Disposable clean delivery kits and prevention of neonatal tetanus in the presence of skilled birth attendants.

OBJECTIVE: To determine whether the use of disposable clean delivery kits (CDKs) is effective in reducing neonatal tetanus (NNT) infection, regardless of the skills of birth attendants in resource-poor settings. METHODS: A secondary analysis was conducted on data from a matched case-control study in Karachi, Pakistan, involving 140 NNT cases and 280 controls between 1998 and 2001. Conditional logistic regression was performed to assess the independent effect on NNT of CDKs and skilled birth attendants (SBAs). RESULTS: After adjustment for socioeconomic factors, both CDKs (adjusted matched odds ratio [mOR] 2.0; 95% confidence interval [CI], 1.3-3.1) and SBAs (adjusted mOR 1.7; 95% CI, 1.1-2.7) were independently associated with NNT. The association with CDKs remained significant when additionally adjusted for SBAs (mOR 2.0; 95% CI, 1.0-3.9; P=0.05). The population attributable risk for lack of CDK use was 24% in the study setting. CONCLUSION: In the context of resource-poor settings in low-income countries with poor coverage of tetanus toxoid immunization, the use of CDKs seems to be an effective strategy for reducing NNT infection, irrespective of the skill levels of birth attendants. Approximately one-quarter of NNT cases could be prevented in low-income populations with the use of CDKs

Demographic, socio-economic and environmental determinants of utilisation of antenatal care in a rural setting of Sindh, Pakistan

Objective: Majority of the women in the developing countries are unable receive antenatal care for a variety of reasons. This study determines the factors affecting utilisation of antenatal care by women of a rural area in Sindh, Pakistan.Methods: A cross-sectional study was conducted during August 1997, in Union Council Jhangara, Sindh, Pakistan. Married women, who had delivered at least one child, were included in the study from each household and systematically 222 eligible women were selected. The effects of demographic, socio-economic and environmental factors on the utilisation of antenatal care, by women during their most recent pregnancy were also studied. Multivariate logistic regression analysis was used to assess independent effect of individual factors.Results: Among the study subjects, 29.3% (65) of the women utilised antenatal care during the last (most recent) pregnancy and out of them 72.3% (47) received it from the government health care provider. Presence of electricity in the house was strongly associated with the utilisation of antenatal care (AOR = 5.3; 95% CI 2.2-12.7). Women whose husbands were in white-collar occupation, were utilizing the antenatal care significantly more (AOR = 2.4; 95% CI 1.2-4.6) compared to women whose husbands were in blue-collar occupations.CONCLUSION: The study shows that social status and economic condition of a woman is an important determinant of utilisation of antenatal care. Therefore, improvement of socioeconomic status is required to increase utilization of antenatal and perinatal care

Spin chains from dynamical quadratic algebras

We present a construction of integrable quantum spin chains where local spin-spin interactions are weighted by ``position''-dependent potential containing abelian non-local spin dependance. This construction applies to the previously defined three general quadratic reflection-type algebras: respectively non-dynamical, semidynamical, fully dynamical.Comment: 12 pages, no figures; v2: corrected formulas of the last sectio

Algebraic Structures and Eigenstates for Integrable Collective Field Theories

Conditions for the construction of polynomial eigen--operators for the Hamiltonian of collective string field theories are explored. Such eigen--operators arise for only one monomial potential $v(x) = \mu x^2$ in the collective field theory. They form a $w_{\infty}$--algebra isomorphic to the algebra of vertex operators in 2d gravity. Polynomial potentials of orders only strictly larger or smaller than 2 have no non--zero--energy polynomial eigen--operators. This analysis leads us to consider a particular potential $v(x)= \mu x^2 + g/x^2$. A Lie algebra of polynomial eigen--operators is then constructed for this potential. It is a symmetric 2--index Lie algebra, also represented as a sub--algebra of $U (s\ell (2)).$Comment: 27 page

Poisson Structures of Calogero-Moser and Ruijsenaars-Schneider Models

We examine the Hamiltonian structures of some Calogero-Moser and Ruijsenaars-Schneider N-body integrable models. We propose explicit formulations of the bihamiltonian structures for the discrete models, and field-theoretical realizations of these structures. We discuss the relevance of these realizations as collective-field theory for the discrete models.Comment: 15 pages, no figures; v2 references added, typos correcte

