'Tweaking' the model for understanding and preventing maternal and neonatal morbidity and mortality in low income countries : "inserting new ideas into a timeless wine skin"

Background: Maternal and neonatal morbidity and mortality in Low Income Countries, especially in sub-Saharan Africa involves numerous interrelated causes. The three-delay model/framework was advanced to better understand the causes and associated Contextual factors. It continues to inform many aspects of programming and research on combating maternal and child morbidity and mortality in the said countries. Although this model addresses some of the core areas that can be targeted to drastically reduce maternal and neonatal morbidity and mortality, it potentially omits other critical facets especially around primary prevention, and pre- and post-hospitalization continuum of care. Discussion: The final causes of Maternal and Neonatal mortality and morbidity maybe limited to a few themes largely centering on infections, preterm births, and pregnancy and childbirth related complications. However, to effectively tackle these causes of morbidity and mortality, a broad based approach is required. Some of the core issues that need to be addressed include:-i) prevention of vertically transmitted infections, intra-partum related adverse events and broad primary prevention strategies, ii) overall health care seeking behavior and delays therein, iii) quality of care at point of service delivery, and iv) post-insult treatment follow up and rehabilitation. In this article we propose a five-pronged framework that takes all the above into consideration. This frameworks further builds on the three-delay model and offers a more comprehensive approach to understanding and preventing maternal and neonatal morbidity and mortality in Low Income Countries Conclusion: In shaping the post 2015 agenda, the scope of engagement in maternal and newborn health need to be widened if further gains are to be realized and sustained. Our proposed five pronged approach incorporates the need for continued investment in tackling the recognized three delays, but broadens this to also address earlier aspects of primary prevention, and the need for tertiary prevention through ongoing follow up and rehabilitation. It takes into perspective the spectrum of new evidence and how it can be used to deepen overall understanding of prevention strategies for maternal and neonatal morbidity and mortality in LICS

La relación entre la experiencia de la atención sanitaria y la depresión perinatal durante la pandemia COVID-19

Background: The prevalence of peripartum depression (PPD) has increased substantially since the start of the COVID-19 pandemic. To reduce the probability of contagion, hospitals had to adapt their care protocols, including the care of women in the perinatal period. Method: A cross-sectional study was used in a total sample of 3,356 women, 1,402 in the prenatal period and 1,954 in the postnatal period. They completed the Edinburgh Postnatal Depression Scale to assess depressive symptoms and the Spanish version of the Coronavirus Perinatal Experiences to assess health experience. Results: The results showed that feeling very well supported by a health professional was associated with a lower risk of PPD. On the other hand, believing it very important to have access to a mental health professional and being concerned about changes in infant care due to COVID-19 were associated with a higher risk of PPD. Conclusion: The results showed the relationship between health experience and the risk of depressive symptoms, highlighting the importance of considering the psychological aspects in the development of measures and protocols for perinatal care.Antecedentes: La prevalencia de la depresión perinatal ha aumentado sustancialmente desde el inicio de la pandemia debido al coronavirus (COVID-19). Para reducir la probabilidad de contagio, los hospitales tuvieron que adaptar sus protocolos asistenciales, incluyendo la atención a las mujeres en el periodo perinatal. Método: Se utilizó un estudio transversal en una muestra total de 3,356 mujeres, 1,402 en el período prenatal y 1,954 en el período postnatal. Cumplimentaron la Escala de Depresión Postnatal de Edimburgo para evaluar los síntomas depresivos y la versión española de la Encuesta sobre Experiencias Perinatales durante el Coronavirus para evaluar la experiencia de la atención sanitaria. Resultados. Los resultados mostraron que sentirse muy bien apoyada por un profesional de la salud se asoció con un menor riesgo de desarrollar depresión perinatal. Por otro lado, creer que es muy importante tener acceso a un profesional de la salud mental y estar preocupada por los cambios en el cuidado del bebé debido al COVID-19 se asociaron con un mayor riesgo de depresión perinatal. Conclusión: Los resultados mostraron la relación entre la experiencia sanitaria y el riesgo de síntomas depresivos, destacando la importancia de considerar los aspectos psicológicos en el desarrollo de medidas y protocolos de atención perinatal

The Relationship between Healthcare Experience and Perinatal Depression during COVID-19 Pandemic

Background: The prevalence of peripartum depression (PPD) has increased substantially since the start of the COVID-19 pandemic. To reduce the probability of contagion, hospitals had to adapt their care protocols, including the care of women in the perinatal period. Method: A cross-sectional study was used in a total sample of 3,356 women, 1,402 in the prenatal period and 1,954 in the postnatal period. They completed the Edinburgh Postnatal Depression Scale to assess depressive symptoms and the Spanish version of the Coronavirus Perinatal Experiences to assess health experience. Results: The results showed that feeling very well supported by a health professional was associated with a lower risk of PPD. On the other hand, believing it very important to have access to a mental health professional and being concerned about changes in infant care due to COVID-19 were associated with a higher risk of PPD. Conclusion: The results showed the relationship between health experience and the risk of depressive symptoms, highlighting the importance of considering the psychological aspects in the development of measures and protocols for perinatal care

Establecimiento de índices para el estudio de la solubilización de fosfatos por bacterias del suelo

