A deployed multi agent system for meteorological alerts

The Australian Bureau of Meteorology has a requirement for complex and evolving systems to manage its weather forecasting, monitoring and alerts. This paper describes a system that monitors in real time the current terminal area forecasts (forecasts for areas around airports) and alerts forecasters to inconsistencies between these and observations obtained from automatic weather station (AWS) data. The contributions of the paper are a description of the overall architecture including legacy components, and the mechanisms that have been used to interface to legacy components; a description of an inferencing mechanism, available in recent versions of the JACK Intelligent Agents toolkit which has been particularly useful in some of the reasoning needed in this application; and a detailed description of the architecture for data sharing and data management. The system is currently deployed and a project is underway to extend this to a much larger system

Misoprostol: An emerging technology for women\u27s health—Report of a seminar

On May 7–8, 2001, the Population Council and the Center for Reproductive Health Research & Policy of the University of California, San Francisco, convened a technical seminar in New York City on the use of misoprostol for women’s health indications. The seminar was designed to provide a forum for researchers, providers, women’s health advocates, and educators to exchange information with the goal of advancing the potential of misoprostol to improve women’s health. Participants discussed the state of the art in research, examined current clinical use of misoprostol, and created strategies for the future. The first day focused on scientific and clinical aspects of misoprostol use. The second day’s discussion centered on the future of misoprostol for women’s health, including identifying priorities for research and the role of provider groups and women’s health and advocacy organizations in helping to ensure misoprostol’s continued, appropriate use. At the end of each session, the group had an opportunity to share ideas and discuss unanswered questions. This report covers the key issues raised by each speaker and highlights general areas of discussion among participants

Misoprostol and teratogenicity: Reviewing the evidence

Misoprostol, a prostaglandin E1 analog marketed as Cytotec® for the prevention and treatment of gastric ulcers, is inexpensive and registered for use in over 80 countries. Many scientific articles show the preparation to be safe and effective for various reproductive health indications, including cervical softening and early pregnancy termination. Owing to the extensive body of published literature on these indications, misoprostol is now widely used for several reproductive health indications. The abortifacient properties of misoprostol are well known to medical professionals and frequently to the public. As noted in this meeting report, because the drug is available at low cost, many women have opted for self-administration of the method to terminate their pregnancies. The pharmaceutical industry and the public health community have raised the concern that if such an abortion attempt fails and the pregnancy results in a live birth, exposure of the fetus to misoprostol in utero could increase the risk of birth anomalies. The most extensively documented accounts of self-medication with misoprostol for induced abortion have come from Brazil, thus the case of Brazil provides a unique opportunity for studying the potential teratogenicity of misoprostol

The MamaMiso study of self-administered misoprostol to prevent bleeding after childbirth in rural Uganda: a community-based, placebo-controlled randomised trial

BACKGROUND: 600 mcg of oral misoprostol reduces the incidence of postpartum haemorrhage (PPH), but in previous research this medication has been administered by health workers. It is unclear whether it is also safe and effective when self-administered by women. METHODS: This placebo-controlled, double-blind randomised trial enrolled consenting women of at least 34 weeks gestation, recruited over a 2-month period in Mbale District, Eastern Uganda. Participants had their haemoglobin measured antenatally and were given either 600 mcg misoprostol or placebo to take home and use immediately after birth in the event of delivery at home. The primary clinical outcome was the incidence of fall in haemoglobin of over 20% in home births followed-up within 5 days. RESULTS: 748 women were randomised to either misoprostol (374) or placebo (374). Of those enrolled, 57% delivered at a health facility and 43% delivered at home. 82% of all medicine packs were retrieved at postnatal follow-up and 97% of women delivering at home reported self-administration of the medicine. Two women in the misoprostol group took the study medication antenatally without adverse effects. There was no significant difference between the study groups in the drop of maternal haemoglobin by >20% (misoprostol 9.4% vs placebo 7.5%, risk ratio 1.11, 95% confidence interval 0.717 to 1.719). There was significantly more fever and shivering in the misoprostol group, but women found the medication highly acceptable. CONCLUSIONS: This study has shown that antenatally distributed, self-administered misoprostol can be appropriately taken by study participants. The rarity of the primary outcome means that a very large sample size would be required to demonstrate clinical effectiveness. TRIAL REGISTRATION: This study was registered with the ISRCTN Register (ISRCTN70408620)

Multiagent cooperation for solving global optimization problems: an extendible framework with example cooperation strategies

This paper proposes the use of multiagent cooperation for solving global optimization problems through the introduction of a new multiagent environment, MANGO. The strength of the environment lays in itsflexible structure based on communicating software agents that attempt to solve a problem cooperatively. This structure allows the execution of a wide range of global optimization algorithms described as a set of interacting operations. At one extreme, MANGO welcomes an individual non-cooperating agent, which is basically the traditional way of solving a global optimization problem. At the other extreme, autonomous agents existing in the environment cooperate as they see fit during run time. We explain the development and communication tools provided in the environment as well as examples of agent realizations and cooperation scenarios. We also show how the multiagent structure is more effective than having a single nonlinear optimization algorithm with randomly selected initial points

Levels and Correlates of Non-Adherence to WHO Recommended Inter-Birth Intervals in Rufiji, Tanzania.

