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2022 ◽  
pp. 101852912110657
Author(s):  
M. Showkat Gani ◽  
A. K. M. Ahsan Ullah ◽  
Thirunaukarasu Subramaniam ◽  
Lennarth Nyström ◽  
A. Mushtaque R. Chowdhury

This study assesses the effect of a customised Maternal Neonatal and Child Survival (MNCS) intervention in the rural areas of Bangladesh. This study attempts to estimate the lifetime fertility rate and the proportion of live births ≥3, and the age-specific lifetime fertility patterns among the women of reproductive age. This quasi-experimental study used impact evaluation data from the MNCS intervention in 2013 and compared these with the baseline data collected in 2008. We used a multi-stage, cluster random sampling technique to include 6,000 and 4,800 women in 2008 and 2013, respectively. The respondents were either mothers who had alive/deceased infants or the mothers whose pregnancy was terminated or who had living children of 12–59 months without pregnancy outcomes in the preceding year of the surveys. Based on the mean difference of live births from baseline to endline year for each intervention union, and then we compared these two areas (intervention and control unions). Overall lifetime fertility rate declined significantly in high-performing intervention unions (from 2.6 to 2.2/woman, p < .001) or in control unions (from 2.4 to 2.2/woman; p < .001). The degree of reduction of fertility increased significantly with age, and such a change was most prominent in the case of women ≥35 years old. Multivariate analyses suggest that the likelihood of having live births ≥3 reduced significantly in high-performed intervention compared to control unions. In conclusion, the probability of reducing lifetime fertility over time increases with a higher level of access, degree and duration of the customised intervention.


Author(s):  
Madhushani J.S.S. ◽  
Bandara W.V.R.T.D.G.

Introduction: Nephrotic Syndrome (NS) is the commonest chronic glomerular disorder characterized by heavy proteinuria, hypoproteinaemia, oedema and hyperlipidaemia. Parental motivation and involvement are essential for home management of a child with NS. This study was conducted to assess caregivers' knowledge and healthcare related practices regarding home management of children with NS. Methods: A descriptive cross-sectional study was conducted among caregivers (n=94) attending the Paediatric Nephrology Clinic (PNC) at the Teaching Hospital Karapitiya, Sri Lanka. Data were collected through an interviewer-administered questionnaire. Data were analyzed using SPSS version 20. Results: The majority of the respondents (71.3%) were mothers. The majority of children with NS in the study sample were boys (70.2%), and their mean age was 7.6±3 years. About 40.4% of children had onset of disease at the age of 2-3 years. The majority of participants (53.2%) had scored more than 75 marks for knowledge. The practice score of the majority (66.0%) was between 50-100. The mean knowledge score was significantly higher in the participants who have managed their child with NS for 6-8 years (p=0.006) and for 9-11 years (p=0.019), compared to the participants who have managed their child with NS for 3-5 years. The mean knowledge score was significantly higher in the participants with the family history with NS in compared to the participants without family history of NS (p=0.001). A statistically significant association was found between mean practice score and the number of living children in the family (p=0.009). Mean practice score of the participants who had more than four living children was significantly higher than the participants who had two living children in their family (p=0.002). However, a significant negative correlation was observed between knowledge on NS and healthcare related practices of the participants (r= -0.240, n=94, p=0.020, 2-tailed). Conclusions: The overall knowledge and practices of parents/caregivers regarding home management of children with NS attending to the PNC, Teaching Hospital Karapitiya, Sri Lanka, was adequate and satisfactory. Keywords: Home management, Paediatric, Nephrotic Syndrome, Knowledge, Practice


