity of populations. We screened for genetic variation, characterized the population genetic structure, and evaluated the extent and patterns of gene flow in the urban landscape using 17 microsatellite loci in 146 rats from 9 sites in the city of Salvador, Brazil. These sites were divided between three neighborhoods within the city spaced an average of 2.7 km apart. Surprisingly, we detected very little relatedness among animals trapped at the same site and found high levels of genetic diversity, as well as structuring across small geographic distances. Most FST comparisons among sites were statistically significant, including sites Salvador, linked to the heterogeneous urban landscape. Future rodent control measures need to take into account the spatial and temporal linkage of rat populations in Salvador, as revealed by genetic data, to develop informed eradication strategies. PMID:24118116

Prevalence of experienced abuse in healthcare and associated obstetric characteristics in six European countries

DEFF Research Database (Denmark)

Lukasse, Mirjam; Schroll, Anne-Mette; Karro, Helle

2015-01-01

OBJECTIVES: To assess the prevalence and current suffering of experienced abuse in healthcare, to present the socio-demographic background for women with a history of abuse in healthcare and to assess the association between abuse in healthcare and selected obstetric characteristics. DESIGN: Cross......-sectional study. SETTING: Routine antenatal care in six European countries. POPULATION: In total 6923 pregnant women. METHODS: Cross-tabulation and Pearson's chi-square was used to study prevalence and characteristics for women reporting abuse in healthcare. Associations with selected obstetric factors were...

21 CFR 884.5100 - Obstetric anesthesia set.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Obstetric anesthesia set. 884.5100 Section 884... § 884.5100 Obstetric anesthesia set. (a) Identification. An obstetric anesthesia set is an assembly of... anesthetic drug. This device is used to administer regional blocks (e.g., paracervical, uterosacral, and...

Suicide risk in relation to level of urbanicity - a population-based linkage study

DEFF Research Database (Denmark)

Qin, Ping

2005-01-01

from various Danish longitudinal registers. Data were analysed with conditional logistic regression. RESULTS: This study confirms that people living in more urbanized areas are at a higher risk of suicide than their counterparts in less urbanized areas. However, this excess risk is largely eliminated...... when adjusted for personal marital, income, and ethnic differences; it is even reversed when further adjusted for psychiatric status. Moreover, the impact of urbanicity on suicide risk differs significantly by sex and across age. Urban living reduces suicide risk significantly among men, especially......BACKGROUND: The extent to which the high suicide rate in urban areas is influenced by exposures to risk factors for suicide other than urbanicity remains unknown. This population-based study aims to investigate suicide risk in relation to the level of urbanicity in the context of other factors...

Urban and rural populations and labour-force structures: current patterns and their implications.

Science.gov (United States)

Marcoux, A

1990-01-01

The discussion of the changing structure in urban and rural areas due to changing migration patterns reflects the effect on crop designation and production, the connection to development and fertility issues, and the labor force structure. Different patterns of migration by sex occur between Ethiopia where female rural-to-urban migration is the dominant trend and Indonesia where males moving to urban areas occurs. When countries are identified as primarily male urban and female rural, the migration pattern is male rural-to-urban and is concentrated in African countries, whereas the reverse with female urban and male rural occurs in Latin America and developed countries. The tendency of the age structure in developed and developing countries is for the concentration of the 20 -49 year olds in urban areas and the under 20 and over 49 in rural areas. It is determined that those under 20 have 3 times greater importance in developing rather than developed countries. While in Tunisia and the Near East the over-age-49 rural population has increased, in Cameroon, Myanmar, and Bangladesh, the rural under-age-30 population has increased suggesting different migration patterns; however, there is insufficient computerized data for analysis of regional world trends. The migration pattern of child bearing age women affects the aging rural population in either of two ways. 1) Women stay and bear children and help with farm production while male migrate, thus increasing the youth and over 50 populations. 2) Whole families move with only the aging remaining. The determinants of migration are complex. When there is inequality in land distribution, the most mobile population are those without land or with very small holdings. If agricultural workers are dependent on a landlord, then migration is decreased. Technology and mechanization which have predominated in the last decades can both displace labor in rural areas when situated next to farms and increase labor when multiple

Prediction of peripartum hysterectomy and end organ dysfunction in major obstetric haemorrhage.

LENUS (Irish Health Repository)

O'Brien, D

2010-12-01

The aims of this study are to determine the incidence and aetiology of major obstetric haemorrhage (MOH) in our population, to examine the success rates of medical and surgical interventions and to identify risk factors for peripartum hysterectomy and end organ dysfunction (EOD).

Managing Recurring Obstetric Cholestasis With Metformin.

Science.gov (United States)

Elfituri, Abdullatif; Ali, Amanda; Shehata, Hassan

2016-12-01

Obstetric cholestasis is a pregnancy-related disorder associated with an adverse pregnancy outcome. It is characterized by generalized pruritus, elevated bile acids, and abnormal liver enzymes. Recent publications show that obstetric cholestasis is associated with, and likely to potentiate, the risk of developing gestational diabetes mellitus. This case describes an unusual pattern of the disease, in which obstetric cholestasis occurred in five consecutive pregnancies with a different course of the disease in the fifth pregnancy. A patient with recurrent cholestasis of pregnancy had worsening disease in her first four pregnancies. In her fifth pregnancy, treatment for gestational diabetes mellitus with metformin was associated with a lowering effect on bile acids and liver enzymes, indicating a possible role for metformin in the management of obstetric cholestasis.

Living with infertility : Experiences among urban slum populations in Bangladesh

NARCIS (Netherlands)

Papreen, N; Sabin, K; Begum, L; Ahsan, SK; Baqui, AH

This paper explores the perceived causes of infertility, treatment-seeking for infertility and the consequences of childlessness, particularly for women, among a predominantly Muslim population in urban slums of Dhaka in Bangladesh. In-depth interviews were conducted with 60 women and GO men

Tropical Journal of Obstetrics and Gynaecology

African Journals Online (AJOL)

reviewed journal. The Journal is Official Publication of Society of Gynaecology and Obstetrics of Nigeria. The journal publishes articles on the subject it provides a forum for the publication of original articles Obstetrics, Gynaecology, ...

Population pressure and health risks in urban market environment: a ...

African Journals Online (AJOL)

Population pressure and health risks in urban market environment: a study of Bodija market, Ibadan, Nigeria. ... International Journal of Development and Management Review ... This study was directed at permanent sellers in Bodija Market, (men and women) and people who frequent the market to make purchases.

[Obesity, body morphology, and blood pressure in urban and rural population groups of Yucatan].

Science.gov (United States)

Arroyo, Pedro; Fernández, Victoria; Loría, Alvar; Pardío, Jeannette; Laviada, Hugo; Vargas-Ancona, Lizardo; Ward, Ryk

2007-01-01

To characterize body morphology and blood pressure of adults of the Mexican state of Yucatan. Rural-urban differences in weight, height, waist, and hip circumferences, and blood pressure were analyzed in 313 urban and 271 rural subjects. No rural-urban differences in prevalence of obesity and overweight were found. Hypertension was marginally higher in urban subjects. Rural abnormal waist circumference was higher in young men and young women. Comparison with two national surveys and a survey in the aboriginal population (rural mixtecos) showed similar prevalence of obesity as ENSA-2000 and higher than mixtecos and ENEC-1993. Abnormal waist circumference was intermediate between ENSANUT-2006 and mixtecos and hypertension was intermediate between ENEC and mixtecos. The Maya and mestizo population of Yucatan showed a high prevalence of obesity and abnormal waist circumference not accompanied by a comparable higher hypertension frequency. This finding requires further confirmation.

Association study of obstetrical complication and depressive disorder

Institute of Scientific and Technical Information of China (English)

无

2007-01-01

Objective:To investigate the correlation between obstetrical complications and depressive disorder.Methods:Depressive disorder probands and their adult sibling were diagnosed using CCMD-3 criteria.Obstetrical data from maternal reports were scored,applying published scales that take into account number and severity of complication.Results:The scores of obstetric complication and prenatal complications and low birth weight were significantly worse in probands than siblings without depressive disorders.Conclusion:Results suggest obstetric complications are etiologically significant in depressive disorder.

Placental biomarkers of PAH exposure and glutathione-S-transferase biotransformation enzymes in an obstetric population from Tijuana, Baja California, Mexico

Energy Technology Data Exchange (ETDEWEB)

Dodd-Butera, Teresa, E-mail: tdbutera@csusb.edu [California State University San Bernardino, Department of Nursing, 5500 University Parkway, San Bernardino, CA 92407 (United States); San Diego State University, Graduate School of Public Health, San Diego, CA (United States); Union Institute & University, Cincinnati, OH (United States); Quintana, Penelope J.E., E-mail: jquintan@mail.sdsu.edu [San Diego State University, Graduate School of Public Health, San Diego, CA (United States); Ramirez-Zetina, Martha, E-mail: martharz8@hotmail.com [Instituto Mexicano del Seguro Social Tijuana, BC (Mexico); Batista-Castro, Ana C., E-mail: anabatista101@hotmail.com [Instituto Mexicano del Seguro Social Tijuana, BC (Mexico); Hospital General de Tijuana, Tijuana (Mexico); Sierra, Maria M., E-mail: sierramer@gmail.com [San Diego State University, Graduate School of Public Health, San Diego, CA (United States); Shaputnic, Carolyn, E-mail: cshaputnic@ucsd.edu [San Diego State University, Graduate School of Public Health, San Diego, CA (United States); University of California, San Diego, Western FASD Practice and Implementation Center, Department of Pediatrics, Division of Dysmorphology-Teratology, San Diego, CA (United States); Garcia-Castillo, Maura, E-mail: mauragarcia@gmail.com [Xochicalco Universidad Escuela de Medicina, BC (Mexico); Institute for Public Health, San Diego State University, San Diego, CA (United States); Ingmanson, Sonja, E-mail: sonejah@yahoo.com [San Diego State University, Graduate School of Public Health, San Diego, CA (United States); Hull, Stacy, E-mail: hulst74@hotmail.com [San Diego State University, Graduate School of Public Health, San Diego, CA (United States)

2017-01-15

Environmental exposures along the US-Mexico border have the potential to adversely affect the maternal-fetal environment. The purpose of this study was to assess placental biomarkers of environmental exposures in an obstetric population at the California-Baja California border in relation to detoxifying enzymes in the placenta and nutritional status. This study was conducted on consenting, full-term, obstetric patients (n=54), delivering in a hospital in Tijuana, Baja California (BC), Mexico. Placental polyaromatic hydrocarbon (PAH)-DNA adducts were measured in addition to placental glutathione-S-transferase (GST) activity and genotype, maternal serum folate, and maternal and umbilical cord blood lead and cadmium levels. A questionnaire was administered to the mothers to determine maternal occupation in a maquiladora, other exposures, and obstetric indicators. In univariate analysis, maternal serum folate levels were inversely correlated with total PAH-DNA adducts (rho=−0.375, p=0.007); adduct #1 (rho=−0.388, p=0.005); and adduct #3 (rho =−0.430, p=0.002). Maternal lead levels were significantly positively correlated with cord blood lead levels (rho=0.512, p<0.001). Cadmium levels were generally very low but significantly higher in mothers exposed to environmental tobacco smoke (ETS) (either at work or at home, n=10). In multivariate analysis, only maternal serum folate levels remained as a significant negative predictor of total DNA-PAH adducts levels in placenta. These findings affirm that placental tissue is a valuable and readily available source of human tissue for biomonitoring; and indicate that further study of the role of nutrition in detoxification and mitigation of environmental exposures in pregnant women is warranted. - Highlights: • Maternal-fetal environment susceptible to toxic exposures at US-Mexico border. • Lower serum folate was correlated with higher PAH-DNA adduct levels at birth. • Placental DNA adducts in GST mu (-) cord blood

Placental biomarkers of PAH exposure and glutathione-S-transferase biotransformation enzymes in an obstetric population from Tijuana, Baja California, Mexico

International Nuclear Information System (INIS)

Dodd-Butera, Teresa; Quintana, Penelope J.E.; Ramirez-Zetina, Martha; Batista-Castro, Ana C.; Sierra, Maria M.; Shaputnic, Carolyn; Garcia-Castillo, Maura; Ingmanson, Sonja; Hull, Stacy

2017-01-01

Environmental exposures along the US-Mexico border have the potential to adversely affect the maternal-fetal environment. The purpose of this study was to assess placental biomarkers of environmental exposures in an obstetric population at the California-Baja California border in relation to detoxifying enzymes in the placenta and nutritional status. This study was conducted on consenting, full-term, obstetric patients (n=54), delivering in a hospital in Tijuana, Baja California (BC), Mexico. Placental polyaromatic hydrocarbon (PAH)-DNA adducts were measured in addition to placental glutathione-S-transferase (GST) activity and genotype, maternal serum folate, and maternal and umbilical cord blood lead and cadmium levels. A questionnaire was administered to the mothers to determine maternal occupation in a maquiladora, other exposures, and obstetric indicators. In univariate analysis, maternal serum folate levels were inversely correlated with total PAH-DNA adducts (rho=−0.375, p=0.007); adduct #1 (rho=−0.388, p=0.005); and adduct #3 (rho =−0.430, p=0.002). Maternal lead levels were significantly positively correlated with cord blood lead levels (rho=0.512, p<0.001). Cadmium levels were generally very low but significantly higher in mothers exposed to environmental tobacco smoke (ETS) (either at work or at home, n=10). In multivariate analysis, only maternal serum folate levels remained as a significant negative predictor of total DNA-PAH adducts levels in placenta. These findings affirm that placental tissue is a valuable and readily available source of human tissue for biomonitoring; and indicate that further study of the role of nutrition in detoxification and mitigation of environmental exposures in pregnant women is warranted. - Highlights: • Maternal-fetal environment susceptible to toxic exposures at US-Mexico border. • Lower serum folate was correlated with higher PAH-DNA adduct levels at birth. • Placental DNA adducts in GST mu (-) cord blood

The Urban-Rural Gradient In Asthma: A Population-Based Study in Northern Europe

Directory of Open Access Journals (Sweden)

Signe Timm

2015-12-01

Full Text Available The early life environment appears to have a persistent impact on asthma risk. We hypothesize that environmental factors related to rural life mediate lower asthma prevalence in rural populations, and aimed to investigate an urban-rural gradient, assessed by place of upbringing, for asthma. The population-based Respiratory Health In Northern Europe (RHINE study includes subjects from Denmark, Norway, Sweden, Iceland and Estonia born 1945–1973. The present analysis encompasses questionnaire data on 11,123 RHINE subjects. Six categories of place of upbringing were defined: farm with livestock, farm without livestock, village in rural area, small town, city suburb and inner city. The association of place of upbringing with asthma onset was analysed with Cox regression adjusted for relevant confounders. Subjects growing up on livestock farms had less asthma (8% than subjects growing up in inner cities (11% (hazard ratio 0.72 95% CI 0.57–0.91, and a significant urban-rural gradient was observed across six urbanisation levels (p = 0.02. An urban-rural gradient was only evident among women, smokers and for late-onset asthma. Analyses on wheeze and place of upbringing revealed similar results. In conclusion, this study suggests a protective effect of livestock farm upbringing on asthma development and an urban-rural gradient in a Northern European population.

‘Essential but not always available when needed’ – an interview study of physicians’ experiences and views regarding use of obstetric ultrasound in Tanzania

Directory of Open Access Journals (Sweden)

Annika Åhman

2016-07-01

Full Text Available Background: The value of obstetric ultrasound in high-income countries has been extensively explored but evidence is still lacking regarding the role of obstetric ultrasound in low-income countries. Objective: We aimed to explore experiences and views among physicians working in obstetric care in Tanzania, on the role of obstetric ultrasound in relation to clinical management. Design: A qualitative study design was applied. Data were collected in 2015, through 16 individual interviews with physicians practicing in obstetric care at hospitals in an urban setting in Tanzania. Data were analyzed using qualitative content analysis. Results: Use of obstetric ultrasound in the management of complicated pregnancy was much appreciated by participating physicians, although they expressed considerable concern about the lack of ultrasound equipment and staff able to conduct the examinations. These limitations were recognized as restricting physicians’ ability to manage complications adequately during pregnancy and birth. Better availability of ultrasound was requested to improve obstetric management. Concerns were also raised regarding pregnant women's lack of knowledge and understanding of medical issues which could make counseling in relation to obstetric ultrasound difficult. Although the physicians perceived a positive attitude toward ultrasound among most pregnant women, occasionally they came across women who feared that ultrasound might harm the fetus. Conclusions: There seems to be a need to provide more physicians in antenatal care in Tanzania with ultrasound training to enable them to conduct obstetric ultrasound examinations and interpret the results themselves. Physicians also need to acquire adequate counseling skills as counseling can be especially challenging in this setting where many expectant parents have low levels of education. Providers of obstetric care and policy makers in Tanzania will need to take measures to ensure appropriate

Pattern and determinants of obstetric complications among women ...

African Journals Online (AJOL)

The number of antenatal care visits also significantly predicted the likelihood of obstetric complications. Binomial logistic regression analysis predicted that the more the number of antenatal care visits the less likely the occurrence of obstetric complications, with 4 or more visits reducing obstetric complications 14 times.

Marginalization and health service coverage among indigenous, rural, and urban populations: a public health problem in Mexico.

Science.gov (United States)

Roldán, José; Álvarez, Marsela; Carrasco, María; Guarneros, Noé; Ledesma, José; Cuchillo-Hilario, Mario; Chávez, Adolfo

2017-12-01

  Marginalization is a significant issue in Mexico, involving a lack of access to health services with differential impacts on Indigenous, rural and urban populations. The objective of this study was to understand Mexico’s public health problem across three population areas, Indigenous, rural and urban, in relation to degree of marginalization and health service coverage.   The sampling universe of the study consisted of 107 458 geographic locations in the country. The study was retrospective, comparative and confirmatory. The study applied analysis of variance, parametric and non-parametric, correlation and correspondence analyses.   Significant differences were identified between the Indigenous, rural and urban populations with respect to their level of marginalization and access to health services. The most affected area was Indigenous, followed by rural areas. The sector that was least affected was urban.   Although health coverage is highly concentrated in urban areas in Mexico, shortages are mostly concentrated in rural areas where Indigenous groups represent the extreme end of marginalization and access to medical coverage. Inadequate access to health services in the Indigenous and rural populations throws the gravity of the public health problem into relief.

“Population Invasion” versus Urban Exclusion in the Tibetan Areas of Western China

NARCIS (Netherlands)

A.M. Fischer (Andrew Martín)

2008-01-01

textabstractThis article examines the confluence of local population transitions (demographic transition and urbanization) with non-local in-migration in the Tibetan areas of western China. The objective is to assess the validity of Tibetan perceptions of "population invasion" by Han Chinese and

Future Career Plans and Practice Patterns of Canadian Obstetrics and Gynaecology Residents in 2011.

Science.gov (United States)

Burrows, Jason; Coolen, Jillian

2016-01-01

The practice patterns of Obstetricians and Gynaecologists continue to evolve with each new generation of physicians. Diversifying subspecialties, changes in resident duty hours, job market saturation, and desire for work-life balance are playing stronger roles. Professional practice direction and needs assessment may be aided by awareness of future Obstetrics and Gynaecology physician career plans and expectations. The objective of this study was to determine the expected career plans and practice patterns of Canadian Obstetrics and Gynaecology residents following residency. The SOGC Junior Member Committee administered its third career planning survey to Canadian Obstetrics and Gynaecology residents electronically in December 2011. The data collected was statistically analyzed and compared to previous surveys. There were 183 responses giving a response rate of 43%. More than one half of all residents were considering postgraduate training (58%). Projected practice patterns included: 84% maintaining obstetrical practice, 60% locuming, and 50% job-sharing. The majority of residents expected to work in a 6 to 10 person call group (48%), work 3 to 5 call shifts per month (72%), work 41 to 60 hours weekly (69%), and practise in a city with a population greater than 500 000 (45%). Only 18% of residents surveyed were in favour of streaming residency programs in Obstetrics and Gynaecology. Canadian resident career plan and expected practice pattern assessment remains an important tool for aiding in resource allocation and strategic development of care and training in Obstetrics and Gynaecology in Canada. Copyright © 2016 Society of Obstetricians and Gynaecologists of Canada. Published by Elsevier Inc. All rights reserved.

Prevalence, predictors and perinatal outcomes of peri-conceptional alcohol exposure - retrospective cohort study in an urban obstetric population in Ireland

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Fahey Tom P

2011-04-01

Full Text Available Abstract Background Evidence-based advice on alcohol consumption is required for pregnant women and women planning a pregnancy. Our aim was to investigate the prevalence, predictors and perinatal outcomes associated with peri-conceptional alcohol consumption. Methods A cohort study of 61,241 women who booked for antenatal care and delivered in a large urban maternity hospital between 2000 and 2007. Self-reported alcohol consumption at the booking visit was categorised as low (0-5 units per week, moderate (6-20 units per week and high (>20 units per week. Results Of the 81% of women who reported alcohol consumption during the peri-conceptional period, 71% reported low intake, 9.9% moderate intake and 0.2% high intake. Factors associated with moderate alcohol consumption included being in employment OR 4.47 (95% CI 4.17 to 4.80, Irish nationality OR 16.5 (95% CI 14.9 to 18.3, private health care OR 5.83 (95% CI 5.38 to 6.31 and smoking OR 1.86 (95% CI 1.73 to 2.01. Factors associated with high consumption included maternal age less than 25 years OR 2.70 (95% CI 1.86 to 3.91 and illicit drug use OR 6.46 (95% CI 3.32 to 12.60. High consumption was associated with very preterm birth ( Conclusions Public Health campaigns need to emphasise the importance of peri-conceptional health and pre-pregnancy planning. Fetal Alcohol Syndrome is likely to be under-reported despite the high prevalence of alcohol consumption in this population.

Obstetric Anaesthetists' Association and Difficult Airway Society guidelines for the management of difficult and failed tracheal intubation in obstetrics*

OpenAIRE

Mushambi, M C; Kinsella, S M; Popat, M; Swales, H; Ramaswamy, K K; Winton, A L; Quinn, A C

2015-01-01

The Obstetric Anaesthetists' Association and Difficult Airway Society have developed the first national obstetric guidelines for the safe management of difficult and failed tracheal intubation during general anaesthesia. They comprise four algorithms and two tables. A master algorithm provides an overview. Algorithm 1 gives a framework on how to optimise a safe general anaesthetic technique in the obstetric patient, and emphasises: planning and multidisciplinary communication; how to prevent ...

Cardiovascular risk assessment between urban and rural population in Malaysia.

Science.gov (United States)

Noor Hassim, I; Norazman, M R; Diana, M; Khairul Hazdi, Y; Rosnah, I

2016-12-01

Cardiovascular disease (CVD) caused significant burden to Malaysia as it accounted for 36% of total deaths. This study aims to evaluate the burden of cardiovascular risk factors among Malaysian adult and assess the difference between urban and rural population in the selected communities. This study is part of the ongoing Prospective Urban Rural Epidemiology (PURE) database, whereby the baseline data were collected since June 2008. CVD risk was measured using INTERHEART risk score which comprised of eleven risk factors i.e. age and gender, family history of heart attack, smoking status, exposure to second hand smoke, diabetes mellitus, hypertension status, waist-hip ratio, self-reported stress, depression, dietary habits and physical activity status. Majority of the studied participants had low cardiovascular risk (57%). Participants from rural area were generally older, had lower educational status, higher prevalence of smokers, obesity, hypertension, diabetes, and more likely to be depressed. In comparison, urbanites had lower physical activities and more likely to be stressful. Mean INTERHEART score among rural participants were higher, especially for male, in comparison to urbanite (11.5±5.83 vs. 10.01±5.74, p<0.001). Contradict to common beliefs, participants in rural areas generally have higher cardiovascular risk factors compared to their urban counterparts. The rural population should be targeted for focused preventive interventions, taking account the socioeconomic and cultural context.

Some Important Observations on the Populations of Hooded Vultures Necrosyrtes monachus in Urban Ghana

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Francis Gbogbo

2016-01-01

Full Text Available Despite major declines in the population of vultures around the world, noticeable increases were reported in the populations of Hooded Vultures Necrosyrtes monachus over the past decade in Accra—an important vulture habitat in Ghana. In recent times, however, there is a growing concern that the vulture numbers are decreasing even though scientific data to support this is nonexisting. As a vital zoogeographical and conservation tool, it is important to keep an up-to-date knowledge about urban bird populations amidst rapid urbanization and associated changes. Using a combination of field data, literature review, and stakeholder consultations, it was indicative that severe decline might have indeed occurred in the populations of Hooded Vultures in Accra. Evidence suggests the killing of vultures for consumption, traditional medicine, and black magic in an undercover trade with possible transboundary connections as important underlying factor. Additional factors suspected to underlie the declines include changes in management of urban facilities and destruction of roosting and nesting trees. The implications of interspecific competition with Pied Crows Corvus albus on Hooded Vultures however remain unclear. There is an urgent need for conservation campaign and education to save the Hooded Vulture in Ghana.

Resistance of Mayan Women against Obstetric Violence

OpenAIRE

Gonzalez-Flores, Marina

2015-01-01

Mayan women are often victims of obstetric violence in the Yucatan Peninsula. Obstetric violence is defined as violence women experience by health officials or midwives during birth. This article will examine five different communities within the states of Yucatan, Campeche, and Quintana Roo in Mexico and compare and contrast activism efforts against obstetric violence among Mayan women. Mayan women are organizing to create unions for midwives, workshops on reproductive rights and health care...

Prevalence of psychiatric and physical morbidity in an urban geriatric population

OpenAIRE

Seby, K.; Chaudhury, Suprakash; Chakraborty, Rudraprosad

2011-01-01

Background: With a rapidly increasing population of older aged people, epidemiological data regarding the prevalence of mental and physical illnesses are urgently required for proper health planning. However, there is a scarcity of such data from India. Aims: To study the frequency and pattern of psychiatric morbidity present and the association of physical illness with psychiatric morbidity in an elderly urban population. Settings and Design: Cross-sectional, epidemiological study. Materials...

Inpatient Obstetric Care at Irwin Army Community Hospital: A Study to Determine the Most Efficient Organization

National Research Council Canada - National Science Library

Bergeron, Timothy

2001-01-01

This study attempts to compare, analyze, and recommend the most efficient model with which to deliver inpatient obstetrics and gynecological services to the served population of Irwin Army Community Hospital...

Influence of human population movements on urban climate of Beijing during the Chinese New Year holiday

Science.gov (United States)

Zhang, Jingyong; Wu, Lingyun

2017-03-01

The population movements for the Chinese New Year (CNY) celebrations, known as the world’s largest yearly migration of human beings, have grown rapidly in the past several decades. The massive population outflows from urban areas largely reduce anthropogenic heat release and modify some other processes, and may thus have noticeable impacts on urban climate of large cities in China. Here, we use Beijing as an example to present observational evidence for such impacts over the period of 1990-2014. Our results show a significant cooling trend of up to 0.55 °C per decade, particularly at the nighttime during the CNY holiday relative to the background period. The average nighttime cooling effect during 2005-2014 reaches 0.94 °C relative to the 1990s, significant at the 99% confidence level. The further analysis supports that the cooling during the CNY holiday is attributable primarily to the population outflow of Beijing. These findings illustrate the importance of population movements in influencing urban climate despite certain limitations. As the world is becoming more mobile and increasingly urban, more efforts are called for to understand the role of human mobility at various spatial and temporal scales.

Obstetric care in Brazil: An analysis of the situation

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Marcia de Freitas

2006-03-01

Full Text Available Objective: To evaluate the situation of obstetric care in Brazil. Methods:Analysis of data from the Ministry of Health: Information System onMortality; Information System on Live Births; Information System onAmbulatory Care of the Brazilian Unified Health System; InformationSystem on Hospital Care of the Brazilian Unified Health System. Otherssource of data: the Brazilian Institute of Geography and Statistics.Results: Maternal mortality rate was 50.83/100000 live births in Brazil.Prenatal care in the Northern and Northeastern regions of the countrypresented the lowest number of prenatal care appointments (27% ofpregnant women with less than 3 appointments. Premature labor wasthe main diagnosis for hospital admission before delivery. The numberof obstetric beds exceeds the population demand throughout the country.The main causes of maternal deaths were direct causes. Conclusions:Maternal mortality rate in Brazil is high and the main causes of deathsare preventable and related to medical and non-medical factors.

Price discrimination in obstetric services--a case study in Bangladesh.

Science.gov (United States)

Amin, Mohammad; Hanson, Kara; Mills, Anne

2004-06-01

This article examines the existence of price discrimination for obstetric services in two private hospitals in Bangladesh, and considers the welfare consequences of such discrimination, i.e. whether or not price discrimination benefited the poorer users. Data on 1212 normal and caesarean section patients discharged from the two hospitals were obtained. Obstetric services were chosen because they are relatively standardised and the patient population is relatively homogeneous, so minimising the scope and scale of product differentiation due to procedure and case-mix differences. The differences between the hospital list price for delivery and actual prices paid by patients were calculated to determine the average rate of discount. The welfare consequences of price discrimination were assessed by testing the differences in mean prices paid by patients from three income groups: low, middle and high. The results suggest that two different forms of price discrimination for obstetric services occurred in both these hospitals. First, there was price discrimination according to income, with the poorer users benefiting from a higher discount rate than richer ones; and second, there was price discrimination according to social status, with three high status occupational groups (doctors, senior government officials, and large businessmen) having the highest probability of receiving some level of discount. Copyright 2003 John Wiley & Sons, Ltd.

OBSTETRIC RENAL FAILURE

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Rajeshwari

2015-11-01

Full Text Available Renal failure in obstetrics is rare but important complication, associated with significant mortality and long term morbidity.1,2 It includes acute renal failure due to obstetrical complications or due to deterioration of existing renal disease. AIMS AND OBJECTIVES: To evaluate the etiology and outcome of renal failure in obstetric patients. METHODS: We prospectively analyzed 30 pregnant and puerperal women with acute renal failure or pre-existing renal disease developing renal failure during pregnancy between November 2007 to sep-2009. Patients who presented/developed ARF during the hospital stay were included in this study. RESULTS: Among 30 patients, mean age was 23 years and 33 years age group. 12 cases (40% patients were primigravidae and 9(30% patients were multigravidae and 9 cases (30% presented in post-partum period. Eighteen cases (60% with ARF were seen in third trimester, followed by in postpartum period 9 cases (30%. Most common contributing factors to ARF were Pre-eclampsia, eclampsia and HELLP syndrome 60%, sepsis 56.6%, post abortal ARF 10%. DIC 40%. Haemorrhage as the aetiology for ARF was present 46%, APH in 20% and PPH in 26.6%. The type of ARF was renal in (63% and prerenal (36%; Oliguric seen in 10 patients (33% and high mortality (30%. Among the 20 pregnant patients with ARF, The average period of gestation was 33±2 weeks (30 -36 weeks, 5 cases (25% presented with intrauterine fetal demise and 18 cases (66% had preterm vaginal delivery and 2 cases (10% had induced abortion. And the average birth weight was 2±0.5 kg (1.5 kg. Eight cases (26% required dialysis. 80% of patients recovered completely of renal functions. 63% patients recovered without renal replacement therapy whereas 17% required dialysis. the maternal mortality was 20%, the main reason for mortality was septic shock and multi organ dysfunction (66%. CONCLUSION: ARF related pregnancy was seen commonly in the primigravidae and in the third trimester, the most

Screening mammography uptake within Australia and Scotland in rural and urban populations.

Science.gov (United States)

Leung, Janni; Macleod, Catriona; McLaughlin, Deirdre; Woods, Laura M; Henderson, Robert; Watson, Angus; Kyle, Richard G; Hubbard, Gill; Mullen, Russell; Atherton, Iain

2015-01-01

To test the hypothesis that rural populations had lower uptake of screening mammography than urban populations in the Scottish and Australian setting. Scottish data are based upon information from the Scottish Breast Screening Programme Information System describing uptake among women residing within the NHS Highland Health Board area who were invited to attend for screening during the 2008 to 2010 round (N = 27,416). Australian data were drawn from the 2010 survey of the 1946-51 cohort of the Australian Longitudinal Study on Women's Health (N = 9890 women). Contrary to our hypothesis, results indicated that women living in rural areas were not less likely to attend for screening mammography compared to women living in urban areas in both Scotland (OR for rural = 1.17, 95% CI = 1.06-1.29) and Australia (OR for rural = 1.15, 95% CI = 1.01-1.31). The absence of rural-urban differences in attendance at screening mammography demonstrates that rurality is not necessarily an insurmountable barrier to screening mammography.

Characteristics of cardiovascular risk factors in an urban and rural population of the Peruvian jungle - July, 2014

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Yordan Martínez-Espichán

2017-02-01

Full Text Available Objective: To determine the characteristics of the place of residence and the cardiovascular risk factors in a Peruvian jungle population in July 2014. Materials and methods: A descriptive cross-sectional study conducted in individuals between 30 and 74 years old without a diagnosis of or treatment for a cardiovascular disease in an urban and rural population of the district of Yantaló. The sample was obtained using the Power Analysis and Sample Size Software (PASS program, and consisted of 268 people (152 urban and 116 rural residents. The studied factors were hypertension (HBP, diabetes mellitus (DM, body mass index (BMI, waist-hip ratio (WHR and smoking. Results: The urban population had higher rates of hypertension (18.4%, while the other risk factors showed no significant differences between the two populations. Conclusions: The only risk factor that showed a significant association with the place of residence was hypertension. In contrast, the other risk factors of the study showed no differences between the two populations, which demonstrates that the district of Yantaló is involved in a process of epidemiological transition due to urbanization.

Hypertension in a Brazilian urban slum population.

Science.gov (United States)

Unger, Alon; Felzemburgh, Ridalva D M; Snyder, Robert E; Ribeiro, Guilherme S; Mohr, Sharif; Costa, Vinícius B A; Melendez, Astrid X T O; Reis, Renato B; Santana, Francisco S; Riley, Lee W; Reis, Mitermayer G; Ko, Albert I

2015-06-01

Low- and middle-income countries account for the majority of hypertension disease burden. However, little is known about the distribution of this illness within subpopulations of these countries, particularly among those who live in urban informal settlements. A cross-sectional hypertension survey was conducted in 2003 among 5649 adult residents of a slum settlement in the city of Salvador, Brazil. Hypertension was defined as either an elevated arterial systolic (≥140 mmHg) or diastolic (≥90 mmHg) blood pressure. Sex-specific multivariable models of systolic blood pressure were constructed to identify factors associated with elevated blood pressure. The prevalence of hypertension in the population 18 years and older was 21% (1162/5649). Men had 1.2 times the risk of hypertension compared with women (95% confidence intervals (CI), 1.05, 1.36). Increasing age and lack of any schooling, particularly for women, were also significantly associated with elevated blood pressure (p slum community was lower than reported frequencies in the non-slum population of Brazil and Salvador, yet both disease awareness and treatment frequency were low. Further research on hypertension and other chronic non-communicable diseases in slum populations is urgently needed to guide prevention and treatment efforts in this growing population.

Obstetric Performance Recallaccuracy (OPERa) amonga low ...

African Journals Online (AJOL)

Nigerian Journal of Clinical Practice ... Accurate obstetric history is of utmost importance in prenatal care to ensure optimal maternal fetal outcomes. ... Primiparous and multiparous women, who accessed antenatal care in a rural Mission Hospital over a two-year period, had their past obstetric histories recorded in a pro ...

Seasonal Differences in Determinants of Time Location Patterns in an Urban Population: A Large Population-Based Study in Korea.

Science.gov (United States)

Lee, Sewon; Lee, Kiyoung

2017-06-22

Time location patterns are a significant factor for exposure assessment models of air pollutants. Factors associated with time location patterns in urban populations are typically due to high air pollution levels in urban areas. The objective of this study was to determine the seasonal differences in time location patterns in two urban cities. A Time Use Survey of Korean Statistics (KOSTAT) was conducted in the summer, fall, and winter of 2014. Time location data from Seoul and Busan were collected, together with demographic information obtained by diaries and questionnaires. Determinants of the time spent at each location were analyzed by multiple linear regression and the stepwise method. Seoul and Busan participants had similar time location profiles over the three seasons. The time spent at own home, other locations, workplace/school and during walk were similar over the three seasons in both the Seoul and Busan participants. The most significant time location pattern factors were employment status, age, gender, monthly income, and spouse. Season affected the time spent at the workplace/school and other locations in the Seoul participants, but not in the Busan participants. The seasons affected each time location pattern of the urban population slightly differently, but overall there were few differences.

Seasonal Differences in Determinants of Time Location Patterns in an Urban Population: A Large Population-Based Study in Korea

Directory of Open Access Journals (Sweden)

Sewon Lee

2017-06-01

Full Text Available Time location patterns are a significant factor for exposure assessment models of air pollutants. Factors associated with time location patterns in urban populations are typically due to high air pollution levels in urban areas. The objective of this study was to determine the seasonal differences in time location patterns in two urban cities. A Time Use Survey of Korean Statistics (KOSTAT was conducted in the summer, fall, and winter of 2014. Time location data from Seoul and Busan were collected, together with demographic information obtained by diaries and questionnaires. Determinants of the time spent at each location were analyzed by multiple linear regression and the stepwise method. Seoul and Busan participants had similar time location profiles over the three seasons. The time spent at own home, other locations, workplace/school and during walk were similar over the three seasons in both the Seoul and Busan participants. The most significant time location pattern factors were employment status, age, gender, monthly income, and spouse. Season affected the time spent at the workplace/school and other locations in the Seoul participants, but not in the Busan participants. The seasons affected each time location pattern of the urban population slightly differently, but overall there were few differences.

Population growth, urban expansion, and private forestry in western Oregon.

Science.gov (United States)

Jeffrey D. Kline; David L. Azuma; Ralph J. Alig

2004-01-01

Private forestlands in the United States face increasing pressures from growing populations, resulting in greater numbers of people living in closer proximity to forests. What often is called the "wildland/urban interface" is characterized by expansion of residential and other developed land uses onto forested landscapes in a manner that threatens forestlands...

The economic impact of rural family physicians practicing obstetrics.

Science.gov (United States)

Avery, Daniel M; Hooper, Dwight E; McDonald, John T; Love, Michael W; Tucker, Melanie T; Parton, Jason M

2014-01-01

The economic impact of a family physician practicing family medicine in rural Alabama is $1,000,000 a year in economic benefit to the community. The economic benefit of those rural family physicians practicing obstetrics has not been studied. This study was designed to determine whether there was any added economic benefit of rural family physicians practicing obstetrics in rural, underserved Alabama. The Alabama Family Practice Rural Health Board has funded the University of Alabama Family Medicine Obstetrics Fellowship since its beginning in 1986. Family medicine obstetrics fellowship graduates who practice obstetrics in rural, underserved areas were sent questionnaires and asked to participate in the study. The questions included the most common types and average annual numbers of obstetrics/gynecological procedures they performed. Ten physicians, or 77% of the graduates asked to participate in the study, returned the questionnaire. Fourteen common obstetrics/gynecological procedures performed by the graduates were identified. A mean of 115 deliveries were performed. The full-time equivalent reduction in family medicine time to practice obstetrics was 20%. A family physician practicing obstetrics in a rural area adds an additional $488,560 in economic benefit to the community in addition to the $1,000,000 from practicing family medicine, producing a total annual benefit of $1,488,560. The investment of $616,385 from the Alabama Family Practice Rural Health Board resulted in a $399 benefit to the community for every dollar invested. The cumulative effect of fellowship graduates practicing both family medicine and obstetrics in rural, underserved areas over the 26 years studied was $246,047,120. © Copyright 2014 by the American Board of Family Medicine.

Conservation genetics of extremely isolated urban populations of the northern dusky salamander (Desmognathus fuscus in New York City

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Jason Munshi-South

2013-04-01

Full Text Available Urbanization is a major cause of amphibian decline. Stream-dwelling plethodontid salamanders are particularly susceptible to urbanization due to declining water quality and hydrological changes, but few studies have examined these taxa in cities. The northern dusky salamander (Desmognathus fuscus was once common in the New York City metropolitan area, but has substantially declined throughout the region in recent decades. We used five tetranucleotide microsatellite loci to examine population differentiation, genetic variation, and bottlenecks among five remnant urban populations of dusky salamanders in NYC. These genetic measures provide information on isolation, prevalence of inbreeding, long-term prospects for population persistence, and potential for evolutionary responses to future environmental change. All populations were genetically differentiated from each other, and the most isolated populations in Manhattan have maintained very little genetic variation (i.e. <20% heterozygosity. A majority of the populations also exhibited evidence of genetic bottlenecks. These findings contrast with published estimates of high genetic variation within and lack of structure between populations of other desmognathine salamanders sampled over similar or larger spatial scales. Declines in genetic variation likely resulted from population extirpations and the degradation of stream and terrestrial paths for dispersal in NYC. Loss of genetic variability in populations isolated by human development may be an underappreciated cause and/or consequence of the decline of this species in urbanized areas of the northeast USA.

Prothrombin G20210A gene mutation in pregnant females with thrombotic obstetric complications

International Nuclear Information System (INIS)

Alam, M.A.; Ali, N.; Ayyub, M.

2018-01-01

To determine the frequency of prothrombin G20210A gene mutation in pregnant females with adverse thrombotic obstetric complication and to compare it with prothrombin G20210A gene's frequency in control population. Study Design: Case control study. Place and Duration of Study: Department of Haematology, Army Medical College Rawalpindi and Military Hospital Rawalpindi, from Nov 2013 to Oct 2014. Material and Methods: Sixty pregnant females were included in the study; 30 were cases with adverse thrombotic obstetric complication, while 30 were controls. Detailed history was obtained and 3 ml blood in EDTA tube was collected. DNA was extracted from whole blood and through RT-PCR, presence of prothrombin G20210A gene mutation was looked for in patients and controls. Data was analyzed using SPSS 21. Results: A total of 60 women-30 cases with thrombotic obstetric complications as 'cases' and 30 as 'controls'- were included in the study. Mean age of 'cases' was 28.70 +- 4.23 years while that of 'controls' was 27.33 +- 4.49 years. There was no statistically significant difference among the two groups (p=0.54). In case group only one of 30 (3.3%) patients had heterozygous F2 G20210A mutation while 29 (96.7%) patients had wild type allele. In control group, all the 30 (100%) subjects had wild type allele. The odds of finding the mutation in cases was 1:29 i.e. 0.03 as compared to zero in the control group. The difference was statistically insignificant (p=0.5). Conclusion: Our study shows that the frequency of F2 G20210A gene mutation in pregnant females having adverse thrombotic obstetric complications was not significantly different from its frequency in control population. (author)

[Population in the northern border area. Urban dynamism and binational interrelation].

