Search results for: traditional birth attendant
5082 Nagabhasma Preparation and Its Effect on Kidneys: A Histopathological Study
Authors: Lydia Andrade, Kumar M. R. Bhat
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Heavy metals, especially lead, is considered to be a multi-organ toxicant. However, such heavy metals, are used in the preparation of traditional medicines. Nagabhasma is one of the traditional medicines. Lead is the metal used in its preparation. Lead is converted into a health beneficial, organometallic compound, when subjected to various traditional methods of purification. Therefore, this study is designed to evaluate the effect of such processed lead in various stages of traditionally prepared Nagabhasma on the histological structure of kidneys. Using the human equivalent doses of Nagabhasma, various stages of its preparation were fed orally for 30 days and 60 days (short term and long term). The treated and untreated rats were then sacrificed for the collection of kidneys. The kidneys were processed for histopathological study. The results show severe changes in the histological structure of kidneys. The animals treated with lead acetate showed changes in the epithelial cells lining the bowman’s capsule. The proximal and distal convoluted tubules were dilated leading to atrophy of their epithelial cells. The amount of inflammatory infiltrates was more in this group. A few groups also showed pockets of inter-tubular hemorrhage. These changes, however, were minimized as the stages progressed form stages 1 to 4 of Nagabhasma preparation. Therefore, it is necessary to stringently monitor the processing of lead acetate during the preparation of Nagabhasma.Keywords: heavy metals, kidneys, lead acetate, Nagabhasma
Procedia PDF Downloads 1465081 A Clinical Study of Placenta Previa and Its Effect on Fetomaternal Outcome in Scarred and Unscarred Uterus at a Tertiary Care Hospital
Authors: Sharadha G., Suresh Kanakkanavar
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Background: Placenta previa is a condition characterized by partial or complete implantation of the placenta in the lower uterine segment. It is one of the main causes of vaginal bleeding in the third trimester and a significant cause of maternal and perinatal morbidity and mortality. Materials and Methods: This is an observational study involving 130 patients diagnosed with placenta previa and satisfying inclusion criteria. The demographic data, clinical, surgical, and treatment, along with maternal and neonatal outcome parameters, were noted in proforma. Results: The incidence of placenta previa among scarred uterus was 1.32%, and in unscarred uterus was 0.67%. The mean age of the study population was 27.12±4.426years. High parity, high abortion rate, multigravida status, and less gestational age at delivery were commonly seen in scarred uterus compared to unscarred uterus. Complete placenta previa, anterior placental position, and adherent placenta were significantly associated with a scarred uterus compared to an unscarred uterus. The rate of caesarean hysterectomy was higher in the scarred uterus, along with statistical association to previous lower-segment caesarean sections. Intraoperative procedures like uterine artery ligation, bakri balloon insertion, and iliac artery ligation were higher in the scarred group. The maternal intensive care unit admission rate was higher in the scarred group and also showed its statistical association with previous lower segment caesarean section. Neonatal outcomes in terms of pre-term birth, still birth, neonatal intensive care unit admission, and neonatal death, though higher in the scarred group, did not differ statistically among the groups. Conclusion: Advancing maternal age, multiparity, prior uterine surgeries, and abortions are independent risk factors for placenta previa. Maternal morbidity is higher in the scarred uterus group compared to the unscarred group. Neonatal outcomes did not differ statistically among the groups. This knowledge would help the obstetricians to take measures to reduce the incidence of placenta previa and scarred uterus which would improve the fetomaternal outcome of placenta previa.Keywords: placenta previa, scarred uterus, unscarred uterus, adherent placenta
Procedia PDF Downloads 595080 Assortative Education and Working Arrangement among Married Couples in Indonesia
Authors: Ratu Khabiba, Qisha Quarina
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This study aims to analyse the effect of married couples’ assortative educational attainments on the division of economic activities among themselves in the household. This study contributes to the literature on women’s participation in employment, especially among married women, to see whether the traditional values about gender roles in the household still continue to shape the employment participation among married women in Indonesia, despite increasing women’s human capital through education. This study utilizes the Indonesian National Socioeconomic Survey (SUSENAS) 2016 and estimates the results using the multinomial logit model. Our results show that compared to high-educated educational homogamy couples, educational heterogamy couples, especially hypergamy, have a higher probability of being a single-worker type. Moreover, the high-educated educational homogamy couples have the highest probability of being a dual-worker type. Thus, we found evidence that the traditional values of gender role segregation seem to still play a significant role in married women’s employment decision in Indonesia, particularly for couples’ with educational heterogamy and low-educated educational homogamy couples.Keywords: assortative education, dual-worker, hypergamy, homogamy, traditional values, women labor participation
Procedia PDF Downloads 1185079 The Russian Preposition 'за': A Cognitive Linguistic Approach
Authors: M. Kalyuga
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Prepositions have long been considered to be one of the major challenges for second language learners, since they have multiple uses that differ greatly from one language to another. The traditional approach to second language teaching supplies students with a list of uses of a preposition that they have to memorise and no explanation is provided. Contrary to the traditional grammar approach, the cognitive linguistic approach offers an explanation for the use of prepositions and provides strategies to comprehend and learn prepositions that would be otherwise seem obscure. The present paper demonstrates the use of the cognitive approach for the explanation of prepositions through the example of the Russian preposition 'за'. The paper demonstrates how various spatial and non-spatial uses of this preposition are linked together through metaphorical and metonymical mapping. The diversity of expressions with за is explained by the range of spatial scenes this preposition is associated with.Keywords: language teaching, Russian, preposition 'за', cognitive approach
Procedia PDF Downloads 4525078 Exclusive Breast Feeding Practices in Bangladesh
Authors: Md. Ashikur Rahman