Doxa ◽  
2021 ◽  
pp. 32-43
Author(s):  
Roman Galuyko

Vasyl Stafanyk entered into Ukrainian literature XIX – XX century as a master of the short story, where he emotionally passionately violates the existential problems of an individual person, lost in a world indifferent to him, of which he is forced to make certain decisions and take responsibility for his choices. The artist’s special attention is drawn to the loneliness of man, which often causes him despair and confusion. In particular, this is reflected in Stefanyk’s short stories on the lives of rural workers. The writer knew well the Ukrainian village, the problems of the peasants. There was already a gradual departure of the rural community from the collective responsibility for the fate of each of its members, which deepened the alienation, created a sense of abandonment, in his time. For example, the village and the community are calmly watching the decline of Anton’s farm – the hero of Stefanyk’s short story «Blue Book». In this short story, the cry of the soul of a once wealthy owner, who was unlucky, who in despair drinks the whole farm. In his drunken bravado there is sadness, rage and hopelessness, deep despair – Anton feels that everyone is indifferent to his grief, there is no compassion in his home community. Such loneliness, alienation and despair of man, indifference of others permeate the pages and short stories «Paliy». Its protagonist, old Fedor, worked all his life for the rich Andriy Kurochka, lost his strength and health on his farm, and is now forced to beg from strangers. The thought of this hurts Fedor’s aching soul, he goes mad with loneliness, deeply offends his human indifference. In despair, deeply offended, lonely in his grief, Fedor sets fire to the hen’s barn, taking revenge on him for his mutilated life. The lyrical hero of V. Stefanyk’s short story «My Word» chooses a different way of reacting to unfavorable life circumstances from the previous character. It is the confession of a lonely, abandoned man in a world indifferent to the fate of everyone. Detached from his native land, the hero of the novel doesn’t find peace and joy in the new world. His longing comrades, who agreed with this new world, don’t understand him. So, abandoned by them, he builds himself a world of his own imagination, in which he is comfortable and where he truly lives, hoping to find happiness. Accordingly, the author of the short story convinces that everyone is lonely and doomed to fight for their happiness, and therefore responsible for their choices. Very often Vasyl Stefanyk addresses the topic of lonely old age, when adult children become busy with their worries and do not need their parents, as, for example, in the short story «Angel», where old Tymchykha, feeling unnecessary for children, prepares for death as a salvation from loneliness. The writer raises a similar theme of loneliness of old parents with living children in such short stories as, in particular, «Sama samisinka», which depicts a gruesome picture of the death of a helpless mother left to fend for her children who went to work. The other side of lonely old age depicts the image of old Maxim, who can’t forget his dead sons. A lone widower who sent two sons to fight for Ukraine, he complains about his fate, rages in the field at work, shouts at the horses. At the same time, in despair, Maxim doesn’t accept any sympathy from neighbors, proudly carries his loneliness and despair, lamenting the whole world. He is disgusted by everything around him, he lives only by memories of the past, when his sons and wife were alive, when life was raging in his house. Thus, as we can see, many of Vasyl Stefanyk’s short stories are imbued with existential problems of man concerning the negative nature of human existence. Among them the loneliness and despair of the person in difficult life situations are especially penetratingly considered by the writer.


Author(s):  
Ken N Falculan ◽  
Ralph N Falculan

This paper examines whether the profile of the respondents: age, number of living children, marital status, income status, employment status, educational background, current feeding practices, and level of knowledge on the importance of EBF affects feeding among infants 0-6 months old. The study uses a descriptive analysis using a normative survey with a study population of 102 mothers from the Municipality of Santa Fe Romblon respondents who were informed and given consent to secure. The result is as follows mothers, whose age ranges from 21 to 25, are the most prevailing, 39%, of the total respondents are practicing EBF. The more children the respondent had higher the percentage of practicing EBF, 55% of respondents say; they are living in with a partner, either married through church wedding, civil or in the state of cohabitation, lower-income mothers (45%) practice EBF more compared to other income class. Mothers without job practice EBF more (51%) exclusive breastfeeding are practiced more by elementary graduate mothers (63%), forty-four (44) mothers out of one hundred two (102) respondents are doing exclusive breastfeeding, at least 63% have revealed little knowledge on the importance of exclusive feeding.


Author(s):  
Katharina Feld ◽  
Tim Ricken ◽  
Dustin Feld ◽  
Janine Helmus ◽  
Maria Hahnemann ◽  
...  

