Systematic review on human resources for health interventions to improve maternal health outcomes: Evidence from low- and middle-income countries

There is a broad consensus and evidence that shows qualified, accessible, and responsive human resources for health (HRH) can make a major impact on the health of the populations. At the same time, there is widespread recognition that HRH crises particularly in low- and middle-income countries (LMICs) impede the achievement of better health outcomes/targets. In order to achieve the Sustainable Development Goals (SDGs), equitable access to a skilled and motivated health worker within a performing health system is need to be ensured. This review contributes to the vast pool of literature towards the assessment of HRH for maternal health and is focused on interventions delivered by skilled birth attendants (SBAs). Studies were included if (a) any HRH interventions in management system, policy, finance, education, partnership, and leadership were implemented; (b) these were related to SBA; (c) reported outcomes related to maternal health; (d) the studies were conducted in LMICs; and (e) studies were in English. Studies were excluded if traditional birth attendants and/or community health workers were trained. The review identified 25 studies which revealed reasons for poor maternal health outcomes in LMICs despite the efforts and policies implemented throughout these years. This review suggested an urgent and immediate need for formative evidence-based research on effective HRH interventions for improved maternal health outcomes. Other initiatives such as education and empowerment of women, alleviating poverty, establishing gender equality, and provision of infrastructure, equipment, drugs, and supplies are all integral components that are required to achieve SDGs by reducing maternal mortality and improving maternal health

Impact of service provision platforms on maternal and newborn health in conflict areas and their acceptability in Pakistan: a systematic review

Various models and strategies have been implemented over the years in different parts of the world to improve maternal and newborn health (MNH) in conflict affected areas. These strategies are based on specific needs and acceptability of local communities. This paper has undertaken a systematic review of global and local (Pakistan) information from conflict areas on platforms of health service provision in the last 10 years and information on acceptability from local stakeholders on effective models of service delivery; and drafted key recommendations for improving coverage of health services in conflict affected areas. The literature search revealed ten studies that described MNH service delivery platforms. The results from the systematic review showed that with utilisation of community outreach services, the greatest impacts were observed in skilled birth attendance and antenatal consultation rates. Facility level services, on the other hand, showed that labour room services for an internally displaced population (IDP) improved antenatal care coverage, contraceptive prevalence rate and maternal mortality. Consultative meetings and discussions conducted in Quetta and Peshawar (capitals of conflict affected provinces) with relevant stakeholders revealed that no systematic models of MNH service delivery, especially tailored for conflict areas, are available. During conflict, even previously available services and infrastructure suffered due to various barriers specific to times of conflict and unrest. A number of barriers that hinder MNH services were discussed. Suggestions for improving MNH services in conflict areas were also laid down by participants. The review identified some important steps that can be undertaken to mitigate the effects of conflict on MNH services, which include: improve provision and access to infrastructure and equipment; development and training of healthcare providers; and advocacy at different levels for free access to healthcare services and for the introduction of the programme model in existing healthcare system. The obligation is enormous, however, for a sustainable programme, it is important to work closely with both the IDP and host community, and collaborating with the government and non-government organisations

Gelatinases Increase in Bleomycin-induced Systemic Sclerosis Mouse Model

Systemic sclerosis is a fibrotic autoimmune disease in which aberrant remodeling of the extracellular matrix in organs disturbs their functionalities. The aim of this study was to investigate the expression of gelatinases on systemic sclerosis. Consequently, a mouse model of systemic sclerosis was employed and the gelatinolytic activity of gelatinases was evaluated on the fibrotic tissues of this model. Two groups of ten mice were considered in this work: a group of systemic sclerosis model and control group. For the generation of systemic sclerosis model, mice received bleomycin, while the control group was subjected to phosphate buffered saline (PBS) reception. Mice were tested for fibrosis by using trichrome staining, hydroxyproline measurement and α-SMA detection in tissue sections. Additionally, the gelatinolytic activity of matrix metalloproteinase 2 and matrix metalloproteinase 9 were measured using gelatin zymography in lungs and skin tissue homogenates. The obtained results indicated that subcutaneous injection of bleomycin-induced fibrosis in skin and lung tissues of mice. Pro and active forms of matrix methaloproteinase 9 were increased in fibrotic lung tissues (p<0.05 and p<0.01, respectively), while, the gelatinolytic activity of MMP2 was unaffected in these tissues. Additionally, in skin tissues of bleomycin-treated animals, both pro and active forms of MMP9 and MMP2 were increased (p<0.05). Pro and active forms of gelatinases increase differently in skin and lung tissues of bleomycin-induced scleroderma