Science.gov (United States)

Ham Chande, R

1988-01-01

The 3300 km border between Mexico and the US constitutes the geopolitical separation between an underdeveloped country on the 1 hand and 1 of the most technologically and economically powerful countries in the world on the other. The border region is characterized by the contrasts on either side of the border and by the strong interrelation between both sides. Vast streams of persons, merchandise, money, services, communications, and cultural influences flow from 1 side to the other. The border region as a seat of population has a recent history. The border was defined in near current form only in the mid-19th century, when the expansionist tendencies of the US encountered a vast area of very sparse population. In 1900, the principal localities of the border zone had only about 39,000 inhabitants, of whom fewer than 5000 lived west of Ciudad Juarez. Between 1910-20, the population of the border region increased from 53,000 to 96,000 as a result of migrants fleeing the ravages of the revolution. The population of the border region was estimated at 3.826 million in 1988, resulting from rates of growth above Mexico's national average. Settlement in the area has depended on events and conditions in Mexico and on such US occurrences as Prohibition, the Great Depression, the 2nd World War, the Bracero program, and the Program of Border Industrialization. 82% of the border population lives in urban zones, partly because of lack of water. 80% of the urban population is concentrated in 6 cities, Juarez, Tijuana, Mexicali, Nuevo Laredo, Reynosa, and Matamoros. Much of the population of the 6 cities is composed of persons born elsewhere. The border area also has a large floating population of undocumented migrants in transit to or from the US. The high rates of urbanization and of binational interaction are reflected in demographic dynamics. In 1979, 71% of women in union in the border area vs 54% in the rest of Mexico had used contraception, and the infant mortality rate was

The population in China’s earthquake-prone areas has increased by over 32 million along with rapid urbanization

Science.gov (United States)

He, Chunyang; Huang, Qingxu; Dou, Yinyin; Tu, Wei; Liu, Jifu

2016-07-01

Accurate assessments of the population exposed to seismic hazard are crucial in seismic risk mapping. Recent rapid urbanization in China has resulted in substantial changes in the size and structure of the population exposed to seismic hazard. Using the latest population census data and seismic maps, this work investigated spatiotemporal changes in the exposure of the population in the most seismically hazardous areas (MSHAs) in China from 1990 to 2010. In the context of rapid urbanization and massive rural-to-urban migration, nearly one-tenth of the Chinese population in 2010 lived in MSHAs. From 1990 to 2010, the MSHA population increased by 32.53 million at a significantly higher rate of change (33.6%) than the national average rate (17.7%). The elderly population in MSHAs increased by 81.4%, which is much higher than the group’s national growth rate of 58.9%. Greater attention should be paid to the demographic changes in earthquake-prone areas in China.

Decomposing the causes of socioeconomic-related health inequality among urban and rural populations in China: a new decomposition approach.

Science.gov (United States)

Cai, Jiaoli; Coyte, Peter C; Zhao, Hongzhong

2017-07-18

In recent decades, China has experienced tremendous economic growth and also witnessed growing socioeconomic-related health inequality. The study aims to explore the potential causes of socioeconomic-related health inequality in urban and rural areas of China over the past two decades. This study used six waves of the China Health and Nutrition Survey (CHNS) from 1991 to 2006. The recentered influence function (RIF) regression decomposition method was employed to decompose socioeconomic-related health inequality in China. Health status was derived from self-rated health (SRH) scores. The analyses were conducted on urban and rural samples separately. We found that the average level of health status declined from 1989 to 2006 for both urban and rural populations. Average health scores were greater for the rural population compared with those for the urban population. We also found that there exists pro-rich health inequality in China. While income and secondary education were the main factors to reduce health inequality, older people, unhealthy lifestyles and a poor home environment increased inequality. Health insurance had the opposite effects on health inequality for urban and rural populations, resulting in lower inequality for urban populations and higher inequality for their rural counterparts. These findings suggest that an effective way to reduce socioeconomic-related health inequality is not only to increase income and improve access to health care services, but also to focus on improvements in the lifestyles and the home environment. Specifically, for rural populations, it is particularly important to improve the design of health insurance and implement a more comprehensive insurance package that can effectively target the rural poor. Moreover, it is necessary to comprehensively promote the flush toilets and tap water in rural areas. For urban populations, in addition to promoting universal secondary education, healthy lifestyles should be promoted

Caesarean delivery in urban second tier missionary hospital in Nigeria

African Journals Online (AJOL)

Objective: To determine the current trend of Caesarean and highlight the role of a major operative obstetric practice in materno-foetal medicine. Design: Descriptive case study. Setting: St Philomena Catholic Hospital (SPCH), an urban second tier missionary hospital. Subjects: One thousand and fourteen (1014) Caesarean ...

Assessment of surgical and obstetrical care at 10 district hospitals in Ghana using on-site interviews.

Science.gov (United States)

Abdullah, Fizan; Choo, Shelly; Hesse, Afua A J; Abantanga, Francis; Sory, Elias; Osen, Hayley; Ng, Julie; McCord, Colin W; Cherian, Meena; Fleischer-Djoleto, Charles; Perry, Henry

2011-12-01

For most of the population in Africa, district hospitals represent the first level of access for emergency and essential surgical services. The present study documents the number and availability of surgical and obstetrical care providers as well as the types of surgical and obstetrical procedures being performed at 10 first-referral district hospitals in Ghana. After institutional review board and governmental approval, a study team composed of Ghanaian and American surgeons performed on-site surveys at 10 district hospitals in 10 different regions of Ghana in August 2009. Face-to-face interviews were conducted documenting the numbers and availability of surgical and obstetrical personnel as well as gathering data relating to the number and types of procedures being performed at the facilities. A total of 68 surgical and obstetrical providers were interviewed. Surgical and obstetrical care providers consisted of Medical Officers (8.5%), nurse anesthetists (6%), theatre nurses (33%), midwives (50.7%), and others (4.5%). Major surgical cases represented 37% of overall case volumes with cesarean section as the most common type of major surgical procedure performed. The most common minor surgical procedures performed were suturing of lacerations or episiotomies. The present study demonstrates that there is a substantial shortage of adequately trained surgeons who can perform surgical and obstetrical procedures at first-referral facilities. Addressing human resource needs and further defining practice constraints at the district hospital level are important facets of future planning and policy implementation. Copyright © 2011 Elsevier Inc. All rights reserved.

Morbidity and mortality associated with obstetric hysterectomy

International Nuclear Information System (INIS)

Shaikh, N.B.; Shaikh, S.; Shaikh, J.M.

2010-01-01

Background: Obstetric hysterectomy still complicates a substantial number of pregnancies in third world countries and is a significant cause of obstetric morbidity and mortality. This study was carried out to evaluate in our setup the frequency of obstetric hysterectomy, its indication, risk factors, complication, morbidity, mortality and avoidable factors. Methods: A descriptive study of all patients who under went obstetric hysterectomy was conducted from May 1, 2004 to October 31, 2005 at Gynaecology and Obstetric Unit-II, III of Liaquat University of Medical and Health Science Hospital, Hyderabad. After collecting the data on pre-designed proforma the data was fed to SPSS in the form of frequency distribution tables and percentages were calculated. Statistical analysis of data was performed by using Chi-square test. The level of significance was taken as p<0.05. Results: During the study time period there were total 6495 deliveries and 41 cases of obstetric hysterectomy were identified, giving a frequency of 0.63% or 1 in 158 deliveries. Most of patients were from rural areas (82.92%), un-booked 73.17%), uneducated (95%), lower socio economical class (92.69%), 25-29 years age (48.78%) multiparae (56.10%), have to travel a distance of <100 km to reach hospital and referred late (51%) by health care providers (doctors). Majority of hysterectomies were performed due to ruptured uteri (51.21%). There were 5 maternal and 26 perinatal deaths; all were due to severity of conditions necessitating hysterectomy. Conclusion: Incidence of obstetric hysterectomy in our woman is very high. The reason being many avoidable factors such as high parity, inadequate maternity and family planning services, lack of proper referral system, un-booked status, mismanaged labour, illiteracy on the part of woman herself, family and health care providers are not taken care of during pregnancy, labour and puerperium. (author)

Trends in the obstetric features and management of twin pregnancies.

LENUS (Irish Health Repository)

Smith, K E

2010-03-01

There are no reports outlining the trends in obstetric features and clinical management of twin pregnancies in an Irish obstetric population. The aim of this study was to investigate these factors for all twin pregnancies delivered during the 19 year period between 1989 and 2007, at Galway University Hospital (GUH). There were 52,199 infants delivered at GUH, of which 1594 infants (3.05% of births) were twins, related to 797 twin pregnancies. The overall incidence of twin pregnancies was 1.52%, increasing from 0.8%-1.0% in the early years of the study to 1.7-1.8% in the latter years of the study (P<0.001). There was a significant increase in incidence of twins born to mothers aged 30-39 years, alongside a significant reduction to mothers aged 20-29 years (P<0.01). The caesarean section rate overall was 41.5% (331\\/797), of which 54% (n=179) were elective, and 46% (n=152) were emergency, representing an emergency caesarean section rate of 19.1% of all twin pregnancies, and of 24.6% after exclusion of elective caesarean sections. The caesarean section rate for twins increased from 30% in 1989 to greater than 50% in the latter years of the study (P<0.01), related largely to a significant increase in elective caesarean sections (P<0.01). The combined vaginal-caesarean delivery rate was remarkably low at 0.75% of all twin pregnancies, and 1% after exclusion of elective caesarean sections. The preterm delivery rates were 4.1% (<32 weeks), and 16.3% (<36 weeks), with an overall perinatal mortality rate of 37 per 1000. These findings highlight the altered demographic and clinical aspects of twin pregnancies in an Irish obstetric population.

[Burnout syndrome in medical and obstetric perception of violence].

Science.gov (United States)

Pintado-Cucarella, Sheila; Penagos-Corzo, Julio C; Casas-Arellano, Marco Antonio

2015-03-01

Obstetric violence involves a violation of reproductive rights of women during pregnancy, childbirth and postpartum. It has been associated with lack of empathy and emotional discomfort of physicians. To identify the perceptions of obstetric violence and to determine the possible relationship with burnout syndrome. We evaluated 29 physicians whose scope of work relates to obstetrics and gynecology. The evaluation instruments were: a) questionnaire on professional perception that collects demographic information, situations of perceived obstetric violence, major concerns of physicians in their professional work, and includes an scale about level of job satisfaction, b) the Maslach Burnout inventory, and c) Jefferson Scale of Physician Empathy. The most prevalent obstetric violence situations perceived were: medical malpractice and harmful practices (10/29), discrimination (10/29), rude treatment and verbal attacks (11/29). Seventeen participants reported lack of information on obstetric violence and not have tools to cope with this problem. Regarding the burnout syndrome, it was associated with several items of the scale of empathy and with the scale of job satisfaction. This study shows the importance of providing knowledge and tools to deal with obstetric violence and stress management to prevent such situations on medical practices.

Obstetric Thromboprophylaxis: The Swedish Guidelines

Directory of Open Access Journals (Sweden)

Pelle G. Lindqvist

2011-01-01

Full Text Available Obstetric thromboprophylaxis is difficult. Since 10 years Swedish obstetricians have used a combined risk estimation model and recommendations concerning to whom, at what dose, when, and for how long thromboprophylaxis is to be administrated based on a weighted risk score. In this paper we describe the background and validation of the Swedish guidelines for obstetric thromboprophylaxis in women with moderate-high risk of VTE, that is, at similar or higher risk as the antepartum risk among women with history of thrombosis. The risk score is based on major risk factors (i.e., 5-fold increased risk of thromboembolism. We present data on the efficacy of the model, the cost-effectiveness, and the lifestyle advice that is given. We believe that the Swedish guidelines for obstetric thromboprophylaxis aid clinicians in providing women at increased risk of VTE with effective and appropriate thromboprophylaxis, thus avoiding both over- and under-treatment.

FOETOMATERNAL OUTCOME OF OBSTETRIC CHOLESTASIS

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Nina Mishra

2017-07-01

Full Text Available BACKGROUND Obstetric cholestasis is a disorder of liver function commonly occurring in the third trimester of pregnancy. Clinical characters of this disorder include unexplained maternal pruritus, most common site being palms and soles, altered liver functions (elevated serum transaminases and increased fasting serum bile acids (>10 micro mol/L in previously healthy pregnant women. The incidence is variable geographically from 0.1% to 15.6% all over the world. The aetiology of this condition is not fully understood. Its pathogenesis is related to increased sex hormone synthesis, environmental factors and genetic predisposition. Obstetric cholestasis can lead to increased foetal morbidity and mortality with regards to preterm delivery, neonatal respiratory distress syndrome, foetal distress and sudden intrauterine foetal death. Treatment of the disease focus on relieving symptoms and signs. The aim of the study is to evaluate the pregnancy and foetal outcome of pregnant women with obstetric cholestasis. MATERIALS AND METHODS A cross-sectional study was conducted in M.K.C.G. Medical College and Hospital, Berhampur from February 2015 to May 2017. Inclusion Criteria- All patients having pruritus during course of pregnancy with biochemical evidence of raised liver function tests attending antenatal clinic or labour room. Exclusion Criteria- 1 Pregnant women without pruritus; 2 Pregnant women having other liver diseases. RESULTS The incidence of obstetric cholestasis was 0.6%. Majority of cases were primigravida (72.9%. Positive family history was present in 11.4% of cases. Majority of cases (77.1% had normal vaginal delivery. 22.9% of cases had caesarean section. Primary postpartum haemorrhage occurred in only 2.9% of cases. CONCLUSION Obstetric cholestasis can be managed by improving the circulating bile acid level, targeting the cause of pruritus and optimising the time of delivery as a result of which we can reduce adverse pregnancy outcomes.

HEALTH OF URBAN POPULATION IN MOSCOW AND BEIJING AGGLOMERETIONS

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Svetlana M. Malkhazova

2014-01-01

Full Text Available The paper presents the results obtained under the joint Russian-Chinese RFBR project № 12-05-91175-ГФЕН_а aimed at assessment of the state of the environment and health of the population in urban areas in Russia and China. The paper presents the authors’ approach to a comprehensive evaluation of the impact of the environment on the populationhealth of urban agglomerations and a method of regional medico-geographical analysis. A series of analytical and synthetic maps was compiled and used for a comparative geographical analysis of medical and environmental situation in Moscow and Beijing – major metropolitan areas with different natural and socio-economic conditions. The paper discusses the influence of the environment on the state of public health and identifies the leading risk factors, both general and specific to each region.

Population-Adjusted Street Connectivity, Urbanicity and Risk of Obesity in the U.S

Science.gov (United States)

Wang, Fahui; Wen, Ming; Xu, Yanqing

2013-01-01

Street connectivity, defined as the number of (3-way or more) intersections per area unit, is an important index of built environments as a proxy for walkability in a neighborhood. This paper examines its geographic variations across the rural-urban continuum (urbanicity), major racial-ethnic groups and various poverty levels. The population-adjusted street connectivity index is proposed as a better measure than the regular index for a large area such as county due to likely concentration of population in limited space within the large area. Based on the data from the Behavioral Risk Factor Surveillance System (BRFSS), this paper uses multilevel modeling to analyze its association with physical activity and obesity while controlling for various individual and county-level variables. Analysis of data subsets indicates that the influences of individual and county-level variables on obesity risk vary across areas of different urbanization levels. The positive influence of street connectivity on obesity control is limited to the more but not the mostly urbanized areas. This demonstrates the value of obesogenic environment research in different geographic settings, helps us reconcile and synthesize some seemingly contradictory results reported in different studies, and also promotes that effective policies need to be highly sensitive to the diversity of demographic groups and geographically adaptable. PMID:23667278

Institutional violence and quality of service in obstetrics are associated with postpartum depression.

Science.gov (United States)

Souza, Karina Junqueira de; Rattner, Daphne; Gubert, Muriel Bauermann

2017-07-20

To investigate the association between institutional violence in obstetrics and postpartum depression (PP depression) and the potential effect of race, age, and educational level in this outcome. This is a cross-sectional study about the health care conditions for the maternal and child population of the Federal District, Brazil, carried out in 2011. The study has used a probabilistic sample of 432 women, whose children were aged up to three months, stratified by clusters. Indicators of institutional violence and demographic characteristics have been used in a logistic regression model to estimate the probability of occurrence of postpartum depression. The model has identified a high prevalence of postpartum depression, being it higher among non-white women and adolescent females, besides having a strong positive association between the several indicators of obstetric violence and postpartum depression. Positive interactions on a multiplicative scale have also been observed between: violence by negligence by health care professionals and race and age; physical violence from health care professionals and age; and, verbal violence from health care professionals and race. The indicators adopted to reflect institutional violence in obstetric care are positively associated with postpartum depression, which calls for a reflection on the need to make the health care protocols adequate to the precepts of the Brazilian humanization of childbirth care policies and changes in the obstetric care model.

Institutional violence and quality of service in obstetrics are associated with postpartum depression

Directory of Open Access Journals (Sweden)

Karina Junqueira de Souza

Full Text Available ABSTRACT OBJECTIVE To investigate the association between institutional violence in obstetrics and postpartum depression (PP depression and the potential effect of race, age, and educational level in this outcome. METHODS This is a cross-sectional study about the health care conditions for the maternal and child population of the Federal District, Brazil, carried out in 2011. The study has used a probabilistic sample of 432 women, whose children were aged up to three months, stratified by clusters. Indicators of institutional violence and demographic characteristics have been used in a logistic regression model to estimate the probability of occurrence of postpartum depression. RESULTS The model has identified a high prevalence of postpartum depression, being it higher among non-white women and adolescent females, besides having a strong positive association between the several indicators of obstetric violence and postpartum depression. Positive interactions on a multiplicative scale have also been observed between: violence by negligence by health care professionals and race and age; physical violence from health care professionals and age; and, verbal violence from health care professionals and race. CONCLUSIONS The indicators adopted to reflect institutional violence in obstetric care are positively associated with postpartum depression, which calls for a reflection on the need to make the health care protocols adequate to the precepts of the Brazilian humanization of childbirth care policies and changes in the obstetric care model.

Urbanization and Condition of Urban Slums in India

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Digambar Abaji Chimankar

2016-08-01

Full Text Available The present paper attempted to study the urbanization in India and condition of urban slums in terms of water, sanitation, electricity, garbage collection and health care, and education which are supposed to be basic minimum needs for the slum dwellers. India is going through the process of rapid urbanization because of industrialization like other third world countries.  The percent of urbanization increase from 27.8 percent in 2001 to 31.1 percent in 2011 census. The increase in the percentage of population in urban areas is because of natural growth, rural to urban migration and the reclassification of village and towns. The share of the slum population in the total urban population of the country was 18.3 percent in 2001 while in 2011 it was 17.4 percent. The condition of urban slums in India is to be improved so as to make them better for living.

The effect of exposure to biomass smoke on respiratory symptoms in adult rural and urban Nepalese populations

OpenAIRE

Kurmi, Om P; Semple, Sean; Devereux, Graham S; Gaihre, Santosh; Lam, Kin Bong Hubert; Sadhra, Steven; Steiner, Markus FC; Simkhada, Padam; Smith, William CS; Ayres, Jon G

2014-01-01

Background Half of the world’s population is exposed to household air pollution from biomass burning. This study aimed to assess the relationship between respiratory symptoms and biomass smoke exposure in rural and urban Nepal. Methods A cross-sectional study of adults (16+ years) in a rural population (n = 846) exposed to biomass smoke and a non-exposed urban population (n = 802) in Nepal. A validated questionnaire was used along with measures of indoor air quality (PM2.5 and CO) and outdoor...

Mathematical modeling of an urban pigeon population subject to local management strategies.

Science.gov (United States)

Haidar, I; Alvarez, I; Prévot, A C

2017-06-01

This paper addresses the issue of managing urban pigeon population using some possible actions that make it reach a density target with respect to socio-ecological constraints. A mathematical model describing the dynamic of this population is introduced. This model incorporates the effect of some regulatory actions on the dynamic of this population. We use mathematical viability theory, which provides a framework to study compatibility between dynamics and state constraints. The viability study shows when and how it is possible to regulate the pigeon population with respect to the constraints. Copyright © 2017 Elsevier Inc. All rights reserved.

The critically ill obstetric patient - Recent concepts

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Anjan Trikha

2010-01-01

Full Text Available Obstetric patients admitted to an Intensive Care Unit (ICU present a challenge to an intensivist because of normal physiological changes associated with pregnancy and puerperium, the specific medical diseases peculiar to pregnancy and the need to take care of both the mother and the foetus. Most common causes of admission to an ICU for obstetric patients are eclampsia, severe preeclampsia, haemorrhage, congenital and valvular heart disease, septic abortions, severe anemia, cardiomyopathy and non-obstetric sepsis. The purpose of this review is to present the recent concepts in critical care management of obstetric patients with special focus mainly on ventilatory strategies, treatment of shock and nutrition. The details regarding management of individual diseases would not be discussed as these would be beyond the purview of this article. In addition, some specific issues of importance while managing such patients would also be highlighted.

Prevalence, predictors and perinatal outcomes of peri-conceptional alcohol exposure - retrospective cohort study in an urban obstetric population in Ireland

LENUS (Irish Health Repository)

Mullally, Aoife

2011-04-11

Abstract Background Evidence-based advice on alcohol consumption is required for pregnant women and women planning a pregnancy. Our aim was to investigate the prevalence, predictors and perinatal outcomes associated with peri-conceptional alcohol consumption. Methods A cohort study of 61,241 women who booked for antenatal care and delivered in a large urban maternity hospital between 2000 and 2007. Self-reported alcohol consumption at the booking visit was categorised as low (0-5 units per week), moderate (6-20 units per week) and high (>20 units per week). Results Of the 81% of women who reported alcohol consumption during the peri-conceptional period, 71% reported low intake, 9.9% moderate intake and 0.2% high intake. Factors associated with moderate alcohol consumption included being in employment OR 4.47 (95% CI 4.17 to 4.80), Irish nationality OR 16.5 (95% CI 14.9 to 18.3), private health care OR 5.83 (95% CI 5.38 to 6.31) and smoking OR 1.86 (95% CI 1.73 to 2.01). Factors associated with high consumption included maternal age less than 25 years OR 2.70 (95% CI 1.86 to 3.91) and illicit drug use OR 6.46 (95% CI 3.32 to 12.60). High consumption was associated with very preterm birth (<32 weeks gestation) even after controlling for socio-demographic factors, adjusted OR 3.15 (95% CI 1.26-7.88). Only three cases of Fetal Alcohol Syndrome were recorded (0.05 per 1000 total births), one each in the low, moderate and high consumption groups. Conclusions Public Health campaigns need to emphasise the importance of peri-conceptional health and pre-pregnancy planning. Fetal Alcohol Syndrome is likely to be under-reported despite the high prevalence of alcohol consumption in this population.

Obstetric acute renal failure 1956-1987.

Science.gov (United States)

Turney, J H; Ellis, C M; Parsons, F M

1989-06-01

A total of 142 women with severe acute renal failure (ARF) resulting from obstetric causes was treated by dialysis at a single centre from 1956 to 1987. One-year survival was 78.6%, which compares favourably with other causes of ARF. Abortion, haemorrhage and preclampsia comprised 95% of cases, with survival being best (82.9%) with abortion. Survival was adversely affected by increasing age. Acute cortical necrosis (12.7% of patients) carried 100% mortality after 6 years. Follow-up of survivors showed normal renal function up to 31 years following ARF; 25-year patient survival was 71.6%. Improvements in obstetric care and the disappearance of illegal abortions have resulted in a dramatic decline in the incidence of obstetric ARF.

Journal of Obstetrics and Gynaecology of Eastern and Central Africa

African Journals Online (AJOL)

JOGECA) is a peer reviewed quarterly journal published by Kenya Obstetrical and Gynaecological Society (KOGS). It publishes: original work in all aspects related to obstetrics and gynaecology, reviews related to obstetrics and gynaecology and ...

A multi disciplinary obstetric emergency training programme.

LENUS (Irish Health Repository)

Whelan, Mary

2012-09-01

The Rotunda Hospital (Dublin) obstetric emergency training programme (RHOET) was designed, in 2008, to meet the ongoing education and training needs of the local multidisciplinary team. Prior to its implementation, senior midwives attended the advanced life support in obstetrics (ALSO) course, and many of the obstetricians attended the Management of obstetric emergencies and trauma (MOET) and\\/or ALSO courses. Attendance at these off site courses meant that the only opportunity for team training was the informal and ad hoc \\'drills and skills\\' that took place in the birthing suite. This paper documents our journey since RHOET was implemented.

Population genetic structure of urban malaria vector Anopheles stephensi in India.

Science.gov (United States)

Sharma, Richa; Sharma, Arvind; Kumar, Ashwani; Dube, Madhulika; Gakhar, S K

2016-04-01

Malaria is a major public health problem in India because climatic condition and geography of India provide an ideal environment for development of malaria vector. Anopheles stephensi is a major urban malaria vector in India and its control has been hampered by insecticide resistance. In present study population genetic structure of A. stephensi is analyzed at macro geographic level using 13 microsatellite markers. Significantly high genetic differentiation was found in all studied populations with differentiation values (FST) ranging from 0.0398 to 0.1808. The geographic distance was found to be playing a major role in genetic differentiation between different populations. Overall three genetic pools were observed and population of central India was found to be coexisting in two genetic pools. High effective population size (Ne) was found in all the studied populations. Copyright © 2015 Elsevier B.V. All rights reserved.

A "Prepaid Package" for Obstetrics: Effect on Teaching and Patient Care in a University Hospital

Science.gov (United States)

Young, Philip E.

1976-01-01

The changing social milieu has removed the charity patient but not the need for a teaching population. The University Hospital's program is described, in which patients prepaid a fixed, single fee for all obstetrics-related care through the third post partum day. (LBH)

Obstetric complications: does training traditional birth attendants make a difference?

Directory of Open Access Journals (Sweden)

Patricia E. Bailey

2002-01-01

Full Text Available Objective. To assess the effect that a training intervention for traditional birth attendants (TBAs in Guatemala had on the detection of obstetric complications, the referral of patients with complications to the formal health care system, and, ultimately, those patients' utilization of essential obstetric care services. Methods. Using a quasi-experimental design, a surveillance system of births was implemented to collect population-based information from 3 518 women between 1990 and 1993. All women were interviewed postpartum by physicians. There were three key independent variables in our study: 1 geographical area (intervention community and non-intervention community, 2 time in relation to the training intervention (before or after, and 3 presence or absence of a TBA at the time of the complication. The key dependent variables for women interviewed were 1 development of an obstetric complication, 2 detection of the problem by the TBA, 3 referral to a health facility, 4 compliance with referral, and 5 use of services. Results. The incidence of postpartum complications decreased after the intervention, controlling for intervention community. On the other hand, after the intervention TBAs were less likely to recognize most maternal complications, and referral rates did not increase significantly. The likelihood of using health care services increased six-fold among women who were not attended by TBAs, and no increase was observed among those who were attended by TBAs. Conclusion. Training TBAs may have had a positive effect on the rate, detection, and referral of postpartum complications. However, the evidence is less convincing for overall increases in the detection of complications, in referral to the formal health care system, and in the utilization of essential obstetric services among women attended by TBAs.

The importance of resident environmental awareness in conservation of urban wildlife populations

Science.gov (United States)

The proximity of humans and wildlife to each other along the wildland-urban interface results in constant potential conflict between human activity and wildlife populations. Since 2002, California biologists have observed a drastic increase in carnivore mortalities that are asso...

[Obstetric analgesia and anesthesia in Switzerland in 1999].

Science.gov (United States)

Zwetsch-Rast, G; Schneider, M C; Siegemund, M

2002-02-01

This survey investigated the common practice of obstetric analgesia and anaesthesia in Swiss hospitals and evaluated the influence of the Swiss interest group for obstetric anaesthesia. In March 1999 we submitted 145 questionnaires to all Swiss hospitals providing an obstetric service. The rate of epidural analgesia (EA) was higher in large hospitals (> 1,000 births/year) than in small services. EA was maintained by continuous infusion techniques in 53% of the responding hospitals. For elective caesarean section, spinal anaesthesia (SA) and EA were performed in 77% and 16% of the patients, respectively. General anaesthesia (5%) was only used in small hospitals (interest group for obstetric anaesthesia, as well as the expectations of pregnant women, increased the numbers of regional anaesthesia compared with the first survey in 1992.

Cardiovascular risk factors in a Mexican middle-class urban population. The Lindavista Study. Baseline data.

Science.gov (United States)

Meaney, Alejandra; Ceballos-Reyes, Guillermo; Gutiérrez-Salmean, Gabriela; Samaniego-Méndez, Virginia; Vela-Huerta, Agustín; Alcocer, Luis; Zárate-Chavarría, Elisa; Mendoza-Castelán, Emma; Olivares-Corichi, Ivonne; García-Sánchez, Rubén; Martínez-Marroquín, Yolanda; Ramírez-Sánchez, Israel; Meaney, Eduardo

2013-01-01

The aim of this communication is to describe the cardiovascular risk factors affecting a Mexican urban middle-class population. A convenience sample of 2602 middle class urban subjects composed the cohort of the Lindavista Study, a prospective study aimed to determine if conventional cardiovascular risks factors have the same prognosis impact as in other populations. For the baseline data, several measurements were done: obesity indexes, smoking, blood pressure, fasting serum glucose, total cholesterol, HDL-c, LDL-c and triglycerides. This paper presents the basal values of this population, which represents a sample of the Mexican growing urban middle-class. The mean age in the sample was 50 years; 59% were females. Around 50% of the entire group were overweighed, while around 24% were obese. 32% smoked; 32% were hypertensive with a 20% rate of controlled pressure. 6% had diabetes, and 14% had impaired fasting glucose; 66% had total cholesterol ≥ 200 mg/dL; 62% showed HDL-c levels150 mg/dL, and 34% levels of LDL-c ≥ 160 mg/dL. Half of the population studied had the metabolic syndrome. These data show a population with a high-risk profile, secondary to the agglomeration of several cardiovascular risk factors. Copyright © 2012 Instituto Nacional de Cardiología Ignacio Chávez. Published by Masson Doyma México S.A. All rights reserved.

Interpolating a consumption variable for scaling and generalizing potential population pressure on urbanizing natural areas

Science.gov (United States)

Varanka, Dalia; Jiang, Bin; Yao, Xiaobai

2010-01-01

Measures of population pressure, referring in general to the stress upon the environment by human consumption of resources, are imperative for environmental sustainability studies and management. Development based on resource consumption is the predominant factor of population pressure. This paper presents a spatial model of population pressure by linking consumption associated with regional urbanism and ecosystem services. Maps representing relative geographic degree and extent of natural resource consumption and degree and extent of impacts on surrounding areas are new, and this research represents the theoretical research toward this goal. With development, such maps offer a visualization tool for planners of various services, amenities for people, and conservation planning for ecologist. Urbanization is commonly generalized by census numbers or impervious surface area. The potential geographical extent of urbanism encompasses the environmental resources of the surrounding region that sustain cities. This extent is interpolated using kriging of a variable based on population wealth data from the U.S. Census Bureau. When overlayed with land-use/land-cover data, the results indicate that the greatest estimates of population pressure fall within mixed forest areas. Mixed forest areas result from the spread of cedar woods in previously disturbed areas where further disturbance is then suppressed. Low density areas, such as suburbanization and abandoned farmland are characteristic of mixed forest areas.

Obstetric ultrasound aids prompt referral of gestational trophoblastic disease in marginalized populations on the Thailand-Myanmar border

NARCIS (Netherlands)

McGregor, Kathryn; Min, Aung Myat; Karunkonkowit, Noaeni; Keereechareon, Suporn; Tyrosvoutis, Mary Ellen; Tun, Nay Win; Rijken, Marcus J.; Hoogenboom, Gabie; Boel, Machteld; Chotivanich, Kesinee; Nosten, François; McGready, Rose

2017-01-01

Background: The use of obstetric ultrasound in the diagnosis of gestational trophoblastic disease (GTD) in high-income settings is well established, leading to prompt management and high survival rates. Evidence from low-income settings suggests ultrasound is essential in identifying complicated

Current applications of big data in obstetric anesthesiology.

Science.gov (United States)

Klumpner, Thomas T; Bauer, Melissa E; Kheterpal, Sachin

2017-06-01

The narrative review aims to highlight several recently published 'big data' studies pertinent to the field of obstetric anesthesiology. Big data has been used to study rare outcomes, to identify trends within the healthcare system, to identify variations in practice patterns, and to highlight potential inequalities in obstetric anesthesia care. Big data studies have helped define the risk of rare complications of obstetric anesthesia, such as the risk of neuraxial hematoma in thrombocytopenic parturients. Also, large national databases have been used to better understand trends in anesthesia-related adverse events during cesarean delivery as well as outline potential racial/ethnic disparities in obstetric anesthesia care. Finally, real-time analysis of patient data across a number of disparate health information systems through the use of sophisticated clinical decision support and surveillance systems is one promising application of big data technology on the labor and delivery unit. 'Big data' research has important implications for obstetric anesthesia care and warrants continued study. Real-time electronic surveillance is a potentially useful application of big data technology on the labor and delivery unit.

Simulation laboratories for training in obstetrics and gynecology.

Science.gov (United States)

Macedonia, Christian R; Gherman, Robert B; Satin, Andrew J

2003-08-01

Simulations have been used by the military, airline industry, and our colleagues in other medical specialties to educate, evaluate, and prepare for rare but life-threatening scenarios. Work hour limits for residents in obstetrics and gynecology and decreased patient availability for teaching of students and residents require us to think creatively and practically on how to optimize their education. Medical simulations may address scenarios in clinical practice that are considered important to know or understand. Simulations can take many forms, including computer programs, models or mannequins, virtual reality data immersion caves, and a combination of formats. The purpose of this commentary is to call attention to a potential role for medical simulation in obstetrics and gynecology. We briefly describe an example of how simulation may be incorporated into obstetric and gynecologic residency training. It is our contention that educators in obstetrics and gynecology should be aware of the potential for simulation in education. We hope this commentary will stimulate interest in the field, lead to validation studies, and improve training in and the practice of obstetrics and gynecology.

Anti-D reagents should be chosen accordingly to the prevalence of D variants in the obstetric population.

Science.gov (United States)

Lukacevic Krstic, Jelena; Dajak, Slavica; Bingulac-Popovic, Jasna; Dogic, Vesna; Mratinovic-Mikulandra, Jela

2018-03-01

Resolving ambiguous results of D antigen typing is crucial for appropriate and rational administration of anti-D immunoprophylaxis and transfusion practice in obstetric population. The aim of the study was to establish selection criteria of anti-D reagents for our population. A total of 12 689 samples from primiparous women in Split-Dalmatia County, Croatia, were typed for RhD antigen during the period of 5 years. Ambiguous results were submitted to additional serologic investigation and genotyping. RHD genotyping was performed by commercial genotyping kits (Ready Gene weak D ® and Ready gene CDE, Inno-Train, Kronberg, Germany). Relative frequencies and accompanying 95% confidence intervals were used to estimate the prevalence of variants. The prevalence of D variants was 0.42% (95% CI 0.31; 0.53). The most common partial D variant was D Va (RHD*05.05), with the prevalence of 0.08% (95% CI 0.03; 0.13). All weak D variants were weak D types 1, 2 and 3 (RHD*weak D type 1, RHD*weak D type 2, RHD*weak D type 3). Weak D samples were distinguishable from partial D in routine typing due to the difference in reactivity of partial D samples with clones D7B8 and RUM-1. Cell line RUM-1 gives weak or negative reactions with partial DVa category. The most common partial D variant in our population is DVa. It is recommended to use cell lines which do not strongly agglutinate DVa variant in routine RhD typing. The appropriate choice of reagents will enable the serology methods to recognize the cases in which RHD genotyping is required. © 2017 Wiley Periodicals, Inc.

Barriers to emergency obstetric care services

DEFF Research Database (Denmark)

Echoka, Elizabeth; Makokha, Anselimo; Dubourg, Dominique

2014-01-01

Introduction: Pregnancy-related mortality and morbidity in most low and middle income countries can be reduced through early recognition of complications, prompt access to care and appropriate medical interventions following obstetric emergencies. We used the three delays framework to explore...... barriers to emergency obstetric care (EmOC) services by women who experienced life threatening obstetric complications in Malindi District, Kenya. Methods: A facility-based qualitative study was conducted between November and December 2010. In-depth interviews were conducted with 30 women who experienced...... decision to seek care and in reaching an appropriate care facility. The "first" delay was due to lack of birth preparedness, including failure to identify a health facility for delivery services regardless of antenatal care and to seek care promptly despite recognition of danger signs. The "second" delay...

Assessment of Emergency Obstetric Care Services in Ibadan ...

African Journals Online (AJOL)

AJRH Managing Editor

ORIGINAL RESEARCH ARTICLE ... Nigeria's high maternal mortality has been attributed to poor utilization of obstetric care services to handle ... Poor obstetric outcome in middle and low-income ... Evidence also showed that access to.

Urban Transport and Communication

International Nuclear Information System (INIS)

Irandu, E.M.

1999-01-01

The population according to the 1989 census was 21,448,774 inhabitants. This figure shows that on average the total population has been increasing by more than 40% every decade since 1948. As a result the widening gap between fertility and mortality, the population is growing at an accelerated rate. The current official population growth rate figure of 3.4% per annum puts the country among the world's most rapidly growing nations. It is projected that by the year 2010, the population will be about 37.4 million. At present the urban centres with a population size of 2,000 people and above constitute about 18.1% of the total population (Kenya, 1994). Rapid economic growth has led to the development of a number of urban centres as centres of commerce, industry and tourism. Consequently, this has led to rural urban drift. This drift to urban areas causes a number of problems which if unresolved will limit the ability of the urban centres to support their population The rapid increase in urban population causes a shortage of facilities to meet the increasing demand in services such as public transport, water supply, sewage and housing (Ramatullah, 1997: 161-168). Urban Transport acts as catalyst to both urban and national development, by facilitating the movements associated with urban and national Development. They provide a means by which goods and services are made available to industry and consumers, creating opportunity for social and economic interaction and employment. Without urban transport, access to health, education and employment would not be possible. Indeed urban transport is what gives life to urban development

Teaching obstetric ultrasound at Mulago Hospital - Kampala, Uganda

African Journals Online (AJOL)

... basic obstetric ultrasound. Keywords: Ultrasound; obstetric; teaching; Uganda; low-resource; curriculum. .... tic and hands-on training were provided by one trainer. (HKA) who at the time .... any formal teaching session. Additionally, the study ...

Non-physician providers of obstetric care in Mexico: Perspectives of physicians, obstetric nurses and professional midwives

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DeMaria Lisa M

2012-04-01

Full Text Available Abstract Background In Mexico 87% of births are attended by physicians. However, the decline in the national maternal mortality rate has been slower than expected. The Mexican Ministry of Health’s 2009 strategy to reduce maternal mortality gives a role to two non-physician models that meet criteria for skilled attendants: obstetric nurses and professional midwives. This study compares and contrasts these two provider types with the medical model, analyzing perspectives on their respective training, scope of practice, and also their perception and/or experiences with integration into the public system as skilled birth attendants. Methodology This paper synthesizes qualitative research that was obtained as a component of the quantitative and qualitative study that evaluated three models of obstetric care: professional midwives (PM, obstetric nurses (ON and general physicians (GP. A total of 27 individual interviews using a semi-structured guide were carried out with PMs, ONs, GPs and specialists. Interviews were transcribed following the principles of grounded theory, codes and categories were created as they emerged from the data. We analyzed data in ATLAS.ti. Results All provider types interviewed expressed confidence in their professional training and acknowledge that both professional midwives and obstetric nurses have the necessary skills and knowledge to care for women during normal pregnancy and childbirth. The three types of providers recognize limits to their practice, namely in the area of managing complications. We found differences in how each type of practitioner perceived the concept and process of birth and their role in this process. The barriers to incorporation as a model to attend birth faced by PMs and ONs are at the individual, hospital and system level. GPs question their ability and training to handle deliveries, in particular those that become complicated, and the professional midwifery model particularly as it relates to

Obstetric complications in women with IVF conceived pregnancies and polycystic ovarian syndrome

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Sunita R Tandulwadkar

2014-01-01

Full Text Available Polycystic ovarian syndrome (PCOS is often accompanied by infertility that necessitates ovulation induction using clomiphene citrate, gonadotropins or even in vitro fertilization (IVF. These treatment methods are known to increase the incidence of multiple pregnancies as well as some negative consequences, including a rise in the risk for gestational diabetes mellitus, pre-eclampsia, etc., Furthermore, pregnancies established after IVF carry an increased risk for maternal complications. However, the increased risk of developing adverse obstetric complications has been suggested to occur independently of obesity as well as in populations without assisted reproductive techniques. Many studies have been performed to study the effect of PCOS on pregnancy and the effect of pregnancy on PCOS. The hormonal milieu that is exaggerated in PCOS women is quite well understood at the biochemical and genetic levels. The maternal and neonatal outcomes of PCOS women who have undergone in vitro fertilization-embryo transfer (IVF-ET have not been widely studied till date. This review aims to evaluate the current evidence regarding adverse obstetric outcomes of PCOS women undergoing IVF-ET. The rationale of this review is to study whether the adverse obstetric outcomes are increased in PCOS women in general, or particularly in those PCOS women who are undergoing IVF-ET. It is also important to analyze via a literature review whether the increased adverse outcomes are due to infertility in general or PCOS per se. An attempt has been made to give evidence regarding preventive strategies for obstetric complications in PCOS women who have undergone IVF-ET.

The Influence of Age and Gender on Skin-Associated Microbial Communities in Urban and Rural Human Populations.

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Shi Ying

Full Text Available Differences in the bacterial community structure associated with 7 skin sites in 71 healthy people over five days showed significant correlations with age, gender, physical skin parameters, and whether participants lived in urban or rural locations in the same city. While body site explained the majority of the variance in bacterial community structure, the composition of the skin-associated bacterial communities were predominantly influenced by whether the participants were living in an urban or rural environment, with a significantly greater relative abundance of Trabulsiella in urban populations. Adults maintained greater overall microbial diversity than adolescents or the elderly, while the intragroup variation among the elderly and rural populations was significantly greater. Skin-associated bacterial community structure and composition could predict whether a sample came from an urban or a rural resident ~5x greater than random.

Perception of the Local Population toward Urban Forests in Municipality of Aerodrom

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Aneta Blazevska

2012-12-01

Full Text Available Background and Purpose: With the development of both society and economy, environmental issues have become a more popular topic. In recent decades both the role and perception of urban forests have changed regarding recreational and environmental aspects on both a local and global level. This coupled with urbanization places great importance on how people see and value the forests in an urban and peri-urban setting. Visitors are not a homogeneous category and hence have different needs and perceptions of urban and peri-urban green spaces. The study aims to understand the visitors` perception from municipality Aerodrom towards urban forests and their recreational use, benefits, preferences and perception regarding management activities of urban forests. Material and Methods: The method used for the research is qualitative with semi-structured questionnaire which was conducted face to face. Gathered data were analyzed by Excel and after that were presented in tables and graphs for better review of the results. The study area was municipality of Aerodrom which has the biggest space under urban forests per capita in Skopje. Results and Conclusion: Results have shown that all respondents have permanent residence in the municipality of Aerodrom, located in different settlements and with the length of stay mainly between 5 to 40 years. There is a dominance of female population and respondent’s age over 40 in the research. Results also showed that the average number of visit in urban forests by respondents during the week is three times. Regarding the meaning and association of term urban forests, results showed that majority of respondents have a clear and concise perception, and mainly this term for them is association on park and greenery, a nice decorated environment and place for walk. When it comes to the way how current situation with urban forest can be improved almost all of the respondents highlighted it can be through the following things

Using a Caesarean Section Classification System based on characteristics of the population as a way of monitoring obstetric practice

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Milanez Helaine M

2010-06-01

Full Text Available Abstract Objective to compare the distribution of caesarean rates in the Robson's 10 groups classification in order to see if any change occurred after the implementation of an audit and feedback intervention. Design: cross sectional, before and after an audit and feedback study. Setting: a university hospital in Brazil. Methods clinical records of all births during two three months-periods were evaluated. Each case of CS was classified into one of ten mutually exclusive categories according to obstetric characteristics. The proportion of CS in each group was compared in both periods. Results total number of deliveries and the high rate of CS were similar in both periods. Group 3 (multiparous excluding previous CS, single, cephalic, ≥ 37 weeks, spontaneous labour accounted for the largest proportion of deliveries, 28.5 and 26.8% in both periods. Group 1 (nulliparous, single, cephalic, ≥ 37 weeks, spontaneous labour was the second largest one, while Group 5 (previous caesarean section, single, cephalic, and ≥ 37 weeks was the third but the largest contributor to CS, accounting for 16.6 and 14.9% among all deliveries in both periods. Groups 2 (nulliparous, single, cephalic, ≥ 37 weeks, induction or CS before labour and 4 (multiparous excluding previous CS, single, cephalic, ≥ 37 weeks, induction or CS before labour were less prevalent, however had higher rates of CS. Only in Group 10 (All single, cephalic, ≤ 36 weeks, including previous CS, there was a significant decrease of CS rate from 70.5 to 42.6% between periods. Conclusion Robson's classification did not identify any significant change in the pattern of CS rates with the audit and feedback process, but showed to be useful for comparing trends among similar obstetric populations.

