Maternal health as a human right: health care system innovations to reduce inequities in maternal health in Bolivia, Nicaragua and Guatemala 1990-2018

In recognition of health as a human right, United Nations (UN) member countries vowed to reduce, by three-quarters, the 1990 maternal mortality ratio (MMR; maternal deaths per 100,000 live births) by 2015. To achieve this, countries implemented evidence-based maternal health interventions, with global impetus to focus on increasing the number of facility births, antenatal care and trained skilled birth attendants at birth. During the Millennium Development Goals (MDG 2000-2015) period, countries in Latin America and the Caribbean (LAC) made remarkable progress in reducing MMR, however, maternal deaths among the rural poor disproportionately constituted this rate. To close equity gaps, the Sustainable Development Goals (2015-2030, SDGs), implemented in 2016, aim to reduce maternal mortality to less than 70 maternal deaths per 100,000 live births (no country should have a MMR greater than 140 deaths/100,000 live births) by 2030, placing maternal health as a human right at the center of the goals. The public health significance of this paper is that no mother should die from preventable causes. This thesis is a comparative case study analysis with a desk review of outcome measures and literature to describe disparities in maternal health outcomes in Bolivia, Nicaragua and Guatemala. It captures policy and health system innovations to identify areas in which countries that have disparities in maternal mortality can improve. Cases are grouped based on their shared stage in the Obstetric Transition Theory and their high rates of inequitable access to health care and MMR. Despite the different country contexts, findings show that governments are successfully translating the language of health as a human right into tangible action, implementing health models for greater inclusion of vulnerable populations. In recognition of population health inequities, countries are investing in health care to achieve health as a human right. Evidence shows that country-led health models, inter-sectoral collaboration, and health financing are key to improving access to health care for vulnerable populations

Breaking the silence: Exploring the impact of pregnancy loss on women who delayed childbirth and remain childless

Pregnancy loss and involuntary childlessness have long been recognised as having potentially devastating impacts on women who desire to be biological mothers. Despite the existence of a number of studies in these areas, no research has been undertaken which explores the relationship between postponing pregnancy, pregnancy loss and childlessness. This phenomenological study explores the lived experience of six women who underwent pregnancy loss at an advanced maternal age and remain childless. The findings illustrate the multiple losses that result, not only is there a loss of a hoped for child but also of an expected, anticipated future. The study explores how women experienced these painful processes as deeply isolating, how they impacted on their sense of self and how they struggled to rewrite a new future. The research demonstrates the continuing silence surrounding pregnancy loss and involuntary childlessness and highlights the fundamental importance of acknowledging the immediate pain and the lingering sadness associated with being childless. It contributes to an understanding of the multiple losses experienced and in doing so, hopes to raise awareness in counsellors of the depth of the existential crisis and the need for the multiple losses to be acknowledged and validated

Chicken CSF2 and IL-4-, and CSF2-Dependent Bone Marrow Cultures Differentiate into Macrophages over time

Chicken bone marrow-derived macrophages (BMMΦ) and dendritic cells (BMDC) are utilized as models to study the mononuclear phagocytic system (MPS). A widely used method to generate macrophages and DC in vitro is to culture bone marrow cells in the presence of colony-stimulating factor-1 (CSF1) to differentiate BMMΦ and granulocyte-macrophage-CSF (GM-CSF, CSF2) and interleukin-4 (IL-4) to differentiate BMDC, while CSF2 alone can lead to the development of granulocyte-macrophage-CSF-derived DC (GMDC). However, in chickens, the MPS cell lineages and their functions represented by these cultures are poorly understood. Here, we decipher the phenotypical, functional and transcriptional differences between chicken BMMΦ and BMDC along with examining differences in DC cultures grown in the absence of IL-4 on days 2, 4, 6 and 8 of culture. BMMΦ cultures develop into a morphologically homogenous cell population in contrast to the BMDC and GMDC cultures, which produce morphologically heterogeneous cell cultures. At a phenotypical level, all cultures contained similar cell percentages and expression levels of MHCII, CD11c and CSF1R-transgene, whilst MRC1L-B expression decreased over time in BMMΦ. All cultures were efficiently able to uptake 0.5 µm beads, but poorly phagocytosed 1 µm beads. Little difference was observed in the kinetics of phagosomal acidification across the cultures on each day of analysis. Temporal transcriptomic analysis indicated that all cultures expressed high levels of CSF3R, MERTK, SEPP1, SPI1 and TLR4, genes associated with macrophages in mammals. In contrast, low levels of FLT3, XCR1 and CAMD1, genes associated with DC, were expressed at day 2 in BMDC and GMDC after which expression levels decreased. Collectively, chicken CSF2 + IL-4- and CSF2-dependent BM cultures represent cells of the macrophage lineage rather than inducing conventional DC

Hyperfine and radiological characterization of soils of the province of Buenos Aires, Argentina