Poorly spaced pregnancies have been documented worldwide to result in adverse maternal and child health outcomes. The World Health Organization (WHO) recommends a minimum inter-birth interval of 33 months between two consecutive live births in order to reduce the risk of adverse maternal and child health outcomes. However, birth spacing practices in many developing countries, including Tanzania, remain scantly addressed. METHODS: Longitudinal data collected in the Rufiji Health and Demographic Surveillance System (HDSS) from January 1999 to December 2010 were analyzed to investigate birth spacing practices among women of childbearing age. The outcome variable, non-adherence to the minimum inter-birth interval, constituted all inter-birth intervals <33 months long. Inter-birth intervals >=33 months long were considered to be adherent to the recommendation. Chi-Square was used as a test of association between non-adherence and each of the explanatory variables. Factors affecting non-adherence were identified using a multilevel logistic model. Data analysis was conducted using STATA (11) statistical software. RESULTS: A total of 15,373 inter-birth intervals were recorded from 8,980 women aged 15--49 years in Rufiji district over the follow-up period of 11 years. The median inter-birth interval was 33.4 months. Of the 15,373 inter-birth intervals, 48.4% were below the WHO recommended minimum length of 33 months between two live births. Non-adherence was associated with younger maternal age, low maternal education, multiple births of the preceding pregnancy, non-health facility delivery of the preceding birth, being an in-migrant resident, multi-parity and being married. CONCLUSION: Generally, one in every two inter-birth intervals among 15--49 year-old women in Rufiji district is poorly spaced, with significant variations by socio-demographic and behavioral characteristics of mothers and newborns. Maternal, newborn and child health services should be improved with a special emphasis on community- and health facility-based optimum birth spacing education in order to enhance health outcomes of mothers and their babies, especially in rural settings

Incidence of Postpartum Infection after Vaginal Delivery in Viet Nam

This study assessed the incidence of postpartum infection which is rarely clinically evaluated and is probably underestimated in developing countries. This prospective study identified infection after vaginal delivery by clinical and laboratory examinations prior to discharge from hospital and again at six weeks postpartum in Ho Chi Minh City, Viet Nam. Textbook definitions, physicians' diagnoses, symptomatic and verbal autopsy definitions were used for classifying infection. Logistic regression was used for determining associations of postpartum infection with socioeconomic and reproductive characteristics. In total, 978 consecutive, eligible consenting women were followed up at 42\ub17 (range 2-45) days postpartum (not associated with incidence). Ninety-eight percent took 'prophylactic' antibiotics. The most conservative estimate of the incidence of postpartum infection was 1.7%. The incidence of serious infection was 0.5%, but increased to 4.6% when verbal autopsy and symptomatic definitions were used. Postpartum infection, particularly serious infection, is greatly underestimated. Just preventing or treating infection could have a substantial impact on reducing maternal mortality in developing countries

Indicators for Women's Health in Developing Countries: What They Reveal and Conceal