Auditing the standard of anaesthesia care in obstetric units.

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Mörch-Siddall, J; Corbitt, N; Bryson, M R

2001-04-01

We undertook an audit of 15 obstetric units in the north of England over a 10-month period to ascertain to what extent they conformed to the Obstetric Anaesthetists' Association 'Recommended Minimum Standards for Obstetric Anaesthetic Services' using a quality assurance approach. We demonstrated that all units conformed to the majority of standards but did not conform in at least one major and minor area.

Is teenage pregnancy an obstetric risk in a welfare society? A population-based study in Finland, from 2006 to 2011.

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Leppälahti, Suvi; Gissler, Mika; Mentula, Maarit; Heikinheimo, Oskari

2013-08-19

To assess obstetric outcomes in teenage pregnancies in a country with a low teenage delivery rate and comprehensive high-quality prenatal care. Retrospective population-based register study. Finland. All nulliparous teenagers (13-15 years (n=84), 16-17 years (n=1234), 18-19 years (n=5987)) and controls (25-year-old to 29-year-old women (n=51 142)) with singleton deliveries in 2006-2011. Risk of adverse obstetric outcomes adjusted for demographic factors and clinically relevant pregnancy complications, with main focus on maternal pregnancy complications. Teenage mothers were more likely than controls to live in rural areas (16% (n=1168) vs 11.8% (n=6035)), smoke (36.4% (n=2661) vs 7% (n=3580)) and misuse alcohol or drugs (1.1% (n=82) vs 0.2% (n=96); pUTI; 2.9, 1.8 to 4.8), pyelonephritis (6.3, 3.8 to 10.4) and eclampsia (3.2, 1.4 to 7.3), the risks increasing with descending age for most outcomes. Elevated risks of pre-eclampsia (3.7, 1.5 to 9.0) and preterm delivery (2.5, 1.2 to 5.3) were also found among 13-year-olds to 15-year-olds. However, teenage mothers were more likely to have vaginal delivery (1.9, 1.7 to 2.0) without complications. Inadequate prenatal care among teenagers was a risk factor of eclampsia (12.6, 2.6 to 62.6), UTI (5.8, 1.7 to 19.7) and adverse neonatal outcomes. Pregnant teenagers tended to be socioeconomically disadvantaged versus controls and faced higher risks of various pregnancy complications. Special attention should be paid to enrolling teenagers into adequate prenatal care in early pregnancy.

Association of Neck Circumference and Obesity with Blood Pressure among Adolescents in Urban and Rural Population in North Tamil Nadu.

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Rajagopalan, Archana; Balaji, Nisha

2017-01-01

Since a few studies exist on the association of neck circumference (NC) and obesity with blood pressure (BP) among adolescents in India, we found it highly relevant to measure the NC and body mass index (BMI) using them as indicators of upper body subcutaneous fat and obesity and relate them to BP in a rural and urban adolescent population in North Tamil Nadu. This is a community-based cross-sectional study of descriptive design where 500 students from urban and rural areas were selected, and their BMI, NC, and BP were measured using standardized instruments. Among urban and rural population high and normal NC positively correlated with BMI, systolic BP (SBP) and diastolic BP (DBP), indicating that the data clearly reflects increase in BMI, SBP, and DBP values with increase in NC or vice versa. The correlation was statistically significant ( P < 0.001) significantly higher BMI ( P < 0.01), SBP ( P < 0.05), and NC ( P < 0.001) was observed in urban population than rural. DBP was not significantly different in rural and urban population. 95 th percentile values are significantly higher than rest in both urban and rural population. Only the 95 th percentile values correlate and reflect similar changes in BMI, SBP, and DBP. Our studies indicate a strong association of elevation in BP with high NC and increase in BMI. Overweight and obesity were positively correlated with increase in SBP and DBP.

[The emergence of obstetrical mechanism: From Lucy to Homo sapiens].

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Frémondière, P; Thollon, L; Marchal, F

2017-03-01

The evolutionary history of modern birth mechanism is now a renewed interest in obstetrical papers. The purpose of this work is to review the literature in paleo-obstetrical field. Our analysis focuses on paleo-obstetrical hypothesis, from 1960 to the present day, based on the reconstruction of fossil pelvis. Indeed, these pelvic reconstructions usually provide an opportunity to make an obstetrical assumption in our ancestors. In this analysis, we show that modern birth mechanism takes place during the emergence of our genus 2 million years ago. References are made to human specificities related to obstetrical mechanism: exclusive bipedalism, increase of brain size at birth, metabolic cost of the pregnancy and deep trophoblastic implantation. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Considerations about our approach to obstetric psychoprophylaxis.

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Cerutti, R; Volpe, B; Sichel, M P; Sandri, M; Sbrignadello, C; Fede, T

1983-01-01

Usually the term "obstetric psychoprophylaxis" refers to a specific method or technique. We prefer to consider it as a procedure that involves on one side the woman, the child and its family, and on the other the services entitled to give pre- and post-natal assistance. In order to realize this, a reformation of our methodological parameters and a critical analysis of the results obtained are required. In the courses of obstetric psychoprophylaxis that are held in the Department of Obstetrics and Gynaecology of the University of Padua we take into consideration the following themes: - Methodological approach - Professional training of the staff - Significance of psychosocial culture in the management of the pregnancy by the health services.

Obstetric risk avoidance: Will anyone be offering obstetrics in private ...

African Journals Online (AJOL)

By the end of the decade indemnifying obstetric risk will probably be too expensive for doctors in private practice. Non-indemnified doctors will be unable or unwilling to do private deliveries; however, women will still fall pregnant and require delivery. These women will inevitably be forced to deliver in provincial facilities, ...

Determining the drivers of population structure in a highly urbanized landscape to inform conservation planning.

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Thomassen, Henri A; Harrigan, Ryan J; Semple Delaney, Kathleen; Riley, Seth P D; Serieys, Laurel E K; Pease, Katherine; Wayne, Robert K; Smith, Thomas B

2018-02-01

Understanding the environmental contributors to population structure is of paramount importance for conservation in urbanized environments. We used spatially explicit models to determine genetic population structure under current and future environmental conditions across a highly fragmented, human-dominated environment in Southern California to assess the effects of natural ecological variation and urbanization. We focused on 7 common species with diverse habitat requirements, home-range sizes, and dispersal abilities. We quantified the relative roles of potential barriers, including natural environmental characteristics and an anthropogenic barrier created by a major highway, in shaping genetic variation. The ability to predict genetic variation in our models differed among species: 11-81% of intraspecific genetic variation was explained by environmental variables. Although an anthropogenically induced barrier (a major highway) severely restricted gene flow and movement at broad scales for some species, genetic variation seemed to be primarily driven by natural environmental heterogeneity at a local level. Our results show how assessing environmentally associated variation for multiple species under current and future climate conditions can help identify priority regions for maximizing population persistence under environmental change in urbanized regions. © 2017 Society for Conservation Biology.

SOME ASPECTS OF FEATURES CONCEPT AND NATURE OF ENVIRONMENTAL SAFETY LIFE URBAN POPULATION

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Kirova M.

2017-05-01

Full Text Available Proved the concept and nature of the environmental safety of life of the urban population. A structural levels in the list of objects to enter the security levels of urban or rural communities of local communities, which changes the nature of the institutional environment environmental security. In assessing the quality of life of urban society used many parameters of socio-economic and environmental. General rules on the prevention of environmental degradation and risks to human health set forth in the applicable law "On Environmental Protection", on the basis of which developed a number of legal documents. As for the capital of Ukraine - Kyiv, it is a great cultural, historical and commercial and industrial center. So we can safely say that Kyiv is characterized by all the environmental problems that are inherent in all large cities. This, above all, traffic pollution, changes in the air quality, noise pollution, emissions of chemicals into the atmosphere, pollution, toxic waste, the problem of waste. But a special place in this region occupies a radioactive problem due to the Chernobyl nuclear power plant. Also, nearby, in the Kyiv region Kiev reservoir are with not the best environmental conditions. The most important components of ecosystems: the air of the city, urban and suburban water sources, soil city. International experts conducted a study in 215 cities around the world. Kyiv international ranking is 29 in place pollution. Thus, the problem of environmental security for the population of the city. Kyiv, as many large cities in Ukraine is quite relevant. In this regard, the article studies that the environmental safety of life of the urban population in the context of national security - a state of effective security systems (environment interconnected structural levels of the individual, the local community, society, state and international (global community of aggregate factors that endanger or threaten the very existence of which

Current obstetrical practice and umbilical cord prolapse.

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Usta, I M; Mercer, B M; Sibai, B M

1999-01-01

The aim of this study was to assess the contribution of current obstetrical practice to the occurrence and complications of umbilical cord prolapse. Maternal and neonatal charts of 87 pregnancies complicated by true umbilical cord prolapse during a 5-year period were reviewed. Twin gestation and noncephalic presentations were common features (14 and 41%, respectively). Eighty-nine percent (77) of infants were delivered by cesarean section of which 29% were classical and 88% were primary. The mean gestational age at delivery was 34.0 +/- 6.0 weeks, and the mean birth weight was 2318 +/- 1159 g. Obstetrical intervention preceded 41 (47%) cases (the obstetrical intervention group): amniotomy (9), scalp electrode application (4), intrauterine pressure catheter insertion (6), attempted external cephalic version (7), expectant management of preterm premature rupture of membranes (14), manual rotation of the fetal head (1), and amnioreduction (1). There were 11 perinatal deaths. Thirty-three percent of the infants (32) had a 5-min Apgar score < 7 and 34% had a cord pH < 7.20. Neonatal seizures, intracerebral hemorrhage, necrotizing enterocolitis, hyaline membrane disease, persistent fetal circulation, sepsis, assisted ventilation, and perinatal mortality were comparable in the "obstetrical intervention" and "no-intervention" groups. Most of the neonatal complications occurred in infants < 32 weeks' gestation. We conclude that obstetrical intervention contributes to 47% of umbilical cord prolapse cases; however, it does not increase the associated perinatal morbidity and mortality.

POPULATION MOBILITY CHARACTERISTIC: NOTES FROM THE URBAN-URBAN INTERACTION IN SEMARANG METROPOLITAN REGION

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MARDHOTILLAH Santi

2016-12-01

Full Text Available The rapid growth of cities is characterized by the "pressure" in the form of increasingly dense urban areas, slums, traffic congestion, unemployment in the cities, and the number of illegal housing in the suburbs. This issue demonstrates the need for a balance between urban and rural areas. The balance is obtained through the interaction, and the interaction there is a process of "transfer" in the form of the human population, natural resources, and other supporting components. This view of the phenomenon makes many researchers conducting various studies in the context of the interaction between rural and urban. Furthermore, the study of the interaction of cities such as Salatiga and Semarang are in fact joined in the same region, KSN Kedungsepur. Semarang and surrounding developments as Semarang Metropolitan Region (SMR are the main attraction for the people who are around Semarang that caused an increase in the spatial interactions between Semarang and surrounding areas. From some areas belonging to KSN Kedungsepur, there are only two areas with the status of the city of Semarang city as a centre of KSN and Salatiga. This becomes interesting, unique conditions for studying the phenomenon under study is the interaction of the cities. The method used in this research was a quantitative method with descriptive analysis. Data was collected through a questionnaire survey technique primary by taking a random sample of migrants from Salatiga City and studied at the city of Semarang. The results of the study there were four mobility characteristics formed between Salatiga and Semarang, namely, commuting-boarding, boarding-commuting, boarding and boarding-permanent.

MITIGATION SCENARIOS FOR RESIDENTIAL FIRES IN DENSELY POPULATED URBAN SETTLEMENTS IN SUKAHAJI VILLAGE, BANDUNG CITY

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Saut Aritua Hasiholan Sagala

2016-10-01

Full Text Available Residential fires are a form of disaster that often occurs in urban areas especially in densely populated settlements. This study looks at possible mitigation scenarios for this kind of disaster. A case study was conducted in Babakan Ciparay Sub-District in Bandung City, among the densely populated settlements, and was focused especially on Sukahaji Village, a sub-unit of Babakan Ciparay, which is the most densely populated village in Bandung City with up to 234.14 people/ha. There have been six structural fires recorded from 2007 until 2010 occurring in Sukahaji. This study applied stratified random sampling as the preferred sampling technique and data collection method from a total population of 3,227 buildings. The data was then examined using risk analysis. The results have led to two intervention measures suggested as mitigation scenarios for residential fires that can be applied within the Sukahaji Village. The study concludes that mitigation measures through strengthening community capacity can be the principal option in reducing risk to fires in densely populated urban settlements.

Obstetric ultrasound aids prompt referral of gestational trophoblastic disease in marginalized populations on the Thailand-Myanmar border.

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McGregor, Kathryn; Myat Min, Aung; Karunkonkowit, Noaeni; Keereechareon, Suporn; Tyrosvoutis, Mary Ellen; Tun, Nay Win; Rijken, Marcus J; Hoogenboom, Gabie; Boel, Machteld; Chotivanich, Kesinee; Nosten, François; McGready, Rose

2017-01-01

The use of obstetric ultrasound in the diagnosis of gestational trophoblastic disease (GTD) in high-income settings is well established, leading to prompt management and high survival rates. Evidence from low-income settings suggests ultrasound is essential in identifying complicated pregnancies, but with limited studies reviewing specific conditions including GTD. The aim of this study is to review the role of ultrasound in diagnosis and management of GTD in a marginalized population on the Thailand-Myanmar border. Antenatal ultrasound became available in this rural setting in 2001 and care for women with GTD has been provided by Thailand public hospitals for 20 years. Retrospective record review. The incidence of GTD was 103 of 57,004 pregnancies in Karen and Burmese women on the Thailand-Myanmar border from 1993-2013. This equates to a rate of 1.8 (95% CI 1.5-2.2) per 1000 or 1 in 553 pregnancies. Of the 102 women with known outcomes, one (1.0%) died of haemorrhage at home. The median number of days between first antenatal clinic attendance and referral to hospital was reduced from 20 (IQR 5-35; range 1-155) to 2 (IQR 2-6; range 1-179) days (p = 0.002) after the introduction of ultrasound. The proportion of severe outcomes (death and total abdominal hysterectomy) was 25% (3/12) before ultrasound compared to 8.9% (8/90) with ultrasound (p = 0.119). A recurrence rate of 2.5% (2/80) was observed in the assessable population. The presence of malaria parasites in maternal blood was not associated with GTD. The rate of GTD in pregnancy in this population is comparable to rates previously reported within South-East Asia. Referral time for uterine evacuation was significantly shorter for those women who had an ultrasound. Ultrasound is an effective method to improve diagnosis of GTD in low-income settings and an effort to increase availability in marginalized populations is required.

Spatial vulnerability of Australian urban populations to extreme heat events

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Loughnan, Margaret; Tapper, Nigel; Phan, Thu; Lynch, Kellie; McInnes, Judith

2013-04-01

Extreme heat events pose a risk to the health of all individuals, especially the elderly and the chronically ill, and are associated with an increased demand for healthcare services. In order to address this problem, policy makers' need information about temperatures above which mortality and morbidity of the exposed population is likely to increase, where the vulnerable groups in the community are located, and how the risks from extreme heat events are likely to change in the future. This study identified threshold temperatures for all Australian capital cities, developed a spatial index of population vulnerability, and used climate model output to predict changes in the number of days exceeding temperature thresholds in the future, as well as changes in risk related to changes in urban density and an ageing population. The study has shown that daily maximum and minimum temperatures from the Bureau of Meteorology forecasts can be used to calculate temperature thresholds for heat alert days. The key risk factors related to adverse health outcomes were found to be areas with intense urban heat islands, areas with higher proportions of older people, and areas with ethnic communities. Maps of spatial vulnerability have been developed to provide information to assist emergency managers, healthcare professionals, and ancillary services develop heatwave preparedness plans at a local scale that target vulnerable groups and address heat-related health risks. The numbers of days exceeding current heat thresholds are predicted to increase over the next 20 to 40 years in all Australian capital cities.

Role of telephone triage in obstetrics.

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Manning, Nirvana Afsordeh; Magann, Everett F; Rhoads, Sarah J; Ivey, Tesa L; Williams, Donna J

2012-12-01

The telephone has become an indispensable method of communication in the practice of obstetrics. The telephone is one of the primary methods by which the patient makes her appointments and contacts her health care provider for advice, reassurance, and referrals. Current methods of telephone triage include personal at the physicians' office, telephone answering services, labor and delivery nurses, and a dedicated telephone triage system using algorithms. Limitations of telephone triage include the inability of the provider to see the patient and receive visual clues from the interaction and the challenges of obtaining a complete history over the telephone. In addition, there are potential safety and legal issues with telephone triage. To date, there is insufficient evidence to either validate or refute the use of a dedicated telephone triage system compared with a traditional system using an answering service or nurses on labor and delivery. Obstetricians and gynecologists, family physicians. After completing this CME activity, physicians should be better able to analyze the scope of variation in telephone triage across health care providers and categorize the components that go into a successful triage system, assess the current scope of research in telephone triage in obstetrics, evaluate potential safety and legal issues with telephone triage in obstetrics, and identify issues that should be addressed in any institution that is using or implementing a system of telephone triage in obstetrics.

Morphometric characteristics of sycamore maple (Acer pseudoplatanus L. fruits in Novi Sad urban populations

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Kostić Saša

2017-01-01

Full Text Available This paper shows the results of the analysis of the fruit morphometric characteristics of 29 trees of sycamore maple (Acer pseudoplatanus L. and red - leaf sycamore maple (Acer pseudoplatanus ‘Аtropurpureum’ Späth. in Novi Sad area. Based on the test trees, it can be concluded that the analyzed secondary population of sycamore maple has a high level of intra - populations variability, based on different degrees of variability of measured parameters and statistically significant differences of all analyzed parameters within the analysed genotypes. The results indicate that there are certain differences between fruit of sycamore maple and its red - leaf variety. Given that there is no statistically significant difference between sites and different urban spaces, it can be concluded that stress factors caused by a high degree of urbanity do not affect the morphometric characteristics of fruits in the analyzed test trees. Testing the symmetry of fruits indicates a high level of genetic variability within the analyzed population.

21st European Congress of Obstetrics and Gynaecology

DEFF Research Database (Denmark)

Hornnes, Peter

2010-01-01

The 21st European Congress of Obstetrics and Gynaecology took place in Antwerp 5-8 May 2010. The congress provided the participants with an overview of recent scientific and clinical developments throughout the field of obstetrics and gynaecology, and these are summarized in this article....

Students’ Scientific Circle of Obstetrics and Gynaecology

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Ivan Polishchuk

2017-06-01

Full Text Available The students’ scientific circle is the kind of teaching obstetrics and gynaecology in a higher medical institution. The circle is an elective form of learning that allows the students to get deeper knowledge of a subject and to perfect themselves in the issues of diagnostics in obstetrics and gynaecology as well as to acquaint themselves with basic medical techniques. It helps identify students who are capable of scientific research and allows the students to improve their ability to analytical perception of professional information, the ability to present it to the audience, ask and answer the questions publicly. The article presents the results of practical and research activities of obstetric and gynaecologic section of the students’ scientific circle of Ivano-Frankivsk National Medical University.

Utility of an Algorithm to Increase the Accuracy of Medication History in an Obstetrical Setting.

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Corbel, Aline; Baud, David; Chaouch, Aziz; Beney, Johnny; Csajka, Chantal; Panchaud, Alice

2016-01-01

In an obstetrical setting, inaccurate medication histories at hospital admission may result in failure to identify potentially harmful treatments for patients and/or their fetus(es). This prospective study was conducted to assess average concordance rates between (1) a medication list obtained with a one-page structured medication history algorithm developed for the obstetrical setting and (2) the medication list reported in medical records and obtained by open-ended questions based on standard procedures. Both lists were converted into concordance rate using a best possible medication history approach as the reference (information obtained by patients, prescribers and community pharmacists' interviews). The algorithm-based method obtained a higher average concordance rate than the standard method, with respectively 90.2% [CI95% 85.8-94.3] versus 24.6% [CI95%15.3-34.4] concordance rates (phistory in our obstetric population, without using substantial resources. Its implementation is an effective first step to the medication reconciliation process, which has been recognized as a very important component of patients' drug safety.

Accounts of severe acute obstetric complications in rural Bangladesh.

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Sikder, Shegufta S; Labrique, Alain B; Ullah, Barkat; Ali, Hasmot; Rashid, Mahbubur; Mehra, Sucheta; Jahan, Nusrat; Shamim, Abu A; West, Keith P; Christian, Parul

2011-10-21

As maternal deaths have decreased worldwide, increasing attention has been placed on the study of severe obstetric complications, such as hemorrhage, eclampsia, and obstructed labor, to identify where improvements can be made in maternal health. Though access to medical care is considered to be life-saving during obstetric emergencies, data on the factors associated with health care decision-making during obstetric emergencies are lacking. We aim to describe the health care decision-making process during severe acute obstetric complications among women and their families in rural Bangladesh. Using the pregnancy surveillance infrastructure from a large community trial in northwest rural Bangladesh, we nested a qualitative study to document barriers to timely receipt of medical care for severe obstetric complications. We conducted 40 semi-structured, in-depth interviews with women reporting severe acute obstetric complications and purposively selected for conditions representing the top five most common obstetric complications. The interviews were transcribed and coded to highlight common themes and to develop an overall conceptual model. Women attributed their life-threatening experiences to societal and socioeconomic factors that led to delays in seeking timely medical care by decision makers, usually husbands or other male relatives. Despite the dominance of male relatives and husbands in the decision-making process, women who underwent induced abortions made their own decisions about their health care and relied on female relatives for advice. The study shows that non-certified providers such as village doctors and untrained birth attendants were the first-line providers for women in all categories of severe complications. Coordination of transportation and finances was often arranged through mobile phones, and referrals were likely to be provided by village doctors. Strategies to increase timely and appropriate care seeking for severe obstetric complications may

Accounts of severe acute obstetric complications in Rural Bangladesh

Directory of Open Access Journals (Sweden)

Sikder Shegufta S

2011-10-01

Full Text Available Abstract Background As maternal deaths have decreased worldwide, increasing attention has been placed on the study of severe obstetric complications, such as hemorrhage, eclampsia, and obstructed labor, to identify where improvements can be made in maternal health. Though access to medical care is considered to be life-saving during obstetric emergencies, data on the factors associated with health care decision-making during obstetric emergencies are lacking. We aim to describe the health care decision-making process during severe acute obstetric complications among women and their families in rural Bangladesh. Methods Using the pregnancy surveillance infrastructure from a large community trial in northwest rural Bangladesh, we nested a qualitative study to document barriers to timely receipt of medical care for severe obstetric complications. We conducted 40 semi-structured, in-depth interviews with women reporting severe acute obstetric complications and purposively selected for conditions representing the top five most common obstetric complications. The interviews were transcribed and coded to highlight common themes and to develop an overall conceptual model. Results Women attributed their life-threatening experiences to societal and socioeconomic factors that led to delays in seeking timely medical care by decision makers, usually husbands or other male relatives. Despite the dominance of male relatives and husbands in the decision-making process, women who underwent induced abortions made their own decisions about their health care and relied on female relatives for advice. The study shows that non-certified providers such as village doctors and untrained birth attendants were the first-line providers for women in all categories of severe complications. Coordination of transportation and finances was often arranged through mobile phones, and referrals were likely to be provided by village doctors. Conclusions Strategies to increase timely

Factors Associated with Physical Inactivity among Adult Urban Population of Puducherry, India: A Population Based Cross-sectional Study.

Science.gov (United States)

Newtonraj, Ariarathinam; Murugan, Natesan; Singh, Zile; Chauhan, Ramesh Chand; Velavan, Anandan; Mani, Manikandan

2017-05-01

Physical inactivity is the fourth leading cause of death worldwide. Increase in physical activity decreases the incidence of cardiovascular diseases, Type 2 diabetes, stroke, and improves psychological wellbeing. To study the level of physical inactivity among the adult population in an urban area of Puducherry in India and its associated risk factors. This cross-sectional study was conducted among 569 adult participants from an urban area of Pondicherry. The level of physical inactivity was measured by using WHO standard Global Physical Activity Questionnaire (GPAQ). Overall prevalence of physical inactivity in our study was 49.7% (CI: 45.6-53.8). Among the physically active people, contribution of physical activity by work was 77.4%, leisure time activities were 11.6% and transport time was 11%. Both men and women were equally inactive {Physically inactive among women was 50% (CI:44.1-55.9)} and {Physically inactive among men was 49.5% (CI:43.8-55.2)}. Prevalence of physical inactivity was increasing with increasing age. Non tobacco users were two times more active than tobacco users {Adjusted Odds Ratio: 2.183 (1.175- 4.057)}. Employed were more active as compared to retired {Adjusted Odds Ratio: 0.412 (0.171-0.991)}, students {Adjusted Odds Ratio: 0.456 (0.196-1.060)}, house wives {Adjusted Odds Ratio: 0.757 (0.509-1.127)} and unemployed {Adjusted Odds Ratio: 0.538 (0.271-1.068)}. Non alcoholics were only 0.34 times as active as alcoholics. Level of physical activity was found to be insufficient among adult urban population of Puducherry. Working adult population found to be active, that too due to their work pattern. There is a need to promote leisure time and travelling time physical activity.

Prevalence and correlates of fear of falling among elderly population in urban area of Karnataka, India.

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Mane, Abhay B; Sanjana, T; Patil, Prabhakar R; Sriniwas, T

2014-07-01

Falls are a major public health problem in the elderly population. Fear of falling (FOF) among elderly persons can compromise quality of life by limiting mobility, diminished sense of well-being and reduced social interactions. India is undergoing a demographic transitional phase with urban elderly population of 6.72% in 2001. The major challenge would be on the prevention of falls among them. Hence there is a need to highlight the problems related to fall faced by the elderly in India. To study the prevalence of FOF and its correlates among the elderly population in urban area. 250 elderly subjects above 60 years were randomly selected from urban area and interviewed for FOF using Short Fall Efficacy Scale-I (FES-I), history of falls and risk factors. The prevalence of FOF among the elderly was 33.2%. The significant correlates of FOF were educational status, family type, associated health problems, history of fall in past 6 months, worried of fall again among fallers, fearfulness of fall again among fallers, restriction of daily activities and depression among them. The insignificant correlates were gender and socio-economic status. FOF is a health problem among the elderly living in urban India needs urgent attention. It represents a significant threat to socialization, independence and morbidity or mortality. Knowledge of correlates of FOF may be useful in developing multidimensional strategies to reduce it among elderly.

Prevalence, awareness, treatment and control of dyslipidemia in older persons in urban and rural population in the Astana region, Kazakhstan.

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Supiyev, Adil; Nurgozhin, Talgat; Zhumadilov, Zhaxybay; Peasey, Anne; Hubacek, Jaroslav A; Bobak, Martin

2017-08-11

Despite high cardiovascular mortality in Central Asian republics of the former Soviet Union, there is limited information about major risk factors, including blood lipids. We investigated the prevalence of impaired concentrations of blood lipids, the awareness, treatment and control of hypercholesterolemia, and factors associated with these indicators in urban and rural populations in Kazakhstan. We conducted a cross-sectional study of random urban and rural population samples (the state capital Astana and Akmol village). Men and women aged 50-74 years were examined; a total of 954 adults participated (response rate 59%). Serum concentrations of total, LDL and HDL cholesterol and triglycerides and a range of other cardiovascular risk factors were measured. The overall prevalence of hypercholesterolemia (total cholesterol ≥6.2 mmol/l) was 37%; among subjects with hypercholesterolemia, 57% were aware of their condition, 41% took medication and 23% had total cholesterol <6.2 mmol/l (4.5% <5 mmol/l). The prevalence, awareness, treatment, and control of hypercholesterolemia were all higher in the urban than the rural area. Similarly, the proportions of subjects with impaired concentrations of specific lipids fractions were also considerably higher in the urban population. Most associations with other covariates were in the expected direction. This study found relatively high prevalence of dyslipidemia in the Kazakh population, and the blood lipid profile was less favourable in the urban area. These pronounced urban-rural differences may be related to urbanization, the associated nutrition transition and to access to health care.

Patients' quality assessment of ambulatory obstetric and gynaecological services.

Science.gov (United States)

Bojar, I; Wdowiak, L; Ostrowski, T

2005-01-01

The quality could be assessed from two perspectives: internal and external. From the internal perspective the quality means being consistent with particular conditions and standards. The external perspective is based on relative assessment of the product made by a client who is also aware of other competitors' offer. Despite the professional assessment which is focused on providing health services according to medical and managerial correctness, patient's assessment is also relevant. Measuring patient's satisfaction is additional method of health services quality assessment. The aim of the study was to estimate patients' opinion on quality of ambulatory obstetric and gynaecological services. The study was conducted in 11 obstetric and gynaecological out-patient clinics of Lublin in September and October 2003. The study tool was an author's questionnaire. Patients were asked to assess such areas as registration before visit, their relationship with nurses and gynaecologists and other aspects of services provision like intimacy assurance and respecting Patient's Rights. The collected data was statistically analysed. 635 patients took part in the study. The biggest groups in the studied population were women at the age of 20-30 years, married, living in cities and secondary educated. It was found that around half of the population is satisfied and 2.2% of them are unsatisfied with the fact that they have chosen particular out-patient clinic. More than 70% of women had positive opinion of following aspects influencing general opinion about service quality: politness of reception desk staff, opening hours, the length of time before a patient is seen by the specialist, intimacy assurance and respect for Patient's Rights in the practice. 80% of patients were satisfied with the relationship with nurses and 3.3% were unsatisfied with it. Eight patients out of ten were satisfied with gynaecological care, less than 2% were unsatisfied. The studied women had also high opinion

Measures of reducing obstetric emergencies hysterectomy incidence.

Science.gov (United States)

Ren, Guo-ping; Wang, Bao-lian; Wang, Yan-hong

2016-03-01

To study the obstetric emergency hysterectomy which can reduce the incidence of measures. In maternity of Xinxiang Central Hospital, the total number of deliveries cases has been up to 50,526 in 20 years, of which 48 cases were retrospectively analyzed for the clinical data of Emergency uterine surgery cases. Cases underwent obstetric emergency hysterectomy accounted for 0.095% of total deliveries (48/50 526), in which 11 cases of vaginal delivery, 37 cases of cesarean section. The indications for surgery: 27 cases were cased by placental factors accounted for 56.25%; 14 cases of uterine inertia, accounting for 29.17%; uterine rupture in 4 cases, accounting for 8.33%; 3 cases of coagulopathy, accounting for 6.25%. Where the maternal placental factors hysterectomy is the most common (69.70%, 23/33) and the predominant factor is early maternal uterine inertia (60.00%, 9/15). There are 74.09% (20/27) of patients with placental abnormalities history of previous cesarean section or uterine surgery. The major risk factors leading to obstetric emergency hysterectomy is placental factors. Preventing the occurrence of placental abnormalities planting actively can effectively reduce the rate of obstetric hysterectomy.

Urban climate archipelagos: a new framework for urban impacts on climate

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J. Marshall Shepherd; T. Andersen; Chris Strother; A. Horst; L. Bounoua; C. Mitra

2013-01-01

Earth is increasingly an “urbanized” planet. The “World Population Clock” registered a Population of 7,175,309,538 at 8:30 pm (LST) on Oct. 6, 2013. Current and future trends suggest that this population will increasingly reside in cities. Currently, 52 percent of the world population is urban, which means we are a majority “urbanized” society. Figure 1 indicates...

[Spatial distribution characteristics of urban potential population in Shenyang City based on QuickBird image and GIS].

Science.gov (United States)

Li, Jun-Ying; Hu, Yuan-Man; Chen, Wei; Liu, Miao; Hu, Jian-Bo; Zhong, Qiao-Lin; Lu, Ning

2012-06-01

Population is the most active factor affecting city development. To understand the distribution characteristics of urban population is of significance for making city policy decisions and for optimizing the layout of various urban infrastructures. In this paper, the information of the residential buildings in Shenyang urban area was extracted from the QuickBird remote sensing images, and the spatial distribution characteristics of the population within the Third-Ring Road of the City were analyzed, according to the social and economic statistics data. In 2010, the population density in different types of residential buildings within the Third-Ring Road of the City decreased in the order of high-storey block, mixed block, mixed garden, old multi-storey building, high-storey garden, multi-storey block, multi-storey garden, villa block, shanty, and villa garden. The vacancy rate of the buildings within the Third-Ring Road was more than 30%, meaning that the real estate market was seriously overstocked. Among the five Districts of Shenyang City, Shenhe District had the highest potential population density, while Tiexi District and Dadong District had a lower one. The gravity center of the City and its five Districts was also analyzed, which could provide basic information for locating commercial facilities and planning city infrastructure.

Obstetrical violence: activism on social networkin

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Lia Hecker Luz

2015-12-01

Full Text Available Normal birth in contemporaneity is discussed and the three models of birth care are presented, accordingly to categorization proposed by the north-American anthropologist Davis-Floyd, pointing out the consequences of the technocratic model, which has become hegemonic in contemporary societies, naturalizing obstetrical violence. The problematic is contextualized to Brazilian reality, with the analyses of the blog Cientista que virou mãe making it evident that Brazilian women on social media are articulating themselves in order to defend and give visibility to initiatives of natural and humanized birth, acting against obstetrical violence. It is concluded that Internet tools have allowed a pioneer mobilization in respecting women’s reproductive rights in Brazil, turning blogs into a potential hegemonic alternative way to reach more democratic forms of social organization. In addition to denaturalize the obstetrical violence, the bloggers also act aiming to pave the way for the humanistic approach and to motivate planned home birth initiatives.

Campylobacter jejuni colonization and population structure in urban populations of ducks and starlings in New Zealand.

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Mohan, Vathsala; Stevenson, Mark; Marshall, Jonathan; Fearnhead, Paul; Holland, Barbara R; Hotter, Grant; French, Nigel P

2013-08-01

A repeated cross-sectional study was conducted to determine the prevalence of Campylobacter spp. and the population structure of C. jejuni in European starlings and ducks cohabiting multiple public access sites in an urban area of New Zealand. The country's geographical isolation and relatively recent history of introduction of wild bird species, including the European starling and mallard duck, create an ideal setting to explore the impact of geographical separation on the population biology of C. jejuni, as well as potential public health implications. A total of 716 starling and 720 duck fecal samples were collected and screened for C. jejuni over a 12 month period. This study combined molecular genotyping, population genetics and epidemiological modeling and revealed: (i) higher Campylobacter spp. isolation in starlings (46%) compared with ducks (30%), but similar isolation of C. jejuni in ducks (23%) and starlings (21%), (ii) significant associations between the isolation of Campylobacter spp. and host species, sampling location and time of year using logistic regression, (iii) evidence of population differentiation, as indicated by FST , and host-genotype association with clonal complexes CC ST-177 and CC ST-682 associated with starlings, and clonal complexes CC ST-1034, CC ST-692, and CC ST-1332 associated with ducks, and (iv) greater genetic diversity and genotype richness in ducks compared with starlings. These findings provide evidence that host-associated genotypes, such as the starling-associated ST-177 and ST-682, represent lineages that were introduced with the host species in the 19th century. The isolation of sequence types associated with human disease in New Zealand indicate that wild ducks and starlings need to be considered as a potential public health risk, particularly in urban areas. © 2013 The Authors. Microbiology Open published by John Wiley & Sons Ltd.

Beyond urban penalty and urban sprawl: back to living conditions as the focus of urban health.

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Freudenberg, Nicholas; Galea, Sandro; Vlahov, David

2005-02-01

Researchers have long studied urban health, both to describe the consequences of urban living and to design interventions to promote the health of people living in cities. Two approaches to understanding the impact of cities on health have been dominant, namely, urban health penalty and urban sprawl. The urban penalty approach posits that cities concentrate poor people and expose them to unhealthy physical and social environments. Urban sprawl focuses on the adverse health and environmental effects of urban growth into outlying areas. We propose a model that integrates these approaches and emphasizes urban living conditions as the primary determinant of health. The aim of the model is to move beyond describing the health-related characteristics of various urban populations towards identifying opportunities for intervention. Such a shift in framework enables meaningful comparisons that can inform public health activities at the appropriate level and evaluate their effectiveness in improving the health of urban populations. The model is illustrated with two examples from current urban public health practice.

Using the unmet obstetric needs indicator to map inequities in life-saving obstetric interventions at the local health care system in Kenya

DEFF Research Database (Denmark)

Echoka, Elizabeth; Dubourg, Dominique; Makokha, Anselimo

2014-01-01

BackgroundDeveloping countries with high maternal mortality need to invest in indicators that not only provide information about how many women are dying, but also where, and what can be done to prevent these deaths. The unmet Obstetric Needs (UONs) concept provides this information. This concept...... was applied at district level in Kenya to assess how many women had UONs and where the women with unmet needs were located.MethodsA facility based retrospective study was conducted in 2010 in Malindi District, Kenya. Data on pregnant women who underwent a major obstetric intervention (MOI) or died...... in facilities that provide comprehensive Emergency Obstetric Care (EmOC) services in 2008 and 2009 were collected. The difference between the number of women who experienced life threatening obstetric complications and those who received care was quantified. The main outcome measures in the study were...

Prevalence of vitamin D deficiency and its associated factors among the urban elderly population in Hyderabad metropolitan city, South India.

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Suryanarayana, Palla; Arlappa, Nimmathota; Sai Santhosh, Vadakattu; Balakrishna, Nagalla; Lakshmi Rajkumar, Pondey; Prasad, Undrajavarapu; Raju, Banavath Bhoja; Shivakeseva, Kommula; Divya Shoshanni, Kondru; Seshacharyulu, Madabushi; Geddam, Jagjeevan Babu; Prasanthi, Prabhakaran Sobhana; Ananthan, Rajendran

2018-03-01

Deficiency of vitamin D has been associated with various health conditions. However, vitamin D deficiency (VDD) and factors associated with VDD are not well studied, especially among the urban elderly population of India. To assess the prevalence of VDD and its associated factors among the urban free-living elderly population in Hyderabad. A community-based cross-sectional study was conducted among 298 urban elderly (≥60 years) by adapting a random sampling procedure. Demographic particulars were collected. Blood pressure and anthropometric measurements were recorded using standard equipment. Fasting glucose, lipid profile and 25-hydroxy vitamin D [25(OH) D] were estimated in plasma samples. The mean ± SE plasma vitamin D and the prevalence of VDD among the urban elderly population were 19.3 ± 0.54 (ng/ml) and 56.3%, respectively. The prevalence of VDD was significantly associated with education, high body mass index (BMI), hypertension (HT) and metabolic syndrome (MS). Multiple logistic regression analysis revealed HT as a significant predictor of vitamin D deficiency and the risk of VDD was double among the elderly with hypertension. The prevalence of VDD was high among the urban elderly population in the south Indian city of Hyderabad. High BMI, MS, HT and education are significant associated factors of VDD.

Partograph utilization and associated factors among obstetric care ...

African Journals Online (AJOL)

Methods: An Institution based cross-sectional study was conducted in June, 2013 on 403 obstetric care providers. A pre-tested and structured ... Being a midwife by profession, on job training, knowledge and attitude of obstetric care providers were factors affecting partograph utilization. Providing on job training for providers ...

Prevalence of metabolic syndrome among an urban population in Kenya.

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Kaduka, Lydia U; Kombe, Yeri; Kenya, Eucharia; Kuria, Elizabeth; Bore, John K; Bukania, Zipporah N; Mwangi, Moses

2012-04-01

Developing countries are undergoing an epidemiologic transition accompanied by increasing burden of cardiovascular disease (CVD) linked to urbanization and lifestyle modifications. Metabolic syndrome is a cluster of CVD risk factors whose extent in Kenya remains unknown. The aim of this study was to determine the prevalence of metabolic syndrome and factors associated with its occurrence among an urban population in Kenya. This was a household cross-sectional survey comprising 539 adults (aged ≥18 years) living in Nairobi, drawn from 30 clusters across five socioeconomic classes. Measurements included waist circumference, HDL cholesterol, triacylglycerides (TAGs), fasting glucose, and blood pressure. The prevalence of metabolic syndrome was 34.6% and was higher in women than in men (40.2 vs. 29%; P Kenya. The Kenyan government needs to create awareness, develop prevention strategies, and strengthen the health care system to accommodate screening and management of CVDs.

Urban dogs in rural areas: Human-mediated movement defines dog populations in southern Chile.

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Villatoro, Federico J; Sepúlveda, Maximiliano A; Stowhas, Paulina; Silva-Rodríguez, Eduardo A

2016-12-01

Management strategies for dog populations and their diseases include reproductive control, euthanasia and vaccination, among others. However, the effectiveness of these strategies can be severely affected by human-mediated dog movement. If immigration is important, then the location of origin of dogs imported by humans will be fundamental to define the spatial scales over which population management and research should apply. In this context, the main objective of our study was to determine the spatial extent of dog demographic processes in rural areas and the proportion of dogs that could be labeled as immigrants at multiple spatial scales. To address our objective we conducted surveys in households located in a rural landscape in southern Chile. Interviews allowed us to obtain information on the demographic characteristics of dogs in these rural settings, human influence on dog mortality and births, the localities of origin of dogs living in rural areas, and the spatial extent of human-mediated dog movement. We found that most rural dogs (64.1%) were either urban dogs that had been brought to rural areas (40.0%), or adopted dogs that had been previously abandoned in rural roads (24.1%). Some dogs were brought from areas located as far as ∼700km away from the study area. Human-mediated movement of dogs, especially from urban areas, seems to play a fundamental role in the population dynamics of dogs in rural areas. Consequently, local scale efforts to manage dog populations or their diseases are unlikely to succeed if implemented in isolation, simply because dogs can be brought from surrounding urban areas or even distant locations. We suggest that efforts to manage or study dog populations and related diseases should be implemented using a multi-scale approach. Copyright © 2016 Elsevier B.V. All rights reserved.

The Contributions of Urban Landscape to Urban Life

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Ahmet Tuğrul Polat

2017-06-01

Full Text Available The issues of urban and urbanization emerged after the industrial revolution. Thus, cities that have increased rapidly in population have become points of attraction for people. Over the past century, the world population has begun to gather quickly in urban areas. Cities are transforming into unhealthy living environments with distorted ecological balance, lost green areas and aesthetic qualities. The value of accessible green spaces in urban areas is increasing to the unprecedented levels. The green space system seen as a necessity in the cities have provided the emergence of the "urban landscape" phenomenon. The issue of urban landscape is now a very serious concept. The landscape change is moving along with the level of civilization. Primarily, guidance service should be offered for more efficient, comfortable and protective areas. An interdisciplinary approach is needed in the creation of urban spaces. In this study, the term of urban landscape was explained and the researches about the contributions of urban landscape to urban life were examined and suggestions were made about the subject.

