Identifying barriers to accessing information and treatment for obstetric fistula in Niamey, Niger

Objective: To identify barriers to accessing information and treatment regarding obstetric fistula (OF) unique to Niger encountered by women referred to the National Referral Fistula Center. Method: A questionnaire was administered at the National Referral Fistula Center to 29 women with OF. Qualitative and quantitative statistics were computed. Results: The average individual was 30.4 years old, illiterate and from a rural area. 76.0% had antenatal care, the average labor time was 3.04 days, and 88.0% had a physician-assisted delivery. Barriers to information included rural dwelling, lack of education, lack of understanding of cause despite contact with health care workers, lack of knowledgeable resources to seek advice from or lack of ability/interest, not given specific information about availability of treatment, and not utilizing available resources to disseminate information. Barriers to treatment included lack of information regarding condition and treatment, traditional healer utilization, inability to access adequate care for condition, delay for childbirth recovery, permission needed to seek treatment, cost, timely treatment unavailable, and lack of social support. Conclusion: Improving efficiency of getting women to the hospital at time of delivery, prompt referrals for OF, and using cell phones for disseminating information or accessing transport may benefit women with OF in Niger

The rapid formation a large rotating disk galaxy three billion years after the Big Bang

[Abridged] Over the past two decades observations and theoretical simulations have established a global frame-work of galaxy formation and evolution in the young Universe. Galaxies formed as baryonic gas cooled at the centres of collapsing dark matter halos. Mergers of halos led to the build up of galaxy mass. A major step forward in understanding these issues requires well resolved physical information on individual galaxies at high redshift. Here we report adaptive optics, spectroscopic observations of a representative luminous star forming galaxy when the Universe was only twenty percent of its age. The superior angular resolution of these data reveals the physical and dynamical properties of a high redshift galaxy in unprecedented detail. A large and massive rotating proto-disk is channelling gas towards a growing central stellar bulge hosting an accreting massive black hole.Comment: Narure, accepted (Released Aug 17th

Stellar populations of bulges at low redshift

This chapter summarizes our current understanding of the stellar population properties of bulges and outlines important future research directions.Comment: Review article to appear in "Galactic Bulges", Editors: Laurikainen E., Peletier R., Gadotti D., Springer Publishing. 34 pages, 12 figure

Gravitational stability and dynamical overheating of stellar disks of galaxies

We use the marginal stability condition for galactic disks and the stellar velocity dispersion data published by different authors to place upper limits on the disk local surface density at two radial scalelengths $R=2h$. Extrapolating these estimates, we constrain the total mass of the disks and compare these estimates to those based on the photometry and color of stellar populations. The comparison reveals that the stellar disks of most of spiral galaxies in our sample cannot be substantially overheated and are therefore unlikely to have experienced a significant merging event in their history. The same conclusion applies to some, but not all of the S0 galaxies we consider. However, a substantial part of the early type galaxies do show the stellar velocity dispersion well in excess of the gravitational stability threshold suggesting a major merger event in the past. We find dynamically overheated disks among both seemingly isolated galaxies and those forming pairs. The ratio of the marginal stability disk mass estimate to the total galaxy mass within four radial scalelengths remains within a range of 0.4---0.8. We see no evidence for a noticeable running of this ratio with either the morphological type or color index.Comment: 25 pages, 5 figures, accepted to Astronomy Letter

Suzaku observation of the LINER NGC 4102

Low ionisation nuclear emission-line region (LINER) nuclei have been claimed to be different than other active galactic nuclei (AGN) due to the presence of complex absorbing structures along the line-of-sight and/or an inefficient mode of accretion onto the supermassive black hole. However, this issue is still open. We have investigated the broad band X-ray spectrum of NGC 4102, one of the most luminous LINERs in the Swift/BAT survey. We studied a 80 ksec Suzaku spectrum of NGC 4102, together with archival Chandra and Swift/BAT observations. We also studied the optical (3.5m/TWIN at Calar Alto observatory) and near-infrared (WHT/LIRIS at Observatorio Roque los Muchachos) spectra that were taken contemporaneous to the Suzaku data. There is strong evidence that NGC 4102 is a Compton-thick AGN, as suggested by the Swift/BAT detected intrinsic continuum and the presence of a strong narrow, neutral FeKa emission line. We have also detected ionised FeXXV emission lines in the Suzaku spectrum of the source. NGC 4102 shows a variable soft excess found at a significantly higher flux state by the time of Suzaku observations when compared to Chandra observations. Finally, a complex structure of absorbers is seen with at least two absorbers apart from the Compton-thick one, derived from the X-ray spectral analysis and the optical extinction.Comment: 11 pages, 6 figures and 3 tables. Accepted for publication in Astronomy & Astrophysic

