Search results for: early maternal separation

Authors: Rasikha Ramanand, Priyanka Dixit

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Background: Continuum of maternal care which includes antenatal care, delivery care and postnatal care aids in averting maternal deaths. The objective of this paper is to identify the association between previous experiences of child death on Continuum of Care (CoC) of recent child. Further, the study aimed at understanding where the drop-out rate was high in the continuum. Methods: The study was based on the Nation-wide District Level Household and Facility Survey (DLHS-4) conducted during 2012-13, which provides information on antenatal care, delivery care, percentage of women who received JSY benefits, percentage of women who had any pregnancy, delivery, the place of delivery etc. The sample included women who were selected from the non-EAG states who delivered at least two children. The data were analyzed using SPSS 20.Binary Logistic regression was applied to the data in which the Continuum of Care (CoC) was the dependent variable while the independent variables were entered as the covariates. Results: A major finding of the study was the antenatal to delivery care period where the drop-out rates were high. Also, it was found that a large proportion of women did not receive any of the services along the continuum. Conclusions: This study has clearly established the relationship between previous history of child loss and continuum of maternal care.

Keywords: antenatal care, continuum of care, child loss, delivery care, India, maternal health care, postnatal care

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Authors: Siddharth Ojha, Varun Dua

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Classified as one of the most important reasons of aerodynamic drag in the sedan automobiles is the fluid flow separation near the vehicle’s rear end. To retard the separation of flow, bump-shaped vortex generators are being tested for its implementation to the roof end of a sedan vehicle. Frequently used in the aircrafts to prevent the separation of fluid flow, vortex generators themselves produce drag, but they also substantially reduce drag by preventing flow separation at the downstream. The net effects of vortex generators can be calculated by summing the positive and negative impacts and effects. Since this effect depends on dimensions and geometry of vortex generators, those present on the vehicle roof are optimized for maximum efficiency and performance. The model was tested through ANSYS CFD analysis and modeling. The model was tested in the wind tunnel for observing it’s properties such as aerodynamic drag and flow separation and a major time lag was gained by employing vortex generators in the scaled model. Major conclusions which were recorded during the analysis were a substantial 24% reduction in the aerodynamic drag and 14% increase in the efficiency of the sedan automobile as the flow separation from the surface is delayed. This paper presents the results of optimization, the effect of vortex generators in the flow field and the mechanism by which these effects occur and are regulated.

Keywords: aerodynamics, aerodynamic devices, body, computational fluid dynamics (CFD), flow visualization

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Authors: Anton James

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This study explored the contribution of parenting styles in the Maternal Perception of Compliance Model (MPCM). This model explores maternal expectations to illustrate the formation of maternal perception of severity of noncompliance in adolescent children. The methodology consisted of three stages: In the first stage, a focus group was held, and the data was analysed to fine-tune the interview schedule. In the second stage, a single interview was held, and the interview schedule was further modified. The third and the final stage consisted of interviewing six mothers who had adolescent children. They were chosen with ‘maximum variation’ approach to represent three tiered socioeconomic statuses, and Asian, white and black ethnicities. The data was thematically analysed in a hybrid fashion: inductive coding and deductive assignment of codes into discrete parenting styles. The study found: a) parenting styles are not always discrete and sometimes it can be mixed. b) The parenting styles are influenced by culture, socioeconomic status, transgenerational knowledge, academic knowledge, observational knowledge, self-reflective knowledge, and parental anxiety. c) The parenting style functioned a mediating mechanism where it attempted to converge discrepancies between parental expectations of compliance with maternal perception of severity of noncompliance. The findings of parenting styles were discussed in relation to MPCM.

Keywords: compliance, expectation, parenting styles, perception

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Authors: Alejandra Cardenas, Ona Flores, Fabiola Gretzinger