Utility of proteomics in obstetric disorders: a review

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Hernández-Núñez J

2015-04-01

Full Text Available Jónathan Hernández-Núñez,1 Magel Valdés-Yong21Department of Obstetrics and Gynecology, Hospital Alberto Fernández-Valdés, Santa Cruz del Norte, Mayabeque, 2Department of Obstetrics and Gynecology, Hospital Luis Díaz Soto, Habana del Este, La Habana, CubaAbstract: The study of proteomics could explain many aspects of obstetric disorders. We undertook this review with the aim of assessing the utility of proteomics in the specialty of obstetrics. We searched the electronic databases of MEDLINE, EBSCOhost, BVS Bireme, and SciELO, using various search terms with the assistance of a librarian. We considered cohort studies, case-control studies, case series, and systematic review articles published until October 2014 in the English or Spanish language, and evaluated their quality and the internal validity of the evidence provided. Two reviewers extracted the data independently, then both researchers simultaneously revised the data later, to arrive at a consensus. The search retrieved 1,158 papers, of which 965 were excluded for being duplicates, not relevant, or unrelated studies. A further 86 papers were excluded for being guidelines, protocols, or case reports, along with another 64 that did not contain relevant information, leaving 43 studies for inclusion. Many of these studies showed the utility of proteomic techniques for prediction, pathophysiology, diagnosis, management, monitoring, and prognosis of pre-eclampsia, perinatal infection, premature rupture of membranes, preterm birth, intrauterine growth restriction, and ectopic pregnancy. Proteomic techniques have enormous clinical significance and constitute an invaluable weapon in the management of obstetric disorders that increase maternal and perinatal morbidity and mortality.Keywords: proteomic techniques, obstetrics, diagnosis, prediction

Measuring urban agglomeration using a city-scale dasymetric population map: A study in the Pearl River Delta, China

OpenAIRE

Wei, Chunzhu; Taubenböck, Hannes; Blaschke, Thomas

2017-01-01

The rates of urbanization and increase in urban sprawl that have occurred in China over the past thirty years have been unprecedented. This article presents a new city-scale dasymetric modelling approach that incorporates historical census data for 28 cities in the Pearl River Delta area of southern China. It combines Landsat imagery (from 2000, 2005, 2010, and 2015) with a ‘limiting variable’ estimation al-gorithm to generate a gridded estimate of population density. These gridded population...

Antinuclear antibody testing in obstetric patients | Afman | South ...

African Journals Online (AJOL)

Objectives. To assess possible associations between the presence of antinuclear antibodies (ANAs) and pregnancy outcome in order to determine the significance of this test in obstetric practice. Methods. A case-control study was performed on 408 patients admitted to an obstetric high care unit and on whom ANA testing ...

Abdominal Fascial Closure in Obstetrics: Comparison of Outcome ...

African Journals Online (AJOL)

Background: Midline laparotomies are in common use in obstetrics for caesarean section and other obstetric laparotomies. Current challenges in this surgical approach include the best approach to the repair of the abdominal wall incision, the optimal suture material for its fascial repair and poor cosmetic outcome of the scar ...

Toolbox for Urban Mobility Simulation: High Resolution Population Dynamics for Global Cities

Science.gov (United States)

Bhaduri, B. L.; Lu, W.; Liu, C.; Thakur, G.; Karthik, R.

2015-12-01

In this rapidly urbanizing world, unprecedented rate of population growth is not only mirrored by increasing demand for energy, food, water, and other natural resources, but has detrimental impacts on environmental and human security. Transportation simulations are frequently used for mobility assessment in urban planning, traffic operation, and emergency management. Previous research, involving purely analytical techniques to simulations capturing behavior, has investigated questions and scenarios regarding the relationships among energy, emissions, air quality, and transportation. Primary limitations of past attempts have been availability of input data, useful "energy and behavior focused" models, validation data, and adequate computational capability that allows adequate understanding of the interdependencies of our transportation system. With increasing availability and quality of traditional and crowdsourced data, we have utilized the OpenStreetMap roads network, and has integrated high resolution population data with traffic simulation to create a Toolbox for Urban Mobility Simulations (TUMS) at global scale. TUMS consists of three major components: data processing, traffic simulation models, and Internet-based visualizations. It integrates OpenStreetMap, LandScanTM population, and other open data (Census Transportation Planning Products, National household Travel Survey, etc.) to generate both normal traffic operation and emergency evacuation scenarios. TUMS integrates TRANSIMS and MITSIM as traffic simulation engines, which are open-source and widely-accepted for scalable traffic simulations. Consistent data and simulation platform allows quick adaption to various geographic areas that has been demonstrated for multiple cities across the world. We are combining the strengths of geospatial data sciences, high performance simulations, transportation planning, and emissions, vehicle and energy technology development to design and develop a simulation

Obstetrical referrals by traditional birth attendants.

Science.gov (United States)

Mustafa, Rozina; Hashmi, Haleema; Mustafa, Rubina

2012-01-01

In Pakistan 90% of births are conducted by TBA's. In most cases, TBA's are unable to diagnose the complications and are often unable to take decisions on timely referral. The objective of this study was to determine the prevalence, nature and outcome of life threatening obstetrical conditions in referrals by Traditional Birth Attendants (TBAs). This Observational, Descriptive study was conducted from January to December 2007, in the obstetrical unit of Fatima Hospital, Baqai Medical University, a tertiary care community based hospital. The study included patients referred by TBA's who developed life threatening obstetric conditions (LTOCs). Total 64 patients were referred by TBA's. The prevalence was 7.8%. Out of them, 53 (82.8%) patients admitted with life threatening obstetric conditions. The near-miss morbidities and mortalities were 45 (84.9%) and 8 (15%) respectively. Maternal mortality to Near-miss morbidity ratio was 1:6. Obstructed labour caused near-miss morbidity in 32 (60.3%) patients with no mortality. Postpartum haemorrhage as life threatening condition developed in 16 (30.1%) patients with 10 (18.8%) near-miss morbidities and 6 (11.3%) mortalities. Puerperal sepsis accounted for 1 (1.88%) near-miss morbidity and 2 (3.76%) mortalities. The mortality index for puerperal sepsis is (66.6%) almost double of postpartum haemorrhage (37.5%). Mortality to near miss morbidity ratio is high. Misidentification and late referrals of complicated cases by TBA's were responsible for near-miss morbidities and mortalities.

Outcomes of cataract surgery in a rural and urban south Indian population

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Vijaya Lingam

2010-01-01

Full Text Available Purpose: To assess the visual outcome after cataract surgery in a south Indian population. Materials and Methods: Population-based cross-sectional study of subjects aged 40 years or more. Three thousand nine hundred and twenty-four rural subjects from 27 contiguous villages and 3850 urban subjects from five randomly selected divisions were studied. All subjects underwent a comprehensive ophthalmic examination that included visual acuity, refraction, slit-lamp biomicroscopy, applanation tonometry, gonioscopy, and dilated retinal examination. Statistical Analysis: Chi square test, t test and multivariate analysis were used. Results: Five hundred and twenty-eight (216 males, 312 females, 781 eyes rural subjects (13.5%, 95% confidence interval (CI 12.4% to 14.6% and 406 (197 males, 209 females, 604 eyes urban subjects (10.5%, 95% CI 9.6-11.5% had undergone cataract surgery. Outcome of cataract surgery was defined based on visual acuity. Using best-corrected visual acuity for classification, the single most important cause for visual impairment was cystoid macular edema in the aphakic group and posterior capsule opacification in the pseudophakic group. Aphakia (visual acuity of < 20/60 to ≤ 20/400 - odds ratio (OR 1.8; 95% CI 1.3 to 2.6%, visual acuity of < 20/400 - OR 6.2; 95% 4.0 to 9.8%, rural residence (visual acuity of < 20/60 to ≤ 20/400 - OR 3.2; 95% CI 2.2 to 4.5% and visual acuity of < 20/400 - OR OR 3.5; 95% CI 2.3 to 5.5% were associated with visual impairment. The urban cataract-operated population had significantly more pseudophakics ( P < 0.001, men ( P = 0.02 and literates ( P < 0.001. In the rural group the prevalence of cataract surgery (13.5% vs. 10.5%, P < 0.001 and number of people that had undergone cataract surgery within three years prior to examination ( P < 0.001 were significantly greater. In 30% of rural and 16% of urban subjects uncorrected refraction was the cause of visual impairment. Conclusions: Surgery

Land development, land use, and urban sprawl in Puerto Rico integrating remote sensing and population census data.

Science.gov (United States)

Sebastian Martinuzzi; William A. Gould; Olga M. Ramos Gonzalez

2007-01-01

The island of Puerto Rico has both a high population density and a long history of ineffective land use planning. This study integrates geospatial technology and population census data to understand how people use and develop the lands. We define three new regions for Puerto Rico: Urban (16%), Densely Populated Rural (36%), and Sparsely Populated Rural (48%). Eleven...

Rural Tanzanian women's awareness of danger signs of obstetric complications

Directory of Open Access Journals (Sweden)

Lindmark Gunilla

2009-03-01

Full Text Available Abstract Background Awareness of the danger signs of obstetric complications is the essential first step in accepting appropriate and timely referral to obstetric and newborn care. The objectives of this study were to assess women's awareness of danger signs of obstetric complications and to identify associated factors in a rural district in Tanzania. Methods A total of 1118 women who had been pregnant in the past two years were interviewed. A list of medically recognized potentially life threatening obstetric signs was obtained from the responses given. Chi- square test was used to determine associations between categorical variables and multivariate logistic regression analysis was used to identify factors associated with awareness of obstetric danger signs. Results More than 98% of the women attended antenatal care at least once. Half of the women knew at least one obstetric danger sign. The percentage of women who knew at least one danger sign during pregnancy was 26%, during delivery 23% and after delivery 40%. Few women knew three or more danger signs. According to multivariate logistic regression analysis having secondary education or more increased the likelihood of awareness of obstetric danger signs six-fold (OR = 5.8; 95% CI: 1.8–19 in comparison with no education at all. The likelihood to have more awareness increased significantly by increasing age of the mother, number of deliveries, number of antenatal visits, whether the delivery took place at a health institution and whether the mother was informed of having a risks/complications during antenatal care. Conclusion Women had low awareness of danger signs of obstetric complications. We recommend the following in order to increase awareness of danger signs of obstetrical complications: to improve quality of counseling and involving other family members in antenatal and postnatal care, to use radio messages and educational sessions targeting the whole community and to intensify

Population structure of fishes from an urban stream

Directory of Open Access Journals (Sweden)

Naiara Zanatta

2017-05-01

Full Text Available The aim of this study was to identify the population structure of the ichthyofauna in an urban stream within an environmental protection area in southern Brazil. Quarterly samplings were conducted between October 2009 and August 2010. Poecilia reticulata was the most abundant species, followed by Hypostomus ancistroides and Rhamdia quelen. It was found a higher proportion of adults instead of juveniles from P. reticulata and R. quelen populations, while the opposite was recorded for H. ancistroides. Sex ratio of 1:1 was found for H. ancistroides, but differed significantly for P. reticulata and R. quelen. Females of P. reticulata and R. quelen reached higher length than males in the smaller and higher length-classes, while H. ancistroides females were only longer in initial length-classes. It was recorded higher occurrence of mature and maturing individuals. Mature individuals of H. ancistroides were sampled in October, and P. reticulata and R. quelen throughout the sampling period. Despite adverse environmental conditions, the occurrence of juveniles indicates reproductive activity for these species. Population structure studies in degraded systems are urgent, since life-history features of species may suffer changes due to anthropic impacts. Providing such information contributes to decision making and management of degraded systems.

Studies on manifestations of canine distemper virus infection in an urban dog population.

Science.gov (United States)

Blixenkrone-Møller, M; Svansson, V; Have, P; Orvell, C; Appel, M; Pedersen, I R; Dietz, H H; Henriksen, P

1993-10-01

An upsurge of canine distemper was recognized at the beginning of 1991 in the urban dog population of the Copenhagen area. The outbreak had the characteristics of a virulent morbillivirus introduction in a partly immune population, where the disease primarily was manifested in young individuals. Testing of single serum samples for the presence of canine distemper virus (CDV) IgM antibodies using an IgM ELISA confirmed current and recent CDV infections in an urban dog population, where the use of attenuated CDV vaccines was widespread. In 49 out of 66 sera from clinical cases suspected of canine distemper we detected CDV IgM antibodies, as compared to the detection of viral antigen by indirect immunofluorescence in 27 of 65 specimens of conjunctival cells. The antigenic make-up of isolates from acute and subacute clinical cases was investigated with a panel of 51 monoclonal antibodies directed against CDV and the related phocine distemper virus. The isolates exhibited an homogeneous reaction pattern and shared overall antigenic characteristics of the CDV prototype. The majority of cases were diagnosed among unvaccinated dogs and individuals with unknown or obscure vaccination record. However, severe clinical cases were also diagnosed in vaccinated individuals.

Modeling the effects of land cover and use on landscape capability for urban ungulate populations: Chapter 11

Science.gov (United States)

Underwood, Harold; Kilheffer, Chellby R.; Francis, Robert A.; Millington, James D. A.; Chadwick, Michael A.

2016-01-01

Expanding ungulate populations are causing concerns for wildlife professionals and residents in many urban areas worldwide. Nowhere is the phenomenon more apparent than in the eastern US, where urban white-tailed deer (Odocoileus virginianus) populations are increasing. Most habitat suitability models for deer have been developed in rural areas and across large (>1000 km2) spatial extents. Only recently have we begun to understand the factors that contribute to space use by deer over much smaller spatial extents. In this study, we explore the concepts, terminology, methodology and state-of-the-science in wildlife abundance modeling as applied to overabundant deer populations across heterogeneous urban landscapes. We used classified, high-resolution digital orthoimagery to extract landscape characteristics in several urban areas of upstate New York. In addition, we assessed deer abundance and distribution in 1-km2 blocks across each study area from either aerial surveys or ground-based distance sampling. We recorded the number of detections in each block and used binomial mixture models to explore important relationships between abundance and key landscape features. Finally, we cross-validated statistical models of abundance and compared covariate relationships across study sites. Study areas were characterized along a gradient of urbanization based on the proportions of impervious surfaces and natural vegetation which, based on the best-supported models, also distinguished blocks potentially occupied by deer. Models performed better at identifying occurrence of deer and worse at predicting abundance in cross-validation comparisons. We attribute poor predictive performance to differences in deer population trajectories over time. The proportion of impervious surfaces often yielded better predictions of abundance and occurrence than did the proportion of natural vegetation, which we attribute to a lack of certain land cover classes during cold and snowy winters

Urban lifestyle and urban biodiversity

DEFF Research Database (Denmark)

Petersen, L. K.; Lyytimäki, J.; Normander, B.

2007-01-01

This report is concerned with the relations between lifestyles of urban populations on one hand and protection of biodiversity in urban areas on the other. Urban areas are of importance for the general protection of biodiversity. In the surroundings of cities and within urban sprawls there can...... biodiversity, recreational, educational and other needs. However, uncovered and unsealed space is constantly under pressure for building and infrastructure development in the urban landscape, and the design and usages of urban green structure is a matter of differing interests and expectations. Integrating...... the green needs of urban lifestyle in the planning process does not come by itself. Nor does finding the synergies between urban lifestyle and urban biodiversity. Careful planning including stakeholder involvement is required. In this process various mapping techniques and use of indicators can be most...

Self-reported post-discharge symptoms following obstetric neuraxial blockade.

LENUS (Irish Health Repository)

Hayes, N E

2010-10-01

Economic pressures are leading to earlier hospital discharge following delivery, before complications of obstetric neuraxial block may become apparent. Our aim was to estimate the incidence of symptoms presenting post-discharge at a single tertiary obstetric centre.

Determinants of obstetric fistula in Ethiopia. Asrat Atsedeweyn ...

African Journals Online (AJOL)

2017-09-03

Sep 3, 2017 ... factors for obstetrics fistula include early age at pregnan- cy, short stature, illiteracy, poverty, not attending antenatal care, and rural place of residence or living far away from a health facility14. Tesfaye17 used the Cox proportional hazard analysis to evaluate time to recovery of obstetric fistula at Yirgalem.

[Obstetrical APS: Is there a place for additional treatment to aspirin-heparin combination?

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Mekinian, A; Kayem, G; Cohen, J; Carbillon, L; Abisror, N; Josselin-Mahr, L; Bornes, M; Fain, O

2017-01-01

Obstetrical APS is defined by thrombosis and/or obstetrical morbidity associated with persistent antiphospholipid antibodies. The aspirin and low molecular weighted heparin combination dramatically improved obstetrical outcome in APS patients. Several factors could be associated with obstetrical prognosis, as previous history of thrombosis, associated SLE, the presence of lupus anticoagulant and triple positivity of antiphospholipid antibodies. Obstetrical APS with isolated recurrent miscarriages is mostly associated with isolated anticardiolipids antibodies and have better obstetrical outcome. The pregnancy loss despite aspirin and heparin combination define the refractory obstetrical APS, and the prevalence could be estimated to 20-39%. Several other treatments have been used in small and open labeled studies, as steroids, intravenous immunoglobulins, plasma exchanges and hydroxychloroquine to improve the obstetrical outcome. Some other drugs as eculizumab and statins could also have physiopathological rational, but studies are necessary to define the place of these various drugs. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Air quality and urban form in U.S. urban areas: evidence from regulatory monitors.

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Clark, Lara P; Millet, Dylan B; Marshall, Julian D

2011-08-15

The layout of an urban area can impact air pollution via changes in emissions and their spatial distribution. Here, we explore relationships between air quality and urban form based on cross-sectional observations for 111 U.S. urban areas. We employ stepwise linear regression to quantify how long-term population-weighted outdoor concentrations of ozone, fine particulate matter (PM(2.5)), and other criteria pollutants measured by the U.S. Environmental Protection Agency depend on urban form, climate, transportation, city size, income, and region. Aspects of urban form evaluated here include city shape, road density, jobs-housing imbalance, population density, and population centrality. We find that population density is associated with higher population-weighted PM(2.5) concentrations (p urban form variables are associated with 4%-12% changes in population-weighted concentrations-amounts comparable, for example, to changes in climatic factors. Our empirical findings are consistent with prior modeling research and suggest that urban form could potentially play a modest but important role in achieving (or not achieving) long-term air quality goals.

Domestic violence in the pregnant patient: obstetric and behavioral interventions.

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Mayer, L; Liebschutz, J

1998-10-01

Every day, obstetric providers treat patients experiencing domestic violence. Domestic violence can have both dramatic and subtle impacts on maternal and fetal morbidity and mortality. This article enumerates patient risk factors for and obstetric consequences of domestic violence. It describes adaptations to the assessment and treatment of pregnancy complications occurring in the context of domestic violence and presents behavioral interventions that can be performed within existing obstetric care delivery systems. Behavioral interventions include assessments of a patient's readiness for change and her emotional responses to the violence. Obstetric interventions include an assessment of risk of physical harm to a pregnant woman and her fetus from domestic violence. Interviewing techniques include educating the patient about the effects of abuse and, over time, validating a patient's efforts to change. Reliance on a team approach and use of community resources are emphasized. All of these mechanisms enable obstetric providers to assist pregnant women in taking steps to end the abuse.

Multistate matrix population model to assess the contributions and impacts on population abundance of domestic cats in urban areas including owned cats, unowned cats, and cats in shelters.

Science.gov (United States)

Flockhart, D T Tyler; Coe, Jason B

2018-01-01

Concerns over cat homelessness, over-taxed animal shelters, public health risks, and environmental impacts has raised attention on urban-cat populations. To truly understand cat population dynamics, the collective population of owned cats, unowned cats, and cats in the shelter system must be considered simultaneously because each subpopulation contributes differently to the overall population of cats in a community (e.g., differences in neuter rates, differences in impacts on wildlife) and cats move among categories through human interventions (e.g., adoption, abandonment). To assess this complex socio-ecological system, we developed a multistate matrix model of cats in urban areas that include owned cats, unowned cats (free-roaming and feral), and cats that move through the shelter system. Our model requires three inputs-location, number of human dwellings, and urban area-to provide testable predictions of cat abundance for any city in North America. Model-predicted population size of unowned cats in seven Canadian cities were not significantly different than published estimates (p = 0.23). Model-predicted proportions of sterile feral cats did not match observed sterile cat proportions for six USA cities (p = 0.001). Using a case study from Guelph, Ontario, Canada, we compared model-predicted to empirical estimates of cat abundance in each subpopulation and used perturbation analysis to calculate relative sensitivity of vital rates to cat abundance to demonstrate how management or mismanagement in one portion of the population could have repercussions across all portions of the network. Our study provides a general framework to consider cat population abundance in urban areas and, with refinement that includes city-specific parameter estimates and modeling, could provide a better understanding of population dynamics of cats in our communities.

Multistate matrix population model to assess the contributions and impacts on population abundance of domestic cats in urban areas including owned cats, unowned cats, and cats in shelters

Science.gov (United States)

Coe, Jason B.

2018-01-01

Concerns over cat homelessness, over-taxed animal shelters, public health risks, and environmental impacts has raised attention on urban-cat populations. To truly understand cat population dynamics, the collective population of owned cats, unowned cats, and cats in the shelter system must be considered simultaneously because each subpopulation contributes differently to the overall population of cats in a community (e.g., differences in neuter rates, differences in impacts on wildlife) and cats move among categories through human interventions (e.g., adoption, abandonment). To assess this complex socio-ecological system, we developed a multistate matrix model of cats in urban areas that include owned cats, unowned cats (free-roaming and feral), and cats that move through the shelter system. Our model requires three inputs—location, number of human dwellings, and urban area—to provide testable predictions of cat abundance for any city in North America. Model-predicted population size of unowned cats in seven Canadian cities were not significantly different than published estimates (p = 0.23). Model-predicted proportions of sterile feral cats did not match observed sterile cat proportions for six USA cities (p = 0.001). Using a case study from Guelph, Ontario, Canada, we compared model-predicted to empirical estimates of cat abundance in each subpopulation and used perturbation analysis to calculate relative sensitivity of vital rates to cat abundance to demonstrate how management or mismanagement in one portion of the population could have repercussions across all portions of the network. Our study provides a general framework to consider cat population abundance in urban areas and, with refinement that includes city-specific parameter estimates and modeling, could provide a better understanding of population dynamics of cats in our communities. PMID:29489854

Normative data and discriminative properties of short form 36 (SF-36 in Turkish urban population

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Akvardar Yildiz

2006-10-01

Full Text Available Abstract Background SF-36 has been both translated into different languages and adapted to different cultures to obtain comparable data on health status internationally. However there have been only a limited number of studies focused on the discriminative ability of SF-36 regarding social and disease status in developing countries. The aim of this study was to obtain population norms of the short form 36 (SF-36 health survey and the association of SF-36 domains with demographic and socioeconomic variables in an urban population in Turkey. Methods A cross-sectional study. Face to face interviews were carried out with a sample of households. The sample was systematically selected from two urban Health Districts in Izmir, Turkey. The study group consisted of 1,279 people selected from a study population of 46,290 people aged 18 and over. Results Internal consistencies of the scales were high, with the exception of mental health and vitality. Physical health scales were associated with both age and gender. On the other hand, mental health scales were less strongly associated with age and gender. Women reported poorer health compared to men in general. Social risk factors (employment status, lower education and economic strain were associated with worse health profiles. The SF-36 was found to be capable of discriminating disease status. Conclusion Our findings, cautiously generalisable to urban population, suggest that the SF-36 can be a valuable tool for studies on health outcomes in Turkish population. SF-36 may also be a promising measure for research on health inequalities in Turkey and other developing countries.

A comparison of rural and urban rheumatoid arthritis populations.

Science.gov (United States)

Basu, N; Steven, M

2009-02-01

There is evidence to suggest that remote populations have poorer clinical outcomes in certain disease processes such as asthma and cancer. This study looks to identify any disparities in the management of patients with rheumatoid arthritis in the context of rurality. A retrospective observational study was performed on all 1314 patients with a diagnosis of rheumatoid arthritis who have been under the care of the principal rheumatologist at Raigmore Hospital, Inverness, between the years 1994 and 2004 inclusive. Rurality was defined according to the Scottish Household Survey. Populations were assessed in terms of age; sex; duration of diagnosis; number of years of Disease Modifying AntiRheumatic Drugs (DMARD) therapy, prednisolone use and the number of musculoskeletal practical interventions undertaken (eg joint aspiration or replacement). Two thirds of patients were considered rural dwellers. No significant difference was established between the populations with regards to management. DMARD therapy had been prescribed in 77% of rural patients vs 70% of their city counterparts for a mean 5.4 and 4.0 years respectively. The proportion of patients exposed to prednisolone therapy and who underwent musculoskeletal procedures were equivalent. Rural dwellers, with rheumatoid arthritis in the Highlands of Scotland, do not appear to be disadvantaged in regards to their disease management in comparison to the urban population.

Obstetric referrals from a rural clinic to a community hospital in Honduras.

Science.gov (United States)

Josyula, Srirama; Taylor, Kathryn K; Murphy, Blair M; Rodas, Dairamise; Kamath-Rayne, Beena D

2015-11-01

referrals between health care facilities are important in low-resource settings, particularly in maternal and child health, to transfer pregnant patients to the appropriate level of obstetric care. Our aim was to characterise the obstetrical referrals from a rural clinic to a community referral hospital in Honduras, to identify barriers in effective transport/referral, and to describe subsequent patient outcomes. we performed a descriptive retrospective study of patients referred during a 9-month period. We reviewed patient charts to review diagnosis, referral, and treatment times at both sites to understand the continuity of care. ninety-two pregnant patients were referred from the rural clinic to the community hospital. Twenty six pregnant patients (28%) did not have complete and accurate medical records and were excluded from the study. The remaining 66 patients were our study population. Of the 66 patients, 54 (82%) received antenatal care with an average of 5.5±2.4 visits. The most common diagnoses requiring referral were non-reassuring fetal status, hypertensive disorders of pregnancy, and preterm labour. The time spent in the rural clinic until transfer was 7.35±8.60 hours, and transport times were 4.42±1.07 hours. Of the 66 women transferred, 24 (36%) had different primary diagnoses and 16 (24%) had additional diagnoses after evaluation in the community hospital, whereas the remaining 26 (40%) had diagnoses that remained the same. No system was in place to give feedback to the referring clinic doctors regarding their primary diagnoses. our results demonstrate challenges seen in obstetric transport from a rural clinic to a community hospital in Honduras. Further research is needed for reform of emergency obstetric care management, targeting both healthcare personnel and medical referral infrastructure. The example of Honduras can be taken to motivate change in other resource-limited areas. Copyright © 2015 Elsevier Ltd. All rights reserved.

Causes and consequences of obstetric fistula in Ethiopia: A literature review

Directory of Open Access Journals (Sweden)

Daniel Nigusse Tollosa, Mengistu Asnake Kibret

2013-04-01

Full Text Available ABSTRACTObstetric fistula (OF is one of the major potential complications of childbirth mostly young women in developing countries including Ethiopia. Though few scientific studies have been conducted related to its causes and consequences, it is challenging to find a comprehensive figure about obstetric fistula in Ethiopia. Therefore, this paper sought that to review the causes and consequences of obstetric fistula in Ethiopia. A number of relevant obstetrics and gynaecology websites and journals were reviewed. Google, Pubmed, and Hinari searching engines were used to find out relevant references. Year of publication, location, language and its type of publication were the inclusion criteria used for reviewing literatures. It is observed that obstetric fistula has been a major burdened mainly for women in the rural Ethiopian and its causes and consequences are very deep and diverse. The great majority of obstetric fistula causes in Ethiopia is due to Obstetric labour. Distance to the health care facility, transportation access, economic factors (poverty, poor knowledge related to the problem, poor health seeking behaviour of the affected women and age at first marriage are the other triggering factors. Stigma and discrimination of obstetric fistula patients by their husbands and families, economic dependency and psychological disorder are often mentioned as consequences for OF patients in Ethiopia.

Urban park characteristics, genetic variation, and historical demography of white-footed mouse (Peromyscus leucopus populations in New York City

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Jason Munshi-South

2014-03-01

Full Text Available Severe fragmentation is a typical fate of native remnant habitats in cities, and urban wildlife with limited dispersal ability are predicted to lose genetic variation in isolated urban patches. However, little information exists on the characteristics of urban green spaces required to conserve genetic variation. In this study, we examine whether isolation in New York City (NYC parks results in genetic bottlenecks in white-footed mice (Peromyscus leucopus, and test the hypotheses that park size and time since isolation are associated with genetic variability using nonlinear regression and information-theoretic model selection. White-footed mice have previously been documented to exhibit male-biased dispersal, which may create disparities in genetic variation between males and females in urban parks. We use genotypes of 18 neutral microsatellite data and four different statistical tests to assess this prediction. Given that sex-biased dispersal may create disparities between population genetic patterns inferred from bi- vs. uni-parentally inherited markers, we also sequenced a 324 bp segment of the mitochondrial D-loop for independent inferences of historical demography in urban P. leucopus. We report that isolation in urban parks does not necessarily result in genetic bottlenecks; only three out of 14 populations in NYC parks exhibited a signature of a recent bottleneck at 18 neutral microsatellite loci. Mouse populations in larger urban parks, or parks that have been isolated for shorter periods of time, also do not generally contain greater genetic variation than populations in smaller parks. These results suggest that even small networks of green spaces may be sufficient to maintain the evolutionary potential of native species with certain characteristics. We also found that isolation in urban parks results in weak to nonexistent sex-biased dispersal in a species known to exhibit male-biased dispersal in less fragmented environments. In

Increasing STEM Competence in Urban, High Poverty Elementary School Populations

Directory of Open Access Journals (Sweden)

Sueanne McKinney

2017-10-01

Full Text Available Enhancing STEM competence (e.g., interests, knowledge, skills, and dispositions among urban, high poverty, elementary school populations in the United States (U.S. is and remains a growing national concern, especially since Science, Technology, Engineering and Mathematics (STEM competence is and will continue to be a necessary requisite for gainful employment in the future, according to workforce development experts. In an attempt to address this gap, many urban elementary schools have begun to offer STEM-related programs to increase STEM learning at an early age. STEM competence (interest, knowledge, skills, and dispositions, however, remains low. This paper results in a matrix used to analyze children's fictional literary selections and a model that argues that elementary teachers, as the first point of contact with young students, can affect STEM competence. By adopting a more culturally responsive pedagogy that attends to the 21st Century Learning Skills and the Next Generation Science Standards, teachers can choose literature that serves to excite and reinforce STEM learning.

The prevalence of angina symptoms and association with cardiovascular risk factors, among rural, urban and rural to urban migrant populations in Peru

Directory of Open Access Journals (Sweden)

Gilman Robert H

2010-10-01

Full Text Available Abstract Background Rural-to-urban migration in low- and middle-income countries causes an increase in individual cardiovascular risk. Cost-effective interventions at early stages of the natural history of coronary disease such as angina may stem an epidemic of premature coronary deaths in these countries. However, there are few data on the prevalence of angina in developing countries, whilst the understanding the aetiology of angina is complicated by the difficulty in measuring it across differing populations. Methods The PERU MIGRANT study was designed to investigate differences between rural-to-urban migrant and non-migrant groups in specific cardiovascular disease risk factors. Mass-migration seen in Peru from 1980s onwards was largely driven by politically motivated violence resulting in less 'healthy migrant' selection bias. The Rose angina questionnaire was used to record chest pain, which was classified definite, possible and non-exertional. Mental health was measured using the General Health Questionnaire (GHQ-12. Mantel-Haenszel odds ratios (adjusted for age, sex, cardiovascular disease risk factors and mental health were used to assess the risk of chest pain in the migrant and urban groups compared to the rural group, and further to assess the relationship (age and sex-adjusted between risk factors, mental health and chest pain. Results Compared to the urban group, rural dwellers had a greatly increased likelihood of possible/definite angina (multi-adjusted OR 2.82 (1.68- 4.73. Urban and migrant groups had higher levels of risk factors (e.g. smoking - 20.1% urban, 5.5% rural. No diabetes was seen in the rural dwellers who complained of possible/definite angina. Rural dwellers had a higher prevalence of mood disorder and the presence of a mood disorder was associated with possible/definite angina in all three groups, but not consistently with non-exertional chest pain. Conclusion Rural groups had a higher prevalence of angina as

[Obstetric emergency and non-emergency transfers to the university teaching hospital Yalgado ouedraogo of Ouagadougou: A 3-year study of their epidemiologic, clinical, and prognostic aspects].

Science.gov (United States)

Ouattara, A; Ouedraogo, C M; Ouedraogo, A; Lankoande, J

2015-01-01

to describe the epidemiologic, clinical, and prognostic aspects of the emergency and non-emergency transfers of obstetric patients to Yalgado Ouédraogo University Hospital Center (UHC-YO) in Ouagadougou. this retrospective descriptive study looked at the outcomes of women transferred, on an emergency basis or not, to the obstetrics department of the UHC-YO. The study population comprised all women transferred to the department during 2010, 2011, and 2012. during the study period, there were 9,806 admissions for obstetric disorders: 43% were transfers. The patients' mean age was 26.11 years [(13-49]. Women transferred from health care facilities within the city of Ouagadougou accounted for 96% of the sample. The leading reason for these transfers - emergency or not - was preeclampsia and eclampsia (24.57%). We recorded a total of 161 maternal deaths, for a mortality rate of 3.9%. Approximately 26.55% of the newborns received immediate intensive care and were then transferred to the neonatology department. maternal and neonatal prognosis is always poor in cases transferred to UHC-YO, despite increased funding for emergency obstetric and neonatal care. Increased population awareness of the importance of prenatal consultation and adequate funding for health care facilities to provide equipment for emergency transfers and staff training in the management of obstetric and neonatal emergencies would probably improve these mortality and morbidity rates.

Seroprevalence of Scrub Typhus, Typhus, and Spotted Fever Among Rural and Urban Populations of Northern Vietnam.

Science.gov (United States)

Trung, Nguyen Vu; Hoi, Le Thi; Thuong, Nguyen Thi Hong; Toan, Tran Khanh; Huong, Tran Thi Kieu; Hoa, Tran Mai; Fox, Annette; Kinh, Nguyen van; van Doorn, H Rogier; Wertheim, Heiman F L; Bryant, Juliet E; Nadjm, Behzad

2017-05-01

AbstractRickettsial infections are recognized as important causes of fever throughout southeast Asia. Herein, we determined the seroprevalence to rickettsioses within rural and urban populations of northern Vietnam. Prevalence of individuals with evidence of prior rickettsial infections (IgG positive) was surprisingly low, with 9.14% (83/908) testing positive to the three major rickettsial serogroups thought to circulate in the region. Prevalence of typhus group rickettsiae (TG)-specific antibodies (6.5%, 58/908) was significantly greater than scrub typhus group orientiae (STG)- or spotted fever group rickettsiae (SFG)-specific antibodies ( P < 0.05). The majority of TG seropositives were observed among urban rather than rural residents ( P < 0.05). In contrast, overall antibody prevalence to STG and SFG were both very low (1.1%, 10/908 for STG; 1.7%, 15/908 for SFG), with no significant differences between rural and urban residents. These results provide data on baseline population characteristics that may help inform development of Rickettsia serological testing criteria in future clinical studies.

Ecotypic differentiation between urban and rural populations of the grasshopper Chorthippus brunneus relative to climate and habitat fragmentation.

Science.gov (United States)

San Martin Y Gomez, Gilles; Van Dyck, Hans

2012-05-01

Urbanization alters environmental conditions in multiple ways and offers an ecological or evolutionary challenge for organisms to cope with. Urban areas typically have a warmer climate and strongly fragmented herbaceous vegetation; the urban landscape matrix is often assumed to be hostile for many organisms. Here, we addressed the issue of evolutionary differentiation between urban and rural populations of an ectotherm insect, the grasshopper Chorthippus brunneus. We compared mobility-related morphology and climate-related life history traits measured on the first generation offspring of grasshoppers from urban and rural populations reared in a common garden laboratory experiment. We predicted (1) the urban phenotype to be more mobile (i.e., lower mass allocation to the abdomen, longer relative femur and wing lengths) than the rural phenotype; (2) the urban phenotype to be more warm adapted (e.g., higher female body mass); and (3) further evidence of local adaptation in the form of significant interaction effects between landscape of origin and breeding temperature. Both males and females of urban origin had significantly longer relative femur and wing lengths and lower mass allocation to the abdomen (i.e., higher investment in thorax and flight muscles) relative to individuals of rural origin. The results were overall significant but small (2-4%). Body mass and larval growth rate were much higher (+10%) in females of urban origin. For the life history traits, we did not find evidence for significant interaction effects between the landscape of origin and the two breeding temperatures. Our results point to ecotypic differentiation with urbanization for mobility-related morphology and climate-related life history traits. We argue that the warmer urban environment has an indirect effect through longer growth season rather than direct effects on the development.

Training of midwives in advanced obstetrics in Liberia.

Science.gov (United States)

Dolo, Obed; Clack, Alice; Gibson, Hannah; Lewis, Naomi; Southall, David P

2016-05-01

The shortage of doctors in Liberia limits the provision of comprehensive emergency obstetric and neonatal care. In a pilot project, two midwives were trained in advanced obstetric procedures and in the team approach to the in-hospital provision of advanced maternity care. The training took two years and was led by a Liberian consultant obstetrician with support from international experts. The training took place in CB Dunbar Maternity Hospital. This rural hospital deals with approximately 2000 deliveries annually, many of which present complications. In February 2015 there were just 117 doctors available in Liberia. In the first 18 months of training, the trainees were involved with 236 caesarean sections, 35 manual evacuations of products of conception, 25 manual removals of placentas, 21 vaginal breech deliveries, 14 vacuum deliveries, four repairs of ruptured uteri, the management of four cases of shoulder dystocia, three hysterectomies, two laparotomies for ruptured ectopic pregnancies and numerous obstetric ultrasound examinations. The trainees also managed 41 cases of eclampsia or severe pre-eclampsia, 25 of major postpartum haemorrhage and 21 of shock. Although, initially they only assisted senior doctors, the trainees subsequently progressed from direct to indirect supervision and then to independent management. To compensate for a shortage of doctors able to undertake comprehensive emergency obstetric and neonatal care, experienced midwives can be taught to undertake advanced obstetric care and procedures. Their team work with doctors can be particularly valuable in rural hospitals in resource-poor countries.

Lifesaving emergency obstetric services are inadequate in south-west Ethiopia: a formidable challenge to reducing maternal mortality in Ethiopia.

Science.gov (United States)

Girma, Meseret; Yaya, Yaliso; Gebrehanna, Ewenat; Berhane, Yemane; Lindtjørn, Bernt

2013-11-04

Most maternal deaths take place during labour and within a few weeks after delivery. The availability and utilization of emergency obstetric care facilities is a key factor in reducing maternal mortality; however, there is limited evidence about how these institutions perform and how many people use emergency obstetric care facilities in rural Ethiopia. We aimed to assess the availability, quality, and utilization of emergency obstetric care services in the Gamo Gofa Zone of south-west Ethiopia. We conducted a retrospective review of three hospitals and 63 health centres in Gamo Gofa. Using a retrospective review, we recorded obstetric services, documents, cards, and registration books of mothers treated and served in the Gamo Gofa Zone health facilities between July 2009 and June 2010. There were three basic and two comprehensive emergency obstetric care qualifying facilities for the 1,740,885 people living in Gamo Gofa. The proportion of births attended by skilled attendants in the health facilities was 6.6% of expected births, though the variation was large. Districts with a higher proportion of midwives per capita, hospitals and health centres capable of doing emergency caesarean sections had higher institutional delivery rates. There were 521 caesarean sections (0.8% of 64,413 expected deliveries and 12.3% of 4,231 facility deliveries). We recorded 79 (1.9%) maternal deaths out of 4,231 deliveries and pregnancy-related admissions at institutions, most often because of post-partum haemorrhage (42%), obstructed labour (15%) and puerperal sepsis (15%). Remote districts far from the capital of the Zone had a lower proportion of institutional deliveries (4% of deliveries, much higher than the average 1.9%). Based on a population of 1.7 million people, there should be 14 basic and four comprehensive emergency obstetric care (EmOC) facilities in the Zone. Our study found that only three basic and two comprehensive EmOC service qualifying facilities serve this large

Litigation in Obstetrics: a Lesson Learnt and a Lesson to Share

Directory of Open Access Journals (Sweden)

Min Min Chou

2006-03-01

Full Text Available A perfect baby is the expectation of all parents, and a perfect outcome is the mission of obstetrics. Every obstetrician dreads to hear that there is an unexpected maternal mortality and/or severe fetal injury at the hospital. The role of a perceived public expectation of perfection in obstetric medicine reflects a belief that bad outcomes in obstetrics should not be tolerated and that every maternal-fetal injury merits financial compensation and punishment. What has brought these troubling times to obstetric medicine? The drivers behind malpractice crises are the four leading interest groups in the medical-legal debate: pregnant patients and their environment (husband, parents, relatives, friends, legislators, and the media, health-care providers, insurance companies, and trial attorneys. Litigation in obstetrics is the result of a complex of events when malpractice (presumed or real impacts on the attitude of pregnant women and their environment. In such complexity, information is mandatory but may often be misinterpreted. If messages are not tailored to the receiver's capacity, communicating well with the pregnant patient becomes crucial. Therefore, to reduce medical-legal issues in obstetrics, increasing attention and an applicable standard of obstetric care to avoid negligence and medical errors should go along with better communication with pregnant women. Communication should be clear, targeted, effective, flexible, and empathic to share a common language and decisions. This review briefly presents and discusses some of the most frequently encountered medical-legal claim cases in obstetric practice. In-depth review of pregnancy-related deaths and major morbidities can help determine strategies needed to continue making pregnancy safer.

The reliability of transabdominal cervical length measurement in a low-risk obstetric population: Comparison with transvaginal measurement.

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Peng, Cheng-Ran; Chen, Chie-Pein; Wang, Kuo-Gon; Wang, Liang-Kai; Chen, Chen-Yu; Chen, Yi-Yung

2015-04-01

To determine the correlation between transabdominal (TA) and transvaginal (TV) cervical length measurement in a low-risk obstetric population in Taiwan. Women with a singleton pregnancy between 20 weeks and 24 weeks of gestation underwent postvoid TA and TV cervical length measurements. Differences between the measurements obtained using the two methods were evaluated. Two hundred and five women agreed to participate in the study. Paired TA and TV measurements were obtained in 174 women. The mean TA cervical length was 36.0 ± 4.9 mm and the mean TV cervical length was 37.6 ± 5.4 mm. The mean TA cervical length was shorter than the mean TV cervical length by 1.6 mm. The 5(th) percentile of TA and TV cervical length was 29 mm and 29.1 mm, respectively. The discrepancies between the two methods were not significantly correlated with maternal body mass index (BMI). All women with TV cervical length women in the present study, and the TA cervical length was closely correlated with the TV cervical length. The use of TA ultrasound could be an effective initial tool for cervical length screening in low-risk pregnant women. TA cervical length TV ultrasound. Copyright © 2015. Published by Elsevier B.V.

Obstetric vesico-vaginal fistula is preventable by timely recognition ...

African Journals Online (AJOL)

Prevention of obstetric fistula should include universal access to maternity care, recognition and timely correction of abnormal progress of labour and punctilious attention to bladder care to avoid post-partum urinary retention. Key words: Obstetric fistula, Risk factors, Pathophysiology, Post-partum urinary retention ...