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Optimal breastfeeding practice is essential to reducing childhood morbidity and mortality and helps to achieve Millennium Development Goal (MDG). A cross-sectional study was conducted in a rural area in Dhaka district to explore the barrier to optimal breastfeeding practices. The population of this study constitutes all nursing mothers having children aged 0-6 months, and they were selected purposively. The study adopted a structured and in-depth interview procedure consisting of open and closed-ended questions. Four hundred rural nursing mothers constituted the sample of the structured interview, while 15 were involved in the in-depth interview. Among the respondent's majority (67%) were in the age group 17-25 years, with a mean age of 24.44 years. Most (39.5%) of the mothers were housewives with a secondary level of education (46.5%). About 32% of mothers started breastfeeding within one hour after birth. But delayed initiation was reported in 31.5% of mothers, whereas 36.8% of mothers forgot the exact time of initiation of breastfeeding. The main reason not to practice colostrum was mothers tried to breastfeed, but there was no milk, stated 13.8% of mothers. In addition, about one-third (34.3%) of the respondents practiced pre-lacteal feeding, and among them, 12.8% introduced sugar with water. Reasons given by the mothers for bottle-feeding was that baby was not satisfied with breast milk only; 22.0% of mothers indicated this cause. The main influence to take formula milk by their mother and mothers-in-law was stated by 18.8% of mothers. Some mothers stated that major constraints to EBF were the perception of not having enough milk (25.5 %) and babies crying seems to be hungry (8.8%). One-third of the mothers (31.5%) felt uncomfortable during breastfeeding. Access to antenatal and postnatal counseling in the study area also was a key obstacle to optimal breastfeeding practices. In a qualitative survey, some mothers believed that there was no difference between breast milk and formula milk. Colostrum feeding, pre-lacteal feeding, early initiation of breastfeeding, and exclusive breastfeeding were strongly associated with family type, family member, birth order, religion, husbands' occupation, delivery attendants and delivery type, postnatal care, and health care facilities. To reduce the barriers to the successful practice of exclusive breastfeeding, there is a need for a grass-roots approach to educating and counseling nursing mothers with identifying factors influencing or discouraging the optimal practice.Keywords: exclusive, breast feeding, practices, Bangladesh
Procedia PDF Downloads 935077 Predictive Factors of Prognosis in Acute Stroke Patients Receiving Traditional Chinese Medicine Therapy: A Retrospective Study
Authors: Shaoyi Lu
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Background: Traditional Chinese medicine has been used to treat stroke, which is a major cause of morbidity and mortality. There is, however, no clear agreement about the optimal timing, population, efficacy, and predictive prognosis factors of traditional Chinese medicine supplemental therapy. Method: In this study, we used a retrospective analysis with data collection from stroke patients in Stroke Registry In Chang Gung Healthcare System (SRICHS). Stroke patients who received traditional Chinese medicine consultation in neurology ward of Keelung Chang Gung Memorial Hospital from Jan 2010 to Dec 2014 were enrolled. Clinical profiles including the neurologic deficit, activities of daily living and other basic characteristics were analyzed. Through propensity score matching, we compared the NIHSS and Barthel index before and after the hospitalization, and applied with subgroup analysis, and adjusted by multivariate regression method. Results: Totally 115 stroke patients were enrolled with experiment group in 23 and control group in 92. The most important factor for prognosis prediction were the scores of National Institutes of Health Stroke Scale and Barthel index right before the hospitalization. Traditional Chinese medicine intervention had no statistically significant influence on the neurological deficit of acute stroke patients, and mild negative influence on daily activity performance of acute hemorrhagic stroke patient. Conclusion: Efficacy of traditional Chinese medicine as a supplemental therapy for acute stroke patients was controversial. The reason for this phenomenon might be complex and require more research to comprehend. Key words: traditional Chinese medicine, acupuncture, Stroke, NIH stroke scale, Barthel index, predictive factor. Method: In this study, we used a retrospective analysis with data collection from stroke patients in Stroke Registry In Chang Gung Healthcare System (SRICHS). Stroke patients who received traditional Chinese medicine consultation in neurology ward of Keelung Chang Gung Memorial Hospital from Jan 2010 to Dec 2014 were enrolled. Clinical profiles including the neurologic deficit, activities of daily living and other basic characteristics were analyzed. Through propensity score matching, we compared the NIHSS and Barthel index before and after the hospitalization, and applied with subgroup analysis, and adjusted by multivariate regression method. Results: Totally 115 stroke patients were enrolled with experiment group in 23 and control group in 92. The most important factor for prognosis prediction were the scores of National Institutes of Health Stroke Scale and Barthel index right before the hospitalization. Traditional Chinese medicine intervention had no statistically significant influence on the neurological deficit of acute stroke patients, and mild negative influence on daily activity performance of acute hemorrhagic stroke patient. Conclusion: Efficacy of traditional Chinese medicine as a supplemental therapy for acute stroke patients was controversial. The reason for this phenomenon might be complex and require more research to comprehend.Keywords: traditional Chinese medicine, complementary and alternative medicine, stroke, acupuncture
Procedia PDF Downloads 3605076 Using Educational Gaming as a Blended Learning Tool in South African Education
Authors: Maroonisha Maharajh
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Based on the Black Swan and Disruptive Innovation Theories, this study proposes an educational game based learning model within the context of the traditional classroom learning environment. In the proposed model, the perceived e-learning component is decomposed into accessibility, perceived quality and perceived usability within the traditional rural classroom environment. A sample of 92 respondents took part in this study. The results suggest that users’ continuance intention is determined by both economic and grassroots internet accessibility, which in turn is jointly determined by perceived usefulness, information quality, service quality, system quality, perceived ease of use and cognitive absorption of learning.Keywords: blended learning, flipped classroom, e-learning, gaming
Procedia PDF Downloads 2545075 Representation of “Gezi Parkı Actions” in Media and Resistance
Authors: Sibel Özkan
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This study aims to set forth the perception of young people in Turkey about “Gezi Parkı Actions” which has been represented by different views on social and traditional media. In-depth interview method was carried out with all of the participants who consisted of high school students. All interviews has been conducted in areas where the actions take place and the numbers of participants who are using and not using social media were equal. There are minor differences between young people who are using and not using social media. Participants who are not using social media had an opinion only about saving nature aspect of Gezi Parkı Actions. On the other hand, people who are using social media had another reasons such as freedom of expression, respect to the lifestyles etc. to join Gezi Parkı Actions. It was found that young people do not completely trust traditional media anymore.Keywords: Gezi Parkı, resistance, social media, hegemony
Procedia PDF Downloads 4375074 On the Influence of Sleep Habits for Predicting Preterm Births: A Machine Learning Approach
Authors: C. Fernandez-Plaza, I. Abad, E. Diaz, I. Diaz
