scholarly journals Regional socio-environmental characteristics associated with inadequate prenatal care during pregnancy: an ecological study of 47 prefectures in Japan

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Eri Osawa ◽  
Tomoko Kodama
Keyword(s):  
Prenatal Care ◽  
Pregnant Women ◽  
Urban Areas ◽  
Ecological Study ◽  
Multiple Logistic Regression Analysis ◽  
Health Coverage ◽  
Environmental Characteristics ◽  
Related Factors ◽  
Healthcare Workforce ◽  
The Impact

Abstract Background Prenatal care (PNC) is a crucial health service that reduces the potential risks of adverse pregnancy and childbirth outcomes. It is monitored as one of the indicators of Universal Health Coverage (UHC) under the United Nations’ Sustainable Development Goals. However, there are still mothers who do not use PNC, even when UHC has been achieved. As there have been few reports on the impact of local socio-environmental characteristics within the country, this study aimed to examine the association between local socio-environmental factors and inadequate use of PNC in Japan. Methods We conducted an ecological analysis of 47 prefectures in Japan using public open data. The dependent variables were the inadequate use of PNC, which are the rates of pregnant women who missed visiting PNC until 28 weeks’ gestational age (GA) or those who never attended PNC before childbirth, and the independent variables were prefectural data of socio-economic, educational, and healthcare workforce-related factors. Multiple logistic regression analysis was used to examine the associations. Results The rate of pregnant women with late PNC initiation and never attending PNC before childbirth was 3.00–11.24 and 0.23–8.06 per 1000 pregnant women, respectively. Population numbers and densities, divorce rates, percentages of non-Japanese nationalities, and low percentages of high school enrolment were positively associated with inadequate PNC use. There was no statistically significant association with healthcare workforce, such as the number of obstetricians and gynaecologists. Conclusions This ecological study revealed that inadequate PNC use is more common in urban areas with more non-Japanese nationality and lower education enrolment. There may be a need to provide education for those who do not have access to reproductive health education, such as that offered in high schools. Further studies are required to examine factors that affect access to PNC in Japan.

Striae Gravidarum, Vitamin C and Other Related Factors

2011 ◽  
Vol 81 (1) ◽  
pp. 43-48 ◽  
Author(s):  
Rahime Bedir Findik ◽  
Nurcihan Karakurt Hascelik ◽  
Kadir Okhan Akin ◽  
Ayse Nurcan Unluer ◽  
Jale Karakaya
Keyword(s):  
Family History ◽  
Vitamin C ◽  
Pregnant Women ◽  
Smoking Status ◽  
Multiple Logistic Regression Analysis ◽  
Blood Levels ◽  
Significant Relation ◽  
Related Factors ◽  
Thigh Circumference ◽  
Striae Gravidarum

Background: Striae gravidarum, a clinical condition commonly seen in pregnant women, produces serious cosmetic problems and may lead to psychological problems. Aim: The present study investigated whether there was any relation between the presence of striae in primigravid pregnant women and blood vitamin C levels, and factors thought to contribute to the formation of striae such as family history, weight gained during pregnancy, smoking status, abdominal and thigh circumference, and age. Methods: Overall, 69 primigravid women attending routine antenatal follow-up and, using prophylactic iron and vitamin preparations, underwent investigation. All were pregnant 36 or more weeks. Scoring was based on striae examination and whether striae were present. The relation between the presence of striae, vitamin C blood levels, and other factors was investigated. Results and Conclusions: Multiple logistic regression analysis showed a significant relation between the presence of striae and blood vitamin C levels (p = 0.046) and between the presence of striae and family history (p = 0.023). No significant relation was found between the presence of striae and age, weight gained during pregnancy, abdominal and thigh circumference, or smoking status. It was concluded that further, more comprehensive studies on the issue are required.

scholarly journals Effects of Children's Outdoor Physical Activity in the Urban Neighborhood Activity Space Environment

2021 ◽  
Vol 9 ◽  
Author(s):  
Yu Bao ◽  
Ming Gao ◽  
Dan Luo ◽  
Xudan Zhou
Keyword(s):  
Physical Activity ◽  
Urban Areas ◽  
Rapid Development ◽  
Space Environment ◽  
Main Concern ◽  
Urban Neighborhood ◽  
Environmental Characteristics ◽  
Growth Environment ◽  
The Impact ◽  
Children’S Physical Activity