Population Density, Climate Variables and Poverty Synergistically Structure Spatial Risk in Urban Malaria in India.

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Mauricio Santos-Vega

2016-12-01

Full Text Available The world is rapidly becoming urban with the global population living in cities projected to double by 2050. This increase in urbanization poses new challenges for the spread and control of communicable diseases such as malaria. In particular, urban environments create highly heterogeneous socio-economic and environmental conditions that can affect the transmission of vector-borne diseases dependent on human water storage and waste water management. Interestingly India, as opposed to Africa, harbors a mosquito vector, Anopheles stephensi, which thrives in the man-made environments of cities and acts as the vector for both Plasmodium vivax and Plasmodium falciparum, making the malaria problem a truly urban phenomenon. Here we address the role and determinants of within-city spatial heterogeneity in the incidence patterns of vivax malaria, and then draw comparisons with results for falciparum malaria.Statistical analyses and a phenomenological transmission model are applied to an extensive spatio-temporal dataset on cases of Plasmodium vivax in the city of Ahmedabad (Gujarat, India that spans 12 years monthly at the level of wards. A spatial pattern in malaria incidence is described that is largely stationary in time for this parasite. Malaria risk is then shown to be associated with socioeconomic indicators and environmental parameters, temperature and humidity. In a more dynamical perspective, an Inhomogeneous Markov Chain Model is used to predict vivax malaria risk. Models that account for climate factors, socioeconomic level and population size show the highest predictive skill. A comparison to the transmission dynamics of falciparum malaria reinforces the conclusion that the spatio-temporal patterns of risk are strongly driven by extrinsic factors.Climate forcing and socio-economic heterogeneity act synergistically at local scales on the population dynamics of urban malaria in this city. The stationarity of malaria risk patterns provides a

Population Density, Climate Variables and Poverty Synergistically Structure Spatial Risk in Urban Malaria in India.

Science.gov (United States)

Santos-Vega, Mauricio; Bouma, Menno J; Kohli, Vijay; Pascual, Mercedes

2016-12-01

The world is rapidly becoming urban with the global population living in cities projected to double by 2050. This increase in urbanization poses new challenges for the spread and control of communicable diseases such as malaria. In particular, urban environments create highly heterogeneous socio-economic and environmental conditions that can affect the transmission of vector-borne diseases dependent on human water storage and waste water management. Interestingly India, as opposed to Africa, harbors a mosquito vector, Anopheles stephensi, which thrives in the man-made environments of cities and acts as the vector for both Plasmodium vivax and Plasmodium falciparum, making the malaria problem a truly urban phenomenon. Here we address the role and determinants of within-city spatial heterogeneity in the incidence patterns of vivax malaria, and then draw comparisons with results for falciparum malaria. Statistical analyses and a phenomenological transmission model are applied to an extensive spatio-temporal dataset on cases of Plasmodium vivax in the city of Ahmedabad (Gujarat, India) that spans 12 years monthly at the level of wards. A spatial pattern in malaria incidence is described that is largely stationary in time for this parasite. Malaria risk is then shown to be associated with socioeconomic indicators and environmental parameters, temperature and humidity. In a more dynamical perspective, an Inhomogeneous Markov Chain Model is used to predict vivax malaria risk. Models that account for climate factors, socioeconomic level and population size show the highest predictive skill. A comparison to the transmission dynamics of falciparum malaria reinforces the conclusion that the spatio-temporal patterns of risk are strongly driven by extrinsic factors. Climate forcing and socio-economic heterogeneity act synergistically at local scales on the population dynamics of urban malaria in this city. The stationarity of malaria risk patterns provides a basis for more

Ultrasound in obstetric anaesthesia: a review of current applications.

LENUS (Irish Health Repository)

Ecimovic, P

2010-07-01

Ultrasound equipment is increasingly used by non-radiologists to perform interventional techniques and for diagnostic evaluation. Equipment is becoming more portable and durable, with easier user-interface and software enhancement to improve image quality. While obstetric utilisation of ultrasound for fetal assessment has developed over more than 40years, the same technology has not found a widespread role in obstetric anaesthesia. Within the broader specialty of anaesthesia; vascular access, cardiac imaging and regional anaesthesia are the areas in which ultrasound is becoming increasingly established. In addition to ultrasound for neuraxial blocks, these other clinical applications may be of value in obstetric anaesthesia practice.

The Nordic Obstetric Surveillance Study

DEFF Research Database (Denmark)

Colmorn, Lotte B.; Petersen, Kathrine B; Jakobsson, Maija

2015-01-01

by using International Classification of Diseases, 10th revision codes on diagnoses and the Nordic Medico-Statistical Committee Classification of Surgical Procedure codes. MAIN OUTCOME MEASURES: Rates of the studied complications and possible risk factors among parturients in the Nordic countries. RESULTS......OBJECTIVE: To assess the rates and characteristics of women with complete uterine rupture, abnormally invasive placenta, peripartum hysterectomy, and severe blood loss at delivery in the Nordic countries. DESIGN: Prospective, Nordic collaboration. SETTING: The Nordic Obstetric Surveillance Study...... (NOSS) collected cases of severe obstetric complications in the Nordic countries from April 2009 to August 2012. SAMPLE AND METHODS: Cases were reported by clinicians at the Nordic maternity units and retrieved from medical birth registers, hospital discharge registers, and transfusion databases...

Challenges of urbanization and peri-urban development in Europe

DEFF Research Database (Denmark)

Nielsen, Thomas Alexander Sick; Nilsson, Kjell Svenne Bernhard

2010-01-01

Urbanisation has arguably been the most significant process of land use change in Europe since Second World War. Over 70% of Europe's population now lives in urban areas, which in turn, have grown in area by almost 80% over the last fifty years (EEA 2006). Urban areas cover approximately five...... percent of the territory of the European Union (EU25), and are growing more than twice as fast as the European population. A general consequence of the urbanisation trend and increasing wealth and mobility is urban sprawl, as well as the emergence of peri-urban areas....

Cardiovascular health among healthy population of Northeast region of India: a cross-sectional study comparing urban-tribal difference.

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Saha, Soma; Gupta, Kinnari; Kumar, Soumitra

2013-12-01

Cardiovascular disease is the leading cause of adult mortality in India but data on the prevalence of cardiovascular risk factors are scarce, especially from North-east region of India. This study aims to assess the prevalence and the urban/tribal gradient of cardiovascular disease risk factors among healthy population of Tripura. A cross-sectional study was carried out among 238 healthy individuals (140 urban and 98 tribal) in one urban and five tribal areas of Tripura. Data was collected on sociodemographic profile, medical history, anthropometry, dietary patterns and addiction. Fasting blood samples were collected for biochemical analysis. Prevalence of cardiovascular disease risk factors and short-term cardiovascular disease risk score was calculated. The association of independent variables with 10-year cardiovascular disease risk score were examined by using multiple regression model. Prevalence of obesity, hypertension, diabetes, dyslipidaemia, metabolic syndrome and short-term cardiovascular disease risk score were higher in urban group. Urban people had higher salt, calories and fat intake. No difference was found in the addiction patterns of tobacco and alcohol but frequency and quantity being higher in tribal area. Dyslipidaemia and alcohol consumption showed significant positive association with 10-year cardiovascular disease risk score in both groups. While the non-sedentary lifestyle and dietary habits (low salt, low fat, carbohydrate predominant) of tribal population need to be promoted as a whole across the nation, they need to be protected from the adverse effects of rampant prevalence of tobacco and alcohol addiction among them. Urban population need to be extricated from adverse effects of sedentary lifestyle, modern food habits (high salt, high fat) and tobacco-alcohol addiction.

Risk factors for reported obstetric complications and near misses in rural northwest Bangladesh: analysis from a prospective cohort study.

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Sikder, Shegufta S; Labrique, Alain B; Shamim, Abu A; Ali, Hasmot; Mehra, Sucheta; Wu, Lee; Shaikh, Saijuddin; West, Keith P; Christian, Parul

2014-10-04

In rural Bangladesh, more than 75% of all births occur at home in the absence of skilled birth attendants. Population-based data are lacking on the burden and risk factors for obstetric complications in settings with low rates of institutional delivery. We sought to describe the prevalence of reported complications and to analyze risk factors for obstetric complications and near misses, using data from a representative, rural setting of Bangladesh. This study utilized existing data on 42,214 pregnant women enrolled in a micronutrient supplementation cohort trial between 2007 and 2011 in rural northwest Bangladesh. Based on self-report of complications, women were categorized as having obstetric complications, near misses, or non-complicated pregnancies using definitions modified from the World Health Organization. Multivariable multinomial regression was used to analyze the association of biological, socioeconomic, and psychosocial variables with obstetric complications or near misses. Of enrolled women, 25% (n = 10,380) were classified as having at least one obstetric complication, 2% (n = 1,004) with reported near misses, and 73% (n = 30,830) with non-complicated pregnancies. Twelve percent (n = 5,232) reported hemorrhage and 8% (n = 3,259) reported sepsis. Of the 27,241 women with live births or stillbirths, 11% (n = 2,950) reported obstructed labor and 1% (n = 328) reported eclampsia. Biological risk factors including women's age less than 18 years (Relative Risk Ratio [RRR] 1.26 95%CI:1.14-1.39) and greater than 35 years (RRR 1.23 95%CI:1.09-1.38), history of stillbirth or miscarriage (RRR 1.15 95%CI:1.07-1.22), and nulliparity (RRR 1.16 95%CI:1.02-1.29) significantly increased the risk of obstetric complications. Neither partner wanting the pregnancy increased the risk of obstetric complications (RRR 1.33 95%CI:1.20-1.46). Mid-upper arm circumference <21.5 cm increased the risk of hemorrhage and sepsis. These analyses indicate a high burden of obstetric

Prevalence of ischemic heart disease among urban population of Siliguri, West Bengal

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Mandal Sukanta

2009-01-01

Full Text Available Objectives: To determine the prevalence of ischemic heart disease and the associated risk factors among the urban population of Siliguri. Materials and Methods: A cross-sectional survey of a random sample of the population aged ≥40 years old in the Municipal Corporation area of Siliguri. Study variables were age, sex, occupation, addiction, food habit, physical activity, body mass index, blood pressure, and electrocardiogram change. Results: Out of 250 individuals who took part in this study, 29 (11.6% had ischemic heart disease (IHD and 118 (47.2% had hypertension. Males had a higher (13.5% prevalence of IHD than females (9.4%. About 5% of the patients had asymptomatic IHD. IHD among the study population is significantly associated with hypertension and smoking.

Does higher body mass index contribute to worse asthma control in an urban population?

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Clerisme-Beaty, Emmanuelle M; Karam, Sabine; Rand, Cynthia; Patino, Cecilia M; Bilderback, Andrew; Riekert, Kristin A; Okelo, Sande O.; Diette, Gregory B.

2009-01-01

Background Epidemiologic findings support a positive association between asthma and obesity. Objective Determine whether obesity or increasing level of body mass index (BMI) are associated with worse asthma control in an ethnically diverse urban population. Methods Cross sectional assessment of asthma control was done in asthmatics recruited from primary care offices using four different validated asthma control questionnaires: the Asthma Control and Communication Instrument (ACCI), the Asthma Control Test (ACT), the Asthma Control Questionnaire (ACQ) and the Asthma Therapy Assessment Questionnaire (ATAQ). Multiple linear regression analysis was performed to evaluate the association between obesity and increasing BMI level and asthma control. Results Of 292 subjects mean age of 47 years, the majority were women (82%) and African American (67%). There was a high prevalence of obesity with 63%, with only 15% being normal weight. The mean score from all four questionnaires showed an average sub-optimal asthma control (mean score/maximum possible score): ACCI (8.3/19), ACT (15.4/ 25), ACQ (2.1/ 6), and ATAQ (1.3/ 4). Regression analysis showed no association between obesity or increasing BMI level and asthma control using all four questionnaires. This finding persisted even after adjusting for FEV1, smoking status, race, gender, selected co-morbid illnesses, and long-term asthma controller use. Conclusion Using four validated asthma control questionnaires, we failed to find an association between obesity and asthma control in an urban population with asthma. Weight loss may not be an appropriate strategy to improve asthma control in this population. Capsule Summary Using four different validated asthma control measures, there was no association between obesity or increasing body mass index and asthma control in a largely obese urban outpatient minority population. PMID:19615731

Communication in obstetrics: where and when it matters | Obimbo ...

African Journals Online (AJOL)

Although most clinical outcomes in obstetrics are generally good, poor and inaccurate communication may lead to unwanted obstetrics complications and medico-legal litigation. Effective communication therefore, is an important and integral part of holistic approach to good patient care and management. We present a case ...

Overweight and Obesity above 18 years of Age in An Urban Population

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Amit Kumar Kamboj

2017-06-01

Full Text Available Background: Today however, as standard of living continues to rise, weight gain and obesity are posing a growing threat to health in both developed and developing countries and affecting children as well as adults. Indeed, it is now so common that it is replacing the more traditional public health concern including under nutrition and infectious diseases. Overweight and obesity is a major risk factor for high morbidity and mortality. Obesity is an independent risk factor for chronic heart disease related morbidity and mortality. Aims and Objectives: To find out the prevalence of overweight & obesity and to suggest measures for prevention of overweight and obesity in adult population. Material and Method: To cover a sample size of 1152 in Urban Health Centre area population ≥18 years every fifth family was selected by systematic random sampling from the total of 1698 families registered at Urban Health Centre. They were interviewed personally and information was collected about sociodemographic characteristics, personal factors, and measurements of weight, height, waist and hip circumference of the individuals were taken to calculate Body Mass Index (BMI and Waist Hip Ratio (WHR. Results: Prevalence of overweight (BMI -25-29.99 and obesity (BMI ≥30 being 28.0% and 8.0% respectively. Prevalence of abdominal obesity was 25.8%. About two-third (66.9% of abdominal obesity rightly corresponded with the high BMI (25+. Conclusion: The prevalence of overweight and obesity is increasing in urban area of Meerut, more in females than males and it is being affected by various socio-demographic correlates.

Reduced flight-to-light behaviour of moth populations exposed to long-term urban light pollution.

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Altermatt, Florian; Ebert, Dieter

2016-04-01

The globally increasing light pollution is a well-recognized threat to ecosystems, with negative effects on human, animal and plant wellbeing. The most well-known and widely documented consequence of light pollution is the generally fatal attraction of nocturnal insects to artificial light sources. However, the evolutionary consequences are unknown. Here we report that moth populations from urban areas with high, globally relevant levels of light pollution over several decades show a significantly reduced flight-to-light behaviour compared with populations of the same species from pristine dark-sky habitats. Using a common garden setting, we reared moths from 10 different populations from early-instar larvae and experimentally compared their flight-to-light behaviour under standardized conditions. Moths from urban populations had a significant reduction in the flight-to-light behaviour compared with pristine populations. The reduced attraction to light sources of 'city moths' may directly increase these individuals' survival and reproduction. We anticipate that it comes with a reduced mobility, which negatively affects foraging as well as colonization ability. As nocturnal insects are of eminent significance as pollinators and the primary food source of many vertebrates, an evolutionary change of the flight-to-light behaviour thereby potentially cascades across species interaction networks. © 2016 The Author(s).

An urban neo-poverty population-based quality of life and related social characteristics investigation from northeast China.

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Ou, Fengrong; Li, Kai; Gao, Qian; Liu, Dan; Li, Jinghai; Hu, Liwen; Wu, Xian; Edmiston, E Kale; Liu, Yang

2012-01-01

To investigate quality of life (QOL) and related characteristics among an urban neo-poverty population in northeast China, and to compare this population with a traditional poverty cohort. The research was a cross-sectional survey executed from June 2005 to October 2007, with a sample of 2940 individuals ages 36 to 55 in three different industrial cities of northeast China. Data were collected on QOL status and sociodemographic characteristics. QOL was assessed using the 36-item Short Form Health Survey (Chinese version). Multiple regression analysis was employed to analyze association between sociodemographic variables and QOL. The scores for QOL in the neo-poverty group were higher than those in the traditional poverty group, but lower than those in the general population. When the neo-poverty population was divided into two subgroups by age, 36-45 years and 46-55 years, the differences in QOL scores were not significant. However, there were significant differences in several dimensions between two subgroups according to unemployment time (5 years). Additionally, stepwise regression analysis indicated that disease burden, including disease and medical expenditures, was a common risk factor for declining QOL in the neo-poverty group. Despite some limitations, this study provides initial evidence that the QOL of the urban neo-poverty population lies between that of the general population and traditional poverty. QOL of the neo-poverty group approached QOL of the traditional poverty group with increased unemployment years. In addition to decreased income, disease burden is the most important factor influencing QOL status in urban neo-poverty.

An epidemiological study of diabetes mellitus amongst high risk age group population in urban and Rural areas of kanpur

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Nadeem Ahmad

2003-12-01

Full Text Available Research Question : - What is the magnitude of Diabetes mellitus in the urban and rural areas of Kanpur.Objectives:To study the prevalence of diabetes mellitus amongst high risk age group population in urban and rural areas of Kanpur.To compare the magnitude of problem of diabetes mellitus between urban and rural areas of Kanpur.To study the possible associates and socio-demographic variables related to diabetes mellitus.Study Design : Cross sectional study.Setting : The study was performed on three thousand population each in urban and rural areas of Kanpur.Participants : High risk age group population i.e. 45 years and above.Study variables : Age, Sex. impaired glucose tolerance. Body mass index, Education, Working status. Social class, family history of diabetes.Statistical analysis : Chi-square lest, percentagesResults From a total of 676 persons of high risk age group i.e. 45 years and above, the overall prevalence of diabetes mellitus in the study areas was observed lobe 7. l%with 9.94% in urban and 3.61% in rural areas, the maximum percetage of diabetes cases (41.66% was in the age group of 56-60 years. Higher prevalence of diabetes was observed in the obese (56.25% and sedentary (87.5% persons. The family history' of diabetes mellitus was present in (35.41% of diabetes mellitus cases.

Diet, nutrition and cardiac risk factor profile of tribal migrant population in an urban slum in India

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Jagajeevan Babu Geddam

2015-03-01

Full Text Available Migration of tribal population to urban areas may increase the risk of non-communicable chronic diseases. In this study an attempt was made to explore the risk factors influencing cardio vascular disease, hypertension and Type 2 diabetes among the tribal migrants living in urban areas. A population based cross sectional study was carried out on tribal migrants (n=138 men, n=137 women aged ≥30 years of low economic status, living in an urban slum (Kondapur of Hyderabad, Telangana, India.  Blood lipids, glucose, homocysteine, glycated Haemoglobin, blood pressure and nutritional biochemical markers such as serum albumin, serum protein, Vitamin-D and haemoglobin were examined in a subsample of tribal migrants. The prevalence of overweight in men and women was 35.3% and 32.4% while general obesity was 14.3% and 24.3% respectively. In addition, high concentration of total cholesterol, low density lipo proteins (LDL, triglycerides, homocysteine and glycosylated haemoglobin in the study population was also observed.  Duration of stay had no significant association with overweight and obesity. Majority of tribal migrants did not meet at least 50% of RDI of micro-nutrients such as iron (80-84%, vitamin A (81-83% and riboflavin (67-84%. Similar finding was observed with food groups such as leafy vegetables (84-91%, milk and milk products. However, the consumption of fat and protein was found to be ≥70% of RDA indicating transition in diet pattern. The present study shows urban life style and diets may predispose to higher incidence of diabetes, hypertension and atherosclerotic cardiovascular disease among tribal migrants living in urban areas.

Beyond repair - family and community reintegration after obstetric fistula surgery: study protocol.

Science.gov (United States)

Byamugisha, Josaphat; El Ayadi, Alison; Obore, Susan; Mwanje, Haruna; Kakaire, Othman; Barageine, Justus; Lester, Felicia; Butrick, Elizabeth; Korn, Abner; Nalubwama, Hadija; Knight, Sharon; Miller, Suellen

2015-12-18

Obstetric fistula is a debilitating birth injury that affects an estimated 2-3 million women globally, most in sub-Saharan Africa and Asia. The urinary and/or fecal incontinence associated with fistula affects women physically, psychologically and socioeconomically. Surgical management of fistula is available with clinical success rates ranging from 65-95 %. Previous research on fistula repair outcomes has focused primarily on clinical outcomes without considering the broader goal of successful reintegration into family and community. The objectives for this study are to understand the process of family and community reintegration post fistula surgery and develop a measurement tool to assess long-term success of post-surgical family and community reintegration. This study is an exploratory sequential mixed-methods design including a preliminary qualitative component comprising in-depth interviews and focus group discussions to explore reintegration to family and community after fistula surgery. These results will be used to develop a reintegration tool, and the tool will be validated within a small longitudinal cohort (n = 60) that will follow women for 12 months after obstetric fistula surgery. Medical record abstraction will be conducted for patients managed within the fistula unit. Ethical approval for the study has been granted. This study will provide information regarding the success of family and community reintegration among women returning home after obstetric fistula surgery. The clinical and research community can utilize the standardized measurement tool in future studies of this patient population.

The Pattern and Obstetric Outcome of Hypertensive Disorders of ...

African Journals Online (AJOL)

There is need for strengthening of communication and referral systems in the healthcare. KEY WORDS: Hypertensive disorders, pattern, obstetrics outcome. Erratum Note: Mbachu 1, Udigwe GO, Okafor CI, Umeonunihu OS, Ezeama C, Eleje GU on the article “The Pattern and Obstetric Outcome of Hypertensive Disorders of ...

[Centralization in obstetrics: pros and cons].

Science.gov (United States)

Roemer, V M; Ramb, S

1996-01-01

Possible advantages and disadvantages of a general centralization of German obstetric facilities are analysed in the study. The need for centralization of risk cases, especially premature births (regionalization) is pointed out. Centralization appears appropriate, since every fifth maternity unit in Germany (19.78%) has 300 or fewer deliveries per year. This one fifth of perinatal clinics accounts for 6.3% of all deliveries (N = 49450). There are appreciable differences between the old and new federal states (Bundesländer): in the recently acceded federal states, 48.7% of all perinatal clinics have deliveries of 300 and less per year. This group of perinatal clinics accounts for 29% of all deliveries in the new federal states. We have carried out a survey of the mother's attitude to centralization: out of 416 patients in the Detmold women's hospital whose mean age was 29.0 +/- 4.2 years, 90.4% were not in favor of general centralization of obstetrics. 43% were also against a centralization of risk cases (regionalization). 75% of the women surveyed objected to centralized obstetrics because of the 'possible absence of the family', the 'possible absence of students and trainees' (44.9%), the 'unfamiliarity with staff and premises' (41.8%) and 'fear of anonymity' (44.5%). The majority of all women (84.1%) did not want to have a drive more than 20 km to an obstetrics center. Fear of 'delivery in a taxi'(78.6%), the 'fear that the husband will come too late to the delivery' (65.4%) and that the 'overall course of the delivery might not be adequate for reasons of time'. The presence of a pediatrics department in conjunction with the perinatal clinic was rated very positively (93%). It is concluded from the data and further juridical considerations that centralization of risk cases (regionalization) is indispensable in the near future and that somewhat more further into the future decentralization should be carried out by closing obstetrics departments with substantially

Urban Landscape Perspectives

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Frederick Steiner

2014-03-01

Full Text Available Cities present significant opportunities for new landscape perspectives that can help inform conservation and development decisions. Early in the twenty-first century, the majority of the planet’s population became urban as more people lived in city-regions for the first time in our history. As the global population increases, so does this urbanization. The environmental challenges of population and urban growth are profound. Landscapes represent a synthesis of natural and cultural processes. Cities are certainly cultural phenomena. Historically, cities provided refuge from nature. The expanding field of urban ecology, coupled with landscape ecology, can enhance how the dual natural and cultural dimensions of landscapes in cities are understood. Furthermore, concepts such as ecosystem services and green infrastructure are proving useful for urban landscape planning and design. Examples from Dayton, Ohio; Brooklyn, New York; and Austin, Texas are presented.

Maternal morbid obesity and obstetric outcomes.

LENUS (Irish Health Repository)

Farah, Nadine

2012-02-01

OBJECTIVE: The purpose of this retrospective cohort study was to review pregnancy outcomes in morbidly obese women who delivered a baby weighing 500 g or more in a large tertiary referral university hospital in Europe. METHODS: Morbid obesity was defined as a BMI > or =40.0 kg\\/m2 (WHO). Only women whose BMI was calculated at their first antenatal visit were included. The obstetric out-comes were obtained from the hospital\\'s computerised database. RESULTS: The incidence of morbid obesity was 0.6% in 5,824 women. Morbidly obese women were older and were more likely to be multigravidas than women with a normal BMI. The pregnancy was complicated by hypertension in 35.8% and diabetes mellitus in 20.0% of women. Obstetric interventions were high, with an induction rate of 42.1% and a caesarean section rate of 45.3%. CONCLUSIONS: Our findings show that maternal morbid obesity is associated with an alarmingly high incidence of medical complications and an increased level of obstetric interventions. Consideration should be given to developing specialised antenatal services for morbidly obese women. The results also highlight the need to evaluate the effectiveness of prepregnancy interventions in morbidly obese women.

Time-to-recovery from obstetric fistula and associated factors: The ...

African Journals Online (AJOL)

EPHA USER33

potential risk factors associated with time to recovery of patients from obstetric fistula. Methods: An ... maternal health service and emergency obstetric care are contributing ..... process that causes the fistula may also lead to further destruction ...

Surgical Site Infection Rate and Risk Factors among Obstetric Cases ...

African Journals Online (AJOL)

2009-04-01

Among surgical patients in obstetrics, Surgical Site Infections were the most ... for delivery from April 1, 2009 to March 31, 2010 in obstetric ward of the Hospital. ... applying improved surgical techniques and improving infection prevention ...

Urban "accidental" wetlands mediate water quality and heat exposure for homeless populations in a desert city

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Palta, M.

2015-12-01

In urban settings where humans interact in complex ways with ecosystems, there may be hidden or unanticipated benefits (services) or harm (disservices) conferred by the built environment. We examined interactions of a highly vulnerable population, the homeless, with urban waterways and wetlands in the desert city of Phoenix, Arizona, U.S.A. Climate change models project increases in heat, droughts, and extreme floods for the southwestern U.S. These projected changes pose a number of problems for sustainability and quality of future water supply, and the ability of human populations to mitigate heat stress and avoid fatalities. Urban wetlands that are created "accidentally" (by water pooling in abandoned areas of the landscape) have many structural (e.g., soils and hydrology) and functional (e.g., high denitrification) elements that mimic natural, unaltered aquatic systems. Accidental wetland systems in the dry bed of the Salt River, fed by storm and waste water from urban Phoenix, are located within economically depressed sections of the city, and show the potential for pollutant and heat mitigation. We used a mixed-method socio-ecological approach to examine wetland ecosystem functions and the ways in which homeless populations utilize Salt River wetlands for ecosystem services. Interviews and trash surveys indicated that homeless people are accessing and utilizing the wetlands as a source of running water, for sanitary and heat mitigation services, and for recreation and habitation. Environmental monitoring demonstrated that the wetlands can provide a reliable source of running water, nutrient and pathogen removal, heat mitigation, and privacy, but they may also pose a health risk to individuals coming in contact with the water through drinking or bathing. Whether wetlands provided a net benefit vs. harm varied according to site, season, and particular service, and several tradeoffs were identified. For example, heat is highest during the summer storm season

Suicidal Ideation among the Chinese Elderly and Its Correlates: A Comparison between the Rural and Urban Populations

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Jianwen Wei

2018-02-01

Full Text Available Background: As China is going through a profound aging process, the mental health of the elderly is becoming an issue. As in many other societies, the elderly in China is a population at high risk of suicide; Methods: Data for the study were taken from the Sample Survey of the Aged Population in Urban/Rural China (SSAPUR accomplished in 2010 by the China Ministry of Civil Affairs. The valid sample for this study was composed of 18,683 individuals, including 9416 urban residents and 9267 rural residents both aged 60 or more years; Results: Logistic regression analyses showed that household income and expenditure, the number of children, chronic diseases, disability of daily living, depression, the frequency of visiting neighbors and having friends or relatives who can help or not had remarkable effects on the suicidal ideation among urban and rural old people. Gender, education, political affiliation, marital status and self-rated health status did not work on the dependent variable. However, some risk factors for suicidal ideation among the Chinese elderly were different between rural and urban regions; Conclusions: We should take different measures when facing the different groups of the elderly.

Strategies to reduce blood product utilization in obstetric practice.

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Neb, Holger; Zacharowski, Kai; Meybohm, Patrick

2017-06-01

Patient blood management (PBM) aims to improve patient outcome and safety by reducing the number of unnecessary RBC transfusions and vitalizing patient-specific anemia reserves. Although PBM is increasingly recognized as best clinical practice in elective surgery, implementation of PBM is restrained in the setting of obstetrics. This review summarizes recent findings to reduce blood product utilization in obstetric practice. PBM-related evidence-based benefits should be urgently adopted in the field of obstetric medicine. Intravenous iron can be considered a safe, effective strategy to replenish iron stores and to correct both pregnancy-related and hemorrhage-related iron deficiency anemia. In addition to surgical techniques and the use of uterotonics, recent findings support early administration of tranexamic acid, fibrinogen and a coagulation factor concentrate-based, viscoelastically guided practice in case of peripartum hemorrhage to manage coagulopathy. In patients with cesarean section, autologous red cell blood salvage may reduce blood product utilization, although its use in this setting is controversial. Implementation of PBM in obstetric practice offers large potential to reduce blood loss and transfusion requirements of allogeneic blood products, even though large clinical trials are lacking in this specific field. Intravenous iron supplementation may be suggested to increase peripartum hemoglobin levels. Additionally, tranexamic acid and point-of-care-guided supplementation of coagulation factors are potent methods to reduce unnecessary blood loss and blood transfusions in obstetrics.

PROVISION OF THE DUTY SERVICE IN GYNECOLOGY AND OBSTETRICS IN SLOVENIA

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Iztok Takač

2018-02-01

Full Text Available Background: Duty service of gyecology and obstetrics in Slovenia is organized on the regional basis and consists of ten regional hospitals, two hospitals for gynecology and obstetrics and two university clinical centres. Methods: Heads of hospitals where duty service is performed, have answered the questionnaires about the doctors who perform duty service. Results: Specialists and trainees in gynecology and obstetrics perform duty service on 21 posts and on 6 on-call posts. In Slovenia there are 287 active specialists in gynecology and obstetrics. 139 (48.4% among them are active on the primary level (outpatient clinics and 148 (51.6% in the hospitals and both clinical centres. Among hospital gynecologists and obstetricians 54 (36.5% of them are older than 55 years. Conclusions: Duty service of gyecology and obstetrics in Slovenia does not meet legislation criteria regard- ing doctors’ work time. Adequate changes for increasing the number of available doctors for duty service are proposed.

Perceptions by medical students of their educational environment for obstetrics and gynaecology in metropolitan and rural teaching sites.

Science.gov (United States)

Carmody, Dianne F; Jacques, Angela; Denz-Penhey, Harriet; Puddey, Ian; Newnham, John P

2009-12-01

Medical student education in Western Australia is expanding to secondary level metropolitan hospitals and rural sites to accommodate workforce demands and increasing medical student numbers. To determine if students' perceptions of the teaching environment for obstetrics and gynaecology differ between tertiary, secondary level metropolitan hospitals and rural sites, and to determine if students' perceptions of their learning environment are associated with improved academic performance. An evaluation was conducted of medical students' perceptions of their learning environment during an obstetrics and gynaecology program at a variety of sites across metropolitan and rural Western Australia. The evaluation was based on the Dundee Ready Education Environmental Measure (DREEM) questionnaire. There were no significant differences in students' perceptions of their learning environment between the tertiary hospital, combined programs involving a tertiary and secondary metropolitan hospital, rural sites with a population of more than 25,000 and rural sites with a population less than 25,000 people. Perceptions were similar in male and female students. The overall mean score for all perceptions of the learning environment in obstetrics and gynaecology were in the range considered to be favorable. Higher scores of perceptions of the learning environment were associated positively with the measures of academic achievement in the clinical, but not written, examination. Medical students' perceptions of their learning environment in obstetrics and gynaecology were not influenced by the geographical site of delivery or their gender but were positively related to higher academic achievement. Providing appropriate academic and clinical support systems have been put in place the education of medical students can be extended outside major hospitals and into outer metropolitan and rural communities without any apparent reduction in perceptions of the quality of their learning

Ultrasonogram in obstetric field

International Nuclear Information System (INIS)

Joo, K. B.; Song, C. H.; Lee, H. B.

1980-01-01

The clinical evaluation of 535 cases of sonogram from Mar. 1, 1979 to Oct. 30, 1979 in obstetric field at Department of Radiology and Ob. and Gy. Eul-Ji General Hospital. We present these cases: normal pregnancy, missed abortion, twin pregnancy, hydatidiform mole and ectopic pregnancy, with brief review of literature.

Urban blight and urban redesign

OpenAIRE

Zsilincsar, Walter

2018-01-01

The phenomenon of urban blight dates back to the 19th century when industrialisation starting in Europe and North America initiated an uncontrolled urban growth in combination with strong demand in cheap an quickly constructed housing. Ghettoisation of mainly the working-class population and other “marginal groups” were the consequence together with a constant decay of single buildings, whole blocks and quarters. These general aspects of urban blight with its additional facettes or aspects re...

Reflections of Civil and Criminal Liability in Obstetrical Violence Cases

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Roberto Carvalho Veloso

2016-10-01

Full Text Available Obstetric violence is characterized by the imposition of interventions harmful to the physical and psychological integrity of pregnant women, perpetrated by health professionals and institutions (public and private in which such women are assisted. This paper aims to discuss the civil and criminal liability in cases of obstetric violence, from the judgments of the Supreme Court (STF, Superior Court of Justice (STJ and the Courts of Justice (TJs of the Rio Grande do Sul State and Minas Gerais, in order to identify the nature of the punishment and characterization of obstetric violence.

Urbanization in Africa since independence.

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Tarver, J D

1994-01-01

Over 185 million inhabitants were added to the urban areas of Africa between 1950 and 1990. Botswana, Lesotho, Namibia, South Africa, and Swaziland is the most highly urbanized, with 55% in 1990; while less than a quarter of Eastern Africa's population is living in urban centers. By the year 2015 more than half of Africa's population will be living in urban areas. Many parts of Africa have suffered prolonged droughts, overgrazing, locust infestations, and desertification. Millions have become refugees from natural disasters, political oppression, and rural poverty. The large exodus from Africa's rural areas has gone to cities but the large cities have attracted disproportionately large numbers of destitute migrants. Alexandria (1 million), Cairo (2.4 million) and the Witwatersrand in South Africa were the only African urban agglomerations with at least one million inhabitants in 1950. By 1990 the two Egyptian cities together had 12.7 million inhabitants and the Witwatersrand some 5 million, whereas the other 25 urban agglomerations with a million inhabitants each in 1990 had a total population of about 51 million. Lagos, Kinshasa, and Algiers ranged from 3 to 7.7 million. The capitals are the largest cities in at least 54 of the 59 countries and territories. Lagos, Nairobi, and Dar es Salaam are disproportionately larger than the next most populous cities in their countries. The 28 urban agglomerations with at least one million inhabitants had a total population of 70 million in 1990, and are projected to reach 100 million in the year 2000. Overall, Africa's urban population is projected to increase by approximately 135 million in the 1990-2000 decade (from 217 million to 352 million). About 105 million of the growth probably will occur in the smaller urban centers. The total African urban population is likely to reach one billion inhabitants within the next 50 years. It stood at 32 million in 1950. Presently, the United Nations projects 912 million urban residents

Misdiagnosis of obstetrical cases and the clinical and cost consequences to patients: a cross-sectional study of urban providers in the Philippines

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Riti Shimkhada

2016-12-01

Full Text Available Background: Misdiagnosis may be a significant and under-recognized quality of care problem. In birthing facilities located in anurban Philippine setting, we investigated the diagnostic accuracy for three obstetric conditions: cephalopelvic disproportion (CPD, post-partum hemorrhage (PPH, and pre-eclampsia. Design: Identical simulated cases were used to measure diagnostic accuracy for every provider (n=103. We linked misdiagnosis – identified by the simulated cases – to obstetrical complications of the patients at the participating facilities. Patient-level data on health outcomes and costs were obtained from medical records and follow-home in-person interviews. Results: The prevalence of misdiagnosis among obstetric providers was 29.8% overall, 25% for CPD, 33% for PPH, and 31% for pre-eclampsia. Linking provider decision-making to patients, we found those who misdiagnosed the simulated cases were more likely to have patients with a complication (OR 2.96; 95% CI 1.39–3.77 compared with those who did not misdiagnose. Complicated patients were significantly less likely to be referred to a hospital immediately, were more likely to be readmitted to a hospital after delivery, had significantly higher medical costs, and lost more income than non-complicated patients. Conclusion: Diagnosis is arguably the most important task a clinician performs because it determines the subsequent course of evaluation and treatment, with the direct and indirect costs of diagnostic error, placing large financial burdens on the patient.

Misdiagnosis of obstetrical cases and the clinical and cost consequences to patients: a cross-sectional study of urban providers in the Philippines

Science.gov (United States)

Shimkhada, Riti; Solon, Orville; Tamondong-Lachica, Diana; Peabody, John W.

2016-01-01

Background Misdiagnosis may be a significant and under-recognized quality of care problem. In birthing facilities located in anurban Philippine setting, we investigated the diagnostic accuracy for three obstetric conditions: cephalopelvic disproportion (CPD), post-partum hemorrhage (PPH), and pre-eclampsia. Design Identical simulated cases were used to measure diagnostic accuracy for every provider (n=103). We linked misdiagnosis – identified by the simulated cases – to obstetrical complications of the patients at the participating facilities. Patient-level data on health outcomes and costs were obtained from medical records and follow-home in-person interviews. Results The prevalence of misdiagnosis among obstetric providers was 29.8% overall, 25% for CPD, 33% for PPH, and 31% for pre-eclampsia. Linking provider decision-making to patients, we found those who misdiagnosed the simulated cases were more likely to have patients with a complication (OR 2.96; 95% CI 1.39–3.77) compared with those who did not misdiagnose. Complicated patients were significantly less likely to be referred to a hospital immediately, were more likely to be readmitted to a hospital after delivery, had significantly higher medical costs, and lost more income than non-complicated patients. Conclusion Diagnosis is arguably the most important task a clinician performs because it determines the subsequent course of evaluation and treatment, with the direct and indirect costs of diagnostic error, placing large financial burdens on the patient. PMID:27987297

Hypertension and diabetes in Africa: design and implementation of a large population-based study of burden and risk factors in rural and urban Malawi

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Amelia Catharine Crampin

2016-02-01

Full Text Available Abstract Background The emerging burden of cardiovascular disease and diabetes in sub-Saharan Africa threatens the gains made in health by the major international effort to combat infectious diseases. There are few data on distribution of risk factors and outcomes in the region to inform an effective public health response. A comprehensive research programme is being developed aimed at accurately documenting the burden and drivers of NCDs in urban and rural Malawi; to design and test intervention strategies. The programme includes population surveys of all people aged 18 years and above, linking individuals with newly diagnosed hypertension and diabetes to healthcare and supporting clinical services. The successes, challenges and lessons learnt from the programme to date are discussed. Results Over 20,000 adults have been recruited in rural Karonga and urban Lilongwe. The urban population is significantly younger and wealthier than the rural population. Employed urban individuals, particularly males, give particular recruitment challenges; male participation rates were 80.3 % in the rural population and 43.6 % in urban, whilst female rates were 93.6 and 75.6 %, respectively. The study is generating high quality data on hypertension, diabetes, lipid abnormalities and risk factors. Conclusions It is feasible to develop large scale studies that can reliably inform the public health approach to diabetes, cardiovascular disease and other NCDs in Sub-Saharan Africa. It is essential for studies to capture both rural and urban populations to address disparities in risk factors, including age structure. Innovative approaches are needed to address the specific challenge of recruiting employed urban males.

The future is urban.

Science.gov (United States)

1992-05-01

Urban centers are growing due to natural increase and the movement of people from rural areas. Urban areas are the traditional centers of trade, science, and culture, but growth over a threshold results in crime, congestion, and pollution. Sustainability is threatened in modern towns that are dependent on other sources for food, fuel, or water. Housing, water, food supplies, and sanitation, communication, and transportation services are threatened in rapidly growing cities. In 1990 45/100 people lived in towns or cities. Hyper-cities have grown in number to 20, of which 14 are in developing countries. 83% of world population increase is expected to occur in cities. In 48 countries with faster population growth cities had growth rates averaging about 6.1% per year, and the urban share of total population averaged 2.8%. In 49 countries with slower population growth, urban growth rates averaged only 3.6% per year, and the urban share of total population averaged about 1.8%. Squatter settlements are endemic to urban areas that are congested and without basic services, limited housing particularly for the poor, and few job opportunities. The number of street children in urban areas has risen. This child population is subjected to low wages, overwork, auto accidents, poor health, and lack of social services. Malnutrition is a more serious issue in urban areas. In the Philippines malnutrition is 3% nationally and 9% in Metro Manila. Rural land reform in the Philippines is no longer a viable solution. In Metro Manila squatters are expected to increase in number to 4 million people by the year 2000, which would be almost 50% of total population. The squatter areas are areas of neglect, decay, and poverty. Cities are viewed as development's "blind alleys."

Teaching Guatemalan traditional birth attendants about obstetrical emergencies.

Science.gov (United States)

Garcia, Kimberly; Dowling, Donna; Mettler, Gretchen

2018-06-01

Guatemala's Maternal Mortality Rate is 65th highest in the world at 120 deaths per 100,000 births. Contributing to the problem is traditional birth attendants (TBAs) attend most births yet lack knowledge about obstetrical emergencies. Government trainings in existence since 1955 have not changed TBA knowledge. Government trainings are culturally insensitive because they are taught in Spanish with written material, even though most TBAs are illiterate and speak Mayan dialects. The purpose of the observational study was to evaluate the effect of an oral training, that was designed to be culturally sensitive in TBAs' native language, on TBAs' knowledge of obstetrical emergencies. one hundred ninety-one TBAs participated. The study employed a pretest-posttest design. A checklist was used to compare TBAs' knowledge of obstetrical emergencies before and after the training. the mean pretest score was 5.006±SD 0.291 compared to the mean posttest score of 8.549±SD 0.201. Change in knowledge was a P value of 0.00. results suggest an oral training that was designed to be culturally sensitive in the native language improved TBAs' knowledge of obstetrical emergencies. Future trainings should follow a similar format to meet the needs of illiterate audiences in remote settings. Copyright © 2018 Elsevier Ltd. All rights reserved.

Maternal and obstetrical predictors of sudden infant death syndrome (SIDS).

