10 research outputs found
A case report of an asymptomatic late term abdominal pregnancy with a live birth at 41Â weeks of gestation
Civil society leadership in the struggle for AIDS treatment in South Africa and Uganda
Includes abstract.Includes bibliographical references.This thesis is an attempt to theorise and operationalise empirically the notion of âcivil society leadershipâ in Sub-Saharan Africa. âAIDS leadership,â which is associated with the intergovernmental institutions charged with coordinating the global response to HIV/AIDS, is both under-theorised and highly context-specific. In this study I therefore opt for an inclusive framework that draws on a range of approaches, including the literature on âleadershipâ, institutions, social movements and the ânetworkâ perspective on civil society mobilisation. This framework is employed in rich and detailed empirical descriptions (âthick descriptionâ) of civil society mobilisation around AIDS, including contentious AIDS activism, in the key case studies of South Africa and Uganda. South Africa and Uganda are widely considered key examples of poor and good leadership (from national political leaders) respectively, while the Treatment Action Campaign (TAC) and The AIDS Support Organisation (TASO) are both seen as highly effective civil society movements. These descriptions emphasise âtransnational networks of influenceâ in which civil society leaders participated (and at times actively constructed) in order to mobilise both symbolic and material resources aimed at exerting influence at the transnational, national and local levels
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Measuring Post-Partum Haemorrhage in Low-Resource Settings: The Diagnostic Validity of Weighed Blood Loss versus Quantitative Changes in Hemoglobin
Background: Accurate estimation of blood loss is central to prompt diagnosis and management of post-partum hemorrhage (PPH), which remains a leading cause of maternal mortality in low-resource countries. In such settings, blood loss is often estimated visually and subjectively by attending health workers, due to inconsistent availability of laboratory infrastructure. We evaluated the diagnostic accuracy of weighed blood loss (WBL) versus changes in peri-partum hemoglobin to detect PPH. Methods: Data from this analysis were collected as part of a randomized controlled trial comparing oxytocin with misoprostol for PPH (NCT01866241). Blood samples for complete blood count were drawn on admission and again prior to hospital discharge or before blood transfusion. During delivery, women were placed on drapes and had pre-weighed sanitary towels placed around their perineum. Blood was then drained into a calibrated container and the sanitary towels were added to estimate WBL, where each gram of blood was estimated as a milliliter. Sensitivity, specificity, negative and positive predictive values (PPVs) were calculated at various blood volume loss and time combinations, and we fit receiver-operator curves using blood loss at 1, 2, and 24 hours compared to a reference standard of haemoglobin decrease of >10%. Results: A total of 1,140 women were enrolled in the study, of whom 258 (22.6%) developed PPH, defined as a haemoglobin drop >10%, and 262 (23.0%) had WBL â„500mL. WBL generally had a poor sensitivity for detection of PPH (85%) in high prevalence settings when WBL exceeds 750mL. Conclusion: WBL has poor sensitivity but high specificity compared to laboratory-based methods of PPH diagnosis. These characteristics correspond to a high PPV in areas with high PPH prevalence. Although WBL is not useful for excluding PPH, this low-cost, simple and reproducible method is promising as a reasonable method to identify significant PPH in such settings where quantifiable red cell indices are unavailable
Negative and positive predictive values of blood loss measurement by weight method versus a reference standard of >10% drop in haemoglobin.
<p>Negative and positive predictive values of blood loss measurement by weight method versus a reference standard of >10% drop in haemoglobin.</p
Sensitivity and specificity of blood loss measurement by weight method at Varying time points and volumes of blood loss, compared to reference standard of >10% drop in haemoglobin.
<p>Sensitivity and specificity of blood loss measurement by weight method at Varying time points and volumes of blood loss, compared to reference standard of >10% drop in haemoglobin.</p
Measurement of PPH by haemoglobin drop and measured blood loss.
<p>Measurement of PPH by haemoglobin drop and measured blood loss.</p
ROC curves comparing measured blood loss and Hb drop (standard) at different time points.
<p>ROC curves comparing measured blood loss and Hb drop (standard) at different time points.</p