Positive postpartum depression screening practices and subsequent mental health treatment for low-income women in Western countries: a systematic literature review

Problem statement and significance Left undiagnosed and/or untreated, the short-and long-term sequelae of postpartum depression may negatively impact both mother and child. In Western countries, access to mental health care is influenced by socioeconomic factors. The objective of this systematic literature review is to compile factors that hinder and improve access to postpartum depression treatment in low-income women after a positive screen for postpartum depression. The key question of focus is: what are the characteristics associated with access to mental health treatment for low-income women with a positive postpartum depression screen in Western countries? Methods A PRISMA-based systematic literature review was conducted of studies published in English before February 2016 that looked at treatment for postpartum depression in low-income women who had been identified with the condition. PubMed and EBSCO databases were searched using MESH and key terms and found 100 articles that met the selection criteria. After review by two independent researchers, 18 studies with 17 unique populations were included in the literature review. Results Two independent abstractors searched the included articles for themes surrounding impediments and advantages for low-income women identified with postpartum depression in obtaining mental health treatment. Characteristics of successful mental health treatment included studies that employed the use of a home visitor and those that separated outcomes for women with previous mental health treatment. Themes that emerged as treatment obstacles included cultural barriers, physical barriers, systemic health care barriers, and social barriers. Implications for practice This review will help to better inform screening and treatment priorities for those in the medical field who may encounter women experiencing postpartum depression and are not aware of the various barriers to care specific to low-income women. This review will also help policymakers identify specific obstacles that are not addressed in postpartum screening mandate policies which can affect the implementation of these policies

Combined antiapoptotic and antioxidant approach to acute neuroprotection for stroke in hypertensive rats

We hypothesized that targeting key points in the ischemic cascade with combined neuroglobin (Ngb) overexpression and c-jun N-terminal kinase (JNK) inhibition (SP600125) would offer greater neuroprotection than single treatment after in vitro hypoxia/reoxygenation and in a randomized, blinded in vivo experimental stroke study using a clinically relevant rat strain. Male spontaneously hypertensive stroke-prone rats underwent transient middle cerebral artery occlusion (tMCAO) and were divided into the following groups: tMCAO; tMCAO+control GFP-expressing canine adenovirus-2, CAVGFP; tMCAO+Ngb-expressing CAV-2, CAVNgb; tMCAO+SP600125; tMCAO+CAVNgb+SP600125; or sham procedure. Rats were assessed till day 14 for neurologic outcome before infarct determination. In vitro, combined lentivirus-mediated Ngb overexpression+SP600125 significantly reduced oxidative stress and apoptosis compared with single treatment(s) after hypoxia/reoxygenation in B50 cells. In vivo, infarct volume was significantly reduced by CAVNgb, SP600125, and further by CAVNgb+SP600125. The number of Ngb-positive cells in the peri-infarct cortex and striatum was significantly increased 14 days after tMCAO in animals receiving CAVNgb. Neurologic outcome, measured using a 32-point neurologic score, significantly improved with CAVNgb+SP600125 compared with single treatments at 14 days after tMCAO. Combined Ngb overexpression with JNK inhibition reduced hypoxia/reoxygenation-induced oxidative stress and apoptosis in cultured neurons and reduced infarct and improved neurologic outcome more than single therapy after in vivo experimental stroke in hypertensive rats

Rectovaginal Fistulae in Post Repair Chronic Perineal Rupture: Fistula Rektovagina pada Pascarepair Ruptur Total Perienum Lama