Science.gov (United States)

Friedmann, Isabel; Dahdouh, Elias M; Kugler, Perlyne; Mimran, Gracia; Balayla, Jacques

2017-10-01

Public Health initiatives, such as the "Safe to Sleep" campaign, have traditionally targeted infants' risk factors for the prevention of Sudden Infant Death Syndrome (SIDS). However, controversy remains regarding maternal and obstetrical risk factors for SIDS. In our study, we sought out to determine both modifiable and non-modifiable obstetrical and maternal risk factors associated with SIDS. We conducted a population-based cohort study using the CDC's Linked Birth-Infant Death data from the United States for the year 2010. The impact of several obstetrical and maternal risk factors on the risk of overall infant mortality and SIDS was estimated using unconditional regression analysis, adjusting for relevant confounders. Our cohort consisted of 4,007,105 deliveries and 24,174 infant deaths during the first year of life, of which 1991 (8.2%) were due to SIDS. Prominent risk factors for SIDS included (OR [95% CI]): black race, 1.89 [1.68-2.13]; maternal smoking, 3.56 [3.18-3.99]; maternal chronic hypertension, 1.73 [1.21-2.48]; gestational hypertension, 1.51 [1.23-1.87]; premature birth <37 weeks, 2.16 [1.82-2.55]; IUGR, 2.46 [2.14-2.82]; and being a twin, 1.81 [1.43-2.29], p < 0.0001. Relative to a cohort of infants who died of other causes, risk factors with a predilection for SIDS were maternal smoking, 2.48 [2.16-2.83] and being a twin, 1.52 [1.21-1.91], p < 0.0001. Conclusions for practice: While certain socio-demographic and gestational characteristics are important risk factors, maternal smoking remains the strongest prenatal modifiable risk factor for SIDS. We recommend the continuation of Public Health initiatives that promote safe infant sleeping practices and smoking cessation during and after pregnancy.

Overweight and Obesity above 18 years of Age in An Urban Population

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Amit Kumar Kamboj

2017-06-01

Full Text Available Background: Today however, as standard of living continues to rise, weight gain and obesity are posing a growing threat to health in both developed and developing countries and affecting children as well as adults. Indeed, it is now so common that it is replacing the more traditional public health concern including under nutrition and infectious diseases. Overweight and obesity is a major risk factor for high morbidity and mortality. Obesity is an independent risk factor for chronic heart disease related morbidity and mortality. Aims and Objectives: To find out the prevalence of overweight & obesity and to suggest measures for prevention of overweight and obesity in adult population. Material and Method: To cover a sample size of 1152 in Urban Health Centre area population ≥18 years every fifth family was selected by systematic random sampling from the total of 1698 families registered at Urban Health Centre. They were interviewed personally and information was collected about sociodemographic characteristics, personal factors, and measurements of weight, height, waist and hip circumference of the individuals were taken to calculate Body Mass Index (BMI and Waist Hip Ratio (WHR. Results: Prevalence of overweight (BMI -25-29.99 and obesity (BMI ≥30 being 28.0% and 8.0% respectively. Prevalence of abdominal obesity was 25.8%. About two-third (66.9% of abdominal obesity rightly corresponded with the high BMI (25+. Conclusion: The prevalence of overweight and obesity is increasing in urban area of Meerut, more in females than males and it is being affected by various socio-demographic correlates.

Differential associations of urbanicity and income with physical activity in adults in urbanizing China: findings from the population-based China Health and Nutrition Survey 1991-2009.

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Attard, Samantha M; Howard, Annie-Green; Herring, Amy H; Zhang, Bing; Du, Shufa; Aiello, Allison E; Popkin, Barry M; Gordon-Larsen, Penny

2015-12-12

High urbanicity and income are risk factors for cardiovascular-related chronic diseases in low- and middle-income countries, perhaps due to low physical activity (PA) in urban, high income areas. Few studies have examined differences in PA over time according to income and urbanicity in a country experiencing rapid urbanization. We used data from the China Health and Nutrition Survey, a population-based cohort of Chinese adults (n = 20,083; ages 18-75y) seen a maximum of 7 times from 1991-2009. We used sex-stratified, zero-inflated negative binomial regression models to examine occupational, domestic, leisure, travel, and total PA in Chinese adults according to year, urbanicity, income, and the interactions among urbanicity, income, and year, controlling for age and region of China. We showed larger mean temporal PA declines for individuals living in relatively low urbanicity areas (1991: 500 MET-hours/week; 2009: 300 MET-hours/week) compared to high urbanicity areas (1991: 200 MET-hours/week; 2009: 125 MET-hours/week). In low urbanicity areas, the association between income and total PA went from negative in 1991 (p Leisure PA was the only domain of PA that increased over time, but >95% of individuals in low urbanicity areas reported zero leisure PA at each time point. Our findings show changing associations for income and urbanicity with PA over 18 years of urbanization. Total PA was lower for individuals living in more versus less urban areas at all time points. However, these differences narrowed over time, which may relate to increases in individual-level income in less urban areas of China with urbanization. Low-income individuals in higher urbanicity areas are a particularly critical group to target to increase PA in China.

Acute Respiratory Distress Syndrome in Obstetric Patients

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S. V. Galushka

2007-01-01

Full Text Available Objective: to define the specific features of the course of acute respiratory distress syndrome (ARDS in puer-peras with a complicated postpartum period. Subjects and methods. Sixty-seven puerperas with ARDS were examined. Group 1 included 27 puerperas with postpartum ARDS; Group 2 comprised 10 puerperas who had been treated in an intensive care and died; Group 3 consisted of nonobstetric patients with ARDS of various genesis (a control group. Results. In obstetric patients, the baseline oxygenation index was significantly lower than that in the control group. However, Group 1 patients showed a rapid increase in PaO2/FiO2 on days 3—4 of treatment. In the control group, the changes occurred later — on days 5—6. The baseline alveolar-arterial oxygen difference was significantly higher in the obstetric patients than that in the controls. In Group 1, AaDpO2 drastically decreased on days 3—4, which took place in parallel with an increase in the oxygenation index. At the beginning of the study, pulmonary shunting was high in the group of survivors, deceased, and controls. In Group 1, the shunting decreased on days 3—4 whereas in the control group this index normalized later — only by days 6—7. In Group 1, compliance remained lower throughout the observation, but on day 7 there was a significant difference in this index between the deceased, survivors, and controls. Conclusion. Thus, more severe baseline pulmonary gas exchange abnormalities are observed in obstetric patients than in general surgical and traumatological patients; the oxygenation index, alveolar-arterial oxygen difference, and pulmonary shunting index more rapidly change in patients with severe obstetric disease in its favorable course than in general surgical and traumatological patients; throughout the observation, thoracopulmonary compliance was less in obstetric patients than in the controls. Key words: acute respiratory distress syndrome, puerperium.

Differences in the distribution of risk factors for stroke among the high-risk population in urban and rural areas of Eastern China.

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Mi, Te; Sun, Shangwen; Du, Yifeng; Guo, Shougang; Cong, Lin; Cao, Mingfeng; Sun, Qinjian; Sun, Yi; Qu, Chuanqiang

2016-05-01

Considering the program of screening for risk factors of stroke in Eastern China, the aim of this study was to compare the distribution differences in risk factors for stroke among the high-risk population living in urban and rural areas. A total of 231,289 residents were screened and basic information collected. Risk factors for stroke among the high-risk population were compared between the urban and rural groups. A total of 117,776 high-risk residents from urban areas and 113,513 from rural areas were included in the analysis. The prevalence of hypertension was much higher in rural areas (73.3%) than that in urban areas (64.1%). Dyslipidemia (48.9% vs. 26.9%), sport lack (46.6% vs. 31.6%), diabetes mellitus (21.3% vs. 16.5%), and atrial fibrillation (18.7% vs. 9.8%) were more prevalent in the urban group, while smoking (26.5% vs. 28.8%), previous stroke (10.1% vs. 16.9%), and transient ischemic attack (20.9% vs. 24.6%) were less prevalent. Among the population at high risk of stroke, there were significant differences in the distribution of the following risk factors between the urban and rural groups: hypertension, atrial fibrillation, dyslipidemia, lack of physical exercise, and a previous stroke.

Medical and licit drug use in an urban/rural study population with a refugee background, 7-8 years into resettlement

Science.gov (United States)

Johansson Blight, Karin; Persson, Jan-Olov; Ekblad, Solvig; Ekberg, Jan

2008-01-01

Objective: Research into medical and licit drug use in resettled refugee populations is scarce, despite the fact that mental health status often has been found to be poorer than in general populations. Hence the aim of this study was to estimate the prevalence of self-rated use of medicine and licit drugs among adults who came to Sweden from Bosnia-Herzegovina (1993/94) and who in 2001 were living in either an urban (low employment context) or a rural (high employment context) region (n=4185). Methods: Prevalence was estimated from a cross-sectional questionnaire distributed to a representative sample (n=650) in 2001 (63.5% response rate). Results: The study population estimates of usage of sedatives (26.5%), sleeping tablets (26.2%) and antidepressants (22.3%) did not differ by gender but did so by region, with a higher urban prevalence. The consumption of alcohol (5.1%) and cigarettes (41.0%) did not differ by region but men reported higher alcohol consumption than women. Conclusion: The high consumption of medicine (compared with general populations) raises the question of treatment efficiency and the need for public health attention and evaluation many years after resettlement. Factors to consider for further research with analytic prerequisites concern indications that regional differences may be influenced, not only by urban employment being lower but also by urban/rural differences in prescription rates and/or access to health care; moreover, there might have been a selection to the urban region of older people, with a more vulnerable family situation, and/or poorer mental health. Finally, the overall alcohol (low) and cigarettes (high) consumption in the study population followed prevalence patterns found in Bosnia-Herzegovina rather than in Sweden. PMID:19742286

Obstetrical APS : Is there a place for hydroxychloroquine to improve the pregnancy outcome?

NARCIS (Netherlands)

Mekinian, Arsene; Costedoat-Chalumeau, Nathalie; Masseau, Agathe; Tincani, Angela; De Caroli, Sara; Alijotas-Reig, Jaume; Ruffatti, Amelia; Ambrozic, Ales; Botta, Angela; Le Guern, Véronique; Fritsch-Stork, Ruth; Nicaise-Roland, Pascale; Carbonne, Bruno; Carbillon, Lionel; Fain, Olivier

2015-01-01

The use of the conventional APS treatment (the combination of low-dose aspirin and LMWH) dramatically improved the obstetrical prognosis in primary obstetrical APS (OAPS). The persistence of adverse pregnancy outcome raises the need to find other drugs to improve obstetrical outcome.

[Prevalence of type 2 diabetes and obesity in two Chilean aboriginal populations living in urban zones].

Science.gov (United States)

Carrasco, Elena P; Pérez, Francisco B; Angel, Bárbara B; Albala, Cecilia B; Santos, J Luis M; Larenas, Gladys Y; Montalvo, Domingo V

2004-10-01

The prevalence of cardiovascular risk factors is increasing in aboriginal populations in Chile. To study the prevalence of obesity, type 2 diabetes and serum lipids in two aboriginal populations, Mapuche and Aymara, that were transferred from a rural to a urban environment. Two groups of subjects over 20 years were analyzed, Mapuche and Aymara. The Mapuche group was formed by 42 men and 105 women, living in four urban communities of Santiago, and an Aymara group formed by 42 men and 118 women, living in Arica, in Northern Chile. Anthropometric measurements, blood pressure, lipid profile, oral glucose tolerance test, fasting insulin and serum leptin were determined. The prevalence of type 2 diabetes was 6.9% in Aymara and 8.2% in Mapuche subjects. The frequency of glucose intolerance was similar in both groups, but greater among men. A total blood cholesterol over 200 mg/dl was observed in 43.1% of Aymara and 27.9% of Mapuche subjects (p Mapuche individuals, respectively (p= NS). The prevalence of type 2 diabetes and dyslipidemia in turban aboriginal populations is higher than that of their rural counterparts. A possible explanation for these results are changes in lifestyles that come along with urbanization, characterized by a high consumption of saturated fat and refined sugars and a low level of physical activity.

Work ability and work-related stress: A cross-sectional study of obstetrical nurses in urban northeastern Ontario.

Science.gov (United States)

Nowrouzi, Behdin; Lightfoot, Nancy; Carter, Lorraine; Larivière, Michel; Rukholm, Ellen; Schinke, Robert; Belanger-Gardner, Diane

2015-01-01

The aim of this study was to determine: 1) if quality of work life (QWL), location of cross-training, stress variables, and various demographic factors in nurses are associated with work ability, and 2) nursing occupational stress, QWL, and various associated factors are related with nurses' work ability. There is limited research examining the obstetrical nursing environment. Given the amount of time and energy people expend at the workplace, it is crucial for employees to be satisfied with their lives at work. This cross sectional study was conducted in 2012 in four hospitals in northeastern Ontario, Canada. A stratified random sample of registered nurses (n= 111) were selected. The majority of participants were female (94.6%) ranging in age from 24 to 64 years (M = 41.9, s.d. = 10.2). For the stress and QWL model, one variable: QWL (home-work support - see Methods for definition) (p= 0.015), cross-trained (see Methods for definition) nurses (p= 0.048), and having more than 4 patients per shift (p= 0.024) significantly contributed to the variance in work ability scores. In the logistic regression model, the odds of a higher work ability for nurses who received home-work support were estimated to be 1.32 (95% CI, 1.06 to 1.66) times the odds of a higher work ability for nurses who did not receive home-work support. Work ability in the work environment of obstetrical nursing is important. To be high functioning, workplaces should maximize the use of their employees' actual and potential skills.

[Use of psychoactive substances and contraceptive methods by the Brazilian urban population, 2005].

Science.gov (United States)

Bastos, Francisco I; Cunha, Cynthia B; Bertoni, Neilane

2008-06-01

To analyze the relationship between utilization patterns for condoms and other contraceptive methods and the consumption of alcohol and drugs. Exploratory study based on data from a probabilistic sample of 5,040 interviewees aged 16 to 65 years living in large urban regions of Brazil in 2005. The data were collected by means of questionnaires. The chi-square automatic interaction classification tree technique was used to study the use of condoms among interviewees of both sexes and other contraceptive methods among women, at the time of the last vaginal sexual intercourse. Among young and middle-aged adults of both sexes and young men in stable relationships, condom use was less frequent among those who said they used psychoactive substances (alcohol and/or illegal drugs). The possible modulating effect of psychoactive substances on contraceptive practices among mature women seems to be more straightforward, compared to the more subtle effects observed among younger women, for whom the different social classes they belonged to seemed to play a more important role. Despite the limitations resulting from an exploratory study, the fact that this was a representative sample of the urban population of Brazil and not from vulnerable populations, reinforces the need to implement integrated public policies directed towards the general population, with regard to preventing drug consumption, alcohol abuse, sexually transmitted infections, HIV/AIDS and unwanted pregnancy and promoting sexual and reproductive health.

Blood transfusion practices in obstetric anaesthesia

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Ashok Jadon

2014-01-01

Full Text Available Blood transfusion is an essential component of emergency obstetric care and appropriate blood transfusion significantly reduces maternal mortality. Obstetric haemorrhage, especially postpartum haemorrhage, remains one of the major causes of massive haemorrhage and a prime cause of maternal mortality. Blood loss and assessment of its correct requirement are difficult in pregnancy due to physiological changes and comorbid conditions. Many guidelines have been used to assess the requirement and transfusion of blood and its components. Infrastructural, economic, social and religious constraints in blood banking and donation are key issues to formulate practice guidelines. Available current guidelines for transfusion are mostly from the developed world; however, they can be used by developing countries keeping available resources in perspective.

[Obstetric Nurses: contributions to the objectives of the Millennium Development Goals].

Science.gov (United States)

Reis, Thamiza da Rosa Dos; Zamberlan, Cláudia; Quadros, Jacqueline Silveira de; Grasel, Jessica Torres; Moro, Adriana Subeldia Dos Santos

2015-01-01

To characterize and analyze assistance to labor and delivery performed by residents in Obstetric Nursing. Quantitative and retrospective study of 189 normal births attended by residents in Obstetric Nursing in the period between July 2013 and June 2014 in a maternity hospital located in the countryside of Rio Grande do Sul. Data collection took place by gathering information from medical records and the analysis was performed using descriptive statistics. It was found the wide use of non-invasive and non-pharmacological pain relief and freedom of position during labor. It is noteworthy that 55.6% of women have not undergone any obstetric intervention. It was possible to identify that the Nursing Residency Program allows the reduction of obstetrical interventions, reflecting directly in the improvement of maternal health.

Prevalence of primary open-angle glaucoma in an urban south Indian population and comparison with a rural population. The Chennai Glaucoma Study.

Science.gov (United States)

Vijaya, Lingam; George, Ronnie; Baskaran, M; Arvind, Hemamalini; Raju, Prema; Ramesh, S Ve; Kumaramanickavel, Govindasamy; McCarty, Catherine

2008-04-01

To estimate the prevalence and risk factors of primary open-angle glaucoma (POAG) in an urban population and compare the same with that of our published rural population data in southern India. Population-based cross-sectional study. Four thousand eight hundred subjects 40 years or older were selected using a multistage random cluster sampling procedure in Chennai city. Three thousand eight hundred fifty (80.2%) subjects underwent a complete ophthalmic examination, including applanation tonometry, gonioscopy, pachymetry, optic disc photography, and automated perimetry. Glaucoma was diagnosed using the International Society of Geographical and Epidemiological Ophthalmology Classification. The distribution of intraocular pressure (IOP) and vertical cup-to-disc ratio (VCDR) was obtained from the right eye of the 2532 subjects with normal suprathreshold visual fields. Mean IOP was 16.17+/-3.74 mmHg (97.5th and 99.5th percentiles, 24 mmHg and 30 mmHg). The mean VCDR was 0.43+/-0.17 (97.5th and 99.5th percentiles, 0.7 and 0.8). One hundred thirty-five (64 men, 71 women) subjects had POAG (3.51%; 95% confidence interval [CI], 3.04-4.0). Primary open-angle glaucoma subjects (58.4+/-11.3 years) were older (P or =40-year-old south Indian urban population was 3.51%, higher than that of the rural population. The prevalence increased with age, and >90% were not aware of the disease.

Urban landscape genetics: canopy cover predicts gene flow between white-footed mouse (Peromyscus leucopus) populations in New York City.

Science.gov (United States)

Munshi-South, Jason

2012-03-01

In this study, I examine the influence of urban canopy cover on gene flow between 15 white-footed mouse (Peromyscus leucopus) populations in New York City parklands. Parks in the urban core are often highly fragmented, leading to rapid genetic differentiation of relatively nonvagile species. However, a diverse array of 'green' spaces may provide dispersal corridors through 'grey' urban infrastructure. I identify urban landscape features that promote genetic connectivity in an urban environment and compare the success of two different landscape connectivity approaches at explaining gene flow. Gene flow was associated with 'effective distances' between populations that were calculated based on per cent tree canopy cover using two different approaches: (i) isolation by effective distance (IED) that calculates the single best pathway to minimize passage through high-resistance (i.e. low canopy cover) areas, and (ii) isolation by resistance (IBR), an implementation of circuit theory that identifies all low-resistance paths through the landscape. IBR, but not IED, models were significantly associated with three measures of gene flow (Nm from F(ST) , BayesAss+ and Migrate-n) after factoring out the influence of isolation by distance using partial Mantel tests. Predicted corridors for gene flow between city parks were largely narrow, linear parklands or vegetated spaces that are not managed for wildlife, such as cemeteries and roadway medians. These results have implications for understanding the impacts of urbanization trends on native wildlife, as well as for urban reforestation efforts that aim to improve urban ecosystem processes. © 2012 Blackwell Publishing Ltd.

Controversies concerning the antiphospholipid syndrome in obstetrics.

Science.gov (United States)

Camarena Cabrera, Dulce María Albertina; Rodriguez-Jaimes, Claudia; Acevedo-Gallegos, Sandra; Gallardo-Gaona, Juan Manuel; Velazquez-Torres, Berenice; Ramírez-Calvo, José Antonio

Antiphospholipid antibody syndrome is a non-inflammatory autoimmune disease characterized by recurrent thrombotic events and/or obstetric complications associated with the presence of circulating antiphospholipid antibodies (anticardiolipin antibodies, anti-β 2 glycoprotein-i antibodies, and/or lupus anticoagulant. Antiphospholipid antibodies are a heterogeneous group of autoantibodies associated with recurrent miscarriage, stillbirth, fetal growth restriction and premature birth. The diversity of the features of the proposed placental antiphospholipid antibodies fingerprint suggests that several disease processes may occur in the placentae of women with antiphospholipid antibody syndrome in the form of immune responses: inflammatory events, complement activation, angiogenic imbalance and, less commonly, thrombosis and infarction. Because of the disparity between clinical and laboratory criteria, and the impact on perinatal outcome in patients starting treatment, we reviewed the aspects of antiphospholipid antibody syndrome related to obstetric complications and seronegative antiphospholipid antibody syndrome, and their treatment in obstetrics. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

Workforce planning and training in Obstetrics and Gynaecology across Europe

DEFF Research Database (Denmark)

Aabakke, Anna J M; Kristufkova, Alexandra; Boyon, Charlotte

2017-01-01

OBJECTIVE(S): To describe the infrastructural differences in training in Obstetrics and Gynaecology (ObGyn) across Europe. STUDY DESIGN: Descriptive web-based survey of 31 national ObGyn trainee societies representing the 30 member countries of the European Network of Trainees in Obstetrics and G...

[Selective embolization to treat obstetric hemorrhage].

Science.gov (United States)

Ferrer Puchol, M D; Lanciego, C; Esteban, E; Ciampi, J J; Edo, M A; Ferragud, S

2014-01-01

To describe cases of obstetric hemorrhage that have called for selective intra-arterial embolization and the different embolization techniques used. To assess the clinical outcomes and postprocedural fertility. We studied 27 women with obstetric hemorrhage. In 24 patients, embolization was performed by catheterizing both uterine arteries and in 2 patients only one uterine artery was catheterized (pseudoaneurysm). The materials used for embolization consisted of Spongostan in 17/27, particles in 9/27, and coils in 1/27. Clinical follow-up included an analysis of early and late complications and of postprocedural fertility. Hemorrhage was classified as primary (25/27) or secondary (2/27). The cause of bleeding was vaginal delivery (20), cesarean sections (5), abortion (1), and cervical ectopic pregnancy (1). The initial technical success rate was 100% and the clinical success rate was 92.6% (25 of the 27 patients). Bleeding ceased and the outcome was satisfactory in 25 patients. During clinical follow-up ranging from one to seven years, 23 patients had normal menstruation and 6 patients completed 7 full-term pregnancies. Intra-arterial embolization for obstetric hemorrhage leads to good outcomes and few complications and it preserves fertility. Copyright © 2011 SERAM. Published by Elsevier Espana. All rights reserved.

Poverty, race, and CKD in a racially and socioeconomically diverse urban population.

Science.gov (United States)

Crews, Deidra C; Charles, Raquel F; Evans, Michele K; Zonderman, Alan B; Powe, Neil R

2010-06-01

Low socioeconomic status (SES) and African American race are both independently associated with end-stage renal disease and progressive chronic kidney disease (CKD). However, despite their frequent co-occurrence, the effect of low SES independent of race has not been well studied in CKD. Cross-sectional study. 2,375 community-dwelling adults aged 30-64 years residing within 12 neighborhoods selected for both socioeconomic and racial diversity in Baltimore City, MD. Low SES (self-reported household income or =125% of guideline); white and African American race. CKD defined as estimated glomerular filtration rate poverty and CKD, stratified by race. Of 2,375 participants, 955 were white (347 low SES and 608 higher SES) and 1,420 were African American (713 low SES and 707 higher SES). 146 (6.2%) participants had CKD. Overall, race was not associated with CKD (OR, 1.05; 95% CI, 0.57-1.96); however, African Americans had a much greater odds of advanced CKD (estimated glomerular filtration rate urban populations. Low SES has a profound relationship with CKD in African Americans, but not whites, in an urban population of adults, and its role in the racial disparities seen in CKD is worthy of further investigation. Copyright 2010 National Kidney Foundation, Inc. All rights reserved.

The Urban Environment and Childhood Asthma (URECA birth cohort study: design, methods, and study population

Directory of Open Access Journals (Sweden)

Sandel Megan T

2009-05-01

Full Text Available Abstract Background The incidence and morbidity of wheezing illnesses and childhood asthma is especially high in poor urban areas. This paper describes the study design, methods, and population of the Urban Environment and Childhood Asthma (URECA study, which was established to investigate the immunologic causes of asthma among inner-city children. Methods and Results URECA is an observational prospective study that enrolled pregnant women in central urban areas of Baltimore, Boston, New York City, and St. Louis and is following their offspring from birth through age 7 years. The birth cohort consists of 560 inner-city children who have at least one parent with an allergic disease or asthma, and all families live in areas in which at least 20% of the population has incomes below the poverty line. In addition, 49 inner-city children with no parental history of allergies or asthma were enrolled. The primary hypothesis is that specific urban exposures in early life promote a unique pattern of immune development (impaired antiviral and increased Th2 responses that increases the risk of recurrent wheezing and allergic sensitization in early childhood, and of asthma by age 7 years. To track immune development, cytokine responses of blood mononuclear cells stimulated ex vivo are measured at birth and then annually. Environmental assessments include allergen and endotoxin levels in house dust, pre- and postnatal maternal stress, and indoor air nicotine and nitrogen dioxide. Nasal mucous samples are collected from the children during respiratory illnesses and analyzed for respiratory viruses. The complex interactions between environmental exposures and immune development will be assessed with respect to recurrent wheeze at age 3 years and asthma at age 7 years. Conclusion The overall goal of the URECA study is to develop a better understanding of how specific urban exposures affect immune development to promote wheezing illnesses and asthma.

The associations between bridal pregnancy and obstetric outcomes among live births in Korea: population-based study.

Directory of Open Access Journals (Sweden)

Jung-Yun Lee

Full Text Available OBJECTIVE: In East Asia the recently increased number of marriages in response to pregnancy is an important social issue. This study evaluated the association of marriage preceded by pregnancy (bridal pregnancy with obstetric outcomes among live births in Korea. METHODS: In this population-based study, 1,152,593 first singleton births were evaluated from data registered in the national birth registration database from 2004 to 2008 in Korea. In the study population, the pregnancy outcomes among live births from the bridal pregnancy group (N = 62,590 were compared with the outcomes of the post-marital pregnancy group (N = 564,749, composed of women who gave birth after 10 months but before 24 months of marriage. The variables preterm birth (PTB; <37 weeks gestation and low birth weight (LBW; <2.5 kg were used to determine the primary outcome. The adjusted odds ratios (aORs and 95% confidence intervals (CIs were calculated after controlling for socio-demographic factors. RESULTS: The socio-demographic factors among the bridal pregnancy group were associated with a social disadvantage and particular risk factors. In the subgroup analyses of maternal age, differences in adverse pregnancy outcomes from bridal pregnancy were identified between women in the following age group: (i ≤19, (ii 20-39, and (iii ≥40 years. After the multivariate analysis, the aORs for each age group were 1.47 (95% CI: 1.15-1.89, 1.76 (1.70-1.83, and 1.13 (0.77-1.66, respectively, for PTB and 0.92 (0.70-1.21, 1.60 (1.53-1.66, and 1.11 (0.71-1.74, respectively, for LBW. In the adjusted logistic regression models, bridal pregnancy was associated with PTB (1.76, 1.69-1.82 and LBW (1.53, 1.48-1.59. CONCLUSION: Pregnancy outcomes among live births from bridal pregnancies are associated with higher risks for PTB and LBW in Korea.

African urbanization in metropolitan South Africa--differential urbanization perspectives.

Science.gov (United States)

Geyer, H S

1993-07-01

"As a potentially important urban development policy consideration, attention is focused in this paper on differential urbanization trends in South Africa at the metropolitan level. Recent informal urban settlement patterns of the African population within the major metropolitan areas are contrasted against these differential urbanization trends to determine the implications of both for residential development in the metropolitan areas during the post-apartheid era." excerpt

The Rise of Urban Slum in Nigeria: Implications on the Urban ...

African Journals Online (AJOL)

... defacement of the urban landscape in Nigeria. It recommends that Government and city planners should provide affordable land and low cost housing for the urban dwellers. This will enable people to own their property or rent as the case may be. Keywords: Urban Slum, Urban Landscape, Implication, Population, Growth

Spatio-Temporal Variability of Urban Heat Island and Urban Mobility

Science.gov (United States)

Kar, B.; Omitaomu, O.

2017-12-01

A 2016 report by the U.S. Census stated that while the rural areas cover 97% of the U.S. landmass, these areas house only 19.7% of the nation's population. Given that the U.S. coastal counties are home to more than 50% of the U.S. population, these urban areas are clustered along the coast that is susceptible to sea level rise induced impacts. In light of increasing climate variability and extreme events, it is pertinent to understand the Urban Heat Island (UHI) effect that results from increasing population density and mobility in the urban areas, and that contributes to increased energy consumption and temperature as well as unmitigated flooding events. For example, in Illinois, warmer summers contribute to heavy precipitation that overwhelms the region's drainage capacity. This study focuses on understanding the spatio-temporal variability of the relationship between population density and mobility distribution, and creation of UHI due to temperature change in selected cities across the U.S. This knowledge will help us understand the role of UHI in energy-water nexus in urban areas, specifically, energy consumption.

Comparison of domestic violence against women in urban versus rural areas of southeast Nigeria

Directory of Open Access Journals (Sweden)

Ajah LO

2014-10-01

Full Text Available Leonard Ogbonna Ajah,1,2 Chukwuemeka Anthony Iyoke,1 Peter Onubiwe Nkwo,1 Boniface Nwakoby,3 Paul Ezeonu2 1Department of Obstetrics and Gynaecology, University of Nigeria Teaching Hospital, Enugu, Nigeria; 2Department of Obstetrics and Gynaecology, Federal Teaching Hospital, Abakaliki, Ebonyi State, Nigeria; 3Department of Community Medicine, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria Background: The perception and prevalence of domestic violence (DV in rural areas is poorly understood; the result is that most efforts at eradicating this harmful practice are concentrated in urban areas. The objective of the study was to compare the burden and perception of DV among women living in rural and urban Igbo communities of southeast Nigeria. Methods: This was a comparative, cross-sectional study of women residing in rural and urban communities in Enugu, Nigeria, who had gathered for an annual religious meeting from August 1–7, 2011. Data analysis involved descriptive and inferential statistics and was conducted with the Statistical Package for Social Sciences, software version 17.0, at a 95% level of confidence. Results: A total of 836 women who met the eligibility criteria participated in the survey. Of these, 376 were from Okpanku, a rural community, while 460 were from Ogui Nike, an urban community. The prevalence of DV among rural women was significantly higher than that among urban women (97% versus 81%, P<0.001. In particular, the prevalence of physical violence was significantly higher among rural women than among urban women (37.2% versus 23.5%; P=0.05. In contrast, rural and urban women did not differ significantly in the proportions that had experienced psychological or sexual violence. The proportion of women who believed that DV was excusable was significantly higher among rural dwellers than among urban dwellers (58.5% versus 29.6%; P=0.03. Conclusion: The burden of DV against women may be higher in rural

Uncanny valley: A preliminary study on the acceptance of Malaysian urban and rural population toward different types of robotic faces

Science.gov (United States)

Tay, T. T.; Low, Raymond; Loke, H. J.; Chua, Y. L.; Goh, Y. H.

2018-04-01

The proliferation of robotic technologies in recent years brings robots closer to humanities. There are many researches on going at various stages of development to bring robots into our homes, schools, nurseries, elderly care centres, offices, hospitals and factories. With recently developed robots having tendency to have appearance which increasingly displaying similarities to household animals and humans, there is a need to study the existence of uncanny valley phenomenon. Generally, the acceptance of people toward robots increases as the robots acquire increasing similarities to human features until a stage where people feel very uncomfortable, eerie, fear and disgust when the robot appearance become almost human like but not yet human. This phenomenon called uncanny valley was first reported by Masahiro Mori. There are numerous researches conducted to measure the existence of uncanny valley in Japan and European countries. However, there is limited research reported on uncanny valley phenomenon in Malaysia so far. In view of the different cultural background and exposure of Malaysian population to robotics technology compared to European or East Asian populations, it is worth to study this phenomenon in Malaysian context. The main aim of this work is to conduct a preliminary study to determine the existence of uncanny valley phenomenon in Malaysian urban and rural populations. It is interesting to find if there are any differences in the acceptance of the two set of populations despite of their differences. Among others the urban and rural populations differ in term of the rate of urbanization and exposure to latest technologies. A set of four interactive robotic faces and an ideal human model representing the fifth robot are used in this study. The robots have features resembling a cute animal, cartoon character, typical robot and human-like. Questionnaire surveys are conducted on respondents from urban and rural populations. Survey data collected are

Teamwork in obstetric critical care.

Science.gov (United States)

Guise, Jeanne-Marie; Segel, Sally

2008-10-01

Whether seeing a patient in the ambulatory clinic environment, performing a delivery or managing a critically ill patient, obstetric care is a team activity. Failures in teamwork and communication are among the leading causes of adverse obstetric events, accounting for over 70% of sentinel events according to the Joint Commission. Effective, efficient and safe care requires good teamwork. Although nurses, doctors and healthcare staff who work in critical care environments are extremely well trained and competent medically, they have not traditionally been trained in how to work well as part of a team. Given the complexity and acuity of critical care medicine, which often relies on more than one medical team, teamwork skills are essential. This chapter discusses the history and importance of teamwork in high-reliability fields, reviews key concepts and skills in teamwork, and discusses approaches to training and working in teams.

Effectiveness of primary conservative management for infants with obstetric brachial plexus palsy.

Science.gov (United States)

Bialocerkowski, Andrea; Kurlowicz, Kirsty; Vladusic, Sharon; Grimmer, Karen

2005-03-01

�� Two independent reviewers assessed the eligibility of each study for inclusion into the review, the study design used and its methodological quality. Where any disagreement occurred, consensus was reached by discussion. Studies were assessed for clinical homogeneity by considering populations, interventions and outcomes. Where heterogeneity was present, synthesis was undertaken in a narrative format. Results  Eight studies were included in the review. Most were ranked low on the Hierarchy of Evidence (no randomised controlled trials were found), and had only fair methodological quality. Conservative management was variable and could consist of active or passive exercise, splints or traction. All studies lacked a clear description of what constituted conservative management, which would not allow the treatment to be replicated in the clinical setting. A variety of outcome instruments were used, none of which had evidence of validity, reliability or sensitivity to detect change. Furthermore, less severely affected infants were selected to receive conservative management. Therefore, it is difficult to draw conclusions regarding the effectiveness of conservative management for infants with obstetric brachial plexus palsy. Conclusions  There is scant, inconclusive evidence regarding the effectiveness of primary conservative intervention for infants with obstetric brachial plexus palsy. Further research should be directed to develop outcome instruments with sound psychometric properties for infants with obstetric brachial plexus palsy and their families. These outcome instruments should then be used in well-designed comparative studies.

Training in motivational interviewing in obstetrics

DEFF Research Database (Denmark)

Lindhardt, Christina L; Rubak, Sune Leisgaard Mørck; Mogensen, Ole

2014-01-01

-adherent interventions). Furthermore, the participants asked fewer closed and more open questions before training in motivational interview. In the assessment of proficiency and competency, most of the participants scored higher after the training in motivational interviewing. CONCLUSIONS: Training in motivational......OBJECTIVE: To examine whether a three day training course in motivational interviewing which is an approach to helping people to change could improve the communication skills of obstetric healthcare professionals in their interaction with obese pregnant women. DESIGN: Intervention study. SETTING......: The Region of Southern Denmark. METHODS: Eleven obstetric healthcare professionals working with obese pregnant women underwent a three day course in motivational interviewing techniques and were assessed before- and after training to measure the impact on their overall performance as well as the effect...

Thyroid function and autoimmunity in Danish pregnant women after an iodine fortification program and associations with obstetric outcomes

DEFF Research Database (Denmark)

Bliddal, Sofie; Boas, Malene; Hilsted, Linda

2015-01-01

the iodine implementation, there has been an increase in thyroid autoimmunity in the background population. This study investigates the thyroid status of pregnant Danish women following the iodine fortification program, and a possible association with preterm delivery. DESIGN: Historical cohort study of 1278...... randomly selected pregnant Danish women attending the national Down's syndrome screening program. METHODS: The main outcome measures were thyroid status according to laboratory- and gestational-age-specific reference intervals, and association with risk of abnormal obstetric outcome. Antibody...... of the Danish iodine fortification program, the prevalence of thyroid dysfunction and autoimmunity in Danish pregnant women is high - even higher by use of pre-established reference intervals from international consensus guidelines. However, no associations were found with abnormal obstetric outcome. Large...

Urbanization and Structural Transformation

OpenAIRE

Michaels, Guy; Rauch, Ferdinand; Redding, Stephen J.

2008-01-01

This paper presents new evidence on urbanization using sub-county data for the United States from 1880-2000 and municipality data for Brazil from 1970-2000. We show that the two central stylized features of population growth for cities - Gibrat's Law and a stable population distribution - are strongly rejected when both rural and urban areas are considered. Population growth exhibits a U-shaped relationship with initial population density, and only becomes uncorrelated with initial population...

Teamwork Assessment Tools in Obstetric Emergencies: A Systematic Review.

Science.gov (United States)

Onwochei, Desire N; Halpern, Stephen; Balki, Mrinalini

2017-06-01

Team-based training and simulation can improve patient safety, by improving communication, decision making, and performance of team members. Currently, there is no general consensus on whether or not a specific assessment tool is better adapted to evaluate teamwork in obstetric emergencies. The purpose of this qualitative systematic review was to find the tools available to assess team effectiveness in obstetric emergencies. We searched Embase, Medline, PubMed, Web of Science, PsycINFO, CINAHL, and Google Scholar for prospective studies that evaluated nontechnical skills in multidisciplinary teams involving obstetric emergencies. The search included studies from 1944 until January 11, 2016. Data on reliability and validity measures were collected and used for interpretation. A descriptive analysis was performed on the data. Thirteen studies were included in the final qualitative synthesis. All the studies assessed teams in the context of obstetric simulation scenarios, but only six included anesthetists in the simulations. One study evaluated their teamwork tool using just validity measures, five using just reliability measures, and one used both. The most reliable tools identified were the Clinical Teamwork Scale, the Global Assessment of Obstetric Team Performance, and the Global Rating Scale of performance. However, they were still lacking in terms of quality and validity. More work needs to be conducted to establish the validity of teamwork tools for nontechnical skills, and the development of an ideal tool is warranted. Further studies are required to assess how outcomes, such as performance and patient safety, are influenced when using these tools.

Obstetric interventions for babies born before 28 weeks of gestation in Europe: results of the MOSAIC study

DEFF Research Database (Denmark)

Kollée, L A A; Cuttini, M; Delmas, D

2009-01-01

to Intensive Care for Very Preterm Babies in Europe' (MOSAIC) project. POPULATION: All births from 22 to 29 weeks of gestation (n = 4146) in 2003, excluding terminations of pregnancy. METHODS: Comparison of three obstetric interventions (antenatal corticosteroids, antenatal transfer and caesarean section...... as a composite score of these three interventions. Outcomes included stillbirth, in-hospital mortality and intraventricular haemorrhage (IVH) grades III and IV and/or periventricular leucomalacia (PVL) and bronchopulmonary dysplasia (BPD). RESULTS: There were large differences between regions in interventions...... the composite intervention score and mortality. No association was observed at 26-27 weeks. For survivors at 24-25 weeks, the intervention score was associated with higher rates of BPD, but not with IVH or PVL. CONCLUSIONS: There are large differences between European regions in obstetric practices at the lower...

Obstetrical ultrasound data-base management system by using personal computer

International Nuclear Information System (INIS)

Jeon, Hae Jeong; Park, Jeong Hee; Kim, Soo Nyung

1993-01-01

A computer program which performs obstetric calculations on Clipper Language using the data from ultrasonography was developed for personal computer. It was designed for fast assessment of fetal development, prediction of gestational age, and weight from ultrasonographic measurements which included biparietal diameter, femur length, gestational sac, occipito-frontal diameter, abdominal diameter, and etc. The Obstetrical-Ultrasound Data-Base Management System was tested for its performance. The Obstetrical-Ultrasound Data-Base Management System was very useful in patient management with its convenient data filing, easy retrieval of previous report, prompt but accurate estimation of fetal growth and skeletal anomaly and production of equation and growth curve for pregnant women

[Japanese who affected modern medicine in Taiwan: obstetrics and gynecology].

Science.gov (United States)

Wang, Ming-Tung

2009-12-01

This text describes the leaders who established the modem obstetrics and gynecology for Taiwan. during the Japan-colonizing period (1895-1945). These leaders are Mr. Kawasoye, M., Mr. Mukae K., and Mr. Magara M. The lives of these leaders were different, but they all strongly contributed to the development of modem obstetrics and gynecology in Taiwan. With regard to the passage of time, Mr. Kawasoye contributed the initial efforts, Mr. Mukae worked during the flourishing period of the clinic; and Mr. Magara worked during the mature period, emphasizing research. These three periods are closely correlated with the course of the development of modem obstetrics and gynecology in Taiwan.

Prevalence of primary glaucoma in an urban South Indian population

Directory of Open Access Journals (Sweden)

Jacob Aby

1998-01-01

Full Text Available Glaucoma is fast emerging as a major cause of blindness in India. In order to estimate the prevalence of primary open angle glaucoma (POAG and primary angle closure glaucoma (PACG in an urban South Indian population, we examined 972 individuals aged 30-60 years, chosen using a cluster sampling technique from 12 census blocks of Vellore town. They underwent a complete ocular examination, including applanation tonometry and gonioscopy, at the Medical College Hospital. Characteristic field defects on automated perimetry was a diagnostic requisite for POAG. Prevalence (95% CI of POAG, PACG, and ocular hypertension were 4.1 (0.08-8.1, 43.2 (30.14-56.3, and 30.8 (19.8-41.9 per 1,000, respectively. All the PACG cases detected were of the chronic type. Hitherto unavailable community-based information on primary glaucoma in our study population indicates that PACG is about five times as common as POAG.

Effects of income and urban form on urban NO2: global evidence from satellites.

Science.gov (United States)

Bechle, Matthew J; Millet, Dylan B; Marshall, Julian D

2011-06-01

Urban air pollution is among the top 15 causes of death and disease worldwide, and a problem of growing importance with a majority of the global population living in cities. A important question for sustainable development is to what extent urban design can improve or degrade the environment and public health. We investigate relationships between satellite-derived estimates of nitrogen dioxide concentration (NO(2), a key component of urban air pollution) and urban form for 83 cities globally. We find a parsimonious yet powerful relationship (model R(2) = 0.63), using as predictors population, income, urban contiguity, and meteorology. Cities with highly contiguous built-up areas have, on average, lower urban NO(2) concentrations (a one standard deviation increase in contiguity is associated with a 24% decrease in average NO(2) concentration). More-populous cities tend to have worse air quality, but the increase in NO(2) associated with a population increase of 10% may be offset by a moderate increase (4%) in urban contiguity. Urban circularity ("compactness") is not a statistically significant predictor of NO(2) concentration. Although many factors contribute to urban air pollution, our findings suggest that antileapfrogging policies may improve air quality. We find that urban NO(2) levels vary nonlinearly with income (Gross Domestic Product), following an "environmental Kuznets curve"; we estimate that if high-income countries followed urban pollution-per-income trends observed for low-income countries, NO(2) concentrations in high-income cities would be ∼10× larger than observed levels.

Patterns of Vaginal, Oral, and Anal Sexual Intercourse in an Urban Seventh-Grade Population

Science.gov (United States)

Markham, Christine M.; Peskin, Melissa Fleschler; Addy, Robert C.; Baumler, Elizabeth R.; Tortolero, Susan R.

2009-01-01

Background: This study examines the prevalence of vaginal, oral, and anal intercourse among a population of urban, public middle school students, the characteristics of early sexual initiators, and the sequence of sexual initiation. Such data are limited for early adolescents. Methods: A total of 1279 seventh-grade students (57.3% female, 43.6%…

Increased risk of schizophrenia from additive interaction between infant motor developmental delay and obstetric complications: evidence from a population-based longitudinal study.

