102 research outputs found
Why do women not use antenatal services in low and middle income countries? A metasynthesis of qualitative studies
Background:
Almost 50% of women in low & middle income countries (LMIC’s) don’t receive adequate antenatal care. Women’s views can offer important insights into this problem. Qualitative studies exploring inadequate use of antenatal services have been undertaken in a range of countries, but the findings are not easily transferable. We aimed to inform the development of future antenatal care programmes through a synthesis of findings in all relevant qualitative studies.
Methods and Findings:
Using a pre-determined search strategy, we identified robust qualitative studies reporting on the views and experiences of women in LMIC’s who received inadequate antenatal care. We used meta-ethnographic techniques to generate themes and a line of argument synthesis. We derived policy relevant hypotheses from the findings.
We included 21 papers representing the views of more than 1230 women from 15 countries. Three key themes were identified: ‘Pregnancy as socially risky and physiologically healthy’; ‘Resource use and survival in conditions of extreme poverty’and ‘Not getting it right first time’. The line of argument synthesis describes a dissonance between programme design and cultural contexts that may restrict access and discourage return visits. We hypothesize that centralized, risk-focused antenatal care programmes may be at odds with the resources, beliefs and experiences of pregnant women who underuse antenatal services.
Conclusions:
Our findings suggest that there may be a mis-alignment between current antenatal provision and the social and cultural context of some women in LMIC’s. Antenatal care provision that is theoretically and contextually at odds with local contextual beliefs and experiences are likely to be underused, especially when attendance generates increased personal risks of lost family resource or physical danger during travel; when the promised care is not delivered due to resource constraints; and when women experience covert or overt abuse in care settings
The effects of prolonged wear of textured shoe insoles on gait, foot sensation and proprioception in people with Multiple Sclerosis: protocol for a randomised controlled trial
Background: Many people with multiple sclerosis experience problems with walking, which can make daily activities difficult and often leads to falls. Foot sensation plays an important role in keeping the body balanced whilst walking; however, people with multiple sclerosis often have poor sensation on the soles of their feet. Wearing a specially designed shoe insole, which enhances plantar sensory information, could help people with multiple sclerosis to walk better. This study will explore whether long-term wear of a textured insole can improve walking in people with multiple sclerosis
A synthesis of past, current and future research for protection and management of papyrus (Cyperus papyrus L.) wetlands in Africa
Papyrus wetlands (dominated by the giant
sedge Cyperus papyrus L.) occur throughout eastern,
central and southern Africa and are important for
biodiversity, for water quality and quantity regulation
and for the livelihoods of millions of people. To draw
attention to the importance of papyrus wetlands, a
special session entitled ‘‘The ecology of livelihoods in
papyrus wetlands’’ was organized at the 9th INTECOL
Wetlands Conference in Orlando, Florida in June
2012. Papers from the session, combined with additional
contributions, were collected in a special issue
of Wetlands Ecology and Management. The current
paper reviews ecological and hydrological characteristics
of papyrus wetlands, summarizes their ecosystem
services and sustainable use, provides an
overview of papyrus research to date, and looks at
policy development for papyrus wetlands. Based on
this review, the paper provides a synthesis of research
and policy priorities for papyrus wetlands and introduces
the contributions in the special issue. Main
conclusions are that (1) there is a need for better
estimates of the area covered by papyrus wetlands.
Limited evidence suggests that the loss of papyrus
wetlands is rapid in some areas; (2) there is a need for a
better understanding and modelling of the regulating
services of papyrus wetlands to support trade-off
analysis and improve economic valuation; (3) research
on papyrus wetlands should include assessment of all
ecosystem services (provisioning, regulating, habitat,
cultural) so that trade-offs can be determined as the
basis for sustainable management strategies (‘wise
use’); (4) more research on the governance, institutional
and socio-economic aspects of papyrus wetlands
is needed to assist African governments in
dealing with the challenges of conserving wetlands in
the face of growing food security needs and climate
change. The papers in the special issue address a
number of these issues
Management of intra-abdominal infections : recommendations by the WSES 2016 consensus conference
This paper reports on the consensus conference on the management of intra-abdominal infections (IAIs) which was held on July 23, 2016, in Dublin, Ireland, as a part of the annual World Society of Emergency Surgery (WSES) meeting. This document covers all aspects of the management of IAIs. The Grading of Recommendations Assessment, Development and Evaluation recommendation is used, and this document represents the executive summary of the consensus conference findings.Peer reviewe
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What can crop stable isotopes ever do for us? An experimental perspective on using crop carbon stable isotope values for reconstructing water availability in semi-arid and arid environments
This study re-assesses and refines the use of crop carbon stable isotopes (Δ13C) to reconstruct past water availability. Durum wheat, six-row barley, and sorghum were experimentally grown at three crop growing stations in Jordan for up to three years under five different irrigation regimes: 0% (rainfall only), 40%, 80%, 100%, and 120% of the crops’ optimum water requirements. Results show large variation in carbon stable isotopes for crops that received similar amounts of water, either as absolute water input or as percentage of crop requirements. We conclude that C3 crop carbon stable isotope composition can therefore be best interpreted in terms of extremely high values showing an abundance of water versus low values indicating water-stress. Values in between these extremes are problematic and best interpreted in conjunction with other proxies. C4 crop isotopes were not found to be useful for the reconstruction of water availability
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