The rapid development of cities results in many public health and built-up environmental problems, which have vital impacts on children's growth environment, the development of children, and city contradictions. There is a lack of children being a main concern when constructing new urban areas or reconstructing old districts. Children's activity spaces tend to be standardized and unified (kit, fence, and carpet) “KFC style” designs, which leads to the urban neighborhood space and the environment being insufficient to attract children to conduct activities. Therefore, starting from the urban neighborhood space environment, this paper explores what kind of spatial environment is needed for children's physical activity and its impact on children's physical activity. Taking six residential areas in the Changchun Economic Development Zone as the research object, based on the theory of children's ability development and game value, this paper uses the Woolley and Lowe evaluation tool to quantify the impact of the theory on the urban neighborhood space environment and children's physical activity. It can be confirmed that there is a significant correlation between the spatial characteristics of an urban neighborhood and the general signs of the environment on the duration and intensity of the physical activity of children. The results show that: (1) the differences in children's ages result in differences in the duration and intensity of children's physical activity in the urban neighborhood space environment; (2) the open space factor of the neighborhood space has the most significant influence on the duration of children's physical activity; (3) in terms of the environmental characteristics, whether children can be provided with education and learning opportunities has a significant impact on the duration of children's physical activity; (4) there is a significant positive correlation between children's age and the duration and intensity of the physical activity, exercise type, and imaginative activity. These results show that the urban neighborhood space environment can affect the duration of children's physical activity. In future urban residential area planning and design, urban children can meet the self-demand of physical activity in the neighborhood space through the reasonable balance and combination of neighborhood space characteristics and environmental characteristics.

scholarly journals Study of the post tuberculosis lung diseases and the impact of various patient and disease related factors on its occurrence

2019 ◽  
Vol 6 (4) ◽  
pp. 1241
Author(s):  
Jayasri Helen Gali ◽  
Harsha Vardhana Varma ◽  
Aruna Kumari Badam
Keyword(s):  
Lung Disease ◽  
Urban Areas ◽  
Lung Diseases ◽  
Lung Damage ◽  
Common Symptom ◽  
Related Factors ◽  
Cross Sectional ◽  
Restrictive Lung Disease ◽  
Co Morbidity ◽  
The Impact

Background: More than fifty percent of the cured cases of pulmonary tuberculosis develop some form of chronic pulmonary dysfunction. It can present with varying degrees of lung damage, ranging from minimum functional abnormalities to severe forms of dysfunction that can be an important cause of death. Objective of the study to identify the various Post Tuberculosis Lung Diseases (PTBLDs) and to study impact of the patient and disease related factors on its occurrence.Methods: Cross-sectional, observational study was conducted in 134 adult, post tuberculosis patients, aged between 18-65 years, who have completed at least one year after the end of anti-tubercular treatment. All symptomatic post TB lung disease patients coming to the pulmonology out-patient clinic at the Apollo Institute of Medical sciences and Research were included in the study.Results: Majority were more than 50 years (35.3%) and males (59.4%). Majority were from urban areas (70.7%), low social class (72.2%), and unskilled workers (56.4%). Most common symptom was cough in 74.4% cases. Majority of the cases had symptoms from one week to one month i.e. 47.4%. Only eight cases were found out to be very prompt in reporting their symptoms. 39 cases had some or the other co-morbidity. Current chest X-ray status was normal in only three cases. Mean FEV1 was 1.38 which increased to 1.52; mean FVC was 1.23 which increased to 1.58; mean FEV1/FVC was 67.37 which increased to 72.76 after giving the bronchodilator. 78(58.6%) cases had obstructive and 27(20.3%) had restrictive lung disease. In 30 cases the disease was reversible. Majority of the cases were of pulmonary fibrosis followed by bronchiectasis.Conclusion: Further studies are needed to develop approaches for the prevention, care and treatment of patients with post TBLD.

