Induced abortion potential among Indian women

Information on abortion is limited and inaccurate especially in the developing world, which has led to several speculations on the prevalence of abortion in this region. A rise in prevalence of abortion is mostly accounted for in terms of increase in the prevalence of induced abortions, which reflects on the reproductive health of women. With the growing concern for reproductive health of women, the study of abortion phenomenon has drawn serious attention of researchers world wide. In such circumstances, this is an attempt to assess the induced abortion potential among Indian women by utilising information on proportion of unwanted and ill-timed pregnancies obtained through National Family Health Survey, India.

Delivery complications and determinants of caesarean section rates in India : an analysis of National Family Health Surveys, 1992-93

Caesarean section rates have been increasing world-wide raising the question of the appropriateness of the selection of cases for the procedure. This paper examines the levels and correlates of delivery related complications and caesarean section deliveries in eighteen selected states of India in terms of specific maternal and institutional factors, using data from the National Family Health Surveys, 1992-93. Goa (15.3 per cent) and Kerala (13.7 per cent) were the two states with relatively higher caesarean section rates. There is reason to believe that the current caesarean section rates are part of a rising trend. This can not be attributed entirely to the rise in institutional deliveries alone because of the strong association between caesarean sections and private sector institutions. Apart from the fact that the states of Kerala and Goa are having relatively high caesarean section rates, in Andhra Pradesh, Bihar, Gujarat, Karnataka, Punjab and Uttar Pradesh the risk of undergoing caesarean section in the private sector institutions is four or more times that in the public sector. It is possible that this extremely useful surgical procedure is being misused for profit purposes in the private sector in several states. There is therefore a need to examine this phenomenon using disaggregated data by the nature of caesarean sections, i.e. whether it was an elective or an emergency c-section along with the reasons for the choice. JEL Classification : I1, I18 Key Words: caesarean section, institutional deliveries, delivery complications, medical interventio

Induced abortion potential among Indian women

Information on abortion is limited and inaccurate especially in the developing world, which has led to several speculations on the prevalence of abortion in this region. A rise in prevalence of abortion is mostly accounted for in terms of increase in the prevalence of induced abortions, which reflects on the reproductive health of women. With the growing concern for reproductive health of women, the study of abortion phenomenon has drawn serious attention of researchers world wide. In such circumstances, this is an attempt to assess the induced abortion potential among Indian women by utilising information on proportion of unwanted and ill-timed pregnancies obtained through National Family Health Survey, India. This exercise may facilitate a better understanding of the exact prevalence of induced abortion which necessarily should be less than the estimated potential depending on the levels of unwanted and illtimed fertility

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Covariates of diarrhoea among under-five children in India: Are they level dependent?

Program interventions like access to improved water supply, sanitation and hygiene do not have a systematic response to the aggregate health outcomes. Therefore, this is an attempt at recognising the concept of level sensitivity while verifying the association between prevalence of diarrhoea in under-five children in a district and its corresponding coverage of improved water supply and sanitation and hygiene. Information obtained in the DLHS-4 including 275 districts from 19 states and 2 union territories of India forms the database for this analysis. Universal access to safe drinking water, improving coverage of sanitation in a district beyond 71 percent across the country and beyond 78 percent among the non-south DLHS districts, has the potential to realise reductions in the prevalence of diarrhoea in under-five children in a district. The effect of improved sanitation seems to work synergistically with these indicators only at better levels of prevalence of diarrhoea in under-five children in a district. This offers lessons for the Clean India Mission in terms of universalising access to safe water and coverage up to three-fourths of households with sanitation in a district for the positive externalities to manifest in reduced prevalence of diarrhoea in under-five children

Exclusion of married adolescents in a study of gestational diabetes mellitus: a case study

Abstract A study on gestational diabetes mellitus (GDM) among 200 married women in Malappruam, Kerala, India, chose to exclude married women below the age of 18 from participation. Marriages before age 18 are not considered legally valid and persons below age 18 do not have the status of an adult. Parents are considered the legal guardians of married women under age 18, but because marriages are patrilocal, obtaining consent from parents would have time costs. Further, obtaining parental consent may also be considered disrespectful of the in-laws. The inclusion of married adolescents in this study was considered difficult for these reasons. This exclusion can also result in wrongly estimating the levels of GDM among all women at risk. We argue that such exclusion is also unethical; it unfair to exclude women who stand to benefit from participation by enabling them to identify the enhanced life time risk for diabetes mellitus and monitor their future health status better. Recognizing married adolescents as emancipated minors would enable their participating without violating confidentiality regarding their GDM status to parents and in-laws

Use of worksheets for children with dyslexia

Dyslexia is a life-long neurological condition which has no physical manifestations. Children with dyslexia have average to above-average IQ with unique potential and abilities for out-of-the-box thinking, yet there is a significant disparity between their potential and their actual performance. In class, a child with dyslexia could struggle to read, spell, write or do maths. In turn, a lack of fluency in these skills could make it difficult for the child to retain, recall and take exams. The degree of dyslexia – mild, moderate or severe-determines the extent of the difficulty faced. Dyslexia could be suspected in children who struggle in class I (or later) and a standardised assessment test could ascertain it

Delivery complications and determinants of caesarean section rates in India: An analysis of national family health surveys, 1992-93

Caesarean section rates have been increasing world-wide raising the question of the appropriateness of the selection of cases for the procedure.This paper examines the levels and correlates of delivery related complications and caesarean section deliveries in eighteen selected states of India in terms of specific maternal and institutional factors, using data from the National Family Health Surveys,1992-93.Goa (15.3 per cent)and Kerala (13.7 per cent)were the two states with relatively higher caesarean section rates.There is reason to believe that the current caesarean section rates are part of a rising trend.This can not be attributed entirely to the rise in institutional deliveries alone because of the strong association between caesarean sections and private sector institutions. Apart from the fact that the states of Kerala and Goa are having relatively high caesarean section rates, in Andhra Pradesh, Bihar, Gujarat, Karnataka, Punjab and Uttar Pradesh the risk of undergoing caesarean section in the private sector institutions is four or more times that in the public sector.It is possible that this extremely useful surgical procedure is being misused for profit purposes in the private sector in several states. There is therefore a need to examine this phenomenon using dis-aggregated data by the nature of caesarean sections,i.e. whether it was an elective or an emergency c-section along with the reasons for the choice.Caesarean section, institutional deliveries, delivery complications, medical intervention