Transition to Skilled Birth Attendance: Is There a Future Role for Trained Traditional Birth Attendants?

A brief history of training of traditional birth attendants (TBAs), summary of evidence for effectiveness of TBA training, and consideration of the future role of trained TBAs in an environment that emphasizes transition to skilled birth attendance are provided. Evidence of the effectiveness of TBA training, based on 60 studies and standard meta-analytic procedures, includes moderate-to-large improvements in behaviours of TBAs relating to selected intrapartum and postnatal care practices, small significant increases in women's use of antenatal care and emergency obstetric care, and small significant decreases in perinatal mortality and neonatal mortality due to birth asphyxia and pneumonia. Such findings are consistent with the historical focus of TBA training on extending the reach of primary healthcare and a few programmes that have included home-based management of complications of births and the newborns, such as birth asphyxia and pneumonia. Evidence suggests that, in settings characterized by high mortality and weak health systems, trained TBAs can contribute to the Millennium Development Goal 4—a two-thirds reduction in the rate of mortality of children aged less than 14 years by 2015—through participation in key evidence-based interventions

A Comparison Of Calcified Structures For Aging Summer Flounder, Paralichthys Dentatus

Calcified structures of summer flounder, Paralichthys dentatus, were evaluated to identify the best age determination method. Scales, the currently preferred structure, were compared with opercular bones and to right and left whole and sectioned otoliths for ages 0 to 10. All structures showed concentric rings that were interpreted as annual; however structures differed greatly in the clarity of their presumed annual marks. Right and left otoliths generally gave the same age, although they differed in the clarity of marks. Sectioned otoliths, particularly right ones, were the best aging structure. Right sectioned otoliths consistently showed the clearest marks and had the highest confidence scores, lowest reading times, and highest agreement within and between readers, 97% and 96%, respectively. Left sectioned otoliths took twice as long to prepare and were more difficult to interpret than right sectioned otoliths. Whole otoliths were the second best structure and were adequate to age 4 or 5, after which sectioning greatly improved the clarity of marks. Scales were inferior to, and often did not give the same age readings as, whole and sectioned otoliths. Compared with otoliths, scales tended to overage at younger ages and to underage at older ages. Opercular bones were undesirable for aging summer flounder. They were often unclear and inconsistent, and they had the lowest confidence scores, the highest reading times, and only 46% within-reader agreement. A major source of disagreement in scale and otolith age readings was the presence of an early, presumably false, mark on some structures. We compare the formation of this early mark in summer flounder with early mark formation on otoliths of Atlantic croaker, a species,vith similar life history traits

Transition to Skilled Birth Attendance: Is There a Future Role for Trained Traditional Birth Attendants?

A brief history of training of traditional birth attendants (TBAs), summary of evidence for effectiveness of TBA training, and consideration of the future role of trained TBAs in an environment that empha\uadsizes transition to skilled birth attendance are provided. Evidence of the effectiveness of TBA training, based on 60 studies and standard meta-analytic procedures, includes moderate-to-large improvements in behaviours of TBAs relating to selected intrapartum and postnatal care practices, small significant increases in women\u2019s use of antenatal care and emergency obstetric care, and small significant decreas\uades in perinatal mortality and neonatal mortality due to birth asphyxia and pneumonia. Such findings are consistent with the historical focus of TBA training on extending the reach of primary healthcare and a few programmes that have included home-based management of complications of births and the new\uadborns, such as birth asphyxia and pneumonia. Evidence suggests that, in settings characterized by high mortality and weak health systems, trained TBAs can contribute to the Millennium Development Goal 4\u2014a two-thirds reduction in the rate of mortality of children aged less than 14 years by 2015\u2014through participation in key evidence-based interventions

Proceedings of the Sixth Caldwell Conference, St. Catherines Island, Georgia, May 20-22, 2011.