The Impact of the Alcohol Warning Label on Drinking during Pregnancy

1993 ◽  
Vol 12 (1) ◽  
pp. 10-18 ◽  
Author(s):  
Janet R. Hankin ◽  
Ira J. Firestone ◽  
James J. Sloan ◽  
Joel W. Ager ◽  
Allen C. Goodman ◽  
...  
Keyword(s):  
Black Women ◽  
Alcohol Consumption ◽  
Prenatal Care ◽  
Inner City ◽  
Pregnant Women ◽  
Differential Effect ◽  
Alcoholic Beverage ◽  
Warning Label ◽  
Absolute Alcohol ◽  
The Impact

Has drinking by pregnant women decreased since the implementation of the alcoholic beverage warning label? The authors examined the reported drinking of 4397 pregnant black women who sought prenatal care in an inner city clinic of Detroit, MI. They found that the warning label had a differential effect on risk drinkers (women consuming at least .5 ounce of absolute alcohol per day at conception) and lighter drinkers/abstainers (women consuming less than .5 ounce of absolute alcohol per day at conception). Six months after the warning label law was implemented (June 1, 1990), lighter drinkers decreased their drinking during pregnancy by a small but statistically significant amount. In contrast, pregnant risk drinkers did not significantly change their alcohol consumption.

scholarly journals Access to prenatal care: inequalities in a region with high maternal mortality in southeastern Brazil

2016 ◽  
Vol 21 (5) ◽  
pp. 1647-1658 ◽  
Author(s):  
Katrini Guidolini Martinelli ◽  
Edson Theodoro dos Santos Neto ◽  
Silvana Granado Nogueira da Gama ◽  
Adauto Emmerich Oliveira
Keyword(s):  
Health Care ◽  
Prenatal Care ◽  
Health Services ◽  
Pregnant Women ◽  
Minimum Wage ◽  
Urban Areas ◽  
Access To Health Care ◽  
Universal Access ◽  
Southeastern Brazil ◽  
Cross Sectional

Abstract Aim This article aims to evaluate access to prenatal care according to the dimensions of availability, affordability and acceptability in the SUS microregion of southeastern Brazil. Methods A cross-sectional study conducted in 2012-2013 that selected 742 postpartum women in seven hospitals in the region chosen for the research. The information was collected, processed and submitted to the chi-square test and the nonparametric Spearman’s test, with p-values less than 5% (p < 0.05). Results Although the SUS constitutionally guarantees universal access to health care, there are still inequalities between pregnant women from rural and urban areas in terms of the availability of health care and among families earning up to minimum wage and more than one minimum wage per month in terms of affordability; however, the acceptability of health care was equal, regardless of the modality of the health services. Conclusion The location, transport resources and financing of health services should be reorganised, and the training of health professionals should be enhanced to provide more equitable health care access to pregnant women.

scholarly journals Finding Tentative Causes for the reduced impact of Covid-19 on the Health Systems of poorer and developing nations: An ecological study of the effect of demographic, climatological and health-related factors on the global spread of Covid-19

2020 ◽  
Author(s):  
Shabnam Banerjee ◽  
Arunanjan Saha
Keyword(s):  
Health Systems ◽  
Ecological Study ◽  
Developing Nations ◽  
Mitigation Measures ◽  
Protective Effects ◽  
Related Factors ◽  
Health Related ◽  
The Impact ◽  
Study Setting ◽  
Correlation Factors

Objective - The objective of this study is to evaluate the association with different factors empirically found to affect the spread and the severity of Covid-19. Evidently there is less likelihood of having one single and absolute solution to this pandemic. It is pragmatic to look for a multi-pronged and collaborative assembly of probable solutions, which is the higher objective of this study. Design - Ecological study. Setting - Global setting including 45 countries from all six inhabited continents Population Two (2) or three (3) countries from each geographical region of the continents selected on the basis of population Main outcome - measures correlation factors derived from comparisons between different sets of variables Results - Empirical trends suggested in the existing literature were quantified in a global setting establishing clear trends. Correlation between the proportion of the population affected and median age, prime climate zones, malaria and tuberculosis incidence, BCG coverage and mitigation measures were established. Conclusions The study findings suggest that demographic and climatological factors, high endemicity of TB and Malaria, and universal BCG programmes may have a cushioning effect in the impact of Covid-19 on health systems of poorer and developing nations. In the light of these findings more emphasis is necessary on the protective effects of BCG and antiviral properties of antimalarial drugs.