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Since the 1990s, legal strategies for the promotion and protection of maternal health rights have achieved significant gains. Successful litigation in courts around the world have shown that these rights can be judicially enforceable. Governments and international organizations have acknowledged the importance of a human rights-based approach to maternal mortality and morbidity, and obstetric violence has been recognized as a human rights issue. Despite the progress made, maternal mortality has worsened in some regions of the world, while progress has stagnated elsewhere, and mistreatment in maternal care is reported almost universally. In this context, issues of maternal autonomy and decision-making during pregnancy, labor, and delivery as a critical barrier to access quality maternal health have been largely overlooked. Indeed, despite the principles of autonomy and informed consent in medical interventions being well-established in international and regional norms, how they are applied particularly during childbirth and pregnancy remains underdeveloped. National and global legal standards and decisions related to maternal health were reviewed and analyzed to determine how maternal autonomy and decision-making during pregnancy, labor, and delivery have been protected (or not) by international and national courts. The results of this legal research and analysis lead to the conclusion that a few standards have been set by courts regarding pregnant people’s rights to make choices during pregnancy and birth; however, most undermine the agency of pregnant people. These decisions recognize obstetric violence and gender-based discrimination, but fail to protect pregnant people’s autonomy, privacy, and their right to informed consent. As current human rights standards stand today, maternal health is the only field in medicine and law in which informed consent can be overridden, and patients can be forced to submit to treatments against their will. Unconsented treatment and loss of agency during pregnancy and childbirth can have long-term physical and mental impacts, reduce satisfaction and trust in health systems, and may deter future health-seeking behaviors. This research proposes a path forward that focuses on the pregnant person as an independent agent, relying on the doctrine of self-determination during pregnancy and childbirth, which includes access to the necessary conditions to enable autonomy and choice throughout pregnancy and childbirth as a critical step towards our approaches to reduce maternal mortality, morbidity, and mistreatment, and realize the promise of access to quality maternal health as a human right.

Keywords: autonomy in childbirth and pregnancy, choice, informed consent, jurisprudential analysis

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Authors: Amina Bouzitouna, Kheireddine Ouali, Sandra Amri, Houria Rahmoun, Mourad Bensouilah

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Aim of this study: To evaluate the effect of Cisthanche tinctoria treatment on maternal-fetal outcome and antioxidant systems of streptozotocin-induced diabetic rats. Materials and methods: Virgin female Wistar rats were injected with 50 mg/kg streptozotocin before mating. Oral administration of an methanolic extract of Cistanche tinctoria was given to non-diabetic and diabetic pregnant rats at doses of 200 mg/kg from 0 to 19th day of pregnancy. At day 20 of pregnancy the rats were killed and a maternal blood sample was collected for the determination Vitamin C (Vit C) and malonaldehyde (MDA). The gravid uterus was weighed with its contents and fetuses were analyzed. Results and conclusion: The data showed that the diabetic dams presented an increased glycemic level, resorption, placental weight, placental index, and fetal anomalies, and reduced VIT C and MDA determinations, live fetuses, maternal weight gain, gravid uterine weight, and fetal weight. It was also verified that Cisthanche tictoria treatment had no hypoglycemic effect, did not improve maternal outcomes in diabetic rats, but it contributed to maintain GSH concentration similarly to non-diabetic groups, suggesting relation with the decreased incidence of visceral anomalies.

Keywords: cistanche tinctoria, diabetes, pregnancy, reproductive outcome, anomaly, orobanchacées

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Authors: Gubair Tarabeh, Ghadir Zriek, David Oppenheim, Avi Sagi-Schwartz, Nina Koren-Karie

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Introduction: Mind-Mindedness (MM) focuses on mothers' attunement to their infant's mental states as reflected in their speech to the infant. Appropriate MM comments are associated with attachment security in individualistic Western societies where parents value their children’s autonomy and independence, and may therefore be more likely to engage in mind-related discourse with their children that highlights individual thoughts, preferences, emotions, and motivations. Such discourse may begin in early infancy, even before infants are likely to understand the semantic meaning of parental speech. Parents in collectivistic societies, by contrast, are thought to emphasize conforming to social norms more than individual goals, and this may lead to parent-child discourse that emphasizes appropriate behavior and compliance with social norms rather than internal mental states of the self and the other. Therefore, the examination of maternal MM and its relationship with attachment in Arab collectivistic culture in Israel was of particular interest. Aims of the study: The goal of the study was to examine whether the associations between MM and attachment in the Arab culture in Israel are the same as in Western samples. An additional goal was to examine whether appropriate and non-attuned MM comments could, together, distinguish among mothers of children in the different attachment classifications. Material and Methods: 76 Arab mothers and their infants between the ages of 12 and 18 months were observed in the Strange Situation Procedure (49 secure (B), 11 ambivalent (C), 14 disorganized (D), and 2 avoidant (A) infants). MM was coded from an 8-minute free-play sequence. Results: Mothers of B infants used more appropriate and less non-attuned MM comments than mothers of D infants, with no significant differences with mothers of C infants. Also, mothers of B infants used less non-attuned MM comments than both mothers of D infants and mothers of C infants. In addition, Mothers of B infants were most likely to show the combination of high appropriate and low non-attuned MM comments; Mothers of D infants were most likely to show the combination of high non-attuned and low appropriate MM comments; and a non-significant trend indicated that mothers of C infants were most likely to show a combination of high appropriate and high non-attuned MM comments. Conclusion: Maternal MM was associated with attachment in the Arab culture in Israel with combinations of appropriate and non-attuned MM comments distinguishing between different attachment classifications.