Objective: To report and discuss the causes and management of rectovaginal fistula in post repair chronic total perineal rupture.Method: A case report, a 29-year-old female patient who came to Fatmawati General Hospital with complaints of anal incontinence 9 days after repair chronic total perineal rupture. Rectovaginal examination revealed a rectovaginal fistula 2 mm in diameter at 1.5 cm proximal to the hymenal ring.Discussion: Rectovaginal fistula is one of the complications after repair of hronic total perineal rupture which disturbs the quality of life of women. The patient was diagnosed with a rectovaginal fistula in post repair chronic total perineal rupture. Conservative management with wound care and administration of honey to the patient showed improved postoperative outcome.Conclusion: Anatomical identification of the anal sphincter complex, surgical technique and postoperative care are important in preventing complications following repair of chronic total perineal rupture repair.Keywords : obstetrics sphincter anal injury,  postrepair chronic, rectovaginal fistulae .   Abstrak Tujuan : Untuk melaporkan dan mendiskusikan penyebab dan tatalaksana kasus fistula rektovagina pasca repair ruptur perineum total lama.Metode: Sebuah laporan kasus, pasien perempuan 29 tahun yang datang ke RSUP Fatmawati dengan keluhan inkontinensia anal 9 hari pascarepair ruptur perineum total lama. Pemeriksaan rectovaginal menunjukkan fistula rektovagina diameter 2 mm pada 1,5 cm proksimal hymenal ring.Diskusi : Fistula rektovagina merupakan salah satu komplikasi pascarepair ruptur perineum total yang mengganggu kualitas hidup perempuan. Pasien didiagnsos fistula rektovagina pascarepair ruptur perineum total lama. Manajemen konservatif dengan perawatan luka dan pemberian madu pada pasien menunjukkan perbaikan luaran paska operasi.Kesimpulan: Identifikasi anatomis kompleks sfingter ani, teknik operasi dan perawatan pascaoperasi penting dalam mencegah komplikasi pascarepair ruptur perineum total lama.Kata kunci: cedera sfingter ani obstetri, fistula rectovagina, repair ruptur perineum total lam

Dual-purpose cowpea for West Africa

Cowpea (Pzgna unguiculata) is grown as an intercrop with cereals in some 9 M ha of West Africa, mostly in the dry savanna. Though grain yields are low (circa 500 kg/ha), it is a nutritious food and dry season fodder. The haulms (leaves and stems) are cut and stored after grain harvest. Cowpea aids soil fertility by fixing soil N and returning N via manure from ruminants fed with haulms. Up to the early 1990s, research had focused on developing high grain yielding varieties. Recognition of farmers' appreciation of multiple uses, in particular the fodder value and the increasing importance of crop residues as feed resources in much of West Africa, where expansion of agricultural land and intensification mean reduced availability of land for planted forages, led to joint research by ILRI and IITA from 1994, which identified "dual purpose" varieties with the potential to provide both good grain yields and quality fodder under farmer conditions. Taking account of the heterogeneity in terms of market access and population density, two factors likely to influence adoption of dual purpose cowpea, this study estimated that, of the 9 M ha of cowpea, dual purpose varieties could be adopted on a consolidated area of 1.4 M ha of West Africa and potentially benefit 9.3 M people. Dual purpose cowpea varieties enable farmers with little land to obtain human food and livestock feed from the same area. Cowpea has also other economic, ecological and social benefits

Experimental investigation of elastic mode control on a model of a transport aircraft

A 4.5 percent DC-10 derivative flexible model with active controls is fabricated, developed, and tested to investigate the ability to suppress flutter and reduce gust loads with active controlled surfaces. The model is analyzed and tested in both semispan and complete model configuration. Analytical methods are refined and control laws are developed and successfully tested on both versions of the model. A 15 to 25 percent increase in flutter speed due to the active system is demonstrated. The capability of an active control system to significantly reduce wing bending moments due to turbulence is demonstrated. Good correlation is obtained between test and analytical prediction

Magnetic field symmetry of pump currents of adiabatically driven mesoscopic structures

We examine the scattering properties of a slowly and periodically driven mesoscopic sample using the Floquet function approach. One might expect that at sufficiently low driving frequencies it is only the frozen scattering matrix which is important. The frozen scattering matrix reflects the properties of the sample at a given instant of time. Indeed many aspects of adiabatic scattering can be described in terms of the frozen scattering matrix. However, we demonstrate that the Floquet scattering matrix, to first order in the driving frequency, is determined by an additional matrix which reflects the fact that the scatterer is time-dependent. This low frequency irreducible part of the Floquet matrix has symmetry properties with respect to time and/or a magnetic field direction reversal opposite to that of the frozen scattering matrix. We investigate the quantum rectification properties of a pump which additionally is subject to an external dc voltage. We split the dc current flowing through the pump into several parts with well defined properties with respect to a magnetic field and/or an applied voltage inversion.Comment: 13 pages, 4 figure

HUBUNGAN ANTARA SOSIAL EKONOMI DENGAN USIA PERTAMA PEMBERIAN MAKANAN PENDAMPING ASI (MP-ASI) PADA BAYI USIA 6-12 BULAN DI PUSKESMAS TUMINTING KOTA MANADO

