Caesarean deliveries, subsequent reproductive behaviour and children ever born in India

Against the backdrop of the alarming rise in Caesarean section (C-section) births in India, this study aimed to examine the association between C-section births, fertility decline and female sterilization in the country. A cross-sectional design was used to investigate the association between C-section delivery and subsequent reproductive behaviour in women in India. Data were from the National Family Health Survey (NFHS-4). The study sample comprised 255,726 currently married women in the age group of 15–49 years. The results showed a strong positive relationship between C-section births and female sterilization. The predicted probabilities (PP) from the multivariate regression model indicated a higher chance of female sterilization in women with C-section births (PP = 0.39, p<0.01) compared with those with non-C-section births (PP = 0.20, p<0.01). Both state-level correlation plots and Poisson regression estimates showed a strong negative relationship between C-section births and mean children ever born (CEB). Based on the results, it may be concluded that the use of C-sections and sterilization were strongly correlated in India at the time of the NFHS-4, thus together contributing to fertility decline. A strong negative association was found between the occurrence of C-sections and CEB. The increased and undesired use of C-section births and consequent female sterilization is a regressive socio-demographic process that often violates women’s rights. Fertility decline should happen through informed choice of family planning and must protect the reproductive rights of women.

Development of approaches to innovation transfer and intellectual property management to ensure enterprise competitiveness

The work deals with the problems of innovation transfer and intellectual property management at enterprises. An approach reasoning the choice of innovations and the type of their transfer at an enterprise has been developed, which increases the efficiency of innovation processes. For this purpose, the essence of the category “innovation transfer” regarding the micro-level was clarified and determined according to the sources of innovations. A set-theoretic model of innovation selection based on evaluating the essence of innovations, their generators (suppliers) and implementation conditions has been developed. For such an assessment, a set of criteria has been proposed, a number of the most essential conditions for introducing innovations at an enterprise have been identified, and an optimization model for the efficiency of the innovation development process has been developed. They allow making an informed choice of innovations in accordance with the needs of the enterprise. Evaluation criteria for the innovative potential are proposed and their essence is determined. Testing of the evaluation confirmed the possibility of using the proposed criteria. A model of innovation transfer, which presents the main processes and participants in the transfer of external and internal innovations has been developed, which allows enterprises to ensure a high level of organization and implementation of the transfer. Given the direct relationship between the transfer of innovations and intellectual property, an approach to improving intellectual property management at the enterprise is proposed. A number of principles of intellectual property management have been determined. The stages of intellectual property management at the enterprise are proposed as a set of specific actions determining all processes directly or indirectly related to such management, as well as those responsible for these processes and resource provision.

ORGANIZATIONAL ASPECTS OF EARLY DIAGNOSIS AND TREATMENT OF SURGICAL SEPSIS IN THE CONDITIONS OF "CITY CLINICAL HOSPITAL №7" IN ALMATY

Сепсис и септический шок являются одной из основных проблем здравоохранения. Ежегодно, по всему миру, он является причиной смерти более миллиона людей, при этом частота летальных исходов составляет примерно один случай из четырех. Летальность при тяжелом сепсисе и септическом шоке может достигать 30-90 процентов. На базе «ГКБ №7» УОЗ г. Алматы нами была разработана и внедрена алгоритм ранней диагностики и лечения сепсиса и современные методы применения биомаркеров диагностики и мониторинга сепсиса (акт внедрения от 01.06.2019г.), где основными показателями были сортировка по «Triage» системе на основе шкалы SOFA 3, определение современных биомаркеров как прокальцитонин и пресепсин. Так же определение гемокультуры, нейтрофильного лейкоцитоза, лактата, C-реактивного белка, и раннее применение эффективных антимикробных препаратов (в первый час) с момента постановки диагноза «септический шок» или «тяжелый сепсис», которые в свою очередь дали возможность своевременной фиксации признаков генерализации гнойного процесса и ранней диагностике осложнений. Упущение времени на этапе диагностики являются причиной возникновения в дальнейшем ошибок постановки окончательного диагноза и проведения соответствующего лечения. Многих ошибок можно избежать, если лечащие врачи будут точно следовать рекомендациям по ранней диагностике сепсиса и обоснованного выбора антимикробной терапии в каждом конкретном случае. На основании вышеизложенного, алгоритм разработанное и утвержденное руководством клиники «ГКБ №7», выполнение диагностических процедур адаптированную под диагностические возможности клиники, лечебную тактику пациентов с диагнозом «Сепсис» и налаженное система контроля над ее выполнением, - дало возможность к раннему выявлению генерализации гнойного процесса и развития тяжелого сепсиса или септического шока и соответственно привели к снижению летальности. Sepsis and septic shock are a major health problem. Globally, it causes more than a million deaths annually, with a death rate of about one in four. Mortality in severe sepsis and septic shock can be as high as 30-90 percent.On the basis of "City Clinical Hospital № 7" of the UOZ in Almaty, we have developed and implemented an algorithm for early diagnosis and treatment of sepsis and modern methods of using biomarkers for diagnosis and monitoring of sepsis (act of implementation dated 01.06.2019), where the main indicators were sorting according to "Triage" system based on the SOFA 3 scale, the definition of modern biomarkers such as procalcitonin and presepsin. Also, the determination of blood culture, neutrophilic leukocytosis, lactate, C-reactive protein, and the early use of effective antimicrobial drugs (in the first hour) from the moment of diagnosis of "septic shock" or "severe sepsis", which in turn made it possible to timely fix signs of generalization purulent process and early diagnosis of complications.Loss of time at the diagnostic stage is the reason for the subsequent occurrence of errors in the final diagnosis and appropriate treatment. Many mistakes can be avoided if the treating physicians strictly follow the recommendations for the early diagnosis of sepsis and the informed choice of antimicrobial therapy on a case-by-case basis.Based on the above, the algorithm developed and approved by the management of the clinic "City Clinical Hospital № 7", the implementation of diagnostic procedures adapted to the diagnostic capabilities of the clinic, the treatment tactics of patients diagnosed with "Sepsis" and an established monitoring system for its implementation, - made it possible to early detection of generalization of the purulent process and the development of severe sepsis or septic shock and, accordingly, led to a decrease in mortality.