Keywords: attachment, maternal mind-mindedness, Arab culture, collectivistic culture

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Authors: Nemeh Ahmad Al-Akour, Ibrahem Alfaouri

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Objective: To examine the level of maternal awareness of SIDS and its prevention amongst Jordanian mothers in the north of Jordan, as well as to determine their SIDS-related infant care practices. Design: A cross-sectional design. Setting: The study was conducted in maternal out-patients clinics of two teaching hospitals and three maternal and child health clinic in three major health care centers in Northern Jordan. Participants: A total of 356 mothers of infants attending the maternal and child health clinics were included in this study. Measurements and findings: A self-administered questionnaire was used for collecting data study. In this study, 64%of mothers didn’t hear about SIDS, while only 7% of mothers were able to identify factors risk-reducing recommendations. Avoidance of prone sleeping was the most frequently identified recommendation (5%). There were 67.7% of mothers who put their infant in a lateral position to sleep, 61% used soft mattress surface for their babies sleep and 25.8% who shared a bed with their babies. Employed mother, mothers of higher age, and mothers living within a nuclear family were the only factors associated with maternal awareness of SIDS. Friends were the highest a source of knowledge of SIDS for mothers (44.7%). Key conclusions: There was a low level of awareness of SIDS and its associated risk factor among the mothers in Jordan. The mothers' misconception about smoking and sleeping position for their infants requires further efforts. Implications for practice: To ensure raising awareness of infant care practice regarding SIDS, a national educational intervention on SIDS risk reduction strategies and recommendations is necessary for maintaining a low rate of SIDS in the population.

Keywords: bed sharing, infant care, Jordan, sleep position, sudden infant death

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Authors: Hassen Mohammed, Michelle Clarke, Helen Marshall

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Maternal immunization is an effective strategy to protect pregnant women and their offspring from vaccine-preventable diseases. Despite the recommendation of maternal influenza and more recently pertussis immunization in Australia, uptake of these vaccines has been suboptimal. Monitoring the impact of the current funded vaccine programs for pregnant women is limited. The study aimed to assess the impact of the funded program and determine factors associated with vaccine uptake in pregnant women. This observational prospective study was undertaken between November 2014 and July 2016 at the Women’s and Children’s Hospital in South Australia (WCH). Demographic details and vaccination history from South Australian pregnant women who attended the WCH were reviewed. A standardized self-reported survey was conducted in antenatal care with a follow up telephone interview at 8-10 weeks post-delivery. A midwife delivered immunization program for pregnant women in antenatal clinic commenced in April 2015. Of the 180 pregnant women who completed the survey questionnaire, 75.5% and 80.5 % received maternal influenza and pertussis vaccines respectively. First-time mothers had twice the odds of having received influenza vaccine during pregnancy than multiparous women (OR 2.4; CI 1.14 - 4.94; p= 0.021). The proportion of women who received pertussis vaccine during pregnancy, following the introduction of the midwife delivered pertussis vaccination program (140/155, 90.3%) was significantly higher compared with women who received maternal pertussis vaccination prior to the introduction of the program (5/22, 23.7%, p < 0.001). The odds of women receiving maternal pertussis vaccine following the implementation of the midwife delivered program were 31 times higher than women who delivered babies prior to the program (OR 31.7, CI 10.24- 98.27; p < 0.001). High uptake of influenza and pertussis vaccines during pregnancy can be attained with health care provider recommendation and inclusion of maternal immunization as part of standard antenatal care.

Keywords: influenza, maternal immunization, pertussis, provider recommendation

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Authors: Homoud Bourisli, Haitham Safar

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Oil is one of main resources of energy in the world. As conventional oil is drying out, oil recovery is crucial to maintain the same level of oil production. Since water injection is one of the commonly used methods to increase and maintain pressure in oil wells, oil-water separation processes of the water associated with oil production for water injection oil recovery is very essential. Therefore, Gas Flotation Units are used for oil-water separation to be able to re-inject the treated water back into the wells to increase pressure.

