Co-establishing an infrastructure for routine data collection to address disparities in infant mortality: planning and implementation

Background Efforts to address infant mortality disparities in Ohio have historically been adversely affected by the lack of consistent data collection and infrastructure across the community-based organizations performing front-line work with expectant mothers, and there is no established template for implementing such systems in the context of diverse technological capacities and varying data collection magnitude among participating organizations. Methods Taking into account both the needs and limitations of participating community-based organizations, we created a data collection infrastructure that was refined by feedback from sponsors and the organizations to serve as both a solution to their existing needs and a template for future efforts in other settings. Results By standardizing the collected data elements across participating organizations, integration on a scale large enough to detect changes in a rare outcome such as infant mortality was made possible. Datasets generated through the use of the established infrastructure were robust enough to be matched with other records, such as Medicaid and birth records, to allow more extensive analysis. Conclusion While a consistent data collection infrastructure across multiple organizations does require buy-in at the organizational level, especially among participants with little to no existing data collection experience, an approach that relies on an understanding of existing barriers, iterative development, and feedback from sponsors and participants can lead to better coordination and sharing of information when addressing health concerns that individual organizations may struggle to quantify alone.

Surnames in south-eastern France: structure of the rural population during the 19th century through isonymy

An analysis of the distribution of surnames through time and space allows us to understand the structure of human groups, their exchanges or even their possible isolation. The French population has already been studied through surnames and it has been shown that the Sud-Provence-Alpes-Côte d’Azur region differed from the rest of France in both the 20th and 21st centuries (Mourrieras et al., 1995; Scapoli et al., 2005). The objective of this study was to understand the population evolution and particularities of the Sud-Provence-Alpes-Côte d’Azur region through an analysis of the distribution of surnames over an earlier period: the 19th century. For this work, 806,069 birth records from 521 communes between 1810 and 1890 were recorded and a total of 23,340 surnames were collected. The estimation of various isonymic parameters has allowed a description of this corpus never exploited before. In order to appreciate the population evolution, the data set was divided into three periods of 25 years. The canton was the geographical unit of this study, and similarities and differences between each of them were evaluated using Lasker distances, which allow the construction of dendrograms. A positive and significant correlation (p<0.0001) was found between Lasker distances and geographical distances using the Mantel test. The lowest inbreeding estimates were found in the Durance Valley. Migration, estimated from the v-index of Karlin and McGregor (1967), showed higher values in the south-western quarter of the region. The decrease in Rst values across the three periods is consistent with a homogenization of the patronymic between the cantons. This three-period approach showed a population evolution influenced by linguistic, cultural, historical and migratory phenomena since the Middle Ages, disrupted by the socioeconomic changes of the 19th century.

Effect of obesity on pregnancy, childbirth and postpartum among Moroccan women

Background: Overweight and obesity among Moroccan adults is continually growing affecting one in three adults from which 63.1% are women. Obesity during pregnancy increases the risk of maternal and fetal complications. The conditions of delivery are also more difficult. Objective: we aimed to describe the complications of obesity occurring in pregnancy, childbirth and postpartum among obese women in Morocco. Material and methods: It is a cross-sectional study conducted, in 2017, in two Hospital maternities in Marrakech. A sample of 200 women, who had just given birth, and have a Body Mass Index more than 30 was recruited. Women sociodemographic conditions and data about complications occurring during pregnancy, childbirth and postpartum, were collected meaning a structured interview and from participants' birth records. We used The SPSS software to realize descriptive analysis of data. Results: we noticed more than 37% of severe obesity and morbid obesity among participants. Several complications were noticed. Gestational diabetes occurs first (23%), followed by preeclampsia (14%). More than 38% of women gave birth by cesarean section. Almost 33% of participants had postpartum complications, the most common being infection (13%) and hemorrhage (12%). Conclusion: the high incidence of complications in obese women during pregnancy, childbirth and post partum emphasizes the need of a women nutritional management in preconception and during pregnancy to minimize complications.

Partnership Context of First Births in Russia: The Enduring Significance of Marriage

While cohabitation and non-marital childbearing have been increasing in Russia since 1990, the share of marital first births that are conceived prior to marriage has changed very little since the Soviet era. The prior findings on the stability of trends in premarital conceptions in Russia have been contradictory and inconclusive. This study aims to extend the existing empirical evidence on premarital conceptions in Russia and to contribute to the discussion on the persistence of marriage as the preferred partnership context for parenthood. We focus on births that occurred within the first two years of marriage, and compare the childbearing patterns of Russian women who married in different historical periods. For our investigation of fertility among marital cohorts who married during the Soviet era (1960–1991), we use individual-level data from the 1994 microcensus. For our examination of fertility among more recent marital cohorts (2000, 2011, and 2016), we draw on data from birth records in civil registers. We also use relevant complementary data sources. Our findings show that there has been a marked shift in the relationship between conception and marriage in Russia. Increasingly, conceptions have been occurring before marriage, and in the most recent marital cohorts, the level of premarital first conceptions has even surpassed the level of marital first conceptions. The average interval between conception and entry into marriage has also been lengthening. We describe this unique pattern of childbearing and discuss some potential explanations for the ongoing association between marriage and childbearing in Russia.