Possibility of the pond culture of Asian sea bass, lates calcarifer in Gwadar farm , Sistan & Baloochestan

In the present study, the possibility of marine culture of Asian sea bass in the shrimp earthen ponds located in the Gwadar region (coastal area of Oman Sea, southeastern of Iran) was investigated. To this end, Asian sea bass frys reared for 7 months including 1 month nursery and 6 months growth-period. During the culturing periods, fish were feed ad libitum by various commercial rainbow trout diets based on fish growth stages. After nursery period, the average weight of 11.05±1.5 g and survival percent of 65 % were obtained for fish. During the growth-out period, the average weight increased continually from 31.4±4.7 g in late June to 252.1±30 g at the end of growth-out period in late Dec. Also, the highest values of monthly weight gain yielded during August, Sept and Oct when fish had the average weight range of (76.9±14.4)-(188.1±12.8) g. The values of monthly feed conversion ratio (FCR) were low and similar from July to Oct and then increased in Nov and Dec. The values of total monthly feed intake (FI) increased continually from July to Oct and then with a decrease in Nov, increased again in Dec. The values of survival percent after nursery and growth-out period were 65 % and 66% respectively. Also, the average of monthly FCR, FCR at the time of fish harvesting, total FI and total harvested biomass were 1.36, 2.5, 630.5 kg and 325 kg. in conclusion, the pond culture of Asian sea bass with marine water results appropriate survival and growth rates so that fish (11.05±1.5 g) obtained marketable weight (252.1±30 g) during 6 months culturing period. It seems that first-half of year in Gwadar area is more suitable for sea bass culture since this time periods results better FCR ( fed by rainbow trout feed) and has economic justification. Also, with regular sorting operation and providing of species-specific feed for Asian sea bass can increase the Production per Unit Area

Study of parasites occurrence and intensity in fishes of Anzali Lagoon

Tish survey prolonged from summer 2011 trough summer 2012. During this period 574 samples of different fish species were investigated for their parasites. Totally 30 species of parasites isolated of the fishes. Some of the isolated parasites are recorded for the first time in Iran. Rafidascaris acus Orientocreadium siluri, Silurotaenia siluri, Acanthocephalus lucii , Argulus foliaceus has recorded for the first time from European catfish, Silurus glanis, and Dactylogyrus inexpectatus has recorded for the first time from Gibel Carp, Carassius auratus gibelio, in Anzali wetland. Statistical comparison of parasites infections and intensity between the different area of Anzali wetland were done. Infection of Pike, Esox lucius, to Diplostomum spathaceum, Raphidascaris acus and Monogenean in western parts of wetland were significantly different from the Eastern and Central areas (p<0.05). So based on the data have concluded the eastern and central regions of the wetland are more polluted than the western part. Comparing the results of the present study with before ones showed that the composition of parasite species has been changed over time, while the prevalence, intensity and abundance of parasites have been increased. It may be due to changing environmental conditions such as increasing discharge of effluent, eutrophication of the wetland. This results accents to necessity of reconstruction of Anzali wetland with preference of eastern and central regions

The three major axes of terrestrial ecosystem function.

The leaf economics spectrum1,2 and the global spectrum of plant forms and functions3 revealed fundamental axes of variation in plant traits, which represent different ecological strategies that are shaped by the evolutionary development of plant species2. Ecosystem functions depend on environmental conditions and the traits of species that comprise the ecological communities4. However, the axes of variation of ecosystem functions are largely unknown, which limits our understanding of how ecosystems respond as a whole to anthropogenic drivers, climate and environmental variability4,5. Here we derive a set of ecosystem functions6 from a dataset of surface gas exchange measurements across major terrestrial biomes. We find that most of the variability within ecosystem functions (71.8%) is captured by three key axes. The first axis reflects maximum ecosystem productivity and is mostly explained by vegetation structure. The second axis reflects ecosystem water-use strategies and is jointly explained by variation in vegetation height and climate. The third axis, which represents ecosystem carbon-use efficiency, features a gradient related to aridity, and is explained primarily by variation in vegetation structure. We show that two state-of-the-art land surface models reproduce the first and most important axis of ecosystem functions. However, the models tend to simulate more strongly correlated functions than those observed, which limits their ability to accurately predict the full range of responses to environmental changes in carbon, water and energy cycling in terrestrial ecosystems7,8