Population Externalities and Optimal Social Policy

If fertility is not chosen in a socially optimal way, and if policies to directly target fertility are ineffective or politically infeasible, then public policies that affect fertility could have important welfare consequences through the fertility channel. We refer to these effects as population externalities, and in this paper we focus on one important variable that may have a causal impact on fertility: the education of potential parents. If increased education causes families to have fewer children, then a government would want to increase college tuition subsidies in the presence of environmental externalities such as climate change, to indirectly discourage families from having children who will generate future environmental costs. Alternatively, if fertility is inefficiently low, due to imperfect parental altruism for example, governments will want to lower tuition subsidies to encourage child-bearing. We present a simple model of the college enrollment decision and its fertility impacts, and show that such population externalities are quantitatively important: the optimal subsidy increases by about $5000 per year with climate change, and decreases by over $7000 per year with imperfect parental altruism. Our paper demonstrates how public economics can incorporate population externalities, and that such externalities can have significant impacts on optimal policy.

Linden Hills

Linden Hills by Gloria Naylor marks psychological fragmentation which results into immense pain and suffering. Naylor, in this novel, addresses the physical and mental hierarchies which act as blockades in the higher purpose of human integration. This paper aims to investigate the saga of undiluted suffering in the lives of women in Linden Hills. The novelist shows in true colors how the black women become sacrificial lambs and receive the brunt of the frustration of the black males of their society. This paper is also a close study of black males mentality when they get unbridled power and exert it on all those who are subversive to them. Women become the easy victim of their ruthless power play. The tragedy is more intense because the women have been suffering for many generations. In every generation, Nedeed male marries a light-complexioned woman just to reduce her to a child-bearing tool. Failing that, the woman has to lead a life full of hardships and depravity. This paper analyses how her loud desires to stand against the institutionalized trauma herald a new era of freedom from pain and suffering.

Can I Be Pregnant? – Diagnostic Challenges in Ruptured Chronic Ectopic Pregnancy

Ectopic pregnancy is an obstetric emergency which accounts for 4% of all pregnancy-related deaths. All women of child bearing age with abdominal pain or vaginal bleeding presenting to the Emergency Department should be evaluated for ectopic pregnancy. However, there have been many reported cases of diagnostic challenges of ectopic pregnancy. One rare variant of ectopic pregnancy that can be easily overlooked is chronic ectopic pregnancy. We present this case of a 39-yearold female, who presented with acute abdomen and free fluid in her abdomen. Urine pregnancy test indicated she was not pregnant. However, intraoperative findings confirmed left tubular pregnancy. We would like to highlight three major diagnostic challenges we faced in this case i.e.; (i) women of child bearing age with abdominal pain should always be evaluated for ectopic pregnancy; (ii) diagnosis of ectopic pregnancy should not be dismissed even though the pregnancy test is negative; and (iii) the role of computed tomography (CT) scan in acute abdomen of unclear aetiology. As a rule, all haemodynamically unstable acute abdomen should be sent to the operation theatre. Haemodynamically stable patients should be carefully evaluated to facilitate surgical management.

Ruptured Hemorrhagic Ectopic Pregnancy Implanted in the Diaphragm: A Rare Case Report and Brief Literature Review

The mortality and morbidity rates of non-tubal ectopic pregnancies with abdominal hemorrhaging are 7–8 times higher than those of tubal pregnancies. Diaphragmatic pregnancy is a rare non-tubal ectopic form, causing acute abdominal hemoperitoneum. Here, we present a case of a primary diaphragmatic ectopic pregnancy with hemorrhage that was immediately diagnosed and successfully managed with laparoscopic surgery. Rapid and accurate diagnosis using appropriate imaging modalities is critical for improving the prognosis of a child-bearing woman with an abdominal pregnancy.

Seroprevalence of CMV in Women with Bad Obstetric History in Babil/Iraq

Placental dysfunction and or fetal central nervous system infestation caused by Human cytomegalovirus (HCMV) is the leading cause of congenital non-genetic neuro-developmental problems of the newborn, worldwide. Although the highest rates of congenital infection and CMV seroprevalence occurs in developing countries like Iraq, there remains a paucity of data from that part of the world. This descriptive case control study was undertaken in Babylon/ Iraq to determine the local seroprevalence of CMV in women of child bearing age, and to identify the socio-demographic factors associated with it. This study found a seropositivity peak amongst the 26-35 yr olds which declined in the 36 – 45 yr olds. However, the evidence of current infection was stable at 25% among the 26-35 yr olds and the 36 – 45 yr old women. Overall seropositivity was at 77.32%, a susceptibility rate was at 22.68%, and seropositivity for IgG was highest among the educated, those living in overcrowded settings, and those with poor obstetric histories. Our study concludes that CMV screening of women in the Al Hamza district in Babylon/Iraq and the availability of advice on how to prevent the infection can be beneficial for health outcomes.

BRAF-mutant melanoma of the skin during pregnancy with dichorionic diamniotic twins. Clinical case

Per the majority of authors, melanoma is the most common tumor diagnosed during pregnancy (31 % of all malignant neoplasms). In approximately 1/3 of women melanoma developed in child-bearing age is diagnosed during pregnancy or in the postpartum period. However, only some retrospective studies analyzed the effect of pregnancy on melanoma development, and conclusive data on development, progression and treatment of BRAF-mutant melanoma is lacking. In this subpopulation of patients, BRAF status supposedly can negatively affect disease outcome irrespective of treatment methods.The article presents a clinical case of recurrence of melanoma with the BRAF V600E mutation during pregnancy. The patient underwent lymph node dissection during pregnancy prolongation, after labor she received antitumor drug therapy with МЕК and ВRAF inhibitors. Melanoma recurrence during pregnancy did not worsen treatment outcomes for the mother and embryo.