AbstractAbusive head trauma (AHT) and its most common variant, the shaken baby syndrome (SBS), are predominantly characterized by central nervous system-associated lesions. Relatively little data are available on the value of skeletal and skin injuries for the diagnosis of SBS or AHT. Thus, the present study retrospectively investigated 72 cases of living children diagnosed with the explicit diagnosis of SBS during medico-legal examinations at three German university institutes of legal medicine. The risk of circular reasoning was reduced by the presence of 15 cases with confession by perpetrators. Accordingly, the comparison with the 57 non-confession cases yielded no significant differences. Skeletal survey by conventional projection radiography, often incomplete, was found to be performed in 78% of the cases only. Fractures were found in 32% of the cases. The skull (43%) and ribs (48%) were affected most frequently; only 8% of the cases showed classic metaphyseal lesions. In 48% of the cases, healing fractures were present. Skin lesions (hematomas and abrasions) were found in 53% of the cases with the face (76%), scalp (26%), and trunk (50%) being the major sites. In 48% of the cases, healing skin lesions were observed. Nearly 80% of the cases with fractures also showed skin lesions. The data prove that SBS is frequently accompanied by other forms of physical abuse. Therefore, skeletal survey is indispensable and should always be done completely and according to existing imaging guidelines if child abuse is suspected.


2021 ◽  
Vol 15 (4) ◽  
pp. 1-9
Author(s):  
Doreen Macherera Mukona ◽  
Maxwell Mhlanga ◽  
Mathilda Zvinavashe

Background/aims Vaginal candidiasis is commonly experienced by women with diabetes, but its prevalence is not well documented in Zimbabwe. This study aimed to assess the prevalence of vaginal candidiasis and factors associated with diabetic treatment adherence in pregnant women with diabetes. Methods This cross-sectional study was conducted on a consecutive sample of 157 participants from a central hospital in Harare, Zimbabwe. A structured questionnaire and physical examination of the perineum were used to collect data. All procedures were conducted in privacy. Diagnosis of vaginal candidiasis was made clinically. Data were analysed using the Chi-squared test, with P<0.05 being significant. Results The prevalence of vaginal candidiasis was 19.7%. There was a significant association between monthly family income (P=0.041), parity (P=0.029) and number of living children (P=0.049) and the presence of vaginal candidiasis. Women with poor adherence to diabetic therapy were 3.95 times more likely to have vaginal candidiasis (P=0.002). Conclusions Individualised health education on glycaemic control and good perineal hygiene remains key in the prevention of vaginal candidiasis among diabetic pregnant women.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yun Zhang ◽  
Wen Hu ◽  
Zhixin Feng

Abstract Background Social isolation is a serious public health issue affecting a significant number of older adults worldwide. However, associations between different dimensions of social isolation and functional health are unclear. We assessed the varied effects of social isolation on health among a nationwide sample of older adults from China. Methods We assessed social isolation among 5,419 people aged 65 and older who took part in both the 2011 and 2014 waves of the Chinese Longitudinal Healthy Longevity Survey. Social isolation includes objective social isolation (kinlessness and lack of social contacts) and subjective social isolation. Four functional health outcomes were examined: self-rated health (SRH), activities of daily living (ADLs), instrumental activities of daily living (IADLs), and cognitive function measured by the Mini-Mental State Examination (MMSE). We used multivariable regression analyses to examine the associations between social isolation and health outcomes. Results Older people who never married or who had recently lost a spouse were more likely to report poor SRH (OR=2.44) and difficulty with IADLs (ORs=1.46) than those who were married and lived with a spouse. Older people who never gave birth were less likely to report cognitive impairment (OR=0.53) than those who had living children, while older people who had recently lost a child were more likely to report poor SRH than those who had living children (OR=1.32). Older people who had no children visiting were more likely to report difficulty with IADLs than those who had children visiting (OR=1.25). In terms of subjective social isolation, older people who felt lonely were more likely to report poor SRH, cognitive impairment, and difficulty with ADLs and IADLs (ORs=1.19, 1.27, 1.28 and 1.21, respectively), and older people who had no one to talk to were more likely to report poor SRH, cognitive decline, and difficulty with ADLs and IADLs (ORs=2.08, 5.32, 2.06 and 1.98, respectively). Conclusions Kinlessness, lack of social contacts and subjective social isolation may impact various dimensions of health in older people. Due to the varied health consequences of social isolation, targeted health interventions should be developed to address relevant situations of social isolation.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mitiku Wale Muluneh ◽  
Yikeber Abebaw Moyehodie