494 pages : illustrations (some color), maps (some color) ; 26 cm. Conference sponsored by the American Museum of Natural History and the St. Catherines Island Foundation.Although this volume covers a broad range of temporal and methodological topics, the chapters are unified by a geographic focus on the archaeology of the Georgia Bight. The various research projects span multiple time periods (including Archaic, Woodland, Mississippian, and contact periods) and many incorporate specialized analyses (such as petrographic point counting, shallow geophysics, and so forth). The 26 contributors conducting this cutting-edge work represent the full spectrum of the archaeological community, including museum, academic, student, and contract archaeologists. Despite the diversity in professional and theoretical backgrounds, temporal periods examined, and methodological approaches pursued, the volume is unified by four distinct, yet interrelated, themes. Contributions in Part I discuss a range of analytical approaches for understanding time, exchange, and site layout. Chapters in Part II model coastal landscapes from both environmental and social perspectives. The third section addresses site-specific studies of late prehistoric architecture and village layout throughout the Georgia Bight. Part IV presents new and ongoing research into the Spanish mission period of this area. These papers were initially presented and discussed at the Sixth Caldwell Conference, cosponsored by the American Museum of Natural History and the St. Catherines Island Foundation, held on St. Catherines Island, Georgia, May 20-22, 2011. TABLE OF CONTENTS: Revising the ¹⁴C reservoir correction for St. Catherines Island, Georgia / David Hurst Thomas, Matthew C. Sanger, and Royce H. Hayes -- An assessment of coastal faunal data from Georgia and northeast Florida / Alexandra L. Parsons and Rochelle A. Marrinan -- Archaeological geophysics on St. Catherines Island : beyond prospection / Ginessa J. Mahar -- Paste variability and clay resource utilization at the Fountain of Youth site, St. Augustine, 8SJ31 / Ann S. Cordell and Kathleen A. Deagan -- Petrographic analysis of pottery and clay samples from the Georgia Bight : evidence of regional social interactions / Neill J. Wallis and Ann S. Cordell -- Past shorelines of the Georgia coast / Chester B. DePratter and Victor D. Thompson -- Coastal landscapes and their relationship to human settlement on the Georgia coast / John A. Turck and Clark R. Alexander -- The role of small islands in foraging economies of St. Catherines Island / Matthew F. Napolitano -- Ever-shifting landscapes : tracking changing spatial usage along coastal Georgia / Matthew C. Sanger -- A paleoeconomic model of the Georgia coast (4500-300 B.P.) / Thomas G. Whitley -- A survey of Irene phase architecture on the Georgia coast / Deborah A. Keene and Ervan G. Garrison -- Life and death on the Ogeechee : a view from the Redbird Creek village / Ryan O. Sipe -- Mission San Joseph de Sapala : mission-period archaeological research on Sapelo Island / Richard W. Jefferies and Christopher R. Moore -- The Guale landscape of Mission Santa Catalina de Guale : 30 years of geophysics at a Spanish colonial mission / Elliot H. Blair -- Missions San Buenaventura and Santa Cruz de Guadalquini : retreat from the Georgia coast / Keith H. Ashley, Vicki L. Rolland, and Robert L. Thunen -- Entangling events : the Guale coastal landscape and the Spanish missions / Victor D. Thompson, John A. Turck, Amanda D. Roberts Thompson, and Chester B. DePratter -- Island and coastal archaeology on the Georgia Bight / Scott M. Fitzpatrick

Activated Cranial Cervical Cord Neurons Affect Left Ventricular Infarct Size and the Potential for Sudden Cardiac Death

To evaluate whether cervical spinal neurons can influence cardiac indices and myocyte viability in the acutely ischemic heart, the hearts of anesthetized rabbits subjected to 30. min of LAD coronary arterial occlusion (CAO) were studied 3. h after reperfusion. Control animals were compared to those exposed to pre-emptive high cervical cord stimulation (SCS; the dorsal aspect of the C1-C2 spinal cord was stimulated electrically at 50. Hz; 0.2. ms; 90% of motor threshold, starting 15. min prior to and continuing throughout CAO). Four groups of animals were so tested: 1) neuroaxis intact; 2) prior cervical vagotomy; 3) prior transection of the dorsal spinal columns at C6; and 4) following pharmacological treatment [muscarinic (atropine) or adrenergic (atenolol, prazosin or yohimbine) receptor blockade]. Infarct size (IS) was measured by tetrazolium, expressed as percentage of risk zone. C1-C2 SCS reduced acute ischemia induced IS by 43%, without changing the incidence of sudden cardiac death (SCD). While SCS-induced reduction in IS was unaffected by vagotomy, it was no longer evident following transection of C6 dorsal columns or atropinization. Beta-adrenoceptor blockade eliminated ischemia induced SCD, while alpha-receptor blockade doubled its incidence. During SCS, myocardial ischemia induced SCD was eliminated following vagotomy while remaining unaffected by atropinization. These data indicate that, in contrast to thoracic spinal neurons, i) cranial cervical spinal neurons affect both adrenergic and cholinergic motor outflows to the heart such that ii) their activation modifies ventricular infarct size and lethal arrhythmogenesis

Interspecies Organogenesis for Human Transplantation

Blastocyst complementation combined with gene editing is an emerging approach in the field of regenerative medicine that could potentially solve the worldwide problem of organ shortages for transplantation. In theory, blastocyst complementation can generate fully functional human organs or tissues, grown within genetically engineered livestock animals. Targeted deletion of a specific gene(s) using gene editing to cause deficiencies in organ development can open a niche for human stem cells to occupy, thus generating human tissues. Within this review, we will focus on the pancreas, liver, heart, kidney, lung, and skeletal muscle, as well as cells of the immune and nervous systems. Within each of these organ systems, we identify and discuss (i) the common causes of organ failure; (ii) the current state of regenerative therapies; and (iii) the candidate genes to knockout and enable specific exogenous organ development via the use of blastocyst complementation. We also highlight some of the current barriers limiting the success of blastocyst complementation