Psychological Cognition of Women of Childbearing Age on the Use of Cosmetics During Pregnancy

Objective: To investigate the psychological cognition of women of childbearing age on the use of cosmetics during pregnancy, so as to provide guidance for women of childbearing age to correctly use cosmetics during pregnancy. Methods: A total of 180 women of childbearing age who underwent gynecological examination in Dezhou People’s Hospital from October 2020 to October 2021 were selected as the research subjects. Questionnaires were used to investigate the psychological cognition of women of childbearing age on the use of cosmetics during pregnancy. Results: Among the 180 women of childbearing age, 48 (26.67%) felt that cosmetics cannot be used during pregnancy, 60 (33.33%) felt that it did not matter, and 72 (40.00%) agreed that cosmetics can be used during pregnancy. In addition, urban women, highly educated women, unmarried women, and enterprise employees agreed with the use of special cosmetics for pregnant women or the selective use of cosmetics during pregnancy. Conclusion: Most women of child-bearing age felt that cosmetics can be used during pregnancy; this cognition is related to their education level, occupation, and registered residence.

Influence of cultural factors on choice of childbirth place among women in Oyigbo L.G.A. Rivers State, Nigeria

BACKGROUND: Choices of childbirth places among women may influence the risk rate of both maternal and newborn health and some cultural practices which encourages both maternal mortality and infant death, are still a major challenge especially in developing countries like Nigeria, cultural norms and practices during childbirth are common but little is documented about how these cultural beliefs and their influence on the women of child bearing age and their childbirth place choices. The aim of this study was to find out the prevalent cultural factors that influence the choice of childbirth places among the women of child bearing age, in Oyigbo Local Government area of Rivers State in Nigeria.METHODOLOGY: A self-structured questionnaire was used as instrument to collect data for the study through simple random sampling, and these data was analyzed using Frequency and percentage for descriptive statistics while chi-square was used for inferential statistics at 0.05 level of significance. RESULT: The result showed that mean age of the women is 35.27 and most of them had secondary education, also there was a high level of hospital/health facility adherence among the women in Oyigbo Local Government Area of Rivers and also there was no significant association between cultural factors and choices of childbirth places among the women.CONCLUSION: Therefore, this study has shown that there is no significant cultural influence on the choices of childbirth places of women in Oyigbo Local Government Area of Rivers State.

COMPARATIVE CHARACTERISTICS (CASE - CONTROL) OF WOMEN WITH AND WITHOUT ENDOMETRIOID DISEASE

Endometrioid disease today is ranking one of the leading positions in the structure of gynaecological diseases. The prevalence of this endometrioid disease reaches 10% among the female population and up to 70% among women of child-bearing age. Ambiguity in terms of the aetiology, pathogenesis, and predictors of the disease impedes the accurate and quick diagnosis and proper management of this disease. The aim of this study is to analyze and to compare symptomatic and anamnestic data presented by women who have with endometrioid disease and have no it, and to identify and analyze predictors and consequences of endometrioid disease. The study examined 80 women of reproductive age. The main group involved 50 women with endometrioid disease; the control group included 30 women without signs of endometrioid disease. All participants underwent clinical examination and were interviewed about symptoms, family history, menstrual function, past gynaecological, reproductive, infectious (infectious diseases, transferred in childhood), somatic diseases. The information about the presence of psychological and physical overstrain in women of both groups was obtained (subjectively from the words of women) and then assessed. Contributory factors or predictors in the development and progression of endometrioid disease are as follows: an increased number of occupational hazards (22.6% versus 0%, respectively, p = 0.03) among working women with endometrioid disease; regular psychological overstrain, which can result from endometrioid disease on the one hand, and, contribute to its progression, on the other (70% versus 43.3%; p = 0.03); the presence of the 0 blood type (40% versus 16.7%; p = 0.029), the presence of chronic inflammation of the uterine appendages in the past (60% versus 36.6%; p = 0.04); human papilloma virus in past or present medical history (14% versus 0%; p = 0.04). The possible consequences of endometrioid disease include somatic pathology prevailing in 1.3 times. Special attention should be paid to the average number of gastro-intestinal diseases in the women of main and control groups: 1.34 ± 1.3 versus 0.77 ± 1.1, respectively; p = 0.04. The prevalence of diseases of urinary system is as follows: 0.66 ± 0.68 versus 0.33 ± 0.54, respectively; p = 0.04. The menstruations are described as irregular, heaving bleedings often with dark brown discharge before menstruation, pain during menstruation. The study revealed a large percentage of infertility in patients with endometrioid disease (60% versus 33.3%, respectively; p = 0.02), reduced reproductive potential in general (the average number of pregnancies per woman in the control group is 1.9 times higher). It should be noted that 14 (28%) women of the main group have relapse of endometrioid disease in the form of repeated cysts after conservative and / or surgical treatment. Thus, endometrioid disease was detected for the first time in 36 (72%) women of the main group. The information obtained in the study can be helpful for medical practitioners as it deepens knowledge about possible predictor factors, premorbid background and the consequences of endometrioid disease, and, thus, will serve in customized management of such patients.