The depth profile concentration of both natural and anthropogenic gamma-ray-emitter nuclides were determined in soil samples collected in an area located at 34° 54.452′ S, 58° 8.365′ W, down to 50 cm in depth, using an hyper-pure Ge spectrometer. The soil samples were also characterized by means of Mössbauer spectrometry and X-ray diffraction. The activities of 238U and 232Th natural chains remain constant in depth at 41 Bq/kg and 46 Bq/kg, respectively, while the 40K activity increases from 531 Bq/kg to 618 Bq/kg between 2.5 cm y 25.5 cm of depth. The only anthropogenic detected nuclide is 137Cs, whose activity changes form 1.4 Bq/kg to values lower than the detection limit (LD) for depths below 25 cm, exhibiting a maximum at 10 cm beneath the surface. The Mössbauer spectra show two magnetic sextets associated with α-Fe2O3 and Fe3O4, as well as two Fe+3 Fe+2 doublets, probably originated in octahedral and tetrahedral sites of paramagnetic phases. The Fe3+ paramagnetic signal relative fraction increases up to 82% at the expense of the α-Fe2O3 one when de depth increases. No correlation between Fe3O4 and the 137Cs was identificated.Facultad de Ciencias ExactasInstituto de Física La Plat

Hyperfine and radiological characterization of soils of the province of Buenos Aires, Argentina

The depth profile concentration of both natural and anthropogenic gamma-ray-emitter nuclides were determined in soil samples collected in an area located at 34° 54.452′ S, 58° 8.365′ W, down to 50 cm in depth, using an hyper-pure Ge spectrometer. The soil samples were also characterized by means of Mössbauer spectrometry and X-ray diffraction. The activities of 238U and 232Th natural chains remain constant in depth at 41 Bq/kg and 46 Bq/kg, respectively, while the 40K activity increases from 531 Bq/kg to 618 Bq/kg between 2.5 cm y 25.5 cm of depth. The only anthropogenic detected nuclide is 137Cs, whose activity changes form 1.4 Bq/kg to values lower than the detection limit (LD) for depths below 25 cm, exhibiting a maximum at 10 cm beneath the surface. The Mössbauer spectra show two magnetic sextets associated with α-Fe2O3 and Fe3O4, as well as two Fe+3 Fe+2 doublets, probably originated in octahedral and tetrahedral sites of paramagnetic phases. The Fe3+ paramagnetic signal relative fraction increases up to 82% at the expense of the α-Fe2O3 one when de depth increases. No correlation between Fe3O4 and the 137Cs was identificated.Facultad de Ciencias ExactasInstituto de Física La Plat

Propiedades de las aleaciones usadas en implantes quirúrgicos

Las aleaciones habitualmente usadas para elaborar dispositivos implantables son los aceros inoxidables ASTM F138 y ASTM F745, la aleación de cobalto ASTM F75, la aleación Ti-6Al-4V y el Ti Grado 4. Las propiedades mecánicas varían desde 480 MPa de resistencia a la tracción del ASTM F745 hasta 890 MPa del Ti-Al-V, con módulos de elasticidad de 200 GPa y 120 GPa, respectivamente. La resistencia a la corrosión es una de las exigencias más importantes, ya que además de la degradación química, genera fenómenos adversos como la liberación de iones metálicos, que pueden depositarse en distintos órganos y producir reacciones sistémico – tóxicas. Los ensayos de polarización cíclica indicaron que el Ti Grado 4 y el Ti-Al-V presentan la menor susceptibilidad a la corrosión localizada en medios que simulan fluidos del cuerpo humano. Otra característica, es que estos materiales no deben ser magnéticos. Las curvas de histéresis magnética mostraron que las aleaciones de Ti experimentan una menor magnetización ante campos magnéticos externos. En cuanto a la biocompatibilidad, se han iniciado estudios de citotoxicidad en el acero inoxidable ASTM F745. Los resultados de los ensayos Rojo neutro y MTT mostraron una aceptable viabilidad celular, sin evidencia de liberación de compuestos citotóxicos al medio

Study on the accuracy of school location information in South Africa

Accurate location information is required for proper planning and informed decision making in a variety of sectors. In the basic education sector, accurate school location information is typically required for road, electricity, internet connectivity and water infrastructure planning as well as planning for the delivery of textbooks and public transport (i.e. busses, taxis). The National Education Collaboration Trust (NECT) commissioned the Council for Scientific and Industrial Research (CSIR) to conduct a study of existing school location information in five NECT education districts (Bohlabela, Bojanala, Mount Frere, Uthungulu and Waterberg). School location information in two existing databases, i.e. Education Management Information System (EMIS) and National Education Information Management System (NEIMS) were assessed. Due to the nature of school buildings (i.e. varying form of schools) it is challenging to automate the identification of schools from satellite imagery by using machine learning/image processing techniques. Manual Geographic Information System (GIS) techniques were applied to conduct the study. High resolution satellite imagery and Google StreetView were utilised to ascertain the locations of schools. This study indicated that there are discrepancies between the EMIS and NEIMS databases and that there is a significant amount of school location information that might not be useful for proper planning and informed decision making in certain sectors due to the degree of positional inaccuracy of the data. If the positional accuracy of the incorrect school location information improves, it will have a positive impact on the overall outcomes of planning and decision making