Evolution of Structure in Late-type Spiral Galaxies I: Ionized Gas Kinematics in NGC 628

We study two dimensional Fabry-Perot interferometric observations of the nearby face-on late-type spiral galaxy, NGC 628, in order to analyse the ionized gas component of the interstellar medium. Covering the galaxy out to a radius larger than 12 kpc, and with a spatial sampling of 1.6 arcsec, we investigate the large-scale dynamics as well as feedback from individual HII regions into their surrounding medium. We study the role of gravitational perturbations along with that of external triggers which can disturb the kinematics and morphology of NGC 628. We verify the presence of an inner rapidly rotating disc-like component in NGC 628, which we interpret as caused by slow secular evolution of the large-scale spiral arms and oval structure. In combination with auxiliary data, we find indication for that gas is falling in from the outer parts towards the central regions, where a nuclear ring has formed at the location of the inner Lindblad resonance radius of an m=2 perturbation which could help build a pseudo-bulge in NGC 628. Moreover, we calculate radial profiles of the emission-line velocity dispersion which we use to study the role of feedback from individual HII regions. The mean velocity dispersion for the ionized gas (even when excluding pixels belonging to individual HII regions) is almost constant out to 12 kpc, although it varies from 14 to 20 km/s, with a steady decline in the outer parts. The current paper demonstrates a number of tools that we have developed for building a solid frame work for studying the evolution of structure in spiral galaxies using two dimensional kinematic observations.Comment: Accepted for publications in A&A. 13 pages, 7 figures, and including a calatogue of 376 HII regions with calibrated luminosities. Please find high-resolution version on http://www.astro.su.se/~kambiz/DOC/paper-N628.ps.g

Mind the (treatment) gap: a global perspective on current and future strategies for prevention of fragility fractures

This narrative review considers the key challenges facing healthcare professionals and policymakers responsible for providing care to populations in relation to bone health. These challenges broadly fall into four distinct themes: (1) case finding and management of individuals at high risk of fracture, (2) public awareness of osteoporosis and fragility fractures, (3) reimbursement and health system policy and (4) epidemiology of fracture in the developing world. Findings from cohort studies, randomised controlled trials, systematic reviews and meta-analyses, in addition to current clinical guidelines, position papers and national and international audits, are summarised, with the intention of providing a prioritised approach to delivery of optimal bone health for all. Systematic approaches to case-finding individuals who are at high risk of sustaining fragility fractures are described. These include strategies and models of care intended to improve case finding for individuals who have sustained fragility fractures, those undergoing treatment with medicines which have an adverse effect on bone health and people who have diseases, whereby bone loss and, consequently, fragility fractures are a common comorbidity. Approaches to deliver primary fracture prevention in a clinically effective and cost-effective manner are also explored. Public awareness of osteoporosis is low worldwide. If older people are to be more pro-active in the management of their bone health, that needs to change. Effective disease awareness campaigns have been implemented in some countries but need to be undertaken in many more. A major need exists to improve awareness of the risk that osteoporosis poses to individuals who have initiated treatment, with the intention of improving adherence in the long term. A multisector effort is also required to support patients and their clinicians to have meaningful discussions concerning the risk-benefit ratio of osteoporosis treatment. With regard to prioritisation of fragility fracture prevention in national policy, there is much to be done. In the developing world, robust epidemiological estimates of fracture incidence are required to inform policy development. As the aging of the baby boomer generation is upon us, this review provides a comprehensive analysis of how bone health can be improved worldwide for all