Summary The health of women has recently resurfaced in the health policy debate and has tended to become viewed as important primarily because of its contribution to infant health. Maternal deaths are characterised by a range of fairly typical causes, all of which can normally be prevented with good obstetric medical services and antenatal care. The most widely used indicator, the maternal mortality rare, is closely associated with a range of socioeconomic determinants; most notably poverty and access to obstetric services, which suggests that medicine alone cannot solve the whole problem. Factors such as urbanization, female secondary education, contraceptive prevalence and fertility all appear to be important intermediate determinants, which highlight the fact that the problem is really rooted in a much wider one of the status and role of women in development. The indicator of the maternal mortality rate itself actually underestimates the true impact of fertility on women's health. The indicator of lifetime risk (of dying in childbirth) is much more relevant and it provides an even starker picture of differentials in health risks, and the role fertility plays in these risks. It puts fertility back into women's health and the object of measurement is women's lives rather than the disembodied event of birth. Resumé Indicateurs de la santé des femmes dans les pays en voie de développement: ce qu'ils révèlent et ce qu'ils cachent Le sujet de la santé des femmes remonte à la surface dans le débat concernant les politiques de santé; ce sujet a été censé important, du moins récemment, en raison principalement de sa contribution à la santé infantile. Les décès maternels sont caractérisés par une gamme de causes relativement typiques et qu'il est normalement possible d'éviter moyennant une bonne obstétrique médicale et des soins adéquats en période prénatale. L'indicateur le plus fréquemment employé, le taux de mortalité maternel, est étroitement lié à une gamme de déterminants socio?économiques, notamment la pauvreté et l'accès aux services obstétriques, qui suggèrent que l'accès à la médecine seule ne peut entièrement résoudre le problème. Les facteurs tels que l'urbanisation, l'enseignement secondaire des femmes, la disponibilité de la contraception et la fécondité sembleraient tous être des indicateurs d'ordre intermédiaire, et ceci aurait tendance à souligner le fait que le problème véritable est effectivement encastré dans un problème encore plus grave, à savoir celui du rôle et de la situation des femmes dans le développement. L'indicateur de mortalité maternelle sous?estime en fait l'impact véritable de la fertilité sur la santé des femmes. L'indicateur de risque à longueur de vie (de mourir durant un accouchement) est beaucoup plus approprié et offre une image encore plus déprimante des différentiels dans les risques à la santé, et du rôle que la fertilité joue dans ces risques. Cet indicateur remet en cause la fertilité au sein de la santé des femmes et en fait une mesure de la vie des femmes, à la place du simple événement qu'est tel ou tel accouchement. Resumen Indicadores de salud femenina en los países en desarrollo: lo que revelan y lo que ocultan El tema de la salud de la mujer ha resurgido recientemente en el debate sobre directivas de salud, y la tendencia ha sido considerarlo importante primordialmente por su contribución a la salud infantil. Las muertes maternales tienen una serie de causas bastante típicas, todas las cuales pueden normalmente ser evitadas con buenos servicios obstétricos y cuidados prenatales. El indicator más usado, la tasa de mortalidad maternal, está asociado a los determinantes socioeconómicos, notablemente la pobreza y la falta de acceso a los servicios ginecológicos, lo que sugiere que la medicina no puede resolver todo el problema por sí sola. Factores como la urbanización, la educación secundaria femenina, la prevalencia anticonceptiva y la fertilidad parecen ser importantes determinantes intermedios, y eso destaca el hecho de que el problema está realmente enraizado en otro mucho mas amplio: la condición y el papel de la mujer en el desarrollo. El indicador de la tasa de mortalidad maternal en realidad subestima el verdadero impacto de la fertilidad en la salud femenina. El indicador de riesgo vital: muerte de parto es mucho más significativo y da una imagen aún más severa de los diferenciales en riesgos de salud y el papel jugado por la fertilidad en esos riesgos. Pone a la fertilidad dentro de la salud femenina nuevamente, y lo que se mide es la vida de la mujer en vez del evento aislado del parto

Client preferences and acceptability for medical abortion and MVA as early pregnancy termination method in Northwest Ethiopia

<p>Abstract</p> <p>Background</p> <p>Increasing access to safe abortion services is the most effective way of preventing the burden of unsafe abortion, which is achieved by increasing safe choices for pregnancy termination. Medical abortion for termination of early abortion is said to safe, effective, and acceptable to women in several countries. In Ethiopia, however, medical methods have, until recently, never been used. For this reason it is important to assess women's preferences and the acceptability of medical abortion and manual vacuum aspiration (MVA) in the early first trimester pregnancy termination and factors affecting acceptability of medical and MVA abortion services.</p> <p>Methods</p> <p>A prospective study was conducted in two hospitals and two clinics from March 2009 to November 2009. The study population consisted of 414 subjects over the age of 18 with intrauterine pregnancies of up to 63 days' estimated gestation. Of these 251 subjects received mifepristone and misoprostol and 159 subjects received MVA. Questionnaires regarding expectations and experiences were administered before the abortion and at the 2-week follow-up visit.</p> <p>Results</p> <p>The study groups were similar with respect to age, marital status, educational status, religion and ethnicity. Their mean age was about 23, majority in both group completed secondary education and about half were married. Place of residence and duration of pregnancy were associated with method choice. Subjects undergoing medical abortions reported significantly greater satisfaction than those undergoing surgical abortions (91.2% vs 82.4%; <it>P </it>< .001). Of those women who had medical abortion, (83.3%) would choose the method again if needed, and (77.4%) of those who had MVA would also choose the method again. Ninety four percent of women who had medical abortion and 86.8% of those who had MVA would recommend the method to their friends.</p> <p>Conclusions</p> <p>Women receiving medical abortion were more satisfied with their method and more likely to choose the same method again than were subjects undergoing surgical abortion. We conclude that medical abortion can be used widely as an alternative method for early pregnancy termination.</p