Abstract Background Desire for more children has an impact on couple’s fertility behaviors. It can be a precursor of actual fertility performance. However, the desire for more children is declining over time in Ethiopia. Therefore, this study aimed to identifying the determinants of the desire for more children among women in Ethiopia. Methods The 2016 Ethiopian Demographic and Health Survey data were used for the analysis. The sample consisted of 15,683 women. The binary logistic regression model was used to assess the determinants of desire for more children among women in Ethiopia. The results are presented as crude odds ratios (COR) and adjusted odds ratios (AOR) together with their corresponding 95% confidence intervals. Results No education (having no formal education) (AOR = 1.85, 95% CI 1.61–2.13), attained primary education (AOR = 1.62, 95% CI 1.43–1.83), age at first marriage 10–19 years (AOR = 1.80, 95% CI 1.27–2.54), Orthodox religion (AOR = 1.48, 95% CI 1.01–2.19), Catholic religion (AOR = 2.15, 95% CI 1.17–3.97), Muslim religion (AOR = 1.70, 95% CI 1.15–2.50), living in Amhara (AOR = 1.45, 95% CI 1.18–1.78), Oromia (AOR = 2.10, 95% CI 1.73–2.54), Benishangul (AOR = 1.17, 95% CI 1.01–1.45), SNNPR (AOR = 1.30, 95% CI 1.05–1.60), Gambela (AOR = 1.25, 95% CI 1.02–1.57), Harari (AOR = 2.24, 95% CI 1.82–2.76), ideal number of children four or fewer (AOR = 0.47, 95% CI 0.42–0.53), number of living children four or fewer (AOR = 2.12, 95% CI 1.90–2.37), and not use of contraceptives (AOR = 1.51, 95% CI 1.35–1.68) were associated with a higher desire for more children. Conclusion This finding showed that the age of women, educational level, age at first marriage, religion, region, occupation, ideal number of children, number of living children, and use of contraceptives were significant determinants of desire for more children. Therefore, it is important to adopt programs to encourage the desire for more children, implement policies in an attempt to increase the total fertility rate in Ethiopia ought to critically consider these factors. Moreover, continuous education and knowledge on reproductive health will help for better fertility behaviour for the women.


Author(s):  
Manoj Dakua ◽  
Bappa Sarkar

Sex preference is highly dominated in India and its adjacent South Asian countries. The present study examines the pattern, prevalence, and determinants of sex preference for an extra child at India's national and regional levels. For this study, we have utilized the secondary data of the Indian Human Development Survey-II. Bivariate analysis and multivariate logistic regression analysis were carried out to understand the difference of sex preference for an extra child by selected background variable- prevalence of sex preference almost 40% in India. Sex preference is higher among women who have three alive children, where the son's preference is more who have at least four living children. Son preference is decreasing with the increase of women's educational levels. On the contrary, sex preference is more among lower age at marriage. The odds of sex preference are higher among those above bachelor's degrees than those with no formal education. On the contrary, sons' preference is higher who completed their primary education than those who have no education. Sex preference, especially son's preference, directly or indirectly affects on sex ratio. Therefore, Government should focus on an awareness program and make some policies for a venerable woman identified in this study.


Author(s):  
Ken N Falculan

This paper examines whether the profile of the respondents: age, number of living children, marital status, income status, employment status, educational background, current feeding practices, and level of knowledge on the importance of EBF has an effect in feeding among infants 0-6 months old. This is a descriptive study using a normative survey with a study population of 102 mothers from the Municipality of Santa Fe, Romblon upon informed consent was secured. The result as follows mothers, whose age ranges from 21 to 25 are the most prevailing, 39%, of the total respondents is practicing EBF. The more children the respondent had the higher the percentage of practicing EBF, 55% said that they are living with a partner, either married through church wedding, civil or in the state of cohabitation, lower-income mothers (45%) practice EBF more compared to other income class. Mothers without job practice EBF more (51%) exclusive breastfeeding are practiced more by elementary graduate mothers (63%), forty-four (44) mothers out of one hundred two (102) respondents are doing exclusive breastfeeding, at least 63% have revealed little knowledge on the importance of exclusive feeding.


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