Childbirth care: the oral history of women who gave birth from the 1940s to 1980s

This study's objective was to gain a greater understanding of the changes that took place in the childbirth care model from the experience of women who gave birth in the State of Sao Paulo, Brazil from the 1940s to the 1980s. This is a descriptive study conducted with 20 women using the Thematic Oral History method. Data were collected through unstructured interviews. The theme extracted from the interviews was "The experience of childbirth". The results indicate a time and generational demarcation in the 1970s. Childbirths from 1940 to 1960 occurred in a context of transition from home to hospital births. The 1980s represents a turning point in the elements that compose the childbirth care model, such as the type and place of birth and the professional assisting women, with an increased use of technology and obstetric interventions

Persistent Place-Making in Prehistory: the Creation, Maintenance, and Transformation of an Epipalaeolithic Landscape

Most archaeological projects today integrate, at least to some degree, how past people engaged with their surroundings, including both how they strategized resource use, organized technological production, or scheduled movements within a physical environment, as well as how they constructed cosmologies around or created symbolic connections to places in the landscape. However, there are a multitude of ways in which archaeologists approach the creation, maintenance, and transformation of human-landscape interrelationships. This paper explores some of these approaches for reconstructing the Epipalaeolithic (ca. 23,000–11,500 years BP) landscape of Southwest Asia, using macro- and microscale geoarchaeological approaches to examine how everyday practices leave traces of human-landscape interactions in northern and eastern Jordan. The case studies presented here demonstrate that these Epipalaeolithic groups engaged in complex and far-reaching social landscapes. Examination of the Early and Middle Epipalaeolithic (EP) highlights that the notion of “Neolithization” is somewhat misleading as many of the features we use to define this transition were already well-established patterns of behavior by the Neolithic. Instead, these features and practices were enacted within a hunter-gatherer world and worldview

Radiocarbon dates constrain the timing of environmental and cultural shifts in the holocene strata of Wonderwerk Cave, South Africa

Wonderwerk Cave has yielded one of the longest and most complete Holocene Later Stone Age (LSA) records for the arid interior of South Africa. This paper presents the results of a new radiocarbon dating program for Excavation 1 that is explored within a Bayesian model of all existing Wonderwerk Cave radiocarbon dates for the Holocene. The proposed model, using Phases within an OxCal Sequence model, provides robust age estimates for changes in the technological and paleoenvironmental record at the site. The more precise dates allow a comparison of the timing of climate shifts across the interior of southern Africa and begin to allow us to identify whether hiatuses in human occupation, or cultural shifts, are synchronous across broader areas of the subcontinent, or not

A new paleoecological context for the Oldowan-Acheulean in Southern Africa

The influence of climatic and environmental change on human evolution in the Pleistocene is understood largely from extensive East African stable isotope records. These records show increasing proportions of C4 plants in the Early Pleistocene. We know far less about the expansion of C4 grasses in higher latitudes, which were also occupied by early Homo but are more marginal for C4 plants. Here we show that both C3 and C4 grasses, and prolonged wetlands remained major components of Early Pleistocene environments in the central interior of southern Africa based on enamel stable carbon and oxygen isotope data and associated faunal abundance and phytolith evidence, from the site of Wonderwerk Cave. Vegetation contexts associated with Oldowan and Early Acheulean lithic industries, in which climate is driven by an interplay of regional rainfall seasonality together with global CO2 levels, develop along a regional distinct trajectory compared to eastern South Africa and East Africa

The palaeoecological context of the Oldowan-Acheulean in southern Africa

The influence of climatic and environmental change on human evolution in the Pleistocene epoch is understood largely from extensive East African stable isotope records. These records show increasing proportions of C4 plants in the Early Pleistocene. We know far less about the expansion of C4 grasses at higher latitudes, which were also occupied by early Homo but are more marginal for C4 plants. Here we show that both C3 and C4 grasses and prolonged wetlands remained major components of Early Pleistocene environments in the central interior of southern Africa, based on enamel stable carbon and oxygen isotope data and associated faunal abundance and phytolith evidence from the site of Wonderwerk Cave. Vegetation contexts associated with Oldowan and early Acheulean lithic industries, in which climate is driven by an interplay of regional rainfall seasonality together with global CO2 levels, develop along a regional distinct trajectory compared to eastern South Africa and East Africa

A new paleoecological context for the Oldowan-Acheulean in Southern Africa

The influence of climatic and environmental change on human evolution in the Pleistocene is understood largely from extensive East African stable isotope records. These records show increasing proportions of C4 plants in the Early Pleistocene. We know far less about the expansion of C4 grasses in higher latitudes, which were also occupied by early Homo but are more marginal for C4 plants. Here we show that both C3 and C4 grasses, and prolonged wetlands remained major components of Early Pleistocene environments in the central interior of southern Africa based on enamel stable carbon and oxygen isotope data and associated faunal abundance and phytolith evidence, from the site of Wonderwerk Cave. Vegetation contexts associated with Oldowan and Early Acheulean lithic industries, in which climate is driven by an interplay of regional rainfall seasonality together with global CO2 levels, develop along a regional distinct trajectory compared to eastern South Africa and East Africa

Predicting streptococcal pharyngitis in adults in primary care: a systematic review of the diagnostic accuracy of symptoms and signs and validation of the Centor score

Background: Stratifying patients with a sore throat into the probability of having an underlying bacterial or viral cause may be helpful in targeting antibiotic treatment. We sought to assess the diagnostic accuracy of signs and symptoms and validate a clinical prediction rule (CPR), the Centor score, for predicting group A ?-haemolytic streptococcal (GABHS) pharyngitis in adults (> 14 years of age) presenting with sore throat symptoms. Methods: A systematic literature search was performed up to July 2010. Studies that assessed the diagnostic accuracy of signs and symptoms and/or validated the Centor score were included. For the analysis of the diagnostic accuracy of signs and symptoms and the Centor score, studies were combined using a bivariate random effects model, while for the calibration analysis of the Centor score, a random effects model was used. Results: A total of 21 studies incorporating 4,839 patients were included in the meta-analysis on diagnostic accuracy of signs and symptoms. The results were heterogeneous and suggest that individual signs and symptoms generate only small shifts in post-test probability (range positive likelihood ratio (+LR) 1.45-2.33, -LR 0.54-0.72). As a decision rule for considering antibiotic prescribing (score ? 3), the Centor score has reasonable specificity (0.82, 95% CI 0.72 to 0.88) and a post-test probability of 12% to 40% based on a prior prevalence of 5% to 20%. Pooled calibration shows no significant difference between the numbers of patients predicted and observed to have GABHS pharyngitis across strata of Centor score (0-1 risk ratio (RR) 0.72, 95% CI 0.49 to 1.06; 2-3 RR 0.93, 95% CI 0.73 to 1.17; 4 RR 1.14, 95% CI 0.95 to 1.37). Conclusions: Individual signs and symptoms are not powerful enough to discriminate GABHS pharyngitis from other types of sore throat. The Centor score is a well calibrated CPR for estimating the probability of GABHS pharyngitis. The Centor score can enhance appropriate prescribing of antibiotics, but should be used with caution in low prevalence settings of GABHS pharyngitis such as primary care