Determinants of maternal care in a region of South India

A cross-sectional survey was conducted during 1993 in urban and rural areas of Karnataka State, India. The survey included 3595 currently married women aged under 35, who had at least one child under five. Nine out of ten women had at least one antenatal consultation during their most recent fertile pregnancies. Most consultations were with doctors and there was minimal use of the services provided by paramedical staff of the primary health care system. Of all respondents, 38 per cent (57% urban and 29% rural) delivered in a hospital, and a majority of institutional deliveries were in private hospitals. Surgical interventions were made in more than one-third of hospital deliveries. There was a marked imbalance between antenatal and postnatal care as fewer than one-fifth of the mothers had a postnatal checkup. The educational level, economic status and religion of the mother are significant predictors of use of maternal health services. The relationship of problems during pregnancy and delivery with subsequent health-related behaviour is also examined

Insights into unmet need in Kenya

Results from this study demonstrate that most women having unmet need for family planning in Kenya were aware of the two main contraceptive methods and a supply source, but many of the poorest, least educated women and those living in North Eastern Province were disadvantaged in this regard. Targeted expansion of access/information is a priority to meet the need of the disadvantaged populations. Kenya has one of the longest records of successful family planning programs in Africa, but this report has revealed some major defects, in particular excess reliance on two hormonal methods. Major future progress may well depend on successful popularization of other methods, particularly long-acting and permanent methods. Broadening the method mix will require simultaneous effort to stimulate the demand and increase access

Insight into the Carboxyl Transferase Domain Mechanism of Pyruvate Carboxylase from \u3cem\u3eRhizobium etli\u3c/em\u3e

The effects of mutations in the active site of the carboxyl transferase domain of Rhizobium etli pyruvate carboxylase have been determined for the forward reaction to form oxaloacetate, the reverse reaction to form MgATP, the oxamate-induced decarboxylation of oxaloacetate, the phosphorylation of MgADP by carbamoyl phosphate, and the bicarbonate-dependent ATPase reaction. Additional studies with these mutants examined the effect of pyruvate and oxamate on the reactions of the biotin carboxylase domain. From these mutagenic studies, putative roles for catalytically relevant active site residues were assigned and a more accurate description of the mechanism of the carboxyl transferase domain is presented. The T882A mutant showed no catalytic activity for reactions involving the carboxyl transferase domain but surprisingly showed 7- and 3.5-fold increases in activity, as compared to that of the wild-type enzyme, for the ADP phosphorylation and bicarbonate-dependent ATPase reactions, respectively. Furthermore, the partial inhibition of the T882A-catalyzed BC domain reactions by oxamate and pyruvate further supports the critical role of Thr882 in the proton transfer between biotin and pyruvate in the carboxyl transferase domain. The catalytic mechanism appears to involve the decarboxylation of carboxybiotin and removal of a proton from Thr882 by the resulting biotin enolate with either a concerted or subsequent transfer of a proton from pyruvate to Thr882. The resulting enolpyruvate then reacts with CO2 to form oxaloacetate and complete the reaction

Sexual behaviour in the face of risk : preliminary results from first AIDS-related surveys

Preliminary results are presented from nationally representative surveys of the adult populations of five African countries, conducted in 1989 and 1990. General awareness of AIDS was high, as was knowledge of sexual transmission. In four of the five surveys, large proportions, from 25 to 64 per cent, of both men and women perceived themselves to have a high or moderate risk of HIV infection. High proportions also reported that they had modified their behaviour typically by more care in selecting partners or greater faithfulness. Greater use of condoms was mentioned rarely. The results, particularly on behavioural change, should not be interpreted literally. But the fact that so many report modification of behaviour at least suggests a willingness to contemplate the need for change. The prognosis would have been much worse, had these surveys indicated widespread denial of risk and unwillingness to consider changes in behaviour

Family Planning Programs for the 21st Century: Rationale and Design

Family planning improves health, reduces poverty, and empowers women. Yet, today, more than 200 million women in the developing world want to avoid pregnancy but are not using a modern method of contraception. They face many obstacles, including lack of access to information and health-care services, opposition from their husbands and communities, misperceptions about side effects, and cost. Family planning programs are among the most successful development interventions of the past 50 years. They are unique in their range of potential benefits, encompassing economic development, maternal and child health, educational advances, and women’s empowerment. Research shows that with high-quality voluntary family planning programs, governments are able to reduce fertility and produce large-scale improvements in health, wealth, human rights, and education. This book is a comprehensive resource for policymakers and donors. It makes the case for increased funding and support of voluntary family planning, and details how to design programs to operate both ethically and effectively

Executive summary—Family planning programs for the 21st century: Rationale and design

This document contains the executive summary of “Family Planning Programs for the 21st Century: Rationale and Design.” The first half of the book makes the case for why increased funding and support for voluntary family planning programs are needed. The second half explains how reinvigorated voluntary family planning programs can be structured to operate more effectively. Family planning is one of the most successful development interventions of the past 50 years. It is unique in its range of potential benefits, encompassing economic development, maternal and child health, educational advances, and women’s empowerment. Research shows that with high-quality voluntary family planning programs, governments can reduce fertility and produce large-scale improvements in health, wealth, human rights, and education. Substantial investments in promoting voluntary family planning programs and increasing access for all women should be a top priority

Forum: On the limited utility of KAP-style survey data in the practical epidemiology of AIDS

This issue of Forum presents a debate on Herbert L. Smith’s, ‘On the limited utility of KAP-style survey data in the practical epidemiology of AIDS, with reference to the AIDS epidemic in Chile’, Health Transition Review 3,1,1993. His response to issues raised in this debate will appear in Health Transition Review 4,1,1994

Prediction of mortality rates in heart failure patients with data mining methods

Heart failure is one of the severe diseases which menace the human health and affectmillions of people. Half of all patients diagnosed with heart failure die within four years. For thepurpose of avoiding life-threatening situations and minimizing the costs, it is important to predictmortality rates of heart failure patients. As part of a HEIF-5 project, a data mining study wasconducted aiming specifically at extracting new knowledge from a group of patients suffering fromheart failure and using it for prediction of mortality rates. The methodology of knowledge discoveryin databases is analyzed within the framework of home telemonitoring. Several data mining methodssuch as a Bayesian network method, a decision tree method, a neural network method and a nearestneighbour method are employed. The accuracy for the data mining methods from the point of view ofavoiding life-threatening situations and minimizing the costs is discussed. It seems that the decisiontree method achieves the best accuracy results and is also interpretable for the clinicians

Caring for people with heart failure and many other medical problems through and beyond the COVID‐19 pandemic; the advantages of universal‐access to home telemonitoring

No abstract available