PROBLEM OPSTANKA BRAKA NAKON PRAVNE PROMENE POLA JEDNOG OD SUPRUŽNIKA

By its decision in case Goodwin v. United Kingdom (2002), The European Court of Human Rights has established positive obligation of states parties to find appropriate means of achieving legal recognition of one’s gender reassignment in the context of the right to protection of private life. Under the direct influence of the mentioned judgement, Constitutional Court of Serbia was deciding on constitutional complaint of a transsexual in 2012 and made the decision that administrative authorithies dealing with civil status registry have subject-matter jurisdiction to enter gender reassignment data in birth records. After, The Law on Civil Records was amended in 2018 enabling adoption of by-law act that esentially involves substantial requirements for legal recognition of preferred gender in birth records. Hence, it is possible for a transsexual to have his/her preferred gender legally recognized during the marriage. Since domestic law still does not allow same-sex marriages, the issue of such marriage survival may arise when both spouse accept legal gender reassignment deciding not to break up their marriage bond. The problem of marriage survival after legal gender reassignment in states that have enabled same-sex marriage is part of legal history. However, for legislations that insist on the heterosexual idea of marriage, these cases give rise to legal difficulties. The historical-legal and comparative-legal approach indicate that after the legal change of gender during the marriage, the values of marriage and the right to gender identity are viewed as opposites. In this regard, a transgender person is required to sacrifice marriage or to renounce his or her right to gender identity. However, the law of Serbia on this issue is, to put it mildly, indefinite. Thus, on the one hand, the Serbian Constitution supports the heterosexual view of marriage, while on the other hand it guarantees the freedom of divorce and the inviolability of human dignity. At the same time, the existing rules on the conditions for legal gender reassignment do not regulate the question of the fate of such a marriage. At the same time, within the framework of the domestic legal order, there is no direct legal means by which the mentioned same-sex marriage would end against the will of the spouses. Ultimately, there is a dilemma as to whether the preservation of the institution of marriage can be insisted on at the expense of the will of the spouses as individuals. According to domestic law, a legal change of gender in the birth records occurs on the basis of a constitutive administrative act of the municipal or city administration responsible for keeping the civil records. The mentioned administrative act determines the gender reassignment on the basis of the certificate of the appropriate health institution. The effect of gender reassignment is tied to the date of the decision of the administrative body and is valid for the future. Thus, a legal change of gender does not affect the parental relationship that may have been previously established between the person who legally changed the gender and the child. Therefore, imposing the termination of a marriage after a legal reassignment of gender of one of the spouses cannot be acceptable. However, as marital status is only one segment of the legal status of transgender persons, it is necessary to enact a special law that would regulate their legal status and eliminate problems that may arise in practice. In the case of a possible procedure for assessing constitutionality and legality, the decision of the Constitutional Court of Germany from 2008 should serve as a guide for the Constitutional Court of Serbia. According to this decision, the marriage would remain valid even after the legal change of gender of one of the spouse until the special legislation that would determine the manner of exercising the right to gender identity is adopted in cases when spouses do not want divorce.

Determinants of low birth weight among newborns delivered at Tirunesh Beijing General Hospital, Addis Ababa, Ethiopia: a case-control study

Background Low birth weight is weight less than 2500 g or 5.5 lb. at birth. Globally, more than 20 million infants (15-20%) are born with a low birth weight each year. Birth weight is the primary indicator of the health status of neonates and is the primary factor that determines the infant’s physical, survival, and mental growth. Thus, the study aimed to investigate the determinants of low birth weight among newborn babies delivered at Tirunesh Beijing General Hospital, Addis Ababa, Ethiopia. Methods We performed a facility-based unmatched case-control study among 453 (151 cases and 302 controls) deliveries conducted at Tirunesh Beijing General Hospital. Birth records and maternal antenatal care (ANC) files were reviewed from March 1 to April 30, 2019. Consecutive sampling was employed to select study participants. Data were entered into Epi-data version 4.2.1 and analyzed using SPSS version 25 statistical software. Descriptive statistics and logistic regression analysis were computed to identify independent determinants of low birth weight. A p-value of ≤0.05 was used to declare statistical significance. Result Four hundred fifty-three birth records of babies (151 cases and 302 controls) were reviewed. Women who reside in rural area [AOR (CI) = 3.12 (1.63-5.98)], being merchant [(AOR (CI) = 2.90 (1.03-8.22)], danger sign during pregnancy [(AOR (CI) = 4.14 (1.68-10.2)], and maternal weight during pregnancy [(AOR (CI) = 4.94 (3.26-7.52)] were found to be a significant determinants of low birth weight. Conclusion Residence, occupation, danger signs, and maternal weight during pregnancy were significant determinants of low birth weight. Socioeconomic development, early detection and management of complications, and encouraging nutrition and weight during pregnancy are crucial for minimizing the risk of delivering low birth weight babies.