‘The System is Not Set up for the Benefit of Women’: Women’s Experiences of Decision-Making During Pregnancy and Birth in Ireland

In this article, I draw on in-depth qualitative interviews with 23 women, conducted in 2019/2020, focusing on their involvement in decision-making during pregnancy and birth. The study is located in Ireland, where comparably progressive national policies regarding informed choice in labour and birth clash with the day-to-day reality of a heavily medicalised, paternalistic maternity care system. I represent the subjective experiences of a diverse group of women through in-depth interview excerpts. In my analysis, I move beyond describing what is happening in the Irish maternity system to discussing why this is happening – relating the findings of the research to the international literature on authoritative knowledge, technocratic hospital cultures and risk-based discourses around birth. In the last section of the article, I offer concrete, empirically grounded and innovative recommendations how to enhance women’s involvement in decision-making.

What do parents think of using informational videos to support recruitment for parenting trials? A qualitative study

Background Lower than expected recruitment and retention rates are common challenges in parenting trials—particularly for community-based trials targeting parents of young children that rely on face-to-face recruitment by frontline workers. Recruitment requires parental informed consent, yet information sheets have been criticized for being lengthy and complex, and particularly challenging for parents with low literacy. Recent innovations include ‘talking head’ information videos. This paper aims to explore parent perceptions of using a ‘talking head’ video to support informed consent, recruitment, and retention procedures in parenting trials. Methods We conducted semi-structured interviews with a sample of 24 mothers recruited after their final follow-ups in two different parenting trials in Denmark. Before consenting to participate in the trials, parents were invited to view a video of a member of the study team giving information about the study, and again before the interviews for the current study. The audio data was transcribed and thematic analysis was conducted. Results We identified three overarching themes: (1) general impression of the video, (2) thoughts on participation in research, and (3) recruitment and retention. Participants were generally positive in their appraisal of the two talking head informational videos. We found that participants felt that a mix of paper-based and video-based sources of information would enable them to make an informed choice about whether to participate in a research study. We also found that a professionally produced video featuring a key member of the study team produced a feeling of commitment to the study that could impact retention rates. Conclusions Informational videos are acceptable to parents; however, co-production or participant/patient involvement in the development of such videos is recommended. Informational videos may not increase recruitment but have the potential for improving retention. Key design recommendations are to ensure a ‘professional’ look to the video, to supplement videos with paper-based information, to keep the length to < 3 min, and for the ‘talking head’ part to feature a key member of the study team.

Investigating Sustainable NGO–firm Partnerships: An Experimental Study of Consumer Perception of Co-Branded Products

With crises like climate change and degradation of the earth’s natural habitats, human consumption needs to become more sustainable to decrease humanity’s environmental footprint. Fostering sustainable consumer behavior by enabling consumers to make an informed choice for sustainable products is vital in changing human consumption for the better. To optimize consumers’ perception of sustainable products, companies can establish partnerships with environmental non-governmental organizations (NGOs). In practice, retailers and NGOs can engage in NGO–firm co-branding of sustainable products. Yet, little is known about the impact of this NGO–firm co-branding on consumer perception. We fill this gap based on a 2 × 2 × 2 experimental study. We test consumers’ trust, product and brand perception of co-branded sustainable products. Our study finds that NGO–firm co-branding has a significant positive effect on all the above. The effect is moderated by familiarity with the co-branding partnership and consumer attitudes. We discuss how those NGO–firm partnerships can be a useful tool to guide customers to more sustainable consumption choices. The results are discussed in light of sustainability communication and cross-sector partnership theory. We offer important insights for consumer perspectives on sustainability communication, business engagement of NGO–firm partnerships and develop future research ideas for consumer behaviour.

Bridging the communication gap: What do primary healthcare practitioners in New Zealand know about health literacy? What are their attitudes towards it, and how do they implement any internationally developed health literacy tools?

<p>Health Literacy has been identified internationally as an important component of health equity. As a health consumer, being health literate includes having the ability to make an informed choice about health. As a healthcare provider or health educator, being health literate is having the ability to enable the consumer to become fully informed, even if there are barriers that complicate or hamper this ability. Many health literacy tools have been developed to support clinicians, including those in primary care, in communicating effectively with their patients. When properly utilised, these tools have the potential to improve the health outcomes of their patients and also to reduce health system costs. The literature produced about health literacy has seen exponential growth, especially over the last eight years, due to increased recognition of its contribution to better healthcare outcomes. This research examined whether General Practitioners (GPs) in New Zealand were aware of health literacy concepts and the specific tools that have been developed, and whether they were utilising them. Although some health literacy tools and strategies are being implemented by GPs, they are not necessarily realising this, as their concept of health literacy seems to be focused on the general literacy level of their patients. Health literacy tools identified tended to be in the form of print and online health education materials.</p>