Pemberian Makanan Pendamping ASI (MPA-ASI) perlu memperhatikan ketepatan waktu pemberian, frekuensi, jenis, jumlah bahan makanan, dan cara pembuatannya (Maseko dan Ogawa, 2012). World Health Organization (WHO) merekomendasikan pemberian Makanan Pedamping ASI tepat pada usia 6 bulan. Tujuan penelitian ini yaitu untuk menganalisis apakah terdapat hubungan antara pendapatan, pendidikan, pekerjaan, dan jumlah anggota keluarga dengan usia pertama pemberian Makanan Pedamping Air Susu Ibu (MP-ASI) di Puskesmas Tuminting. Penelitian ini bersifat survei analitik dengan desain cross sectional study. Sampel pada penelitian ini berjumlah 82 bayi yang berusia 6-12 bulan, tidak sakit, cacat, dan tinggal di wilayah kerja Puskesmas Tuminting yang diambil menggunakan teknik purposive sampling. Analisis data statistik menggunakan Uji Chi-Square dengan α = 0,05. Hasil penelitian ini menunjukan terdapat hubungan antara pendidikan dengan usia pertama pemberian MP-ASI (p=0,000), dan tidak terdapat hubungan antara pendapatan, pekerjaan, dan jumlah anggota keluarga dengan usia pertama pemberian MP-ASI pada bayi usia 6-12 bulan di Puskesmas Tuminting dengan nilai secara berurut (p=0,718), (p=0,501), dan (p=0,231). Perlu adanya peningkatan pengetahuan ibu mengenai pola pemberian MP-ASI yang baik dan benar.Kata Kunci: Sosial Ekonomi, Pendapatan, Pendidikan, Pekerjaan, Jumlah Anggota Keluarga, MP-ASI, Bayi Usia 6-12 BulanABSTRACTComplementary feeding of the breastfed child needs to pay attention to timeliness of administration, frequency, type and amount of food, and how to make (Maseko and Ogawa, 2012). World Health Organization (WHO) recommends giving complementary food right at the age of 6 months. The purpose of this study is to analyze whether there is a relationship between income, education, occupation, and number of family members with the age of first giving complementary food in Tuminting Public Health Care. This research is an analytic survey with cross sectional design. The samples in this research were 82 infants aged 6-12 months, no pain, disability, and living in Tuminting Public Health Care taken using purposive sampling technique. Statistical data analysis using Chi-Square test with α = 0.05. These results indicate there is a relationship between education and age of first administration of breastfeeding (p = 0.000), and there is no relationship between income, employment, and the number of family members with the first age giving breastfeeding in infants aged 6-12 months in Tuminting Public Health Care with sequential values (p = 0.718), (p = 0.501), and (p = 0.231). Mothers need to increase knowledge of complementary feeding patterns of provision is good and right.Keywords: Social Economy, Income, Education, Employment, Number of Family Members, Complementary Feeding Of The Breastfed Child, Babies Ages 6-12 Month

Farmers' perceptions of benefits and factors affecting the adoption of improved dual-purpose cowpea in the dry savannas of Nigeria

This study links participatory research methods, geographic information systems (GIS) techniques, village and household-level surveys, and a tobit analysis to examine the adoption and impact issues related to a new technology, improved varieties of dual-purpose cowpea (IDPC), developed by International Institute of Tropical Agriculture (IITA) and International Livestock Research Institute (ILRI) and recently released in Nigeria. The article analyzes factors affecting the adoption and impact of the technology across different socioeconomic domains as defined by degree of market access and population density. The results show multiple benefits from this flexible leguminous crop, many of which relate to the fodder and soil fertility-enhancing aspects of IDPC rather than higher grain yields per se. The intensity of adoption was affected by different village- and household-level factors in each socioeconomic domain, allowing more sharply defined recommendation domain-targeting strategies. The multiple research approaches taken also provided useful lessons at different system levels regarding the benefits of, and perceived problems with, this technology for researchers, development practitioners, and policy makers. The collaborative research approaches taken in this study are helping to close the "feedback loop" from farmers back to researchers and others attempting to disseminate the technology, and by doing so, should contribute to faster and more widespread uptake of this technology