Levels and trends in sex ratio at birth in provinces of Pakistan from 1980 to 2020 with scenario-based missing female birth projections to 2050: a Bayesian modeling approach

BACKGROUND: Pakistan has a strong preference for boys over girls; previous evidence on sex preference is primarily reported at the postnatal stage in which the child mortality rate is higher for females than males. Prenatal sex discrimination in Pakistan, reflected in the inflated sex ratio at birth (SRB; ratio of male to female births) has been barely mentioned before this study.OBJECTIVE: We estimate the SRB and missing female births in Pakistan provinces from 1980 to 2020 and identify provinces with imbalanced SRB. We provide scenario-based projections of missing female births in provinces without the existing SRB inflation.METHODS: An extensive SRB database of 832,091 birth records was compiled from all available surveys and censuses. To synthesize different data sources and provide annual estimates and their associated uncertainties of SRBs across provinces, we adopted a Bayesian hierarchical time series model.RESULTS: As per our model, Balochistan has had SRB imbalance since 1980. The maximum SRB was estimated as 1.121 (95% credible interval [1.066; 1.142]) in 1997. Assuming different start year of SRB inflation process in provinces without existing imbalance, the largest female birth deficit is projected to be 76.2 thousand in Punjab in 2033 when the SRB inflation starts in 2021.CONTRIBUTION: This is the first study on estimating the SRB from 1980 to 2020 and providing scenario-based projections of missing female births up to 2050 by Pakistan province. We identified the Balochistan province with imbalanced SRB and demonstrated important disparities in the occurrence and quantity of female birth deficits before 2050.

Health Effects of Trade Liberalization: Evidence from US Counties

This paper explores the potential externality of trade liberalization between the US and China on air pollution and infants’ health outcomes. Exploiting the differential impact of tariff reductions due to trade liberalization across industries combined with compositional variations of industry-specific employment across counties as the main source of identification strategy and using the universe of birth records in the US over the years 1990-2017 (over 97 million observations), we document substantial improvements in birth outcomes of mothers residing in counties with higher exposure to trade policy change. The exposed counties experienced sharp drops in employment specifically for manufacturing industries and revealed sharp reductions in a wide array of pollutants. A 1 percent reduction in tariff rates is associated with an 11.5 and 12.7 percentage point reduction in the likelihood of low birth weight and preterm birth, respectively.

27 Machine Learning Algorithms Based on Haplotype Libraries for Classification of Stillbirth Susceptibility in Holstein Cows

Reduced fertility is one of the main causes of economic losses in dairy farms. The cost of a stillbirth is estimated in US$ 938 per case in Holstein herds. Machine learning (ML) is gaining popularity in the livestock sector as a mean to identify hidden patterns and due to its potential to address dimensionality problems. Here we investigate the application of ML algorithms for the prediction of cows with higher stillbirth susceptibility in two scenarios: cows with &gt;25% and &gt;33.33% of stillbirths among birth records. These thresholds correspond to percentiles 75 (still_75) and 90 (still_90), respectively. A total of 10,570 cows and 50,541 birth records were collected to perform a haplotype-based genome-wide association study. Five-hundred significant pseudo single nucleotide polymorphisms (pseudo-SNPs) (False-Discovery Rate&lt; 0.05) were used as input features of ML-based predictions to determine if the cow is in the top-75 and top-90 percentiles. Table 1 shows the classification performance of the investigated ML and linear models. The ML models outperformed linear models for both thresholds. In general, still_75 showed higher F1 values compared to still_90, suggesting a lower misclassification ratio when a less stringent threshold is used. We observe that accuracy of the models in our study is higher when compared to ML-based prediction accuracies in other breeds, e.g. compared to the accuracies of 0.46 and 0.67 that were achieved using SNPs for body weight in Brahman and fertility traits in Nellore, respectively. Xgboost algorithm shows the highest balanced accuracy (BA; 0.625), F1-score (0.588) and area under the curve (AUC; 0.688), suggesting that xgboost can achieve the highest predictive performance and the lowest difference in misclassification ratio between classes. The ML applied over haplotype libraries is an interesting approach for the detection of animals with higher susceptibility to stillbirths due to highest predictive accuracy and relatively lower misclassification ratio.