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Births occurring before the 37th week of gestation are considered preterm births. A threat of preterm is defined as the beginning of regular uterine contractions, dilation and cervical effacement between 23 and 36 gestation weeks. To author's best knowledge, the factors that determine the beginning of the birth are not completely defined yet. In particular, the incidence of sleep habits on preterm births is weekly studied. The aim of this study is to develop a model to predict the factors affecting premature delivery on pregnancy, based on the above potential risk factors, including those derived from sleep habits and light exposure at night (introduced as 12 variables obtained by a telephone survey using two questionnaires previously used by other authors). Thus, three groups of variables were included in the study (maternal, fetal and sleep habits). The study was approved by Research Ethics Committee of the Principado of Asturias (Spain). An observational, retrospective and descriptive study was performed with 481 births between January 1, 2015 and May 10, 2016 in the University Central Hospital of Asturias (Spain). A statistical analysis using SPSS was carried out to compare qualitative and quantitative variables between preterm and term delivery. Chi-square test qualitative variable and t-test for quantitative variables were applied. Statistically significant differences (p < 0.05) between preterm vs. term births were found for primiparity, multi-parity, kind of conception, place of residence or premature rupture of membranes and interruption during nights. In addition to the statistical analysis, machine learning methods to look for a prediction model were tested. In particular, tree based models were applied as the trade-off between performance and interpretability is especially suitable for this study. C5.0, recursive partitioning, random forest and tree bag models were analysed using caret R-package. Cross validation with 10-folds and parameter tuning to optimize the methods were applied. In addition, different noise reduction methods were applied to the initial data using NoiseFiltersR package. The best performance was obtained by C5.0 method with Accuracy 0.91, Sensitivity 0.93, Specificity 0.89 and Precision 0.91. Some well known preterm birth factors were identified: Cervix Dilation, maternal BMI, Premature rupture of membranes or nuchal translucency analysis in the first trimester. The model also identifies other new factors related to sleep habits such as light through window, bedtime on working days, usage of electronic devices before sleeping from Mondays to Fridays or change of sleeping habits reflected in the number of hours, in the depth of sleep or in the lighting of the room. IF dilation < = 2.95 AND usage of electronic devices before sleeping from Mondays to Friday = YES and change of sleeping habits = YES, then preterm is one of the predicting rules obtained by C5.0. In this work a model for predicting preterm births is developed. It is based on machine learning together with noise reduction techniques. The method maximizing the performance is the one selected. This model shows the influence of variables related to sleep habits in preterm prediction.Keywords: machine learning, noise reduction, preterm birth, sleep habit
Procedia PDF Downloads 1475073 Historical Development of Bagh-e Dasht in Herat, Afghanistan: A Comprehensive Field Survey of Physical and Social Aspects
Authors: Khojesta Kawish, Tetsuya Ando, Sayed Abdul Basir Samimi
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Bagh-e Dasht area is situated in the northern part of Herat, an old city in western Afghanistan located on the Silk Road which has received a strong influence from Persian culture. Initially, the Bagh-e Dasht area was developed for gardens and palaces near Joy-e Injil canal during the Timurid Empire in the 15th century. It is assumed Bagh-e Dasht became a settlement in the 16th century during the Safavid Empire. The oldest area is the southern part around the canal bank which is characterized by Dalans, sun-dried brick arcades above which houses are often constructed. Traditional houses in this area are built with domical vault roofs constructed with sun-dried bricks. Bagh-e Dasht is one of the best-preserved settlements of traditional houses in Herat. This study examines the transformation of the Bagh-e Dasht area with a focus on Dalans, where traditional houses with domical vault roofs have been well-preserved until today. The aim of the study is to examine the extent of physical changes to the area as well as changes to houses and the community. This research paper contains original results which have previously not been published in architectural history. The roof types of houses in the area are investigated through examining high resolution satellite images. The boundary of each building and space is determined by both a field survey and aerial photographs of the study area. A comprehensive field survey was then conducted to examine each space and building in the area. In addition, a questionnaire was distributed to the residents of the Dalan houses and interviews were conducted with the Wakil (Chief) of the area, a local historian, residents and traditional builders. The study finds that the oldest part of Bagh-e Dasht area, the south, contains both Dalans and domical vault roof houses. The next oldest part, which is the north, only has domical vault roof houses. The rest of the area only has houses with modernized flat roofs. This observation provides an insight into the process of historical development in the Bagh-e Dasht area.Keywords: Afghanistan, Bagh-e Dasht, Dalan, domical vault, Herat, over path house, traditional house
Procedia PDF Downloads 1335072 A Comparative Semantic Network Study between Chinese and Western Festivals
Authors: Jianwei Qian, Rob Law
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With the expansion of globalization and the increment of market competition, the festival, especially the traditional one, has demonstrated its vitality under the new context. As a new tourist attraction, festivals play a critically important role in promoting the tourism economy, because the organization of a festival can engage more tourists, generate more revenues and win a wider media concern. However, in the current stage of China, traditional festivals as a way to disseminate national culture are undergoing the challenge of foreign festivals and the related culture. Different from those special events created solely for developing economy, traditional festivals have their own culture and connotation. Therefore, it is necessary to conduct a study on not only protecting the tradition, but promoting its development as well. This study conducts a comparative study of the development of China’s Valentine’s Day and Western Valentine’s Day under the Chinese context and centers on newspaper reports in China from 2000 to 2016. Based on the literature, two main research focuses can be established: one is concerned about the festival’s impact and the other is about tourists’ motivation to engage in a festival. Newspaper reports serve as the research discourse and can help cover the two focal points. With the assistance of content mining techniques, semantic networks for both Days are constructed separately to help depict the status quo of these two festivals in China. Based on the networks, two models are established to show the key component system of traditional festivals in the hope of perfecting the positive role festival tourism plays in the promotion of economy and culture. According to the semantic networks, newspaper reports on both festivals have similarities and differences. The difference is mainly reflected in its cultural connotation, because westerners and Chinese may show their love in different ways. Nevertheless, they share more common points in terms of economy, tourism, and society. They also have a similar living environment and stakeholders. Thus, they can be promoted together to revitalize some traditions in China. Three strategies are proposed to realize the aforementioned aim. Firstly, localize international festivals to suit the Chinese context to make it function better. Secondly, facilitate the internationalization process of traditional Chinese festivals to receive more recognition worldwide. Finally, allow traditional festivals to compete with foreign ones to help them learn from each other and elucidate the development of other festivals. It is believed that if all these can be realized, not only the traditional Chinese festivals can obtain a more promising future, but foreign ones are the same as well. Accordingly, the paper can contribute to the theoretical construction of festival images by the presentation of the semantic network. Meanwhile, the identified features and issues of festivals from two different cultures can enlighten the organization and marketing of festivals as a vital tourism activity. In the long run, the study can enhance the festival as a key attraction to keep the sustainable development of both the economy and the society.Keywords: Chinese context, comparative study, festival tourism, semantic network analysis, valentine’s day
Procedia PDF Downloads 2325071 Cross-Sectional Analysis of Partner Support and Contraceptive Use in Adolescent Females
Authors: Ketan Tamirisa, Kathleen P. Tebb
