Costs of publicly provided maternity services in Rosario, Argentina

This material is posted here with permission of the publishers, Instituto Nacional de Salud Pública. Internal or personal use of this material is permitted. However, permission to reprint/republish this material must be obtained from the Publisher.Objective. This study estimates the costs of maternal health services in Rosario, Argentina. Material and Methods. The rovider costs (US$1999) of antenatal care, a normal vaginal delivery and a caesarean section, were evaluated retrospectively in two municipal hospitals. The cost of an antenatal visit was evaluated in two health centres and the patient costs associated with the visit were evaluated in a hospital and a health centre. Results. The average cost per hospital day is$114.62. The average cost of a caesarean section ($525.57) is five times greater than that of a normal vaginal delivery ($105.61). A normal delivery costs less at the general hospital and a c-section less at the aternity hospital. The average cost of an antenatal visit is $31.10. The provider cost is lower at the health centre than at the hospital. Personnel accounted for 72-94$4.70. Direct costs are minimal compared to indirect costs of travel and waiting time. Conclusions. These results suggest the potential for increasing the efficiency of resource use by promoting antenatal care visits at the primary level. Women could also benefit from reduced travel and waiting time. Similar benefits could accrue to the provider by encouraging normal delivery at general hospitals, and complicated deliveries at specialised maternity hospitals.Josephine Borghi is funded by the Department for International Development through the Maternal Health Programme at the London School of Hygiene and Tropical Medicine. This project was conducted for and funded by the Human Reproduction Programme at WHO, Geneva

Soil Survey Circular No. 1: Nitrogen From the Air

Summary1. Nitrogen is necessary for the growth of crops.2. Nitrogen is disappearing from cultivated soils.3. Maintain the nitrogen supply by growing legume crops.a. See to it that the soil is not sour.b. Inoculate the seed.4. Don’t burn stalks or straw, becausea. A ton of wheat straw contains $4 worth of nitrogen.b. A ton of oats straw contains$4.80 worth of nitrogen.c. A ton of corn stalks contains $6.40 worth of nitrogen

Running a research consultation group with parents and carers of children with complex health needs who use children’s rehabilitation therapy services: practical considerations and insights

Participatory research, user involvement, consultation, co-production, and service user participation are terms and approaches that ensure the beneficiaries of research shape how it is developed and conducted. While such approaches are accepted practice there is little guidance for researchers on how to conduct such activities with parents/carers of children with complex health needs. Using insights from a series of consultation activities, the authors explore ways to work effectively with parents/ carers when care responsibilities and other constraints may restrict or limit their ability to participate. We defined children with complex needs children as those who use two or more therapy services (Occupational therapy, Speech and Language Therapy and Physiotherapy) on a regular basis

Consulting parents and carers of children with complex needs who use rehabilitation therapy services about research - what issues are important?

With the aim of establishing a foundation for collaboration and partnership in research, parents and carers of children with complex needs were invited through a local parent carer forum to take part in a consultation about their priorities for research, with a focus on rehabilitation therapy. Three meetings were organised where researchers and parents and carers could discuss issues and topics of importance. Potential research ideas were generated at these meetings and shared via email with other parents and carers who were unable to attend face-to-face meetings and professionals who work with children with complex need. A number of researchable questions were developed, based on these topics during the time allocated to the consultation. The aim is to build on this work to develop a proposal for funded research that will make a difference to parents and carers and their families

Phase transition in the Countdown problem

Here we present a combinatorial decision problem, inspired by the celebrated quiz show called the countdown, that involves the computation of a given target number T from a set of k randomly chosen integers along with a set of arithmetic operations. We find that the probability of winning the game evidences a threshold phenomenon that can be understood in the terms of an algorithmic phase transition as a function of the set size k. Numerical simulations show that such probability sharply transitions from zero to one at some critical value of the control parameter, hence separating the algorithm's parameter space in different phases. We also find that the system is maximally efficient close to the critical point. We then derive analytical expressions that match the numerical results for finite size and permit us to extrapolate the behavior in the thermodynamic limit.Comment: Submitted for publicatio

The Impact of Imigration on American Labor Markets Prior to the Quotas

Current debate on the impact and assimilation of immigrants into the American labor market sounds remarkably like the debate which eventually triggered the imposition of the quotas in the 1920s. Then as now observers failed to agree on exactly what the impact of the mass migration was on labor markets. Despite its relevance to current discussion, there has been almost no quantitative effort to assess late nineteenth century impact, while instead analysis has been obsessed with assimilation issues. This paper redresses this imbalance by confronting three macro-impact questions that are just as relevant today as they were almost a century ago: Did late nineteenth century American immigrants act as a flexible (guestworker) labor supply? Did they flow into occupations where job creation was fast, or did they displace natives in occupations where job creation was slow? Did immigrants reduce the growth of wages and living standards for natives while increasing their unemployment? We use econometrics and computable general equilibrium models to get surprising and unambiguous answers.