LENUS (Irish Health Repository)

Clarke, Mary C

2011-12-01

Obstetric complications and developmental delay are well-established risk factors for schizophrenia. The authors investigated whether these risk factors interact in an additive manner to further increase risk for schizophrenia.

Epidemiology and population structure of Staphylococcus aureus in various population groups from a rural and semi urban area in Gabon, Central Africa

NARCIS (Netherlands)

Ateba Ngoa, Ulysse; Schaumburg, Frieder; Adegnika, Ayola Akim; Kösters, Katrin; Möller, Tina; Fernandes, Jose Francisco; Alabi, Abraham; Issifou, Saadou; Becker, Karsten; Grobusch, Martin Peter; Kremsner, Peter Gottfried; Lell, Bertrand

2012-01-01

Little data is available on the epidemiology of Staphylococcus aureus in Africa. In the present study we aim at characterizing the population structure of S. aureus in healthy subjects from a rural and a semi-urban area in Lambarene, Gabon as well as in hospital staff and inpatients. In total, 500

[Medication use among community-dwelling older Icelanders. Population-based study in urban and rural areas].

Science.gov (United States)

Sigurdardottir, Arun K; Arnadottir, Solveig Asa; Gunnarsdottir, Elín Díanna

2011-12-01

To describe medication use among older community-dwelling Icelanders by collecting information on number of medicine, polypharmacy (>5 medications), and medications by ATC categories. Moreover, to explore the relationship between medication use and various influential factors emphasizing residency in urban and rural areas. Population-based, cross-sectional study. Participants were randomly selected from the National registry in one urban (n=118) and two rural (n=68) areas. 1) ≥ 65 years old, 2) community-dwelling, 3) able to communicate verbally. Information on medication use was obtained from each person's medication list and interviews. A questionnaire and five standardized instruments were used to assess the potential influencing factors. On average, participants used 3.9 medications and prevalence of polypharmacy was 41%. Men used 3.5 medications on average and women 4.4 (p=0.018). Compared to rural residents, urban residents had fewer medical diagnoses, better mobility, less pain, and fewer depressive symptoms. By controlling for the effects of these variables, more medications were associated with urban living (pbetter scores on health assessments.

How Should Trainees Respond in Situations of Obstetric Violence?

Science.gov (United States)

Rubashkin, Nicholas; Minckas, Nicole

2018-03-01

Argentina passed a law for humanized birth in 2004 and another law against obstetric violence in 2009, both of which stipulate the rights of women to achieve respectful maternity care. Clinicians and women might still be unaware of these laws, however. In this article, we discuss the case of a fourth-year medical student who, while visiting Argentina from the United States for his obstetric rotation, witnesses an act of obstetric violence. We show that the student's situation can be understood as one of moral distress and argue that, in this specific instance, it would be appropriate for the student to intervene by providing supportive care to the patient. However, we suggest that medical schools have an obligation to better prepare students for rotations conducted abroad. © 2018 American Medical Association. All Rights Reserved.

Natural areas and urban populations: communication and environmental education challenges and actions in outdoor recreation

Science.gov (United States)

Deborah J. Chavez

2005-01-01

Challenges, opportunities, and actions exist in areas where large urban populations interface with natural areas, such as outdoor recreation sites in southern California. Challenges in the interface include intense recreation use, public safety issues, and complex information strategies. Research results on communications and environmental education offer opportunities...

Urban Environmental Problems

International Nuclear Information System (INIS)

Situma, F.D.P.

1999-01-01

The rapid urbanization and resultant heavy concentration of population in urban centres have led to many urban areas failing to provide the necessary infrastructure and amenities as the demands placed on them have overwhelmed their financial and institutional capacities. In many urban areas, the capacity for resource mobilization and delivery of social services has either broken down completely or tethers on breaking point. Although in 1986 the GoK launched a new strategy for the balanced development of rural and urban areas aimed at avoiding excessive concentration of population in urban areas, the fruits of this strategy are yet to be realized. As a result, developments in urban areas have been unsustainable and environmentally unsound. The general quality of the environment has deteriorated so much so that urgent policy intervention is required. Appropriate environmental management measures and practices are needed to address the current trend of spiralling environmental problems in the context of the existing legal and institutional frameworks and makes some proposals for reform to address these problems in order to make urban areas environmentally

[Anesthesia in obstetrics: Tried and trusted methods, current standards and new challenges].

Science.gov (United States)

Kranke, P; Annecke, T; Bremerich, D H; Hanß, R; Kaufner, L; Klapp, C; Ohnesorge, H; Schwemmer, U; Standl, T; Weber, S; Volk, T

2016-01-01

Obstetric analgesia and anesthesia have some specific aspects, which in particular are directly related to pathophysiological alterations during pregnancy and also to the circumstance that two or even more individuals are always affected by complications or therapeutic measures. This review article deals with some evergreens and hot topics of obstetric anesthesia and essential new knowledge on these aspects is described. The article summarizes the talks given at the 16th symposium on obstetric anesthesia organized by the Scientific Committee for Regional Anaesthesia and Obstetric Anaesthesia within the German Society of Anaesthesiology. The topics are in particular, special features and pitfalls of informed consent in the delivery room, challenges in education and training in obstetric anesthesia, expedient inclusion of simulation-assisted training and further education on risk minimization, knowledge and recommendations on fasting for the delivery room and cesarean sections, monitoring in obstetric anesthesia by neuraxial and alternative procedures, the possibilities and limitations of using ultrasound for lumbal epidural catheter positioning in the delivery room, recommended approaches in preparing peridural catheters for cesarean section, basic principles of cardiotocography, postoperative analgesia after cesarean section, the practice of early bonding in the delivery room during cesarean section births and the management of postpartum hemorrhage.

Human fertility variation, size-related obstetrical performance and the evolution of sexual stature dimorphism

OpenAIRE

Guégan, Jean-François; Teriokhin, A.T.; Thomas, F.

2000-01-01

In several animal species, change in sexual size dimorphism is a correlated response to selection on fecundity. In humans, different hypotheses have been proposed to explain the variation of sexual dimorphism in stature, but no consensus has yet emerged. In this paper, we evaluate from a theoretical and an empirical point of view the hypothesis that the extent of sexual dimorphism in human populations results from the interaction between fertility and size-related obstetric complications. We ...

Epidemiology of uveitis in a Western urban multiethnic population. The challenge of globalization.

Science.gov (United States)

Llorenç, Victor; Mesquida, Marina; Sainz de la Maza, Maite; Keller, Johannes; Molins, Blanca; Espinosa, Gerard; Hernandez, María V; Gonzalez-Martín, Julian; Adán, Alfredo

2015-09-01

To report the anatomical pattern and etiological spectrum of uveitis in an urban multi-ethnic population from Barcelona, Spain. General and specific epidemiological data for the most prevalent aetiologies are also calculated. A cross-sectional study of consecutive uveitis cases was performed between 1 January 2009 and 31 December 2012. Exogenous endophthalmitis, surgery-related, post-traumatic and toxic uveitis along with masquerade syndromes were excluded. Anatomical (Standard Uveitis Nomenclature criteria) and aetiological patterns (by tailored tests), age, sex, geographical origin and laterality were analysed. Mean incidence and prevalence were calculated for a mid-period reference population. From 1022 patients included, 52% were anterior uveitis (AU), 23% posterior, 15% panuveitis and 9% intermediate uveitis. Aetiologically, 26% were unclassifiable, 29% infectious, 25% associated with systemic immune diseases, and 20% corresponded to ocular-specific syndromes. Among classified causes, herpesvirus (12%), toxoplasma (7%), Behçet's disease (BD) (5%), HLA-B27-isolated AU (5%), ankylosing spondylitis (5%), tuberculosis-related uveitis (TRU) (5%), birdshot chorioretinopathy (3%) and sarcoidosis (3%) were the most frequent. Non-Spanish origin was recorded in 22%, with 47% of Vogt-Koyanagi-Harada and 36% of toxoplasma cases coming from South America, 10% of BD and 11% of TRU from Africa and 24% of TRU cases from Asia. A mean annual incidence of 51.91 cases/100,000 inhabitants was found for the referral population. In our referral area, 74% of the uveitis cases can be correctly classified. A large myriad of uveitis aetiologies with a strong geographical origin burden are found in Western urban multi-ethnic populations. © 2015 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

Inherited thrombophilia in women with poor aPL-related obstetric history: prevalence and outcomes. Survey of 208 cases from the European Registry on Obstetric Antiphospholipid Syndrome cohort.

Science.gov (United States)

Alijotas-Reig, Jaume; Ferrer-Oliveras, Raquel; Esteve-Valverde, Enrique; Ruffatti, Amelia; Tincani, Angela; Lefkou, Elmina; Bertero, Maria Tiziana; Espinosa, Gerard; Coloma, Emmanuel; de Carolis, Sara; Rovere-Querini, Patrizia; Canti, Valentina; Picardo, Elisa; Fredi, Micaela; Mekinian, Arsene

2016-08-01

To analyse the prevalence and effects of inherited thrombophilic disorders (ITD) on maternal-foetal outcomes in cases of antiphospholipid antibody related to obstetric complications. Women with obstetric complaints who tested positive for aPL and with inherited thrombophilia were prospectively and retrospectively included. ITD data were available in 208 of 338: 147 had obstetric antiphospholipid syndrome (OAPS) and 61 aPL-related obstetric morbidity (OMAPS). 24.1% had ITD. Laboratory categories I and IIa were more related to OAPS-ITD and IIb and IIc to OMAPS-ITD. No significant differences in obstetric complaints were observed. Regarding ITD carriers, treatment rates were higher in OAPS than in OMAPS for LMWH and LDA plus LMWH (P=.002). Cases with aPL-related OAPS/OMAPS showed no differences in maternal-foetal outcomes regardless of the presence of one ITD. Maternal thrombotic risk was low, with ITD-positive cases included. Registry data concur with Sydney criteria, whereby aPL-ITD-positive patients are classified as having antiphospholipid syndrome. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Improved obstetric safety through programmatic collaboration.

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Goffman, Dena; Brodman, Michael; Friedman, Arnold J; Minkoff, Howard; Merkatz, Irwin R

2014-01-01

Healthcare safety and quality are critically important issues in obstetrics, and society, healthcare providers, patients and insurers share a common goal of working toward safer practice, and are continuously seeking strategies to facilitate improvements. To this end, 4 New York City voluntary hospitals with large maternity services initiated a unique collaborative quality improvement program. It was facilitated by their common risk management advisors, FOJP Service Corporation, and their professional liability insurer, Hospitals Insurance Company. Under the guidance of 4 obstetrics and gynecology departmental chairmen, consensus best practices for obstetrics were developed which included: implementation of evidence based protocols with audit and feedback; standardized educational interventions; mandatory electronic fetal monitoring training; and enhanced in-house physician coverage. Each institution developed unique safety related expertise (development of electronic documentation, team training, and simulation education), and experiences were shared across the collaborative. The collaborative group developed robust systems for audit of outcomes and documentation quality, as well as enforcement mechanisms. Ongoing feedback to providers served as a key component of the intervention. The liability carrier provided financial support for these patient safety innovations. As a result of the interventions, the overall AOI for our institutions decreased 42% from baseline (January-June 2008) to the most recently reviewed time period (July-December 2011) (10.7% vs 6.2%, p Risk Management of the American Hospital Association.

Delays in accessing electroconvulsive therapy: a comparison between two urban and two rural populations in Australia.

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Johnston, Natalie E

2015-10-01

A comparison of the timing, rates and characteristics of electroconvulsive therapy use between urban and rural populations. The medical records of patients who received an acute course of electroconvulsive therapy at two rural and two urban psychiatric hospitals in New South Wales (NSW), Australia, in 2010 were reviewed retrospectively. Main outcome measures were the time from symptom onset, diagnosis and admission to commencing electroconvulsive therapy. Rates of use of electroconvulsive therapy were also compared between rural and urban hospitals using NSW statewide data. There was a significant delay in the time it took for rural patients to receive electroconvulsive therapy compared with urban patients when measured both from the time of symptom onset and from when they received a diagnosis. There were corresponding delays in the time taken for rural patients to be admitted to hospital compared with urban patients. There was no difference in the time it took to commence electroconvulsive therapy once a patient was admitted to hospital. NSW statewide urban-rural comparisons showed rates of electroconvulsive therapy treatment were significantly higher in urban hospitals. Patients in rural areas receive electroconvulsive therapy later in their acute illness due to delays in being admitted to hospital. The rate of use of electroconvulsive therapy also differs geographically. © The Royal Australian and New Zealand College of Psychiatrists 2015.

Seroprevalence of Scrub Typhus, Typhus, and Spotted Fever Among Rural and Urban Populations of Northern Vietnam

NARCIS (Netherlands)

Trung, N.V.; Hoi, L.T.; Thuong, N.T.H.; Toan, T.K.; Huong, T.T.K.; Hoa, T.M.; Fox, A.; Kinh, N.V.; Doorn, H.R. van; Wertheim, H.F.L.; Bryant, J.E.; Nadjm, B.

2017-01-01

AbstractRickettsial infections are recognized as important causes of fever throughout southeast Asia. Herein, we determined the seroprevalence to rickettsioses within rural and urban populations of northern Vietnam. Prevalence of individuals with evidence of prior rickettsial infections (IgG

The framework of urban exposome: Application of the exposome concept in urban health studies.

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Andrianou, Xanthi D; Makris, Konstantinos C

2018-05-02

Horizontal challenges, such as climate change or the growing populations, and their manifestations require the development of multidisciplinary research synergies in urban health that could benefit from concepts, such as the human exposome. Cities are composed of interconnected systems which are influenced, by global trends, national policies and local complexities. In this context, the exposome concept could be expanded having the city setting in its core, providing the conceptual framework for the new generation of urban studies. The objectives of this work were to define the urban exposome and outline its utility. The urban exposome can be defined as the continuous spatiotemporal surveillance/monitoring of quantitative and qualitative indicators associated with the urban external and internal domains that shape up the quality of life and the health of urban populations, using small city areas, i.e. neighborhoods, quarters, or smaller administrative districts, as the point of reference. Research should focus on the urban exposome's measurable units at different levels, i.e. the individuals, small, within-city areas and the populations. The urban exposome framework applied in the city of Limassol, Cyprus combines three elements: (i) a mixed-methods study on stakeholders' opinions about quality of life in the city; (ii) a systematic assessment of secondary data from the cancer and death registries, including city infrastructure data; and (iii) a population health and biomonitoring survey. Continuous assessment of environmental and health indicators that are routinely collected, and the incorporation of primary data from population studies, will allow for the timely identification of within-city health and environmental disparities to inform policy making and public health interventions. The urban exposome could facilitate evidence-based public health response, offering researchers, policy-makers, and citizens effective tools to address the societal needs of large

Microsporum spp. onychomycosis: disease presentation, risk factors and treatment responses in an urban population

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Erick Martínez

2014-03-01

Conclusion: This is the largest reported series of Microsporum onychomycosis and demonstrates such a disease in an urban population. In 27.78% of the cases risk factors for infection were associated to comorbid states. We also report the first 2 cases of successfully treated M. canis onychomycosis with photodynamic therapy and a rare case of M. canis associated dermatophytoma.

[Antiphospholipid syndrome and pregnancy: Obstetrical prognosis according to the type of APS].

Science.gov (United States)

Delesalle, C; de Vienne, C; Le Hello, C; Verspyck, E; Dreyfus, M

2015-05-01

The objective of our study was to compare treatment-based obstetrical outcomes in women with either thrombotic or obstetrical antiphospholipid syndrome (APS). This was a historical cohort study conducted between 1998 and 2009 in 23 patients who had a total of 83 pregnancies. The syndrome was diagnosed using the 2006 Sapporo criteria. Thirty-one of these 83 pregnancies were valid before the diagnosis was made. A live infant was born in 22% of them, the infant being small for gestational age in 26% of cases. The fetus died in utero in a further 26% of cases. Pregnancies were subdivided into 2 groups depending on whether the initial event leading to APS diagnosis was obstetrical or thrombotic. Treatment (aspirin and low molecular weight heparin) was based on this classification: the latter was given in a curative dose for thrombotic events, in a preventive dose for obstetrical events. No fetal loss was observed when treatment was administered according to the protocol. Nevertheless, 20% of the pregnancies with obstetrical APS were complicated by smallness for gestational age and only 38% of the infants were live births. More than 87% of the thrombotic forms treated were free of complications and led to birth of a living child. Appropriate treatment appears to improve the prognosis for pregnancies in patients with APS. These patients are nevertheless at increased risk of an obstetrical event and require close monitoring, especially in obstetrical manifestations, which appear to have a poorer prognosis. Multidisciplinary follow-up by an experienced team is essential. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

[Rapid Response obstetrics Team at Instituto Mexicano del Seguro Social,enabling factors].

Science.gov (United States)

Dávila-Torres, Javier; González-Izquierdo, José de Jesús; Ruíz-Rosas, Roberto Aguli; Cruz-Cruz, Polita Del Rocío; Hernández-Valencia, Marcelino

2015-01-01

There are barriers and enablers for the implementation of Rapid Response Teams in obstetric hospitals. The enabling factors were determined at Instituto Mexicano del Seguro Social (IMSS) MATERIAL AND METHODS: An observational, retrospective study was conducted by analysing the emergency obstetric reports sent by mobile technology and e-mail to the Medical Care Unit of the IMSS in 2013. Frequency and mean was obtained using the Excel 2010 program for descriptive statistics. A total of 164,250 emergency obstetric cases were reported, and there was a mean of 425 messages per day, of which 32.2% were true obstetric emergencies and required the Rapid Response team. By e-mail, there were 73,452 life threatening cases (a mean of 6 cases per day). A monthly simulation was performed in hospitals (480 in total). Enabling factors were messagés synchronisation among the participating personnel,the accurate record of the obstetrics, as well as the simulations performed by the operational staff. The most common emergency was pre-eclampsia-eclampsia with 3,351 reports, followed by obstetric haemorrhage with 2,982 cases. The enabling factors for the implementation of a rapid response team at IMSS were properly timed communication between the central delegation teams, as they allowed faster medical and administrative management and participation of hospital medical teams in the process. Mobile technology has increased the speed of medical and administrative management in emergency obstetric care. However, comparative studies are needed to determine the statistical significance. Published by Masson Doyma México S.A.

What's new and novel in obstetric anesthesia? Contributions from the 2003 scientific literature.

Science.gov (United States)

Tsen, L C

2005-04-01

THE PREGNANT PATIENT: Age; maternal disease; prophylactic antibiotics; gastroesophageal reflux; obesity; starvation; genotyping; coagulopathy; infection; substance abuse; altered drug responses in pregnancy; physiological changes of pregnancy. THE FETUS: Fetal monitoring; intrauterine surgery. THE NEWBORN: Breastfeeding; maternal infection, fever, and neonatal sepsis evaluation. OBSTETRIC COMPLICATIONS: Embolic phenomena; hemorrhage; preeclampsia; preterm delivery. OBSTETRIC MANAGEMENT: External cephalic version and cervical cerclage; elective cesarean delivery; fetal malpresentation; vaginal birth after cesarean delivery; termination of pregnancy. OBSTETRIC ANESTHESIA: Analgesia for labor and delivery; anesthesia for cesarean delivery; anesthesia for short obstetric operations; complications of anesthesia. MISCELLANEOUS: Consent; ethics; history; labor support; websites/books/leaflets/journal announcements.

A Simulation Study on the Urban Population of China Based on Nighttime Light Data Acquired from DMSP/OLS

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Qingxu Huang

2016-05-01

Full Text Available The urban population (UP measure is one of the most direct indicators that reflect the urbanization process and the impacts of human activities. The dynamics of UP is of great importance to studying urban economic, social development, and resource utilization. Currently, China lacks long time series UP data with consistent standards and comparability over time. The nighttime light images from the Defense Meteorological Satellite Program’s (DMSP Operational Linescan System (OLS allow the acquisition of continuous and highly comparable long time series UP information. However, existing studies mainly focus on simulating the total population or population density level based on the nighttime light data. Few studies have focused on simulating the UP in China. Based on three regression models (i.e., linear, power function, and exponential, the present study discusses the relationship between DMSP/OLS nighttime light data and the UP and establishes optimal regression models for simulating the UPs of 339 major cities in China from 1990 to 2010. In addition, the present study evaluated the accuracy of UP and non-agricultural population (NAP simulations conducted using the same method. The simulation results show that, at the national level, the power function model is the optimal regression model between DMSP/OLS nighttime light data and UP data for 1990–2010. At the provincial scale, the optimal regression model varies among different provinces. The linear regression model is the optimal regression model for more than 60% of the provinces. In addition, the comparison results show that at the national, provincial, and city levels, the fitting results of the UP based on DMSP/OLS nighttime light data are better than those of the NAP. Therefore, DMSP/OLS nighttime light data can be used to effectively retrieve the UP of a large-scale region. In the context of frequent population flows between urban and rural areas in China and difficulty in obtaining

Obstetric Emergencies: Shoulder Dystocia and Postpartum Hemorrhage.

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Dahlke, Joshua D; Bhalwal, Asha; Chauhan, Suneet P

2017-06-01

Shoulder dystocia and postpartum hemorrhage represent two of the most common emergencies faced in obstetric clinical practice, both requiring prompt recognition and management to avoid significant morbidity or mortality. Shoulder dystocia is an uncommon, unpredictable, and unpreventable obstetric emergency and can be managed with appropriate intervention. Postpartum hemorrhage occurs more commonly and carries significant risk of maternal morbidity. Institutional protocols and algorithms for the prevention and management of shoulder dystocia and postpartum hemorrhage have become mainstays for clinicians. The goal of this review is to summarize the diagnosis, incidence, risk factors, and management of shoulder dystocia and postpartum hemorrhage. Copyright © 2017 Elsevier Inc. All rights reserved.

Urban domestic dog populations as a source of canine distemper virus for wild carnivores in the Coquimbo region of Chile.

Science.gov (United States)

Acosta-Jamett, G; Chalmers, W S K; Cunningham, A A; Cleaveland, S; Handel, I G; Bronsvoort, B M deC

2011-09-28

Urban areas can support dog populations dense enough to maintain canine distemper virus (CDV) and can be a source of infection for rural dogs and free-ranging carnivores. The aim of this study was to investigate the relationships between urban and rural domestic dog and wild carnivore populations and their effects on the epidemiology of CDV to explain retrospectively a CD outbreak in wild foxes in 2003. From 2005 to 2007 a cross-sectional household questionnaire survey was conducted in Coquimbo and Ovalle cities, in three towns and in rural sites along two transects from these cities to the Fray Jorge National Park (FJNP) in the Coquimbo region, Chile. Blood samples were collected from unvaccinated dogs at surveyed households and from free-ranging foxes in rural areas along the transects. The seroprevalence of CDV in domestic dogs was higher in urban than in rural areas and in the later was highest in dogs born before 2001-2002. The seroprevalence of CDV in foxes was higher in areas closer to human settlements. A high seroprevalence in dogs born before 2001-2002 further supports a link between CDV patterns in rural dog and fox populations. In our study area, urban dogs are proposed to be the source of CDV infection to wild carnivores. The large dog population size and density detected in Coquimbo and Ovalle provides optimal conditions for maintaining a large and dense susceptible population of dogs, which can act as a reservoir for highly infectious diseases and could have been the source of infection in the CD outbreak in wild foxes. Copyright © 2011 Elsevier B.V. All rights reserved.

Computing Pathways for Urban Decarbonization.

Science.gov (United States)

Cremades, R.; Sommer, P.

2016-12-01

Urban areas emit roughly three quarters of global carbon emissions. Cities are crucial elements for a decarbonized society. Urban expansion and related transportation needs lead to increased energy use, and to carbon-intensive lock-ins that create barriers for climate change mitigation globally. The authors present the Integrated Urban Complexity (IUC) model, based on self-organizing Cellular Automata (CA), and use it to produce a new kind of spatially explicit Transformation Pathways for Urban Decarbonization (TPUD). IUC is based on statistical evidence relating the energy needed for transportation with the spatial distribution of population, specifically IUC incorporates variables from complexity science related to urban form, like the slope of the rank-size rule or spatial entropy, which brings IUC a step beyond existing models. The CA starts its evolution with real-world urban land use and population distribution data from the Global Human Settlement Layer. Thus, the IUC model runs over existing urban settlements, transforming the spatial distribution of population so the energy consumption for transportation is minimized. The statistical evidence that governs the evolution of the CA departs from the database of the International Association of Public Transport. A selected case is presented using Stuttgart (Germany) as an example. The results show how IUC varies urban density in those places where it improves the performance of crucial parameters related to urban form, producing a TPUD that shows where the spatial distribution of population should be modified with a degree of detail of 250 meters of cell size. The TPUD shows how the urban complex system evolves over time to minimize energy consumption for transportation. The resulting dynamics or urban decarbonization show decreased energy per capita, although total energy increases for increasing population. The results provide innovative insights: by checking current urban planning against a TPUD, urban

Pattern and frequency of substance abuse in urban population of Lucknow

Directory of Open Access Journals (Sweden)

S C Tiwari

2008-01-01

Full Text Available Background: The urban Lucknow community was studied during a project "A study to evolve material for prevention of drug/alcohol/tobacco (substance abuse through social marketing" funded by Council of Science & Technology, Lucknow. The paper presents pattern and frequency of substance abuse in urban population of Lucknow based upon it. Method: Two mohallas of a ward from Lucknow Municipal Corporation were selected randomly. A total of 842 heads of the households (out of 5420 members were studied using Semi Structured Socio demographic data-sheet and Proforma from WHO-ICMR a collaborative study on narcotics and psychotropic drugs. Data was analyzed using percentage, mean and S.D. Results: Out of 5420 subjects 34.31% (30.22% males & 4.09% females were found to be substance abusers. Majority of subjects used tobacco (68.17% smoking, 65.17% eating. Conclusion : Majority of subjects were regular users constituted 73.65% tobacco smokers and 74.38% eaters/chewers, 62.38% alcoholics were experimenters and amongst those who were psychotropic drug abusers, 64.28% were dependant.

Antibiotic prophylaxis in obstetric procedures.

Science.gov (United States)

van Schalkwyk, Julie; Van Eyk, Nancy

2010-09-01

To review the evidence and provide recommendations on antibiotic prophylaxis for obstetrical procedures. Outcomes evaluated include need and effectiveness of antibiotics to prevent infections in obstetrical procedures. Published literature was retrieved through searches of Medline and The Cochrane Library on the topic of antibiotic prophylaxis in obstetrical procedures. Results were restricted to systematic reviews, randomized controlled trials/controlled clinical trials, and observational studies. Searches were updated on a regular basis and articles published from January 1978 to June 2009 were incorporated in the guideline. Current guidelines published by the American College of Obstetrics and Gynecology were also incorporated. Grey (unpublished) literature was identified through searching the websites of health technology assessment and health technology assessment-related agencies, clinical practice guideline collections, clinical trial registries, and national and international medical specialty societies. The evidence obtained was reviewed and evaluated by the Infectious Diseases Committee of the Society of Obstetricians and Gynaecologists of Canada under the leadership of the principal authors, and recommendations were made according to guidelines developed by the Canadian Task Force on Preventive Health Care (Table 1). Implementation of this guideline should reduce the cost and harm resulting from the administration of antibiotics when they are not required and the harm resulting from failure to administer antibiotics when they would be beneficial. SUMMARY STATEMENTS: 1. Available evidence does not support the use of prophylactic antibiotics to reduce infectious morbidity following operative vaginal delivery. (II-1) 2. There is insufficient evidence to argue for or against the use of prophylactic antibiotics to reduce infectious morbidity for manual removal of the placenta. (III) 3. There is insufficient evidence to argue for or against the use of

Assessing the combined risks of PAHs and metals in urban soils by urbanization indicators

International Nuclear Information System (INIS)

Peng, Chi; Ouyang, Zhiyun; Wang, Meie; Chen, Weiping; Li, Xiaoma; Crittenden, John C.

2013-01-01

We quantitatively describe the impacts of urbanization on the accumulation of polycyclic aromatic hydrocarbons (PAHs) and heavy metals (HMs) in urban soils as well as their health risks to residents. Residential building age, population density, road density, and distance from urban center were used as urbanization level indicators. Significant correlations were found between those urbanization indicators and the amounts of PAHs, Cu, Cd, Pb, Zn and As in residential soils. The exposure time of soils to urban air was the primary factor affecting soil pollution, followed by local road density and population density. Factor analysis suggested that 59.0% of the elevated pollutant concentrations were caused by citywide uniform deposition, and 15.3% were resulted from short-range deposition and/or non-combustion processes. The combined health risks posed by soil PAHs and HMs were aggravated with time and can be expressed as functions of residence age, road density, and other urbanization indicators. Highlights: •The soil PAH and HM contents were closely related to urbanization progression. •The PAH and HM contents were primarily affected by soil exposure time. •Local input loads of pollutants correlated with road density and population density. •The combined risks of PAHs and HMs increased with the urban development level. •The carcinogenic risks of PAHs and As were above 10 −5 and increased over time. -- The health risks of PAHs and HMs in residential soils were connected to building age, population density and road density of the community as well as its distance from urban center

An Assessment of the Relationship between Urban Air Quality and Environmental Urban Factors in Urban Regeneration Areas

Directory of Open Access Journals (Sweden)

Yakup Egercioglu

2016-06-01

Full Text Available Urban air pollution has been increasing due to ever increasing population, rapid urbanization, industrialization, energy usage, traffic density. The purpose of the study is to examine the relation between urban air quality and urban environmental factors in urban regeneration areas. Two common air polluters (SO2 and PM10 are considered in the study. The data are collected for Cigli district, including the level of air pollutants, the local natural gas service lines and planning decisions for the years between 2007 and 2011. According to the examinations, urban environmental factors and planning decisions affect the urban air quality in urban regeneration areas.

Evaluation of trainees' ability to perform obstetrical ultrasound using simulation: challenges and opportunities.

Science.gov (United States)

Chalouhi, Gihad E; Bernardi, Valeria; Gueneuc, Alexandra; Houssin, Isabelle; Stirnemann, Julien J; Ville, Yves

2016-04-01

Evaluation of trainee's ability in obstetrical ultrasound is a time-consuming process, which requires involving patients as volunteers. With the use of obstetrical ultrasound simulators, virtual reality could help in assessing competency and evaluating trainees in this field. The objective of the study was to test the validity of an obstetrical ultrasound simulator as a tool for evaluating trainees following structured training by comparing scores obtained on obstetrical ultrasound simulator with those obtained on volunteers and by assessing correlations between scores of images and of dexterity given by 2 blinded examiners. Trainees, taking the 2013 French national examination for the practice of obstetrical ultrasound were asked to obtain standardized ultrasound planes both on volunteer pregnant women and on an obstetrical ultrasound simulator. These planes included measurements of biparietal diameter, abdominal circumference, and femur length as well as reference planes for cardiac 4-chamber and outflow tracts, kidneys, stomach/diaphragm, spine, and face. Images were stored and evaluated subsequently by 2 national examiners who scored each picture according to previously established quality criteria. Dexterity was also evaluated and subjectively scored between 0 and 10. The Raghunathan's modification of Pearson, Filon's z, Spearman's rank correlation, and analysis of variance tests were used to assess correlations between the scores by the 2 examiners and scores of dexterity and also to compare the final scores between the 2 different methods. We evaluated 29 trainees. The mean dexterity scores in simulation (6.5 ± 2.0) and real examination (5.9 ± 2.3) were comparable (P = .31). Scores with an obstetrical ultrasound simulator were significantly higher than those obtained on volunteers (P = .027). Nevertheless, there was a good correlation between the scores of the 2 examiners judging on simulation (R = 0.888) and on volunteers (R = 0.873) (P = .81). An

Integrating psychology and obstetrics for medical students: shared labour ward teaching.

Science.gov (United States)

Chalmers, B E; McIntyre, J A

1993-01-01

Two studies relating to the inclusion of psycho-social issues in the training of obstetricians are reported here. The first reports on the extent to which currently practising obstetricians have received training in these aspects. The second explored the value of an innovative teaching approach combining psychological and obstetric training for medical students in the labour ward. A postal survey with responses from 220 obstetricians and paediatricians revealed that little information on psychological aspects of obstetric practice had been included in their undergraduate or postgraduate training or obtained from voluntary continuing education programmes. Experience was the primary source of training in these subjects. The second study explored the impact of joint psychological and obstetric teaching ward rounds for medical students. Students attending these integrated sessions reported being better prepared for the psycho-social aspects of obstetrics and showed a greater awareness of cross-cultural differences in needs of women during birth.

PRONTO training for obstetric and neonatal emergencies in Mexico.

Science.gov (United States)

Walker, Dilys M; Cohen, Susanna R; Estrada, Fatima; Monterroso, Marcia E; Jenny, Alisa; Fritz, Jimena; Fahey, Jenifer O

2012-02-01

To evaluate the acceptability, feasibility, rating, and potential impact of PRONTO, a low-tech and high-fidelity simulation-based training for obstetric and neonatal emergencies and teamwork using the PartoPants low-cost birth simulator. A pilot project was conducted from September 21, 2009, to April 9, 2010, to train interprofessional teams from 5 community hospitals in the states of Mexico and Chiapas. Module I (teamwork, neonatal resuscitation, and obstetric hemorrhage) was followed 3 months later by module II (dystocia and pre-eclampsia/eclampsia) and an evaluation. Four elements were assessed: acceptability; feasibility and rating; institutional goal achievement; teamwork improvement; and knowledge and self-efficacy. The program was rated highly both by trainees and by non-trainees who completed a survey and interview. Hospital goals identified by participants in the module I strategic-planning sessions were achieved for 65% of goals in 3 months. Teamwork, knowledge, and self-efficacy scores improved. PRONTO brings simulation training to low-resource settings and can empower interprofessional teams to respond more effectively within their institutional limitations to emergencies involving women and newborns. Further study is warranted to evaluate the potential impact of the program on obstetric and neonatal outcome. Copyright © 2011 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Posttraumatic stress and depression may undermine abuse survivors' self-efficacy in the obstetric care setting.

Science.gov (United States)

Stevens, Natalie R; Tirone, Vanessa; Lillis, Teresa A; Holmgreen, Lucie; Chen-McCracken, Allison; Hobfoll, Stevan E

2017-06-01

Posttraumatic stress symptoms (PTS) are associated with increased risk of obstetric complications among pregnant survivors of trauma, abuse and interpersonal violence, but little is known about how PTS affects women's actual experiences of obstetric care. This study investigated the rate at which abuse history was detected by obstetricians, whether abuse survivors experienced more invasive exams than is typically indicated for routine obstetric care, and whether psychological distress was associated with abuse survivors' sense of self-efficacy when communicating their obstetric care needs. Forty-one pregnant abuse survivors completed questionnaires about abuse history, current psychological distress and self-efficacy for communicating obstetric care needs and preferences. Electronic medical records (EMRs) were reviewed to examine frequency of invasive prenatal obstetric procedures (e.g. removal of clothing for external genital examination, pelvic exams and procedures) and to examine the detection rate of abuse histories during the initial obstetric visit. The majority of participants (83%) reported at least one past incident of violent physical or sexual assault. Obstetricians detected abuse histories in less than one quarter of cases. Nearly half of participants (46%) received invasive exams for non-routine reasons. PTS and depression symptoms were associated with lower self-efficacy in communicating obstetric care preferences. Women most at risk for experiencing distress during their obstetric visits and/or undergoing potentially distressing procedures may also be the least likely to communicate their distress to obstetricians. Results are discussed with implications for improving screening for abuse screening and distress symptoms as well as need for trauma-sensitive obstetric practices.

A Pain Beyond Childbirth: Obstetrical Violence In Focus

Directory of Open Access Journals (Sweden)

Artenira da Silva e Silva Sauaia

2016-06-01

Full Text Available Obstetric violence is a type of gender violence and it implies violation of human rights, characterized by the imposition of harmful interventions to the physical and psychological integrity of pregnant women, perpetrated by health professionals and institutions (public and private in which such women are assisted. Thus, this paper has as the purpose to discuss obstetric violence as well as its characterization through the judgments of the Supreme Federal Court (STF and the Superior Court of Justice (STJ. The judgments with more evidence about the theme were selected and discussed.

Effect of maternal factors on nutritional status of 1-5-year-old children in urban slum population

OpenAIRE

Mittal A; Ahluwalia S; Singh J

2007-01-01

Objective: To study the effect of various maternal factors on the prevalence of underweight and stunting among 1-5-year-old children in urban slum population. Design: Cross-sectional study. Materials and Methods: The study was carried out in three urban slums of Tripuri Town, Patiala. All 1-5-year children living in these slums were included, whose mother′s demographic profile, weight and height were recorded. Results: Out of 482 children who participated in the study, 185 (38.38�...

[Husband's presence at childbirth in light of obstetric psychoprophylaxis].

Science.gov (United States)

Sioma-Markowska, Urszula; Sipiński, Adam; Majerczyk, Iwona; Selwet, Monika; Kuna, Anna; Machura, Mariola

2004-01-01

Contemporary obstetric psychoprophylaxis gives prospective parents wide opportunities to prepare to the pregnancy period and delivery. It is educationally-minded and points the importance to modify the life style, introduces exercises accompanied by the relative during the pregnancy and delivery. The survey portrays husband's--child father's role in obstetric psychoprophylaxis. The importance to continue the psychoprophylaxis in the delivery room was spotted in the survey, too. The continuation might be reached by close relative's presence.

Obstetrics

International Nuclear Information System (INIS)

Hricak, H.

1987-01-01

Ultrasound will remain the primary modality for evaluating the obstetrical patient. MRI, however, is a useful adjunct when sonography cannot provide sufficient information. Currently, the use of MRI is limited to late pregnancy with the following indications: (a) evaluation of marginal placenta previa; (b) determination of IUGR; (c) assessment of cervical effacement; (d) fetal anomalies of the CNS; and (e) evaluation of concomitant maternal neoplasms. Specific advantages of MRI include: 1. Provision of crucial information in patients with a medical or surgical condition that ordinarily would require ionizing radiation. 2. Provision of important data about fetal anomalies and growth and development when sonography is limited by oligohydramnios or maternal obesity. 3. Confirmation of fetal anomalies when US is equivocal. 4. Demonstration of maternal pelvic structures when US is unsuccessful due to overlying bowel gas or obesity. 5. Pelvimetry without ionizing radiation

China's Urban Transition.

Science.gov (United States)

Pannell, Clifton

1995-01-01

Maintains that Chinese urbanization is proceeding rapidly in step with population growth and a structural shift in employment patterns. Discusses governmental policies and economic reforms that enhance the urbanization process. Describes four extended metropolitan areas and maintains they will be the models for future urbanization. (CFR)

Assessing obstetric patient experience: a SERVQUAL questionnaire.

Science.gov (United States)

Garrard, Francesca; Narayan, Harini

2013-01-01

Across health services, there is a drive to respond to patient feedback and to incorporate their views into service improvement. The SERVQUAL method has been used in several clinical settings to quantify whether services meet patient expectations. However, work has been limited in the obstetric population. This paper seeks to address these issues. This study used an adapted SERVQUAL questionnaire to assess a reconfigured antenatal clinic service. The most important care aspects, as rated by patients, were used to construct the SERVQUAL questions. The questionnaire was administered to eligible women in two parts. The first was completed before their first hospital antenatal appointment and the second either at home (a postal-chasing exercise) or while waiting for their next appointment. Only fully completed questionnaires (both parts) were analysed. Service strengths included staff politeness, patient respect and privacy. Areas for improvement included hand cleanliness, women's involvement in decision making and communicating risk. However, the low variability in patient responses makes concrete conclusions difficult and methodological issues complicate evaluating hand cleanliness. The new antenatal clinic service received low negative weighted and un-weighted overall scores. The SERVQUAL measure was developed from patient feedback and used to further improve services. The SERVQUAL-based measure allowed an internal evaluation of patient experience and highlighted areas for improvement. However, without validation, the questionnaire cannot be used as an outcome measure and variation between published SERVQUAL questionnaires makes comparisons difficult. This highlights an important balance in patient evaluation measures--between locally responsive and externally comparable. The SERVQUAL approach allows healthcare teams to evaluate patient experience, while accounting for variation in their expectations and priorities. The study highlights several areas that are

Characteristics of peri-urbanization of a secondary city: a challenge in recent urban development

Science.gov (United States)

Rahayu, P.; Mardiansjah, F. H.

2018-03-01

Urbanization process creates a tremendous spatial phenomenon since the last century. Especially for the country of the South, the phenomenon is still relevant to the situation today and the processes will still going until the foreseeable future. The metropolitan-based of urbanization process involves the development of peri-urban areas, which could be defined as transitional zones between city and rural areas characterized by integrated mixed-structures of agricultural and non-agricultural activities. This article reveals the characteristics of periurbanization process of an emerging secondary city in Java, which uses Surakarta, the second largest city in Central Java Province based on the population size, as the case. During the last ten years, there have been significant changes in peri-urban areas regarding urban population, land use, and urban activities that strengthening the contribution of the urban component into peri-urban system.

Constructing spatialised knowledge on urban poverty : (multiple) dimensions, mapping spaces and claim-making in urban governance

NARCIS (Netherlands)

Baud, I.; Lemanski, C.; Marx, C.

2015-01-01

Recently, increasing attention is given to poverty issues in urban areas in the Global South. This follows recognition that population growth is shifting to urban areas, as more than half the world population is found in urban areas, which are expected to grow mainly in South Asia and sub-Saharan

Development of vegetable farming: a cause of the emergence of insecticide resistance in populations of Anopheles gambiae in urban areas of Benin

Science.gov (United States)

Yadouleton, Anges William M; Asidi, Alex; Djouaka, Rousseau F; Braïma, James; Agossou, Christian D; Akogbeto, Martin C

2009-01-01

Background A fast development of urban agriculture has recently taken place in many areas in the Republic of Benin. This study aims to assess the rapid expansion of urban agriculture especially, its contribution to the emergence of insecticide resistance in populations of Anopheles gambiae. Methods The protocol was based on the collection of sociological data by interviewing vegetable farmers regarding various agricultural practices and the types of pesticides used. Bioassay tests were performed to assess the susceptibility of malaria vectors to various agricultural insecticides and biochemical analysis were done to characterize molecular status of population of An. gambiae. Results This research showed that: (1) The rapid development of urban agriculture is related to unemployment observed in cities, rural exodus and the search for a balanced diet by urban populations; (2) Urban agriculture increases the farmers' household income and their living standard; (3) At a molecular level, PCR revealed the presence of three sub-species of An. gambiae (An. gambiae s.s., Anopheles melas and Anopheles arabiensis) and two molecular forms (M and S). The kdr west mutation recorded in samples from the three sites and more specifically on the M forms seems to be one of the major resistance mechanisms found in An. gambiae from agricultural areas. Insecticide susceptibility tests conducted during this research revealed a clear pattern of resistance to permethrin (76% mortality rate at Parakou; 23.5% at Porto-Novo and 17% at Cotonou). Conclusion This study confirmed an increase activity of the vegetable farming in urban areas of Benin. This has led to the use of insecticide in an improper manner to control vegetable pests, thus exerting a huge selection pressure on mosquito larval population, which resulted to the emergence of insecticide resistance in malaria vectors. PMID:19442297

Morbidity And Mortality Following Emergency Obstetric ...