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In the U.S., annually, there are over 1 million pregnancies in teenagers and most (85%) are unintended. The need for proactive prevention measures is imperative to support adolescents with their pregnancy prevention and family planning goals. To date, there is limited research examining the extent to which support from a sexual partner(s) influences contraceptive use. To address this gap, this study assessed the relationship between sexually active adolescents, sex-assigned birth as female, and their perceived support from their sexual partner(s) about their contraceptive use in the last three months. Baseline data from sexually active adolescent females, between 13-19 years who were not currently using a long-acting contraceptive device, were recruited from 32 school-based health centers (SBHCs) in seven states in the U.S. as part of a larger study to evaluate Health-E You/ Salud iTuTM, a web-based contraceptive decision support tool. Fisher’s exact test assessed the cross-sectional association between perceived sexual partner support of contraceptive use in the past three months (felt no support, felt little support, and felt a lot of support), and current use of non-barrier contraception. A total of 91 sexually active adolescent females were eligible and completed the baseline survey. The mean age was 16.7 and nearly half (49.3%) were Hispanic/Latina. Most (85.9%) indicated it was very important to avoid becoming pregnant. A total of 60 participants (65.9%) reported use of non-barrier contraception. Of these, most used birth control pills (n=26), followed by Depo-Provera injection (n=12), patch (n=1), and ring (n=1). Most of the participants (80.2%) indicated that they perceived a lot of support from their partners and 19.8% reported no or little support. Among those reporting a lot of support, 69.9% (51/73) reported current use of non-barrier contraception compared to 50% (9/18) who felt no/little support and reported contraceptive use. This difference approached but did not reach statistical significance (p=0.096). Results from this preliminary data indicate that many adolescents who are coming in for care at SBHCs are at risk of unintended pregnancy. Many participants also reported a lot of support from their sexual partner(s) to use contraception. While the associations only approached significance, this is likely due to the small sample size. This and future research can better understand this association to inform interventions aimed at sexual partners to strengthen education and social support, increase healthcare accessibility, and ultimately reduce rates of unintended pregnancy.Keywords: adolescents, contraception, pregnancy, SBHCs, sexual partners
Procedia PDF Downloads 445070 Evaluating Social Sustainability in Historical City Center in Turkey: Case Study of Bursa
Authors: Şeyda Akçalı
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This study explores the concept of social sustainability and its characteristics in terms of neighborhood (mahalle) which is a social phenomenon in Turkish urban life. As social sustainability indicators that moving away traditional themes toward multi-dimensional measures, the solutions for urban strategies may be achieved through learning lessons from historical precedents. It considers the inherent values of traditional urban forms contribute to the evolution of the city as well as the social functions of it. The study aims to measure non-tangible issues in order to evaluate social sustainability in historic urban environments and how they could contribute to the current urban planning strategies. The concept of neighborhood (mahalle) refers to a way of living that represents the organization of Turkish social and communal life rather than defining an administrative unit for the city. The distinctive physical and social features of neighborhood illustrate the link between social sustainability and historic urban environment. Instead of having a nostalgic view of past, it identifies both the failures and successes and extract lessons of traditional urban environments and adopt them to modern context. First, the study determines the aspects of social sustainability which are issued as the key themes in the literature. Then, it develops a model by describing the social features of mahalle which show consistency within the social sustainability agenda. The model is used to analyze the performance of traditional housing area in the historical city center of Bursa, Turkey whether it meets the residents’ social needs and contribute collective functioning of the community. Through a questionnaire survey exercised in the historic neighborhoods, the residents are evaluated according to social sustainability criteria of neighborhood. The results derived from the factor analysis indicate that social aspects of neighborhood are social infrastructure, identity, attachment, neighborliness, safety and wellbeing. Qualitative evaluation shows the relationship between key aspects of social sustainability and demographic and socio-economic factors. The outcomes support that inherent values of neighborhood retain its importance for the sustainability of community although there must be some local arrangements for few factors with great attention not to compromise the others. The concept of neighborhood should be considered as a potential tool to support social sustainability in national political agenda and urban policies. The performance of underlying factors in historic urban environment proposes a basis for both examining and improving traditional urban areas and how it may contribute to the overall city.Keywords: historical city center, mahalle, neighborhood, social sustainability, traditional urban environment, Turkey
Procedia PDF Downloads 2895069 Biosensor System for Escherichia coli and Staphylococcus aureus Detection in Traditional Ice Cream
Authors: Raana Babadi Fathipour
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Ice cream is a nutritious dairy product that, given its constituent materials and high nutritional value, is a suitable growth medium for the growth of various food microorganisms. The contamination of this product with pathogenic microorganisms may cause food poisoning and infections, and so could be harmful to human health. The foremost critical pathogenic microscopic organisms of ice cream incorporate Escherichia coli, Staphylococcus aureus, Bacillus cereus, Enterobacteriaceae, coliforms, Listeria monocytogenes and Enterococcus. Biosensor technology, albeit a recent addition to the dairy industry, has proven its worth in other fields, such as medical devices. Through numerous studies, the advantages of employing biosensors have consistently emerged. These incredible tools present expeditious and straightforward means while specifically targeting analytes. Thus, they bring forth unparalleled solutions that bolster ongoing advancements within dairy products and processes. This review delves into the latest developments in the realm of biosensors and evaluates the diverse techniques of bio-recognition and transduction in terms of their benefits, drawbacks, and relevance to traditional ice cream. Furthermore, the obstacles that impede the progress of these approaches in meeting the growing need for swift and real-time quality control of milk products, particularly ice cream, are also expounded upon.Keywords: traditional ice cream, Escherichia coli, Staphylococcus aureus, biosensors
Procedia PDF Downloads 815068 Orthopedic Trauma in Newborn Babies
Authors: Joanna Maj, Awais Hussain, Lyndsey Vu, Catherine Roxas