Keywords: Kuwait oil company, dissolved gas flotation unit, induced gas flotation unit, oil-water separation

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Authors: Chona Gelani, Mylene Uy, Keisuke Yasuda, Emi Ohta, Shinji Ohta

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The marine environment is undoubtedly a rich source of diverse organisms that possess bioactive secondary metabolites with important pharmacological activities. Marine sponges have since been contributing a wide array of compounds of biomedical and pharmaceutical importance. This study is an attempt to contribute to the growing and advancing marine natural products research. It aims to evaluate the cytotoxicity of the hexane extract (H) from the Philippine marine sponges, Rhabdastrella globostellata (Rg), Callyspongia sp. (Calsp), Callyspongia aerizusa (Ca), Carteriospongia sp. (Carsp), and Cinachyrella sp. (Cisp) using the eggs of starfish, Asterina pectinifera, and sea urchin, Hemicentrotus pulcherrimus. Specifically, the cytotoxicity of the marine sponge hexane extract was determined through its inhibition of starfish and sea urchin embryonic development. After 24 hours, CarspH and RgH inhibited early gastrulation of sea urchin at a minimum concentration of 15.63 and 31.25 μg/mL, respectively. CalspH inhibited the early gastrulation of both sea urchin and starfish at 125 μg/mL, whereas CaH halted the morula of sea urchin and early gastrulation of starfish at 250 μg/mL. CispH exhibited relatively weak inhibitory activity on starfish embryogenesis but inhibited the early gastrulation of sea urchin at 250 μg/mL. The results obtained from this study were used as basis for the separation, isolation and purification of the component(s) of the hexane extracts from the five Philippine marine sponges.

Keywords: embryonic development, marine sponge cytotoxicity, Philippine marine sponges, sea urchin and starfish embryogenesis

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Authors: Julie Mariam Abraham, G. J. Melendez-Torres

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Background. Maternal mortality is disproportionately higher in low- and middle- income countries (LMICs) compared to other parts of the world. At the current pace of progress, the Sustainable Development Goals for maternal mortality rate will not be achieved by 2030. A variety of factors influence the increased risk of maternal complications in LMICs. These are exacerbated by socio-economic and political factors, including poverty, illiteracy, and gender inequality. This paper aims to use realist synthesis to identify the contexts, mechanisms, and outcomes (CMOs) of maternal health interventions conducted in LMICs to inform evidence-based practice for future maternal health interventions. Methods. In May 2022, we searched four electronic databases for systematic reviews of maternal health interventions in LMICs published in the last five years. We used open and axial coding of CMOs to develop an explanatory framework for intervention effectiveness. Results. After eligibility screening and full-text analysis, 44 papers were included. The intervention strategies and measured outcomes varied within reviews. Healthcare system level contextual factors were the most frequently reported, and infrastructural capacity was the most reported context. The most prevalent mechanism was increased knowledge and awareness. Discussion. Health system infrastructure must be considered in interventions to ensure effective implementation and sustainability. Healthcare-seeking behaviours are embedded within social and cultural norms, environmental conditions, family influences, and provider attitudes. Therefore, effective engagement with communities and families is important to create new norms surrounding pregnancy and delivery. Future research should explore community mobilisation and involvement to enable tailored interventions with optimal contextual fit.

Keywords: maternal mortality, service delivery and organisation, realist synthesis, sustainable development goals, overview of reviews

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Authors: Martina Kanciruk, Jac J. W. Andrews, Tyrone Donnon

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The purpose of this study was to determine the significance of maternal smoking for the development of childhood overweight and/or obesity. Accordingly, a systematic literature review of English-language studies published from 1980 to 2012 using the following data bases: MEDLINE, PsychINFO, Cochrane Database of Systematic Reviews, and Dissertation Abstracts International was conducted. The following terms were used in the search: pregnancy, overweight, obesity, smoking, parents, childhood, risk factors. Eighteen studies of maternal smoking during pregnancy and obesity conducted in Europe, Asia, North America, and South America met the inclusion criteria. A meta-analysis of these studies indicated that maternal smoking during pregnancy is a significant risk factor for overweight and obesity; mothers who smoke during pregnancy are at a greater risk for developing obesity or overweight; the quantity of cigarettes consumed by the mother during pregnancy influenced the odds of offspring overweight and/or obesity. In addition, the results from moderator analyses suggest that part of the heterogeneity discovered between the studies can be explained by the region of world that the study occurred in and the age of the child at the time of weight assessment.