Factors influencing women’s preference for health facility deliveries in Jharkhand state, India: a cross sectional analysis

BACKGROUND: Expanding institutional deliveries is a policy priority to achieve MDG5. India adopted a policy to encourage facility births through a conditional cash incentive scheme, yet 28% of deliveries still occur at home. In this context, it is important to understand the care experience of women who have delivered at home, and also at health facilities, analyzing any differences, so that services can be improved to promote facility births. This study aims to understand women's experience of delivery care during home and facility births, and the factors that influence women's decisions regarding their next place of delivery. METHOD: A community-based cross-sectional survey was undertaken in a district of Jharkhand state in India. Interviews with 500 recently delivered women (210 delivered at facility and 290 delivered at home) included socio-demographic characteristics, experience of their recent delivery, and preference of future delivery site. Data analysis included frequencies, binary and multiple logistic regressions. RESULTS: There is no major difference in the experience of care between home and facility births, the only difference in care being with regard to pain relief through massage, injection and low cost of delivery for those having home births. 75% women wanted to deliver their next child at a facility, main reasons being availability of medicine (29.4%) and perceived health benefits for mother and baby (15%). Women with higher education (AOR = 1.67, 95% CI = 1.04-3.07), women who were above 25 years (AOR = 2.14, 95% CI = 1.26-3.64), who currently delivered at facility (AOR = 5.19, 95% CI = 2.97-9.08) and had health problem post-delivery (AOR = 1.85, 95% CI = 1.08-3.19) were significant predictors of future facility-based delivery. CONCLUSION: The predictors for facility deliveries include, availability of medicines and supplies, potential health benefits for the mother and newborn and the perception of good care from the providers. There is a growing preference for facility delivery particularly among women with higher age group, education, income and those who had antennal checkup. In order to uptake facility births, the quality improvement initiatives should regularly assess and address women's experiences of care

Elliptic quantum groups and Ruijsenaars models

We construct symmetric and exterior powers of the vector representation of the elliptic quantum groups $E_{\tau,\eta}(gl_N)$. The corresponding transfer matrices give rise to various integrable difference equations which could be solved in principle by the nested Bethe ansatz method. In special cases we recover the Ruijsenaars systems of commuting difference operators.Comment: 15 pages, late

R-matrix Quantization of the Elliptic Ruijsenaars--Schneider model

It is shown that the classical L-operator algebra of the elliptic Ruijsenaars-Schneider model can be realized as a subalgebra of the algebra of functions on the cotangent bundle over the centrally extended current group in two dimensions. It is governed by two dynamical r and $\bar{r}$-matrices satisfying a closed system of equations. The corresponding quantum R and $\overline{R}$-matrices are found as solutions to quantum analogs of these equations. We present the quantum L-operator algebra and show that the system of equations on R and $\overline{R}$ arises as the compatibility condition for this algebra. It turns out that the R-matrix is twist-equivalent to the Felder elliptic R^F-matrix with $\overline{R}$ playing the role of the twist. The simplest representation of the quantum L-operator algebra corresponding to the elliptic Ruijsenaars-Schneider model is obtained. The connection of the quantum L-operator algebra to the fundamental relation RLL=LLR with Belavin's elliptic R matrix is established. As a byproduct of our construction, we find a new N-parameter elliptic solution to the classical Yang-Baxter equation.Comment: latex, 29 pages, some misprints are corrected and the meromorphic version of the quantum L-operator algebra is discusse

Parametrization of semi-dynamical quantum reflection algebra

We construct sets of structure matrices for the semi-dynamical reflection algebra, solving the Yang-Baxter type consistency equations extended by the action of an automorphism of the auxiliary space. These solutions are parametrized by dynamical conjugation matrices, Drinfel'd twist representations and quantum non-dynamical $R$-matrices. They yield factorized forms for the monodromy matrices.Comment: LaTeX, 24 pages. Misprints corrected, comments added in Conclusion on construction of Hamiltonian

The Gervais-Neveu-Felder equation and the quantum Calogero-Moser systems

We quantize the spin Calogero-Moser model in the $R$-matrix formalism. The quantum $R$-matrix of the model is dynamical. This $R$-matrix has already appeared in Gervais-Neveu's quantization of Toda field theory and in Felder's quantization of the Knizhnik-Zamolodchikov-Bernard equation.Comment: Comments and References adde