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Background: Bone injuries in babies are common conditions that arise during delivery. Fractures of the clavicle, humerus, femur, and skull are the most common neonatal bone injuries sustained from labor and delivery. During operative deliveries, zealous tractions, ineffective delivery techniques, improper uterine incision, and inadequate relaxation of the uterus can lead to bone fractures in the newborn. Neonatal anatomy is unique. Just as children are not mini-adults, newborns are not mini children. A newborn’s anatomy and physiology are significantly different from a pediatric patient's. In this paper, we describe common orthopedic trauma in newborn babies. We provide a comprehensive overview of the different types of bone injuries in newborns. We hypothesize that the rate of bone fractures sustained at birth is higher in cases of operative deliveries. Methods: Relevant literature was selected by using the PubMed database. Search terms included orthopedic conditions in newborns, neonatal anatomy, and bone fractures in neonates during operative deliveries. Inclusion criteria included age, gender, race, type of bone injury and progression of bone injury. Exclusion criteria were limited in the medical history of cases reviewed and comorbidities. Results: This review finds that a clavicle fracture is the most common type of neonatal orthopedic injury sustained at birth in both operative and non-operative deliveries. We confirm the hypothesis that infants born via operative deliveries have a significantly higher rate of bone fractures than non-cesarean section deliveries. Conclusion: Newborn babies born via operative deliveries have a higher rate of bone fractures of the clavicle, humerus, and femur. A clavicle bone fracture in newborns is most common during emergency operative deliveries in new mothers. We conclude that infants born via an operative delivery sustained more bone injuries than infants born via non-cesarean section deliveries.Keywords: clavicle fracture, humerus fracture, neonates, newborn orthopedics, orthopedic surgery, pediatrics, orthopedic trauma, orthopedic trauma during delivery, cesarean section, obstetrics, neonatal anatomy, neonatal fractures, operative deliveries, labor and delivery, bone injuries in neonates
Procedia PDF Downloads 1015067 The Quantitative Analysis of the Traditional Rural Settlement Plane Boundary
Authors: Yifan Dong, Xincheng Pu
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Rural settlements originate from the accumulation of residential building elements, and their agglomeration forms the settlement pattern and defines the relationship between the settlement and the inside and outside. The settlement boundary is an important part of the settlement pattern. Compared with the simplification of the urban settlement boundary, the settlement of the country is more complex, fuzzy and uncertain, and then presents a rich and diverse boundary morphological phenomenon. In this paper, China traditional rural settlements plane boundary as the research object, using fractal theory and fractal dimension method, quantitative analysis of planar shape boundary settlement, and expounds the research for the architectural design, ancient architecture protection and renewal and development and the significance of the protection of settlements.Keywords: rural settlement, border, fractal, quantification
Procedia PDF Downloads 2485066 Surrogacy: A Comparative, Legal, Children’s Rights Perspective
Authors: Ronli Sifris
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The last Australian Parliamentary inquiry into surrogacy took place in 2016. Since then, a number of countries have reviewed their surrogacy laws, including countries such as New Zealand and the United Kingdom, which traditionally have invoked similar legal approaches to Australia on a broad range of issues. The time is ripe to reform Australia’s surrogacy laws with a view to putting in place a system that best protects the rights of all parties to a surrogacy arrangement, and especially the rights of the child. There are two specific, linked issues which tend to be particularly contentious in the surrogacy context. The first relates to legal parentage. There are questions around whether the surrogate or the intended parents should be deemed the legal parents of a child born through surrogacy and what should be the process for any transfer of parentage. The second key issue relates to compensation and whether a surrogate should be compensated for the reproductive labour inherent in conceiving, gestating, and birthing a child. This paper will invoke a comparative analysis with a view to considering how different countries are regulating surrogacy and which approach best protects the rights all parties involved in the surrogacy arrangement, especially the rights of the children born through surrogacy. The specific countries to be considered are Australia, Canada, and California (United States). I have selected these countries for the following reasons: Australia is the jurisdiction where the author is based, it is, therefore, the jurisdiction with which she has the most familiarity. It allows altruistic surrogacy only and post-birth parentage orders in favour of the intended parents of children born through altruistic surrogacy California, as a jurisdiction allowing for compensated surrogacy and pre-birth parentage orders in favour of the intended parents, sits at the other end of the spectrum to Australia thereby providing an interesting point of comparison. Canada sits somewhere in the middle; it ostensibly allows only altruistic surrogacy, but in practice, many aspects of the Canadian process resemble compensated surrogacy. In addition to conducting a comparative analysis with other countries, the paper will also consider international human rights law as its overarching framework for determining the approach that best protects the rights of a child born through surrogacy. Particular attention will be paid to the United Nations Convention on the Rights of the Child as the key children’s rights treaty. The European Court of Human Rights will also be extensively considered as it has decided a number of cases relating to the rights of children born through surrogacy.Keywords: surrogacy, children’s rights, australia, compensation, parentage
Procedia PDF Downloads 1305065 Traditional Practices of Conserving Biodiversity: A Case Study around Jim Corbett National Park, Uttarakhand, India
Authors: Rana Parween, Rob Marchant
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With the continued loss of global biodiversity despite the application of modern conservation techniques, it has become crucial to investigate non-conventional methods. Accelerated destruction of ecosystems due to altered land use, climate change, cultural and social change, necessitates the exploration of society-biodiversity attitudes and links. While the loss of species and their extinction is a well-known and well-documented process that attracts much-needed attention from researchers, academics, government and non-governmental organizations, the loss of traditional ecological knowledge and practices is more insidious and goes unnoticed. The growing availability of 'indirect experiences' such as the internet and media are leading to a disaffection towards nature and the 'Extinction of Experience'. Exacerbated by the lack of documentation of traditional practices and skills, there is the possibility for the 'extinction' of traditional practices and skills before they are fully recognized and captured. India, as a mega-biodiverse country, is also known for its historical conservation strategies entwined in traditional beliefs. Indigenous communities hold skillsets, knowledge, and traditions that have accumulated over multiple generations and may play an important role in conserving biodiversity today. This study explores the differences in knowledge and attitudes towards conserving biodiversity, of three different stakeholder groups living around Jim Corbett National Park, based on their age, traditions, and association with the protected area. A triangulation designed multi-strategy investigation collected qualitative and quantitative data through a questionnaire survey of village elders, the general public, and forest officers. Following an inductive approach to analyzing qualitative data, the thematic content analysis was followed. All coding and analysis were completed using NVivo 11. Although the village elders and some general public had vast amounts of traditional knowledge, most of it was related to animal husbandry and the medicinal value of plants. Village elders were unfamiliar with the concept of the term ‘biodiversity’ albeit their way of life and attitudes ensured that they care for the ecosystem without having the scientific basis underpinning biodiversity conservation. Inherently, village elders were keen to conserve nature; the superimposition of governmental policies without any tangible benefit or consultation was seen as detrimental. Alienating villagers and consequently the village elders who are the reservoirs of traditional knowledge would not only be damaging to the social network of the area but would also disdain years of tried and tested techniques held by the elders. Forest officers advocated for biodiversity and conservation education for women and children. Women, across all groups, when questioned about nature conservation, showed more interest in learning and participation. Biodiversity not only has an ethical and cultural value, but also plays a role in ecosystem function and, thus, provides ecosystem services and supports livelihoods. Therefore, underpinning and using traditional knowledge and incorporating them into programs of biodiversity conservation should be explored with a sense of urgency.Keywords: biological diversity, mega-biodiverse countries, traditional ecological knowledge, society-biodiversity links