Hepatitis B Surface Antigen Prevalence Among Pregnant Women in Urban Areas: Implications for Testing, Reporting, and Preventing Perinatal Transmission

PEDIATRICS ◽  
2003 ◽  
Vol 111 (Supplement_1) ◽  
pp. 1192-1197 ◽  
Author(s):  
Gary L. Euler ◽  
Karen G. Wooten ◽  
Andrew L. Baughman ◽  
Walter W. Williams
Keyword(s):  
Hepatitis B ◽  
Prenatal Care ◽  
Pregnant Women ◽  
Urban Area ◽  
Surface Antigen ◽  
Urban Areas ◽  
Hepatitis B Surface Antigen ◽  
Prevalence Rates ◽  
Odds Ratios ◽  
Factors Associated

Objectives. To estimate race/ethnicity-specific prevalence of hepatitis B surface antigen (HBsAg) in pregnant urban women and to evaluate factors associated with maternal HBsAg testing. Methods. A multicenter, retrospective chart review was conducted of a racially/ethnically stratified random sample of maternal/infant charts of 10 523 women who gave birth to live infants during 1990–1993 in 4 urban areas in the United States. Data were collected on multiple variables, including demographic variables, HBsAg test dates and results, prenatal care type, and amount and source of payment. Results. HBsAg prevalence among white non-Hispanics was 0.60% (95% confidence interval [CI]: 0.22–0.98), black non-Hispanics 0.97% (95% CI: 0.48–1.47), Hispanics 0.14% (95% CI: 0.01–0.26), and Asians 5.79% (95% CI: 4.42–7.16). HBsAg testing rates increased from 56.6% in 1990 to 78.2% in 1993. Factors associated with not being tested varied by urban area, but in the combined area model, they were having no or private prenatal care (odds ratios: 18.75 and 5.07, respectively) and being black (odds ratios: 2.08). Only 20.9% (95% CI: 19.1%–22.8%) of those not tested prenatally were tested at delivery. The expected number of infants born to HBsAg-positive study-area women was 3327 using study prevalence rates, compared with 1761 using national rates. Conclusions. To help ensure that all urban infants who are born to HBsAg-positive women receive appropriate prophylaxis, health officials in urban areas should use urban-area prevalence rates to ascertain completeness of reporting maternal HBsAg positivity. Needed steps to increase maternal HBsAg testing rates include ensuring that more pregnant women receive prenatal care, promoting testing by private providers, educating providers about testing in all racial and ethnic groups, and reminding providers to test at delivery those women not tested prenatally.

scholarly journals Effect of hypovitaminosis D and its related factors in pregnant women and their newborns

2019 ◽  
Vol 8 (3) ◽  
pp. 1115
Author(s):  
Amrita Sandhu ◽  
Ruchira Nautiyal ◽  
Vinit Mehrotra ◽  
Sanober Wasim
Keyword(s):  
Vitamin D ◽  
Cord Blood ◽  
Pregnant Women ◽  
Vitamin D Deficiency ◽  
Negative Correlation ◽  
Serum Vitamin ◽  
Related Factors ◽  
Serum Vitamin D ◽  
Vitamin D Levels ◽  
The Impact

Background: Maternal and fetal vitamin D deficiency has nowadays emerged as a frequent morbidity. Adequate vitamin D concentrations during pregnancy are necessary to maintain neonatal calcium homeostasis, bone maturation and mineralization. Objectives of this study were to evaluate serum vitamin D concentration in mothers and its correlation with neonatal cord blood vitamin D at the time of delivery and to study the impact of hypovitaminosis on neonatal anthropometry. Effect of related factors like calcium (Ca), alkaline phosphatase (ALP) and parathyroid hormone (PTH) on maternal vitamin D levels were to be evaluated.Methods: Cross sectional study was done on a total of 220 healthy uncomplicated antenatal females with singleton pregnancy attending labor room at the time of delivery. Maternal and neonatal cord blood samples were drawn in the delivery room and analyzed. Neonatal anthropometry was recorded. Correlations among various maternal and neonatal factors were studied.Results: Widespread vitamin D deficiency was observed in expectant subjects and neonates with 70.91% having deficient levels which were also reflected in newborns (71.82%). Maternal ALP (r= -0.5503, p=0.000) bears a weak negative correlation (p<0.05), maternal serum Ca positive correlation (r = 0.7486, p=0.000) and plasma PTH levels a negative correlation (r = -2.084, p=0.000) with hypovitaminosis. No significant correlation was observed between neonatal anthropometry and vitamin D levels.Conclusions: High prevalence of hypovitaminosis was observed among pregnant women and their neonates in this study. A positive linear relationship was seen between maternal and cord blood vitamin D (r 0.974, p 0.0001).