African Journals Online (AJOL)

Morbidity And Mortality Following Emergency Obstetric Hysterectomy In Calabar, Nigeria. ... Nigerian Journal of Clinical Practice ... in 15 (33.3%) of the case and hysterectomy for puerperal sepsis was an indication in 3 (6.7%) of the cases

City Magistrate of Tsaritsyn as the Estates Court for Urban Population 1784-1866

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Elena V. Bulyulina

2017-10-01

Full Text Available At the end of the 18th century in Russia caste system of the judiciary was legalized. For urban and suburban trade and craft population of the Russian Empire estates courts were magistrates. Despite the fact that the activities of magistrates are studied by native historians and legal scholars, regional aspects of the topic are not adequately reflected. This article examines the activities of the Tsaritsyn city magistrate court as an estates court for a merchant and petty-bourgeois population of the city of Tsaritsyn in 1784-1866. In 1775 Ekaterina II carried out a major reform of local government and the court, significantly expanding the functions of local government institutions, and, in fact, restoring estates of municipal government. From that moment in cities the magistrates managed the city, including city magistrates who represented the court of first instance in criminal and civil cases for the urban population – merchants, craftsmen, townspeople. Appeal to the city magistrate was of the Saratov provincial magistrate. Different aspects of his functional features and relations with another official instances are presented. The limits of the jurisdiction of the Tsaritsyn city magistrate was limited to the territory of Tsaritsyn. The objects of the jurisdiction could be only the regular citizens, i.e. assigned to the city, and not the entire population. Implementation of the rule of law, particularly the application of penalties in the material presented in the aspect of not only the all-Russian legal requirements, but also regarding regional social and legal assessments. Tsaritsyn city magistrate heard cases of theft, vandalism, rape, false receipts, and bills of exchange, unauthorized occupation of urban land, abandoned children, the accountability for deviations from the canons of Orthodoxy, committing a schismatic rites, violation of rules of transportation and logging, concealment of recruits, about the insult of the authorities

The influence of coyotes on an urban Canada goose population in the Chicago metropolitan area

Energy Technology Data Exchange (ETDEWEB)

Brown, Justin L.; /Ohio State U.

2007-01-01

Canada geese (Branta canadensis) have become common in many urban areas, often creating nuisance problems for human residents. The presence of urban geese has raised concerns about the spread of disease, increased erosion, excessive noise, eutrophication of waterways, and general nuisance problems. Goose populations have grown due to an increase in urbanization resulting in an abundance of high quality food (urban grass) and suitable nesting sites, as well as a decrease in some predators. I monitored nest predation in the Chicago suburbs during the 2004 and 2005 nesting seasons using 3 nest monitoring techniques to identify predators: video cameras, plasticine eggs, and sign from nest using a classification tree analysis. Of 58 nests monitored in 2004 and 286 in 2005, only raccoons (Procyon lotor) and coyotes (Canis latrans) were identified as nest predators. Raccoons were responsible for 22-25% of depredated nests, but were rarely capable of depredating nests that were actively defended by a goose. Coyotes were responsible for 75-78% of all Canada goose nest depredation and were documented killing one adult goose and feeding on several others. The coyote is a top-level predator that had increased in many metropolitan areas in recent years. To determine if coyotes were actively hunting geese or eggs during the nesting season, I analyzed coyote habitat selection between nesting and pre-nesting or post-nesting seasons. Coyote home ranges (95% Minimum Convex Polygon) were calculated for 19 coyotes to examine third order habitat selection related to goose nest abundance. A 100 m buffer (buffer habitat) was created and centered on each waterway edge and contained 90% of all nests. Coyotes showed selection for habitats during all seasons. Buffer habitat was the top ranked habitat in both pre-nesting and nesting seasons, but dropped to third ranked in post-nesting season. Habitat selection across seasons was compared using a repeated measures MANOVA. Habitat selection

The light pollution as a surrogate for urban population of the US cities

Science.gov (United States)

Operti, Felipe G.; Oliveira, Erneson A.; Carmona, Humberto A.; Machado, Javam C.; Andrade, José S.

2018-02-01

We show that the definition of the city boundaries can have a dramatic influence on the scaling behavior of the night-time light (NTL) as a function of population (POP) in the US. Precisely, our results show that the arbitrary geopolitical definition based on the Metropolitan/Consolidated Metropolitan Statistical Areas (MSA/CMSA) leads to a sublinear power-law growth of NTL with POP. On the other hand, when cities are defined according to a more natural agglomeration criteria, namely, the City Clustering Algorithm (CCA), an isometric relation emerges between NTL and population. This discrepancy is compatible with results from previous works showing that the scaling behaviors of various urban indicators with population can be substantially different for distinct definitions of city boundaries. Moreover, considering the CCA definition as more adequate than the MSA/CMSA one because the former does not violate the expected extensivity between land population and area of their generated clusters, we conclude that, without loss of generality, the CCA measures of light pollution and population could be interchangeably utilized in future studies.

Does Uterine Fibroid Adversely Affect Obstetric Outcome of Pregnancy?

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Hend S. Saleh

2018-01-01

Full Text Available Background. Fibroid is the most common benign tumor of the uterus and if associated with pregnancy may adversely affect the outcome of pregnancy. Objective of the present study was to assess the obstetric outcome (maternal and fetal in pregnancy with fibroid. Methods. A prospective observational study was performed over a period from May 2015 to August 2017 at Obstetrics and Gynecology Department in Zagazig University Hospitals, Egypt. 64 pregnant patients with >2 cm fibroid were taken in the study. Routine fundamental investigations were done for all. They were followed during antenatal period clinically and scanned by ultrasonogram which was done at booking visit and during subsequent visits to assess the change in the size of the fibroid and other obstetric complications. Maternal age, parity, size of fibroid, complications during pregnancy, and mode of delivery were noted. Results. 64 pregnant patients with uterine fibroids were recruited; 47 of them completed the study to the end. The average age was 31.80±3.27 years, body mass index (BMI [calculated as weight in kilograms divided by the square of height in meters] was 24.67±2.46, primigravida was 23.4%, multigravida was 76.6%, duration of menstrual cycle/day was 29.68±3.10, and duration of menstrual period/day was 6.46±1.12. The percentage of spontaneous conception was 59.57% and 40.43% for using assisted reproductive technology. The results of obstetric outcome were spontaneous abortion in 2%, premature delivery in 27.7%, and delivery at 37–41 weeks of pregnancy in 70.2%. The mode of delivery was vaginal delivery in 15% and cesarean sections in 85%. Also, 34% had threatened miscarriage, 21% had preterm labor, 2% had antepartum bleeding in the form of placenta previa, 4% had abdominal pain needing admission, one of them underwent laparotomy and was diagnosed as red degeneration, 2 (4% had postpartum hemorrhage, and only one needed blood transfusion. Cesarean sections were done in

Are slum dwellers at heightened risk of HIV infection than other urban residents? Evidence from population-based HIV prevalence surveys in Kenya.

Science.gov (United States)

Madise, Nyovani J; Ziraba, Abdhalah K; Inungu, Joseph; Khamadi, Samoel A; Ezeh, Alex; Zulu, Eliya M; Kebaso, John; Okoth, Vincent; Mwau, Matilu

2012-09-01

In 2008, the global urban population surpassed the rural population and by 2050 more than 6 billion will be living in urban centres. A growing body of research has reported on poor health outcomes among the urban poor but not much is known about HIV prevalence among this group. A survey of nearly 3000 men and women was conducted in two Nairobi slums in Kenya between 2006 and 2007, where respondents were tested for HIV status. In addition, data from the 2008/2009 Kenya Demographic and Health Survey were used to compare HIV prevalence between slum residents and those living in other urban and rural areas. The results showed strong intra-urban differences. HIV was 12% among slum residents compared with 5% and 6% among non-slum urban and rural residents, respectively. Generally, men had lower HIV prevalence than women although in the slums the gap was narrower. Among women, sexual experience before the age of 15 compared with after 19 years was associated with 62% higher odds of being HIV positive. There was ethnic variation in patterns of HIV infection although the effect depended on the current place of residence. Copyright © 2012 Elsevier Ltd. All rights reserved.

Prayer Attendance and General Health in the Iranian Adult Urban Population.

Science.gov (United States)

Sotodehasl, Nemat; Ghorbani, Raheb; Mahdavi-Nejad, Gholamhosein; Haji-Aghajani, Saeed; Mehdizadeh, Jamileh

2016-02-01

This study was conducted to determine the relationship between prayer attendance and general health among adult urban population in Iran. A total of 470 males older than 17 years, chosen by multistage sampling, were investigated. The results showed that people who did not perform prayers compared to those who said prayers on time and performed Nafilahs (supererogatory prayers) were 2.87 (OR 2.87, 95 % CI 1.23-6.70, p = 0.015) times at risk of general health problems. In conclusion, the findings show that increasing the degree of people's belief in prayer can lead to improve general health.

Outcome of Prevention of Parent-to-Child Transmission of HIV in an Urban Population in Southern India.

Science.gov (United States)

Seenivasan, Subramani; Vaitheeswaran, Natarajan; Seetha, Viswanathan; Anbalagan, Selvaraj; Karunaianantham, Ramesh; Swaminathan, Soumya

2015-09-01

To analyze the outcomes of Prevention of Parent to Child Transmission (PPTCT) of HIV program in an urban Southern Indian setting. Observational study. Anti-retroviral Therapy (ART) Centers/ Integrated Counseling and Testing Centers (ICTC) at four government Obstetrics Institutes in an urban area. 100 HIV-positive pregnant women and their infants delivered in the study centers. Triple drug ART to HIV-positive pregnant women was started for maternal indications only. Rest of the pregnant women were given single dose Nevirapine (200 mg) at the onset of labor. All infants were given single dose Nevirapine (2 mg/kg) prophylaxis, according to National AIDS Control Organization guidelines. Mothers were counseled regarding breastfeeding and artificial feeding, and the choice was left to them. Whole blood HIV 1 DNA PCR was done for all infants at 6 weeks of life. A second PCR was done at 6 months or 6 weeks after stopping breastfeeds. PCR-positive infants were started on ART, and were followed-up till18 months of life. Four infants were PCR-positive for HIV. All of them were breastfed. They were born to mothers of HIV stage 1 or 2 who were not on ART as CD4 counts were >350 cells/mm3. Among the mothers in Stage 3 or 4 or CD4 count ART, none of the infants was HIV-positive. The cumulative HIV-free survival at 18 months was 94%. Parent-to-child transmission rate in HIV was low with the currently used strategies. Triple drug ART to mother reduces mother-to-child transmission despite advanced maternal stage or low CD4 counts.

Obstetric medicine

Directory of Open Access Journals (Sweden)

L. Balbi

2013-05-01

Full Text Available BACKGROUND Obstetric assistance made major advances in the last 20 years: improved surgical technique allows quicker caesarean sections, anaesthesiology procedures such as peripheral anaesthesia and epidural analgesia made safer operative assistance, remarkably reducing perioperative morbidity and mortality, neonatology greatly improved the results of assistance to low birth weight newborns. A new branch of medicine called “obstetric medicine” gained interest and experience after the lessons of distinguished physicians like Michael De Swiet in England. All together these advances are making successful pregnancies that 20 years ago would have been discouraged or even interrupted: that’s what we call high risk pregnancy. High risk of what? Either complications of pregnancy on pre-existing disease or complications of pre-existing disease on pregnancy. Nowadays, mortality in pregnancy has a medical cause in 80% of cases in Western countries (Confidential Enquiry on Maternal Deaths, UK, 2004. DISCUSSION The background is always changing and we have to take in account of: increase of maternal age; widespread use of assisted fertilization techniques for treatment of infertility; social feelings about maternity desire with increasing expectations from medical assistance; immigration of medically “naive” patients who don’t know to have a chronic disease, but apt and ready to conceive; limited knowledge of feasibility of drug use in pregnancy which may induce both patients and doctors to stopping appropriate drug therapy in condition of severe disease. Preconception counseling, planning the pregnancy, wise use of drugs, regular follow-up throughout the pregnancy and, in selected cases, preterm elective termination of pregnancy may result in excellent outcome both for mother and foetus. CONCLUSIONS Highly committed and specifically trained physicians are required to counsel these patients and to plan their treatment before and during pregnancy.

Neck pain in a sample of Greek urban population (fifteen to sixty-five years): analysis according to personal and socioeconomic characteristics.

Science.gov (United States)

Stranjalis, George; Kalamatianos, Theodosis; Stavrinou, Lampis C; Tsamandouraki, Kiki; Alamanos, Yiannis

2011-07-15

A cross-sectional study of neck pain and its related aspects in a sample of Greek urban population (15-65 years). To estimate the prevalence of neck pain in a Greek urban population (15-65 years) and to study the association of neck pain with several socioeconomic and demographic characteristics. The results of several prevalence studies carried out in different populations indicate a high frequency of neck pain in the general population. Socioeconomic and demographic factors are likely to influence neck pain frequency and neck pain-associated burden. A 1000-person sample of the general Greek population (15-65 years) living in the Greek capital and other urban centers of the country was selected by multiple-stage sampling, with definition of sample quotas based on demographic characteristics. Data on neck pain and its related aspects, including healthcare utilization, as well as demographic, socioeconomic, and employment data, were collected through personal interviews. Of the 204 individuals who reported neck pain during the last month, 35 (17.2%) consulted a physician, 72 (35.3%) received medication, and 15 (7.4%) stayed in bed for some time, during this period and because of neck pain. The mean duration of pain for individuals who reported neck pain during the last month was 12 days. A total of 8.6% of working individuals who experienced neck pain during the last month reported work absenteeism due to this pain, during this period; the mean duration of absence was 4.6 days. Neck pain frequency was related to several sociodemographic factors. Female sex, increased age, and being married showed a statistically significant association with the presence of neck pain. The present results indicate that neck pain is a common symptom in the studied Greek urban population. Nevertheless, relatively few individuals seek medical advice for this symptom. Neck pain frequency is associated with age, sex, and marital status.

Does Experience Rating Improve Obstetric Practices?

DEFF Research Database (Denmark)

Amaral-Garcia, Sofia; Bertoli, Paola; Grembi, Veronica

2015-01-01

is associated with a decrease in the probability of performing a C-section from 2.3 to 3.7 percentage points (7–11.6%) with no consequences for medical complications or neonatal outcomes. The impact can be explained by a reduction in the discretion of obstetric decision-making rather than by patient cream......Using inpatient discharge records from the Italian region of Piedmont, we estimate the impact of an increase in malpractice pressure brought about by experience-rated liability insurance on obstetric practices. Our identification strategy exploits the exogenous location of public hospitals in court...... districts with and without schedules for noneconomic damages. We perform difference-in-differences analysis on the entire sample and on a subsample which only considers the nearest hospitals in the neighborhood of court district boundaries. We find that the increase in medical malpractice pressure...

The Conundrum of Impacts of Climate Change on Urbanization and the Urban Heat Island Effect

Science.gov (United States)

Quattrochi, Dale A.

2011-01-01

The twenty-first century is the first urban century according to the United Nations Development Program. The focus on cities reflects awareness of the growing percentage of the world's population that lives in urban areas. In 2000, approximately 3 billion people representing about 40% of the global population resided in urban areas. The United Nations estimates that by 2025, 60% of the world s population will live in urban areas. As a consequence, the number of megacities (those cities with populations of 10 million inhabitants or more) will increase by 100 by 2025. Thus, there is a critical need to understand the spatial growth of urban areas and what the impacts are on the environment. Moreover, there is a critical need to assess how under global climate change, cities will affect the local, regional, and even global climate. As urban areas increase in size, it is anticipated there will be a concomitant growth of the Urban Heat Island effect (UHI), and the attributes that are related to its spatial and temporal dynamics. Therefore, how climate change, including the dynamics of the UHI, will affect the urban environment, must be explored to help mitigate potential impacts on the environment (e.g., air quality, heat stress, vectorborne disease) and on human health and well being, to develop adaptation schemes to cope with these impacts.

Nest suitability, fine-scale population structure and male-mediated dispersal of a solitary ground nesting bee in an urban landscape.

Science.gov (United States)

López-Uribe, Margarita M; Morreale, Stephen J; Santiago, Christine K; Danforth, Bryan N

2015-01-01

Bees are the primary pollinators of flowering plants in almost all ecosystems. Worldwide declines in bee populations have raised awareness about the importance of their ecological role in maintaining ecosystem functioning. The naturally strong philopatric behavior that some bee species show can be detrimental to population viability through increased probability of inbreeding. Furthermore, bee populations found in human-altered landscapes, such as urban areas, can experience lower levels of gene flow and effective population sizes, increasing potential for inbreeding depression in wild bee populations. In this study, we investigated the fine-scale population structure of the solitary bee Colletes inaequalis in an urbanized landscape. First, we developed a predictive spatial model to detect suitable nesting habitat for this ground nesting bee and to inform our field search for nests. We genotyped 18 microsatellites in 548 female individuals collected from nest aggregations throughout the study area. Genetic relatedness estimates revealed that genetic similarity among individuals was slightly greater within nest aggregations than among randomly chosen individuals. However, genetic structure among nest aggregations was low (Nei's GST = 0.011). Reconstruction of parental genotypes revealed greater genetic relatedness among females than among males within nest aggregations, suggesting male-mediated dispersal as a potentially important mechanism of population connectivity and inbreeding avoidance. Size of nesting patch was positively correlated with effective population size, but not with other estimators of genetic diversity. We detected a positive trend between geographic distance and genetic differentiation between nest aggregations. Our landscape genetic models suggest that increased urbanization is likely associated with higher levels of inbreeding. Overall, these findings emphasize the importance of density and distribution of suitable nesting patches for enhancing

Nest suitability, fine-scale population structure and male-mediated dispersal of a solitary ground nesting bee in an urban landscape.

Directory of Open Access Journals (Sweden)

Margarita M López-Uribe

Full Text Available Bees are the primary pollinators of flowering plants in almost all ecosystems. Worldwide declines in bee populations have raised awareness about the importance of their ecological role in maintaining ecosystem functioning. The naturally strong philopatric behavior that some bee species show can be detrimental to population viability through increased probability of inbreeding. Furthermore, bee populations found in human-altered landscapes, such as urban areas, can experience lower levels of gene flow and effective population sizes, increasing potential for inbreeding depression in wild bee populations. In this study, we investigated the fine-scale population structure of the solitary bee Colletes inaequalis in an urbanized landscape. First, we developed a predictive spatial model to detect suitable nesting habitat for this ground nesting bee and to inform our field search for nests. We genotyped 18 microsatellites in 548 female individuals collected from nest aggregations throughout the study area. Genetic relatedness estimates revealed that genetic similarity among individuals was slightly greater within nest aggregations than among randomly chosen individuals. However, genetic structure among nest aggregations was low (Nei's GST = 0.011. Reconstruction of parental genotypes revealed greater genetic relatedness among females than among males within nest aggregations, suggesting male-mediated dispersal as a potentially important mechanism of population connectivity and inbreeding avoidance. Size of nesting patch was positively correlated with effective population size, but not with other estimators of genetic diversity. We detected a positive trend between geographic distance and genetic differentiation between nest aggregations. Our landscape genetic models suggest that increased urbanization is likely associated with higher levels of inbreeding. Overall, these findings emphasize the importance of density and distribution of suitable nesting

Social Stigma, Social Capital Reconstruction and Rural Migrants in Urban China: A Population Health Perspective.

Science.gov (United States)

Chen, Xinguang; Stanton, Bonita; Kaljee, Linda M; Fang, Xiaoyi; Xiong, Qing; Lin, Danhua; Zhang, Liying; Li, Xiaoming

2011-01-01

In this study, we examine migrant stigma and its effect on social capital reconstruction among rural migrants who possess legal rural residence but live and work in urban China. After a review of the concepts of stigma and social capital, we report data collected through in-depth interviews with 40 rural migrant workers and 38 urban residents recruited from Beijing, China. Findings from this study indicate that social stigma against rural migrants is common in urban China and is reinforced through media, social institutions and their representatives, and day-to-day interactions. As an important part of discrimination, stigma against migrant workers creates inequality, undermines trust, and reduces opportunities for interpersonal interactions between migrants and urban residents. Through these social processes, social stigma interferes with the reconstruction of social capital (including bonding, bridging and linking social capital) for individual rural migrants as well as for their communities. The interaction between stigma and social capital reconstruction may present as a mechanism by which migration leads to negative health consequences. Results from this study underscore the need for taking measures against migrant stigma and alternatively work toward social capital reconstruction for health promotion and disease prevention among this population.

Urban and rural land use in Puerto Rico

Science.gov (United States)

Sebastian Martinuzzi; William A. Gould; Olga M. Ramos Gonzalez; Maya Quinones; Michael E. Jimenez

2008-01-01

We have developed three land use regions for Puerto Rico: Urban, Suburban, and Rural (Gould et al. 2008; Martinuzzi et al. 2007). These three regions can also be considered urban, densely-populated rural, and sparsely-populated rural or as urban and wildland with a wildland-urban interface. The suburban use is the most dynamic in terms of population growth and land...

Obstetrical complications of endometriosis, particularly deep endometriosis.

Science.gov (United States)

Leone Roberti Maggiore, Umberto; Inversetti, Annalisa; Schimberni, Matteo; Viganò, Paola; Giorgione, Veronica; Candiani, Massimo

2017-12-01

Over the past few years, a new topic in the field of endometriosis has emerged: the potential impact of the disease on pregnancy outcomes. This review aims to summarize in detail the available evidence on the relationship between endometriosis, particularly deep endometriosis (DE), and obstetrical outcomes. Acute complications of DE, such as spontaneous hemoperitoneum, bowel perforation, and uterine rupture, may occur during pregnancy. Although these events represent life-threatening conditions, they are rare and unpredictable. Therefore, the current literature does not support any kind of prophylactic surgery before pregnancy to prevent such complications. Results on the impact of DE on obstetrical outcomes are debatable and characterized by several limitations, including small sample size, lack of adjustment for confounders, lack of adequate control subjects, and other methodologic flaws. For these reasons, it is not possible to draw conclusions on this topic. The strongest evidence shows that DE is associated with higher rates of placenta previa; for other obstetrical outcomes, such as miscarriage, intrauterine growth restriction, preterm birth and hypertensive disorders, results are controversial. Although it is unlikely that surgery of DE may modify the impact of the disease on the course of pregnancy, no study has yet investigated this issue. Copyright © 2017 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Complications of gynecologic and obstetric management

International Nuclear Information System (INIS)

Newton, M.; Newton, E.R.

1987-01-01

This book examines the incidence, diagnosis and management of complications associated with interventions used in gynecology and obstetrics. These are encountered in all phases of gynecologic and therapeutic procedures, radiation therapy, drug therapy and pre- and post-treatment care

Obstetric X-rays

International Nuclear Information System (INIS)

Mwachi, M.K.

2006-01-01

Radiography of the pelvis should never be taken to diagnose early pregnancy, because of potential hazards of radiation damage to the growing foetus. the only indication occurs in the last week of pregnancy (37 weeks). Obstetric X-ray will help you answer like confirmation of malposition,multiple pregnancies; fetal abnormalities e.g. hydrocephalus, foetal disposition. The choice of radiographic projection will help give foetal presentation, disposition as well as foetal maturity. The search pattern helps you determine maternal and spine deformity, foetal spine and head , foetal presentation and any other anomalies

Understanding the health impacts of urbanization in China: A living laboratory for urban biogeochemistry research

Science.gov (United States)

Zhu, Y. G.

2015-12-01

China has the largest population in the world, and by 2011, more than 50% of its population are now living in cities. This ongoing societal change has profound impacts on environmental quality and population health. In addition to intensive discharges of waste, urbanization is not only changing the land use and land cover, but also inducing fundamental changes in biogeochemical processes. Unlike biogeochemistry in non-urban environment, the biological component of urban biogeochemistry is dominated by direct human activities, such as air pollution derived from transport, wastewater treatment, garbage disposal and increase in impervious surface etc. Managing urban biogeochemistry will include source control over waste discharge, eco-infrastructure (such as green space and eco-drainage), resource recovery from urban waste stream, and integration with peri-urban ecosystem, particularly with food production system. The overall goal of managing urban biogeochemistry is for human health and wellbeing, which is a global challenge. In this paper, the current status of urban biogeochemistry research in China will be briefly reviewed, and then it will focus on nutrient recycling and waste management, as these are the major driving forces of environmental quality changes in urban areas. This paper will take a holistic view on waste management, covering urban metabolism analysis, technological innovation and integration for resource recovery from urban waste stream, and risk management related to waste recycling and recovery.

Risk factors for preterm premature rupture of membranes in Chinese women from urban cities.

Science.gov (United States)

Zhou, Qiongjie; Zhang, Weiyuan; Xu, Huan; Liang, Huan; Ruan, Yan; Zhou, Shufeng; Li, Xiaotian

2014-12-01

To investigate the prevalence of preterm premature rupture of membranes (PPROM) in urban areas in China and examine the associated risk factors. A population-based, prospective study was undertaken in 14 cities in China between January 1, 2011, and January 31, 2012. Women were recruited at their first prenatal-care visit, when maternal characteristics were recorded. Risk factors were analyzed by one-way analysis of variance. Of 112 439 women included in analyses, 3077 (2.7%) had PPROM. Univariate analysis showed an increased risk of PPROM before 28weeks of pregnancy in migrant women (odds ratio [OR] 2.25; 95% confidence interval [CI] 1.53-3.30; P<0.001), in those with a history of recurrent induced abortions (OR 2.75; 95% CI 1.66-4.56; P<0.001), and in those with a history of preterm birth (OR 3.90; 95% CI 0.77-19.61; P<0.001). The associations were maintained in multivariate analysis (P<0.001). Migration as a result of urbanization, high rates of induced abortion, and preterm birth are potential risk factors for PPROM in Chinese women. Copyright © 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

The effect of exposure to biomass smoke on respiratory symptoms in adult rural and urban Nepalese populations.

Science.gov (United States)

Kurmi, Om P; Semple, Sean; Devereux, Graham S; Gaihre, Santosh; Lam, Kin Bong Hubert; Sadhra, Steven; Steiner, Markus F C; Simkhada, Padam; Smith, William C S; Ayres, Jon G

2014-11-06

Half of the world's population is exposed to household air pollution from biomass burning. This study aimed to assess the relationship between respiratory symptoms and biomass smoke exposure in rural and urban Nepal. A cross-sectional study of adults (16+ years) in a rural population (n = 846) exposed to biomass smoke and a non-exposed urban population (n = 802) in Nepal. A validated questionnaire was used along with measures of indoor air quality (PM2.5 and CO) and outdoor PM2.5. Both men and women exposed to biomass smoke reported more respiratory symptoms compared to those exposed to clean fuel. Women exposed to biomass were more likely to complain of ever wheeze (32.0 % vs. 23.5%; p = 0.004) and breathlessness (17.8% vs. 12.0%, p = 0.017) compared to males with tobacco smoking being a major risk factor. Chronic cough was similar in both the biomass and non-biomass smoke exposed groups whereas chronic phlegm was reported less frequently by participants exposed to biomass smoke. Higher PM2.5 levels (≥2 SDs of the 24-hour mean) were associated with breathlessness (OR = 2.10, 95% CI 1.47, 2.99) and wheeze (1.76, 1.37, 2.26). The study suggests that while those exposed to biomass smoke had higher prevalence of respiratory symptoms, urban dwellers (who were exposed to higher ambient air pollution) were more at risk of having productive cough.

Moral implications of obstetric technologies for pregnancy and motherhood.

Science.gov (United States)

Brauer, Susanne

2016-03-01

Drawing on sociological and anthropological studies, the aim of this article is to reconstruct how obstetric technologies contribute to a moral conception of pregnancy and motherhood, and to evaluate that conception from a normative point of view. Obstetrics and midwifery, so the assumption, are value-laden, value-producing and value-reproducing practices, values that shape the social perception of what it means to be a "good" pregnant woman and to be a "good" (future) mother. Activities in the medical field of reproduction contribute to "kinning", that is the making of particular social relationships marked by closeness and special moral obligations. Three technologies, which belong to standard procedures in prenatal care in postmodern societies, are presently investigated: (1) informed consent in prenatal care, (2) obstetric sonogram, and (3) birth plan. Their widespread application is supposed to serve the moral (and legal) goal of effecting patient autonomy (and patient right). A reconstruction of the actual moral implications of these technologies, however, reveals that this goal is missed in multiple ways. Informed consent situations are marked by involuntariness and blindness to social dimensions of decision-making; obstetric sonograms construct moral subjectivity and agency in a way that attribute inconsistent and unreasonable moral responsibilities to the pregnant woman; and birth plans obscure the need for a healthcare environment that reflects a shared-decision-making model, rather than a rational-choice-framework.

Implications of rural-urban migration for conservation of the Atlantic Forest and urban growth in Misiones, Argentina (1970-2030).

Science.gov (United States)

Izquierdo, Andrea E; Grau, Héctor R; Aide, T Mitchell

2011-05-01

Global trends of increasing rural-urban migration and population urbanization could provide opportunities for nature conservation, particularly in regions where deforestation is driven by subsistence agriculture. We analyzed the role of rural population as a driver of deforestation and its contribution to urban population growth from 1970 to the present in the Atlantic Forest of Argentina, a global conservation priority. We created future land-use-cover scenarios based on human demographic parameters and the relationship between rural population and land-cover change between 1970 and 2006. In 2006, native forest covered 50% of the province, but by 2030 all scenarios predicted a decrease that ranged from 18 to 39% forest cover. Between 1970 and 2001, rural migrants represented 20% of urban population growth and are expected to represent less than 10% by 2030. This modeling approach shows how rural-urban migration and land-use planning can favor nature conservation with little impact on urban areas.

Teaching veterinary obstetrics using three-dimensional animation technology.

Science.gov (United States)

Scherzer, Jakob; Buchanan, M Flint; Moore, James N; White, Susan L

2010-01-01

In this three-year study, test scores for students taught veterinary obstetrics in a classroom setting with either traditional media (photographs, text, and two-dimensional graphical presentations) were compared with those for students taught by incorporating three-dimensional (3D) media (linear animations and interactive QuickTime Virtual Reality models) into the classroom lectures. Incorporation of the 3D animations and interactive models significantly increased students' scores on essay questions designed to assess their comprehension of the subject matter. This approach to education may help to better prepare students for dealing with obstetrical cases during their final clinical year and after graduation.

Obstetric care: competition or co-operation.

NARCIS (Netherlands)

Veer, A.J.E. de; Meijer, W.J.

1996-01-01

OBJECTIVE: The aim of this study was to determine the feasibility of co-operation within maternity and obstetric care between midwives, general practitioners (GPs) and obstetricians. DESIGN: descriptive correlational study. SETTING: The Netherlands. Policy is towards more co-operation between

Oral Health Inequalities between Rural and Urban Populations of the African and Middle East Region.

Science.gov (United States)

Ogunbodede, E O; Kida, I A; Madjapa, H S; Amedari, M; Ehizele, A; Mutave, R; Sodipo, B; Temilola, S; Okoye, L

2015-07-01

Although there have been major improvements in oral health, with remarkable advances in the prevention and management of oral diseases, globally, inequalities persist between urban and rural communities. These inequalities exist in the distribution of oral health services, accessibility, utilization, treatment outcomes, oral health knowledge and practices, health insurance coverage, oral health-related quality of life, and prevalence of oral diseases, among others. People living in rural areas are likely to be poorer, be less health literate, have more caries, have fewer teeth, have no health insurance coverage, and have less money to spend on dental care than persons living in urban areas. Rural areas are often associated with lower education levels, which in turn have been found to be related to lower levels of health literacy and poor use of health care services. These factors have an impact on oral health care, service delivery, and research. Hence, unmet dental care remains one of the most urgent health care needs in these communities. We highlight some of the conceptual issues relating to urban-rural inequalities in oral health, especially in the African and Middle East Region (AMER). Actions to reduce oral health inequalities and ameliorate rural-urban disparity are necessary both within the health sector and the wider policy environment. Recommended actions include population-specific oral health promotion programs, measures aimed at increasing access to oral health services in rural areas, integration of oral health into existing primary health care services, and support for research aimed at informing policy on the social determinants of health. Concerted efforts must be made by all stakeholders (governments, health care workforce, organizations, and communities) to reduce disparities and improve oral health outcomes in underserved populations. © International & American Associations for Dental Research 2015.

Validity of a hospital-based obstetric register using medical records as reference

DEFF Research Database (Denmark)

Brixval, Carina Sjöberg; Thygesen, Lau Caspar; Johansen, Nanna Roed

2015-01-01

BACKGROUND: Data from hospital-based registers and medical records offer valuable sources of information for clinical and epidemiological research purposes. However, conducting high-quality epidemiological research requires valid and complete data sources. OBJECTIVE: To assess completeness...... and validity of a hospital-based clinical register - the Obstetric Database - using a national register and medical records as references. METHODS: We assessed completeness of a hospital-based clinical register - the Obstetric Database - by linking data from all women registered in the Obstetric Database...... Database therefore offers a valuable source for examining clinical, administrative, and research questions....

Strategies for Sustainable Urban Development and Urban-Rural Linkages

DEFF Research Database (Denmark)

Nilsson, Kjell; Nielsen, Thomas Alexander Sick; Aalbers, Carmen

2014-01-01

of transport, land use and open space planning; (ii) urban containment and densification – development a green compact city; (iii) preservation of blue and green infrastructure; and (iv) preservation of agricultural land and the promotion of local production. The need also remains to strengthen governance......An important driving force behind urban expansion is the growth of the urban population. But for Europe, this is not a sufficient explanation. The major trend is that European cities have become much less compact. Since the mid-1950s European cities have expanded on average by 78%, whereas...... the population has grown by only 33%. In the PLUREL project - an integrated project within the EU’s 6th Research Framework Programme - more than 100 researchers from 15 countries analysed the impacts of urban land consumption at a pan-European level and, through six European and one Chinese case studies...

Obstetrical complications in people at risk for developing schizophrenia

OpenAIRE

Ballon, Jacob S; Seeber, Katherine; Cadenhead, Kristin S

2007-01-01

Many factors have been associated with the development of schizophrenia, yet few studies have looked at these same factors in individuals considered at risk for schizophrenia, but who have not yet reached diagnostic threshold. The rate of obstetrical complications was assessed as part of a comprehensive battery in subjects at risk (N=52), or in the first episode of schizophrenia (N=18), and in normal comparison subjects (N=43). The rate of obstetrical complications was increased in the at ris...

Obstetric and psychosocial risk factors for Australian-born and non-Australian born women and associated pregnancy and birth outcomes: a population based cohort study.

Science.gov (United States)

Dahlen, Hannah Grace; Barnett, Bryanne; Kohlhoff, Jane; Drum, Maya Elizabeth; Munoz, Ana Maria; Thornton, Charlene

2015-11-09

One in four Australians is born overseas and 47% are either born overseas or have a parent who was. Obstetric and psychosocial risk factors for these women may differ. Data from one Sydney hospital (2012-2013) of all births recorded in the ObstetriX database were analysed (n = 3,092). Demographics, obstetric and psychosocial risk profile, obstetric interventions and complications and selected maternal and neonatal outcomes were examined for women born in Australia and overseas. Women born in Australia were younger, more likely to be primiparous (28.6 v 27.5%), be obese (32.0% v 21.4%), smoke (19.7 % v 3.0%), have an epidural (26.2% v 20.2%) and were less likely to have gestational diabetes mellitus (GDM) (6.8% v 13.7% when compared to non-Australian born women. The highest rates of GDM, Gestational Hypertension (GH) and maternal anaemia were seen in women born in China, the Philippines and Pakistan respectively. Differences were also seen in psychosocial screening between Australian and non-Australian women with Australian-born women more likely to smoke and report a mental health disorder. There was an association between having an Edinburgh Postnatal Depression Scale (EPDS) ≥ 13 and other psychosocial issues, such as thoughts of self-harm, domestic violence, childhood abuse etc. These women were also less likely to breastfeed. Women with an EPDS ≥ 13 at booking compared to women with EPDS ≤12 had a higher chance of being diagnosed with GDM (AOR 1.85 95% CI 1.14-3.0). There are significant differences in obstetric and psychosocial risk profiles and maternal and neonatal outcomes between Australian-born and non-Australian born women. In particular there appears to be an association between an EPDS of ≥13 and developing GDM, which warrants further investigation.

Urban and global populism: An analysis of Jakarta as Resilient City

Science.gov (United States)

Sustikarini, A.; Kabinawa, L. N. R. W.

2018-03-01

One of the important elements of friendly city is its cordiality towards diversity. Cities will naturally attract people from different nationalities to live, study and work. The rapid development of cities has long been regarded as major drive of urbanization from other areas which contributed to the high level of ethnic and race diversities. However diversity is currently seen under threat due to the rise of global populism that is mainly fuelled by anxiety over economic condition. The growth of nationalist movement, anti-immigrant parties and xenophobia is gaining foothold across the planet. Against this backdrop, this paper aims at investigating the nexus between diversity and inequality in Jakarta. The current local election provides example of these two competing concepts. Jakarta as emerging global city with diverse communities had been marred by public protest and narration of identity issues. On the other hands, populism has deep root in severe economic inequality among the residents. A robust development in Jakarta has been marked by concentration of wealth in the hands of few. This paper presents case study on the root causes of growing populism and its relations with inequality in Jakarta.

A case-control study of the risk factors for obstetric fistula in Tigray, Ethiopia.

Science.gov (United States)

Lewis Wall, L; Belay, Shewaye; Haregot, Tesfahun; Dukes, Jonathan; Berhan, Eyoel; Abreha, Melaku

2017-12-01

We tested the null hypothesis that there were no differences between patients with obstetric fistula and parous controls without fistula. A unmatched case-control study was carried out comparing 75 women with a history of obstetric fistula with 150 parous controls with no history of fistula. Height and weight were measured for each participant, along with basic socio-demographic and obstetric information. Descriptive statistics were calculated and differences between the groups were analyzed using Student's t test, Mann-Whitney U test where appropriate, and Chi-squared or Fisher's exact test, along with backward stepwise logistic regression analyses to detect predictors of obstetric fistula. Associations with a p value divorce/separation, and lived in more impoverished circumstances than controls. Fistula patients had worse reproductive histories, with greater numbers of stillbirths/abortions and higher rates of assisted vaginal delivery and cesarean section. The final logistic regression model found four significant risk factors for developing an obstetric fistula: age at marriage (OR 1.23), history of assisted vaginal delivery (OR 3.44), lack of adequate antenatal care (OR 4.43), and a labor lasting longer than 1 day (OR 14.84). Our data indicate that obstetric fistula results from the lack of access to effective obstetrical services when labor is prolonged. Rural poverty and lack of adequate transportation infrastructure are probably important co-factors in inhibiting access to needed care.

Provider-associated factors in obstetric interventions

NARCIS (Netherlands)

Pel, M.; Heres, M. H.; Hart, A. A.; van der Veen, F.; Treffers, P. E.

1995-01-01

OBJECTIVE: To assess which factors influence provider-associated differences in obstetric interventions. STUDY DESIGN: A survey of obstetricians and co-workers in a sample consisting of 38 Dutch hospitals was taken, using a questionnaire that contained questions about personal and hospital-policy

[Has the urban transition ended in sub-Saharan Africa?].

Science.gov (United States)

Bocquier, P

1999-01-01

In 1950, 28% of the world¿s population lived in cities. At that point, localities larger than 10,000 inhabitants were home to 0.7 billion people, of whom 36% were in developing countries. However, according to UN projections, the rate of urbanization will reach 47.4% in 2000, with cities housing 2.9 billion people, of whom 68.7% will be in developing countries. Africa, like other continents, is urbanizing. Although Africa is among the world¿s least urbanized regions, it is nonetheless the continent with the highest rate of urbanization. Urban population growth reached its height during the 1950s, then the urban population in the region multiplied by a factor of 10 during 1950-90, far outpacing the rate of overall population growth on the continent. However, during the 1980s and 1990s, urban growth in Africa declined sharply. The author discusses urbanization in Africa devoid of industrialization, declining rates of urban population growth in the region, the uncertain future of urbanization in Africa, and how future urbanization in Africa depends upon the role the continent will play in the global economy.

Pregnancy, obstetric, and perinatal health outcomes in eating disorders.

Science.gov (United States)

Linna, Milla S; Raevuori, Anu; Haukka, Jari; Suvisaari, Jaana M; Suokas, Jaana T; Gissler, Mika

2014-10-01

The purpose of this study was to assess pregnancy, obstetric, and perinatal health outcomes and complications in women with lifetime eating disorders. Female patients (n = 2257) who were treated at the Eating Disorder Clinic of Helsinki University Central Hospital from 1995-2010 were compared with unexposed women from the population (n = 9028). Register-based information on pregnancy, obstetric, and perinatal health outcomes and complications were acquired for all singleton births during the follow-up period among women with broad anorexia nervosa (AN; n = 302 births), broad bulimia nervosa (BN; n = 724), binge eating disorder (BED; n = 52), and unexposed women (n = 6319). Women with AN and BN gave birth to babies with lower birthweight compared with unexposed women, but the opposite was observed in women with BED. Maternal AN was related to anemia, slow fetal growth, premature contractions, short duration of the first stage of labor, very premature birth, small for gestational age, low birthweight, and perinatal death. Increased odds of premature contractions, resuscitation of the neonate, and very low Apgar score at 1 minute were observed in mothers with BN. BED was associated positively with maternal hypertension, long duration of the first and second stage of labor, and birth of large-for-gestational-age infants. Eating disorders appear to be associated with several adverse perinatal outcomes, particularly in offspring. We recommend close monitoring of pregnant women with either a past or current eating disorder. Attention should be paid to children who are born to these mothers. Copyright © 2014. Published by Elsevier Inc.

Compliance with the CONSORT checklist in obstetric anaesthesia randomised controlled trials.

Science.gov (United States)

Halpern, S H; Darani, R; Douglas, M J; Wight, W; Yee, J

2004-10-01

The Consolidated Standards for Reporting of Trials (CONSORT) checklist is an evidence-based approach to help improve the quality of reporting randomised controlled trials. The purpose of this study was to determine how closely randomised controlled trials in obstetric anaesthesia adhere to the CONSORT checklist. We retrieved all randomised controlled trials pertaining to the practice of obstetric anaesthesia and summarised in Obstetric Anesthesia Digest between March 2001 and December 2002 and compared the quality of reporting to the CONSORT checklist. The median number of correctly described CONSORT items was 65% (range 36% to 100%). Information pertaining to randomisation, blinding of the assessors, sample size calculation, reliability of measurements and reporting of the analysis were often omitted. It is difficult to determine the value and quality of many obstetric anaesthesia clinical trials because journal editors do not insist that this important information is made available to readers. Both clinicians and clinical researchers would benefit from uniform reporting of randomised trials in a manner that allows rapid data retrieval and easy assessment for relevance and quality.

1 POPULATION PRESSURE AND HEALTH RISKS IN URBAN ...

African Journals Online (AJOL)

on urban market environment (and in this case, Bodija Market, Ibadan). Particular ... markets in most LDCs have become huge waste production centers. ... market. With about 90 percent of food purchases of urban residents being sourced from .... up a child's excrement in between attending to customers are created. Often ...

Some notions on urbanity

DEFF Research Database (Denmark)

Grønlund, Bo

According to International Federation of Housing and Planning the majority of the population of the planet will be urban in 2007. That definition of the urban, however, is based on zombie categories, to speak as Ulrich Beck. Urbanization and urban areas as we normally understand them are concepts...... of 'the first modernity'. Nowadays, in 'the second modernity', we have instead to aks: where in the city do you really find urbanity? A large part of what statistically is called urban areas lack urban quality and visible urban life. In the space syntax community urbanity is basically understood...