Procedia PDF Downloads 1055064 An Exploratory Study of Chinese Paper-Cut Art in Household Product Design
Authors: Ruining Wu, Na Song
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Paper-cut, as one of the Chinese traditional folk decoration art, has become a unique visual aesthetic characteristics of the Chinese nation in the long-term evolution of cultural symbols. Chinese paper-cut art is the treasure-house for product design in natural resources. This paper first analyzed Chinese folk art of historical origin, cultural background, cultural values, aesthetic value, style features of Chinese paper cut art, then analyzed the design thought and design cases of paper-cut art application in different areas, such as clothing design, logo design and product design areas. Through the research of Chinese paper-cut art culture and design elements, this paper aims to build a household product design concept of Chinese traditional culture.Keywords: paper-cut art, culture, household products, design
Procedia PDF Downloads 6135063 Evaluating Problems Arose Due to Adoption of Dual Legal Framework in Regulating the Transactions under Islamic Capital Market with Special Reference to Malaysia
Authors: Rafikoddin Kazi
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Almost all the major religions of the world condemn the transactions based on interest which promotes self-centered and materialistic thinking. Still, it is amazing to note that it has become the tradition of transaction at world level hence it is called traditional financial system. The main feature of this system is that it considers economic aspects of the transaction only. This system supports the economic development and not the welfare of humankind. However, it is worth mentioning the fact that, except Islamic financial system no other financial system stood in front of it as a viable alternative system. Although many countries have tried to create financial infrastructure and system, still the Malaysian Islamic financial system has got its own peculiarity. It has made tremendous progress in creating sound Islamic Financial system. However, the historical aspect of this country which has passed through Islamic and traditional financial system has got its own advantages and disadvantages. The advantageous factor is that, despite having mix and heterogeneous culture, it has succeeded in creating Islamic Financial System based on the dual legal system to satisfy the needs of multi-cultural factors. This fact has proved that Islamic Financial System does not need purely Muslim population. However, due to adoption of the dual legal system, several legal issues have been taken place. According to this system, the application of Islamic Law has been limited only up to some family and religious matters. The rest of the matters are being dealt with under the traditional laws, the principles and practices of which are different from that of the Islamic Legal System. The matter becomes all the more complicated when the cases are partially or simultaneously concerned with traditional vis-à-vis Islamic Laws as it requires expertise in both the legal systems. However, the educational principles and systems are different in respect of both the systems. To face this problem, Shariah Advisory Council has been established. But the Multiplicity of Shariah authorities without judicial power has created confusion at various levels. Therefore, some experts have stressed the need for improving, empowering the Islamic financial, legal system to make it more integrated and holistic. In view of the above, an endeavor has been made in this paper to throw some light on the matters related to the adoption of the dual legal system. The paper is conceptual in nature and the method adopted is the intensive survey of literature thereby all the information has been gathered from the secondary sources.Keywords: Islamic financial system, Islamic legal system, Islamic capital market (ICM) , traditional financial system
Procedia PDF Downloads 1995062 Maternal and Neonatal Outcome Analysis in Preterm Abdominal Delivery Underwent Umbilical Cord Milking Compared to Early Cord Clamping
Authors: Herlangga Pramaditya, Agus Sulistyono, Risa Etika, Budiono Budiono, Alvin Saputra
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Preterm birth and anemia of prematurity are the most common cause of morbidity and mortality in neonates, and anemia of the preterm neonates has become a major issue. The timing of umbilical cord clamping after a baby is born determines the amount of blood transferred from the placenta to fetus, Delayed Cord Clamping (DCC) has proven to prevent anemia in the neonates but it is constrained concern regarding the delayed in neonatal resuscitation. Umbilical Cord Milking (UCM) could be an alternative method for clamping the umbilical cord due to the active blood transfer from the placenta to the fetus. The aim of this study was to analyze the difference between maternal and neonatal outcome in preterm abdominal delivery who underwent UCM compared to ECC. This was an experimental study with randomized post-test only control design. Analyzed maternal and neonatal outcomes, significant P values (P <0.05). Statistical comparison was carried out using Paired Samples t-test (α two tailed 0,05). The result was the mean of preoperative mother’s hemoglobin in UCM group compared to ECC (10,9 + 0,9 g/dL vs 10,4 + 0,9 g/dL) and postoperative (11,1 + 1,1 g/dL vs 10,5 + 0,7 g/dL), the delta was (0,2 + 0,7 vs 0,1 + 0,6.). It showed no significant difference (P=0,395 vs 0,627). The mean of 3rd phase labor duration in UCM group vs ECC was (20,5 + 3,5 second vs 21,1 + 3,3 second), showed insignificant difference (P=0,634). The amount of bleeding after delivery in UCM group compared to ECC has the median of 190 cc (100-280cc) vs 210 cc (150-330 cc) showed insignificant difference (P=0,083) so the incidence of post-partum bleeding was not found. The mean of the neonates hemoglobin, hematocrit and erythrocytes of UCM group compared to ECC was (19,3 + 0,7 vs 15,9 + 0,8 g/dl), (57,1 + 3,6 % vs 47,2 + 2,8 %), and (5,4 + 0,4 g/dl vs 4,5 + 0,3 g/dl) showed significant difference (P<0,0001). There was no baby in UCM group received blood transfusion and one baby in the control ECC group received blood transfusion was found. Umbilical Cord Milking has shown to increase the baby’s blood component such as hemoglobin, hematocrit, and erythrocytes 6 hours after birth as well as lowering the incidence of blood transfusions. Maternal and neonatal morbidity were not found. Umbilical Cord Milking was the act of clamping the umbilical cord that was more beneficial to the baby and no adverse or negative effects on the mother.Keywords: umbilical cord milking, early cord clamping, maternal and neonatal outcome, preterm, abdominal delivery
Procedia PDF Downloads 2415061 Audience Perceptions and Attitudes Towards the Representation of Tribal South African Culture in Drama Series
Authors: Oluwayemisi Mary Onyenanakeya, Kevin Onyenankeya