Performance of Small-Fruited Pumpkin Cultivars in Maine

A small-fruited (2-4 lb) or “pie” type pumpkin variety trial was established in the spring of 2009 at Highmoor Farm in Monmouth, ME. Three replications of seven varieties were direct-seeded on 18 June through black plastic mulch. Plots were 18 feet long with three feet between plants and six feet between rows. All fertilizer was applied according to soil test recommendations and incorporated prior to mulch application and seeding. Fruit were harvested on 18 September. Top performing varieties in terms of yield per plot included ‘Chucky’, ‘Small Sugar’, and ‘Field Trip’. ‘Fall Splendor’ produced the largest fruit in the trial, followed by ‘Winter Luxury’ and ‘Mystic Plus’. ‘Field Trip’ and ‘Fall Splendor’ had the highest stem quality in the trial and ‘Field Trip’, ‘Mystic Plus’ and ‘Fall Splendor’ were rated highest for exterior color and ribbing. The results of this trial suggest that ‘Field Trip’, ‘Mystic Plus’ and ‘Fall Splendor’ offer very high quality fruit with acceptable yields for pie-type pumpkins, while ‘Chucky’ offers acceptable fruit quality and very high yields.https://digitalcommons.library.umaine.edu/extension_ag/1000/thumbnail.jp

Perinatal or neonatal mortality among women who intend at the onset of labour to give birth at home compared to women of low obstetrical risk who intend to give birth in hospital: A systematic review and meta-analyses

Background: More women are choosing to birth at home in well-resourced countries. Concerns persist that out-of-hospital birth contributes to higher perinatal and neonatal mortality. This systematic review and meta-analyses determines if risk of fetal or neonatal loss differs among low-risk women who begin labour intending to give birth at home compared to low-risk women intending to give birth in hospital. Methods: In April 2018 we searched five databases from 1990 onward and used R to obtain pooled estimates of effect. We stratified by study design, study settings and parity. The primary outcome is any perinatal or neonatal death after the onset of labour. The study protocol is peer-reviewed, published and registered (PROSPERO No.CRD42013004046). Findings: We identified 14 studies eligible for meta-analysis including ~ 500,000 intended home births. Among nulliparous women intending a home birth in settings where midwives attending home birth are well-integrated in health services, the odds ratio (OR) of perinatal or neonatal mortality compared to those intending hospital birth was 1.07 (95% Confidence Interval [CI], 0.70 to 1.65); and in less integrated settings 3.17 (95% CI, 0.73 to 13.76). Among multiparous women intending a home birth in well-integrated settings, the estimated OR compared to those intending a hospital birth was 1.08 (95% CI, 0.84 to 1.38); and in less integrated settings was 1.58 (95% CI, 0.50 to 5.03). Interpretation: The risk of perinatal or neonatal mortality was not different when birth was intended at home or in hospital. Funding: Partial funding: Association of Ontario Midwives open peer reviewed grant. Research in Context: Evidence before this study Although there is increasing acceptance for intended home birth as a choice for birthing women, controversy about its safety persists. The varying responses of obstetrical societies to intended home birth provide evidence of contrasting views. A Cochrane review of randomised controlled trials addressing this topic included one small trial and noted that in the absence of adequately sized randomised controlled trials on the topic of intended home compared to intended hospital birth, a peer reviewed protocol be published to guide a systematic review and meta-analysis including observational studies. Reviews to date have been limited by design or methodological issues and none has used a protocol published a priori.Added value of this study Individual studies are underpowered to detect small but potentially important differences in rare outcomes. This study uses a published peer-reviewed protocol and is the largest and most comprehensive meta-analysis comparing outcomes of intended home and hospital birth. We take study design, parity and jurisdictional support for home birth into account. Our study provides much needed information to policy makers, care providers and women and families when planning for birth.Implications of all the available evidence Women who are low risk and who intend to give birth at home do not appear to have a different risk of fetal or neonatal loss compared to a population of similarly low risk women intending to give birth in hospital

Cloning transformations in spin networks without external control

In this paper we present an approach to quantum cloning with unmodulated spin networks. The cloner is realized by a proper design of the network and a choice of the coupling between the qubits. We show that in the case of phase covariant cloner the XY coupling gives the best results. In the 1->2 cloning we find that the value for the fidelity of the optimal cloner is achieved, and values comparable to the optimal ones in the general N->M case can be attained. If a suitable set of network symmetries are satisfied, the output fidelity of the clones does not depend on the specific choice of the graph. We show that spin network cloning is robust against the presence of static imperfections. Moreover, in the presence of noise, it outperforms the conventional approach. In this case the fidelity exceeds the corresponding value obtained by quantum gates even for a very small amount of noise. Furthermore we show how to use this method to clone qutrits and qudits. By means of the Heisenberg coupling it is also possible to implement the universal cloner although in this case the fidelity is 10% off that of the optimal cloner.Comment: 12 pages, 13 figures, published versio