Se ha determinado la capacidad de solubilización de fosfato inorgánico de bacterias del suelo que poseen esta condición. Se establecen diferentes grupos atendiendo de una parte a la intensidad solubilizadora de las bacterias (mediante unos in dices de solubilización) y de otra al tiempo empleado en producirla. Posteriormente se estudian las relaciones existentes entre ambos aspectos: capacidad solubilizadora y tiempo de solubilización y -entre éstos y la Gram positividad y negatividad de las bacterias. El obj·eto de estas relaciones 'es contribuir a establecer criterios de selección que pueden ayudar en la elección de cepas solubilizadoras. Se ha realizado igualmente un cuidadoso análisis estadístico de los resultados.The ability to dissolve inorganic phosphate by soil bacteria was determined in these kind of organisms. Different groups were established according to the intensity of the solving action using a proposed solubilization parameters, and with time required to produce it. A study of the posible correction among the ability to dissolve phosphate, the time used and the Gram stain was made. The purpose of the work was to contribute in the critería of selection oí the dissolving phosphate strains. A carefully statistical analysis oI the results was also made

Investigación de la síntesis y acumulación de vitaminas por especies del genero bacillus

Se investiga la capacidad de producir y acumular vitaminas (vitamina B12, pantenol, riboftavina, niacina y biotina) en 58 estirpes diferentes del género Bacillus. La vitamina producida por mayor número de microorganismos fue la vitamina B12 y la sintetizada por menor número de Bacillus fue la niacina. Sin embargo de los resultados obtenidos no puede deducirse ninguna conclusión de valor taxonómico. Se señala la importancia que puede tener la producción de sustancias antibióticas cuando se detecte la acumulación de vitaminas por medio de una cepa auxotróflca, que puede ser susceptible para la sustancia antibiótica producida

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Se investiga la capacidad de producir y acumular vitaminas (vitamina B12, pantenol, riboftavina, niacina y biotina) en 58 estirpes diferentes del género Bacillus. La vitamina producida por mayor número de microorganismos fue la vitamina B12 y la sintetizada por menor número de Bacillus fue la niacina. Sin embargo de los resultados obtenidos no puede deducirse ninguna conclusión de valor taxonómico. Se señala la importancia que puede tener la producción de sustancias antibióticas cuando se detecte la acumulación de vitaminas por medio de una cepa auxotróflca, que puede ser susceptible para la sustancia antibiótica producida.We have researched the capacity to produce and accumulate vitamins (Vitamin B12, panthenol, rivoftavin, niacin, biotin) in 58 different strains of Bacillus. The vitamin produced by larger number of microorganisms was the vitamin B12 and the synthesized one by the least number of Bacillus was the niacin. However we can't produce any conclusions of taxonomic value from the obtained results. We point out the importance can have the production of antibiotic substances whem we detect the accumulation of vitamins utilizing auxotrophic strains that can be susceptible for the produced antibiotic substance

First recorded breeding of Clarke’s Weaver Ploceus golandi

The breeding site and nest of the Kenyan-endemic Clarke’s Weaver had remained a mystery for 100 years. The species was described in 1913 from the north Kenya Coast, but the first breeding colony was found in March 2013 in the northern section of the Dakatcha Woodlands, northwest of Malindi. An estimated 400–500 nests were concentrated in a small area of a tiny wetland. Adults were displaying and nest-building on 23 March, and when next visited on 7 April, adults were feeding young in the nest. Nests were coarsely woven with a low side entrance, placed in the tops of tall sedges, standing in water. Both males and females contributed to nest building and to feeding the young on insects, and breeding appeared to be closely synchronized, so that by 19 April the colony had been abandoned

Programme evaluation training for health professionals in francophone Africa: process, competence acquisition and use

This is an Open Access article distributed under the terms of the Creative Commons Attribution Licens

Evolution of Mycobacterium tuberculosis complex lineages and their role in an emerging threat of multidrug resistant tuberculosis in Bamako, Mali

In recent years Bamako has been faced with an emerging threat from multidrug resistant TB (MDR-TB). Whole genome sequence analysis was performed on a subset of 76 isolates from a total of 208 isolates recovered from tuberculosis patients in Bamako, Mali between 2006 and 2012. Among the 76 patients, 61(80.3%) new cases and 15(19.7%) retreatment cases, 12 (16%) were infected by MDR-TB. The dominant lineage was the Euro-American lineage, Lineage 4. Within Lineage 4, the Cameroon genotype was the most prevalent genotype (n=20, 26%), followed by the Ghana genotype (n=16, 21%). A sub-clade of the Cameroon genotype, which emerged ~22 years ago was likely to be involved in community transmission. A sub-clade of the Ghana genotype that arose approximately 30 years ago was an important cause of MDR-TB in Bamako. The Ghana genotype isolates appeared more likely to be MDR than other genotypes after controlling for treatment history. We identifed a clade of four related Beijing isolates that included one MDR-TB isolate. It is a major concern to fnd the Cameroon and Ghana genotypes involved in community transmission and MDR-TB respectively. The presence of the Beijing genotype in Bamako remains worrying, given its high transmissibility and virulence

A formal framework to prove the correctness of model driven engineering composition operators

International audienceCurrent trends in system engineering combine modeling, composition and verification technologies in order to harness their ever growing complexity. Each composition operator dedicated to a different modeling concern should be proven to be property preserving at assembly time. These proofs are usually burdensome with repetitive aspects. Our work targets the factorisation of these aspects relying on primitive generic composition operators used to express more sophisticated language specific ones. These operators are defined for languages expressed with OMG MOF metamodeling technologies. The proof are done with the Coq proof assistant relying on the Coq4MDE framework defined previously. These basic operators, Union and Substitution, are illustrated using the MOF Package Merge as composition operator and the preservation of model conformance as verified property