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Commercial media entertainment offerings especially mainstream soap operas, in South Africa, are progressively infusing dominant social values and ideas which are alien to South African tribal societies. In most of the commodified television drama series, people who hold tight to traditional beliefs and values are often characterised as traditionalists, while those who have imbibed the western defined dicta and ideology of modernity are seen as progressives. This study, therefore, sought to ascertain how South African tribal language, traditional institutions, values, social norms and ancestral beliefs are portrayed through the television drama, Generations: The Legacy, and what the viewers think about those constructions and the implication for cultural identity. The mixed methods approach was employed involving the administration of questionnaire to 350 participants selected through random sampling and a content analysis of 20 episodes of Generations: The Legacy. The findings further showed that the values and traditions represented in generation do not significantly reflect the South African tribal tradition and values (p-value > 0.05). In most instances where traditional values are represented they tend to be portrayed as old fashioned (p-value > 0.05), and inferior and backward (p-value > 0.05). In addition, the findings indicate that Generations: The legacy is a vehicle for promoting dominant culture.Keywords: identity, soap opera, South Africa, television
Procedia PDF Downloads 2885060 A Traditional Settlement in a Modernized City: Yanbu, Saudi Arabia
Authors: Hisham Mortada
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Transition in the urban configuration of Arab cities has never been as radical and visible as it has been since the turn of the last century. The emergence of new cities near historical settlements of Arabia has spawned a series of developments in and around the old city precincts. New developments are based on advanced technology and conform to globally prevalent standards of city planning, superseding the vernacular arrangements based on traditional norms that guided so-called ‘city planning’. Evidence to this fact are the extant Arab buildings present at the urban core of modern cities, which inform us about intricate spatial organization. Organization that subscribed to multiple norms such as, satisfying gender segregation and socialization, economic sustainability, and ensuring security and environmental coherence etc., within settlement compounds. Several participating factors achieved harmony in such an inclusive city—an organization that was challenged and apparently replaced by the new planning order in the face of growing needs of globalized, economy-centric and high-tech models of development. Communities found it difficult to acclimatize with the new western planning models that were implemented at a very large scale throughout the Kingdom, which later experienced spatial re-structuring to suit users’ needs. A closer look the ancient city of Yanbu, now flanked with such new developments, allows us to differentiate and track the beginnings of this unprecedented transition in settlement formations. This paper aims to elaborate the Arabian context offered to both the ‘traditional’ and ‘modern’ planning approaches, in order to understand challenges and solutions offered by both at different times. In the process it will also establish the inconsistencies and conflicts that arose with the shift in planning paradigm, from traditional-'cultural norms’, to modern-'physical planning', in the Arabian context. Thus, by distinguishing the two divergent planning philosophies, their impact of the Arabian morphology, relevance to lifestyle and suitability to the biophysical environment, it concludes with a perspective on sustainability particularly for in case of Yanbu.Keywords: Yanbu, traditional architecture, Hijaz, coral building, Saudi Arabia
Procedia PDF Downloads 3215059 Deep Routing Strategy: Deep Learning based Intelligent Routing in Software Defined Internet of Things.
Authors: Zabeehullah, Fahim Arif, Yawar Abbas
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Software Defined Network (SDN) is a next genera-tion networking model which simplifies the traditional network complexities and improve the utilization of constrained resources. Currently, most of the SDN based Internet of Things(IoT) environments use traditional network routing strategies which work on the basis of max or min metric value. However, IoT network heterogeneity, dynamic traffic flow and complexity demands intelligent and self-adaptive routing algorithms because traditional routing algorithms lack the self-adaptions, intelligence and efficient utilization of resources. To some extent, SDN, due its flexibility, and centralized control has managed the IoT complexity and heterogeneity but still Software Defined IoT (SDIoT) lacks intelligence. To address this challenge, we proposed a model called Deep Routing Strategy (DRS) which uses Deep Learning algorithm to perform routing in SDIoT intelligently and efficiently. Our model uses real-time traffic for training and learning. Results demonstrate that proposed model has achieved high accuracy and low packet loss rate during path selection. Proposed model has also outperformed benchmark routing algorithm (OSPF). Moreover, proposed model provided encouraging results during high dynamic traffic flow.Keywords: SDN, IoT, DL, ML, DRS
Procedia PDF Downloads 1105058 Effective Communication Within Workplace: Key to Growth of Business
Authors: Mamta
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Communication is the mixture of the various activities such as words, body language, volume and voice tone. Mankind has always throughout its history had the necessity for communication. It starts from birth and continues throughout life. Communication is just the right means of success and advancement in a workplace. Communication is one of the means to connect to different people at far distances. The modern workplace is inherently collaborative, and this collaboration relies on effective communication among co-workers. Also it has been observed that a lack in good communication skills especially within a workplace can result in conflicts and chaos hence hindering the productivity of an organization. Thus there is a dire need for developing good and effective communication skills which will result in increase in productivity and will enhance its efficiency.Keywords: communication skills, professional communication, workplace communication, workplace efficiency
Procedia PDF Downloads 4565057 Asabiyyah Prejudice and Its Harmful Effects on Muslim Community
Authors: Lawal Abdulkareem
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Asabiyyah prejudice is one of the causes of enmity, hatred and disharmony among Muslims. It is man’s supporting of his people to whom he belongs, whether they are right or wrong, oppressing or oppressed. This belonging can be due to kith and kin, ethnicity, color, birth place, citizenship, school of thought, or a group of people with common interest. The prejudice in its different forms and kinds is one of the deadly diseases that transformed the once unified, merciful, and cohesive Muslim community into differing, conflicting and warring entities. This has been witnessed within the Muslims from the earliest generations to the present. It is against this background that this research is undertaken to examine the major types of Asabiyyah prejudice and their harmful effects on Muslim community.Keywords: Asabiyyah, causes, enmity, hatred
Procedia PDF Downloads 4845056 Gestational Vitamin D Levels Mitigate the Effect of Pre-pregnancy Obesity on Gestational Diabetes Mellitus: A Birth Cohort Study
Authors: Majeda S. Hammoud