scholarly journals Being in an oasis: a restorative and reassuring place - women’s experiences of a valuable antenatal diabetes midwifery consultation

2013 ◽  
Vol 3 (1) ◽  
pp. 2
Author(s):  
Christina Furskog Risa ◽  
Febe Friberg ◽  
Eva Lidén
Keyword(s):  
Prenatal Care ◽  
Pregnant Women ◽  
Urban Areas ◽  
Structured Interviews ◽  
Prenatal Consultation ◽  
Organization Of Care ◽  
Personal Approach ◽  
Insufficient Time ◽  
Purposive Sample ◽  
Limited Scope

The prevalence of diabetes in the childbearing population is increasing globally. Pregnant diabetic women are considered to be at high risk, and thus require specialized, multidisciplinary prenatal care in which midwives play an integral part. These women&rsquo;s views and experiences of encounters with midwives during diabetes care have not yet been investigated. Our aim was to use an exploratory interpretive approach to investigate the experiences of pregnant women and their perceptions towards the meaning of prenatal consultation provided by midwives in the prenatal care team. A purposive sample was recruited from four hospital-based prenatal diabetes outpatient clinics in the urban areas of Norway: 10 pregnant women (5 primiparous, 5 multiparous) aged 28-45 and diagnosed with different types of diabetes. Data from semi-structured interviews were transcribed and subjected to thematic analysis. Three main themes emerged: being in an open atmosphere, being seen as a person, and being reassured. Together, these themes created a construct that we labeled <em>being in an oasis-a restorative and reassuring place</em>. The counterpoint of this view was a more negative perspective described as having insufficient time, feelings of being objectified and rushed, and diseaseoriented care. The women valued the focus on surveillance in the consultations, although at their best, the midwife-woman encounters complemented and counteracted the iatrogenic effect of the biomedical focus in specialist prenatal care. However, the organization of care may have contributed to and created feelings of suffering, as these women had limited scope for addressing their concerns in the consultation. We conclude that these consultations are complex co-created activities in which interpersonal aspects of the midwifewoman encounters, such as the midwives&rsquo; openness and responsiveness to the women, seem to be significant in developing a personal approach.

scholarly journals The catastrophic and impoverishing effects of out-of-pocket healthcare payments in Kenya, 2018

2019 ◽  
Vol 4 (6) ◽  
pp. e001809
Author(s):  
Paola Salari ◽  
Laura Di Giorgio ◽  
Stefania Ilinca ◽  
Jane Chuma
Keyword(s):  
Rural Areas ◽  
Urban Areas ◽  
Health Expenditure ◽  
Scale Up ◽  
Two Dimensions ◽  
Poor People ◽  
Financial Protection ◽  
Health Coverage ◽  
Catastrophic Payments ◽  
The Impact

IntroductionProgress towards effective service coverage and financial protection—the two dimensions of Universal Health Coverage (UHC)—has been limited in Kenya in the last decade. The government of Kenya has embarked on a highly ambitious reform programme currently being piloted in four Kenyan counties and aiming at national rollout by 2022. This study provides an updated assessment of the performance of the Kenyan health system in terms of financial protection allowing to monitor trends over time. In light of the UHC initiative, the study provides a baseline to assess the impact of the UHC pilot programme and inform scale-up plans. It also investigates household characteristics associated with catastrophic payments.MethodsUsing data from the Kenya Household Health Expenditure and Utilization Survey (KHHEUS) 2018, we investigated the incidence and intensity of catastrophic and impoverishing health expenditure. We used a logistic regression analysis to assess households’ characteristics associated with the probability of incurring catastrophic health expenditures.ResultsThe results show that the incidence of catastrophic payments is more severe for the poorest households and in the rural areas and mainly due to outpatient services. Results for the impoverishing effect suggest that after accounting for out-of-pocket(OOP) payments, the proportion of poor people increases by 2.2 percentage points in both rural and urban areas. Thus, between 1 and 1.1 million individuals are pushed into poverty due to OOP payments. Among the characteristics associated with the probability of incurring OOP expenditures, socioeconomic conditions, the presence of elderly and of people affected by chronic conditions showed significant results.ConclusionKenya is still lagging behind in terms of protecting its citizens against financial risks associated with ill health and healthcare seeking behaviour. More effort is needed to protect the most vulnerable population groups from the high costs of illness.

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