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Background and Aim: Gestational diabetes mellitus (GDM) is a common pregnancy complication affecting around 14% of pregnancies globally that carries short and long-term consequences to the mother and her child. Pre-pregnancy overweight or obesity is the most consistently and strongly associated modifiable risk factor with GDM development. This analysis aimed to determine whether vitamin D status during pregnancy modulates the effect of pre-pregnancy obesity/overweight on GDM risk while stratifying by maternal age. Methods: Data from the Kuwait Birth Cohort (KBC) study were analyzed, which enrolled pregnant women in the second or third trimester of gestation. Pre-pregnancy body mass index (BMI; kg/m2) was categorized as under/normal weight (<25.0), overweight (25.0 to <30.0), and obesity (≥30.0). 25 hydroxyvitamin D levels were measured in blood samples that were collected at recruitment and categorized as deficiency (<50 nmol/L) and insufficiency/sufficiency (≥50 nmol/L). GDM status was ascertained according to international guidelines. Logistic regression was used to evaluate associations, and adjusted odds ratios (aOR) and 95% confidence intervals (CI) were estimated. Results: The analyzed study sample included a total of 982 pregnant women, with a mean (SD) age of 31.4 (5.2) years. The prevalence of GDM was estimated to be 17.3% (95% CI: 14.9-19.7), and the prevalence of pre-pregnancy overweight and obesity was 37.8% (95% CI: 34.8-40.8) and 28.8% (95% CI: 26.0-31.7), respectively. The prevalence of gestational vitamin D deficiency was estimated to be 55.3% (95% CI: 52.2-58.4). The association between pre-pregnancy overweight or obesity with GDM risk differed according to maternal age and gestational vitamin D status (Pinteraction[BMI × age × vitamin D = 0.047). Among pregnant women aged <35 years, prepregnancy obesity compared to under/normal weight was associated with increased GDM risk among women with gestational vitamin D deficiency (aOR: 3.65, 95% CI: 1.50-8.86, p = 0.004) and vitamin D insufficiency/sufficiency (aOR: 2.55, 95% CI: 1.16-5.61, p = 0.019). In contrast, among pregnant women aged ≥35 years, pre-pregnancy obesity compared to under/normal weight was associated with increased GDM risk among women with gestational vitamin D deficiency (aOR: 9.70, 95% CI: 2.01-46.69, p = 0.005), but not among women with vitamin D insufficiency/sufficiency (aOR: 1.46, 95% CI: 0.42-5.16, p = 0.553). Conclusion: The effect of pre-pregnancy obesity on GDM risk is modulated by maternal age and gestational vitamin D status, with the effect of pre-pregnancy obesity being more pronounced among older pregnant women (aged ≥35 years) with gestational vitamin D deficiency compared to those with vitamin D insufficiency/sufficiency. Whereas, among younger women (aged <35 years), the effect of pre-pregnancy obesity on GDM risk was not modulated by gestational vitamin D status. Therefore, vitamin D supplementation among pregnant women, specifically older women with pre-pregnancy obesity, may mitigate the effect of pre-pregnancy obesity on GDM risk.Keywords: gestational diabetes mellitus, vitamin D, obesity, body mass index
Procedia PDF Downloads 385055 Design and Implementation of a Fan Coil Unit Controller Based on the Duty Ratio Fuzzy Method
Authors: Liang Zhao, Jili Zhang, Kai Li
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A microcontroller-based fan coil unit (FCU) fuzzy controller is designed and implemented in this paper. The controller employs the concept of duty ratio on the electric valve control, which could make full use of the cooling and dehumidifying capacity of the FCU when the valve is off. The traditional control method and its limitations are analyzed. The hardware and software design processes are introduced in detail. The experimental results show that the proposed method is more energy efficient compared to the traditional controlling strategy. Furthermore, a more comfortable room condition could be achieved by the proposed method. The proposed low-cost FCU fuzzy controller deserves to be widely used in engineering applications.Keywords: fan coil unit, duty ratio, fuzzy controller, experiment
Procedia PDF Downloads 3385054 How to Incorporate Vernacular Architecture into Practice for Sustainable Development: Case Studies from Kashmir and Kerala, India
Authors: Debanjana Chatterjee
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Vernacular settlements in India often take the form that is dictated by the climate they are in. India, with its vast cultural diversity and various climatic regions, offers a wide range of vernacular architecture. This paper focuses on two main geographical regions: Kashmir and Kerala. They bring together myriad challenges of climatic and social characteristics to incorporate into their vernacular architectures, which are still relevant despite the advent of globalization and modernization. Scholars like William Wurster and Catherine Bauer even claimed that all the traditional buildings in these places have the kind of urbanity, which is dignified and elegant but also lively and human that every architect would like to achieve if they knew how. With modernization, and with a greater ease of construction, a reduction in labor, and the apparent robustness of contemporary construction techniques, people have, however, become increasingly tentative in respect of vernacular architecture. And yet modern architecture has typically led to energize intensive structures without much consideration to the location and surroundings of the structure itself. In contrary, Laurie Baker, the British-born Indian architect, had shown us the way to integrate the knowledge of vernacular when he developed his designs based on the traditional architecture of Kerala, respecting the local climate and environment. This paper also explores his technical creativity in his design of Center for Development Studies (CDS) in Trivandrum. Hence, in order to protect and conserve our rich cultural and architectural heritage, the elements of vernacular should be incorporated into the contemporary planning and architecture for sustainable building design. The provision should be made to incorporate vernacular architecture and traditional knowledge in the policies. Ultimately, the policymakers, planners, and architects should consider this incorporation of traditional vernacular and contemporary sustainability in their work for the betterment of society now.Keywords: vernacular, architecture, sustainable development, Kashmir and Kerala, climate, Laurie Baker
Procedia PDF Downloads 1775053 A Qualitative Review and Meta-Analyses of Published Literature Exploring Rates and Reasons Behind the Choice of Elective Caesarean Section in Pregnant Women With No Contraindication to Trial of Labor After One Previous Caesarean Section
Authors: Risheka Suthantirakumar, Eilish Pearson, Jacqueline Woodman
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Background: Previous research has found a variety of rates and reasons for choosing medically unindicated elective repeat cesarean section (ERCS). Understanding the frequency and reasoning of ERCS, especially when unwarranted, could help healthcare professionals better tailor their advice and service. Therefore, our study conducted meta-analyses and qualitative analyses to identify the reasons and rates worldwide for choosing this procedure over the trial of labor after cesarean (TOLAC), also referred to in published literature as vaginal birth after cesarean (VBAC). Methods: We conducted a systematic review of published literature available on PubMed, EMBASE, and science.gov and conducted a blinded peer review process to assess eligibility. Search terms were created in collaboration with experts in the field. An inclusion and exclusion criteria were established prior to reviewing the articles. Included studies were limited to those published in English due to author constraints, although no international boundaries were used in the search. No time limit for the search was used in order to portray changes over time. Results: Our qualitative analyses found five consistent themes across international studies, which were socioeconomic and cultural differences, previous cesarean experience, perceptions of risk with vaginal birth, patients’ perceptions of future benefits, and medical advice and information. Our meta-analyses found variable rates of ERCS across international borders and within national populations. The average rate across all studies was 44% (CI 95% 36-51). Discussion: The studies included in our qualitative analysis demonstrated similar repetitive themes, which give validity to the findings across the studies included. We consider the rate variation across and within national populations to be partially a result of differing inclusion and eligibility assessment between different studies and argue that a proforma be utilized for future research to be comparable.Keywords: elective cesarean section, VBAC, TOLAC, maternal choice
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