Keywords: childhood obesity, overweight, smoking, parents, risk factors

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Authors: R. Fegas, S. Zerkout, S. Taberkokt, M. Righezza

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The present work demonstrate the potential of Betacyclodextrine (BCD) for the chiral analysis of a drug .Various separation mechanisms were applied and several parameters affecting the separation were studied, including the type and concentration of chiral selector, and pH of buffer. A simple and sensitive high-performance liquid chromatography (HPLC) method was developed as an assay for fexofenadine enantiomers in pharmaceutical preparation. Fexofenadine enantiomers were separated using a mobile phase of 0.25mM NaH2PO4–acetonitrile (65:35, v/v) – Betacyclodextrine on achiral phenyl-urea column at a flow rate of 1ml/min and measurement at 220nm. The chiral mechanism of separation was mainly based on specific interaction between the solute and the stationary phase. The retention was directly controlled by mobile phase composition but not the selectivity which results of the two mechanisms, electrostatic interactions and partition mechanism.

Keywords: fexofenadine enantiomer, HPLC, achiral phenyl-urea column

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Authors: Abdulla Al Hmoudi

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The impacts and costs of natural disasters on people, properties and the environment is often severe when they occur on a large scale or when not prepared for. Factors such as impacts of climate change, urban growth, poor planning to mention a few, have continued to significantly increase the frequencies and aggravate the impacts of natural hazards across the world; the United Arab Emirates (UAE) inclusive. The lack of deployment of an early warning system, low risk and hazard knowledge and impact of natural hazard experienced in some communities in the UAE have emphasised the need for more effective early warning systems. This paper focuses on the collaborative approach taken to instituting and implementing an early warning system. Using mixed methods 888 people completed the questionnaire and eight people were interviewed in Abu Dhabi. The results indicate that the collaborative approach to early warning system is UAE is needed, but lacks essential principles of the early warning system and currently underutilised. It is recommended that the collaborative early warning system is applied at every stage of the early warning system with the specific responsibility of each stakeholder and actor.

Keywords: community, early warning system, emergency management, UAE

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Authors: Fekadu Melak, Tsegaye Girma Asere

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Trace element ions, such as Cr(VI) and F−, are of particular interest due to their environmental impact. Both ions exhibit an anionic nature in water that can show similar removal tendencies except for their significant differences in ionic radius. Accordingly, partial freezing was performed to examine freeze separation efficiencies of Cr(VI) and F– from aqueous solutions. Real groundwater and simulated wastewater were included to test effeciency of F– and Cr(VI), respectively. Parameters such as initial ion concentration, salt addition, and freeze duration were explored. Under optimal operating conditions, freeze separation efficiencies of 90 ± 0.12 to 97 ± 0.54% and 58 ± 0.23% to 60 ± 0.34% from 5 mg/L of Cr(VI) and F–, respectively, were demonstrated. The F– ion intercalation into the ice, initiating the decrement of freeze separation efficiency was observed in the salt addition processes. The influences of structuring-destructuring (kosmotropicity-chaotropicity) and the size-exclusion nature of ice crystals were used to explain the plausible mechanism in freeze separation efficiency trace elemental ions.

Keywords: Cr(VI), F-, partial freezing, size exclusion

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Authors: Rayanne Branco Dos Santos Lima, Lorena Pinheiro Barbosa, Kamila Ferreira Lima, Victor Manuel Tegoma Ruiz, Monyka Brito Lima Dos Santos, Maria Wendiane Gueiros Gaspar, Luzia Camila Coelho Ferreira, Leandro Cardozo Dos Santos Brito, Deyse Maria Alves Rocha

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Introduction: The lack of regulation of the baby's sleep-wake pattern in the first years of life affects the health of thousands of women. Maternal sleep deprivation can trigger or aggravate psychosomatic problems such as depression, anxiety and stress that can directly influence maternal safety, with consequences for the baby's and mother's sleep. Such conditions can affect the family's quality of life and child development. Objective: To correlate maternal security with maternal state anxiety scores and the mother's and baby's total sleep time. Method: Cross-sectional study carried out with 96 mothers of babies aged 10 to 24 months, accompanied by nursing professionals linked to a Federal University in Northeast Brazil. Study variables were maternal security, maternal state anxiety scores, infant latency and sleep time, and total nocturnal sleep time of mother and infant. Maternal safety was calculated using a four-point Likert scale (1=not at all safe, 2=somewhat safe, 3=very safe, 4=completely safe). Maternal anxiety was measured by State-Trait Anxiety Inventory, state-anxiety subscale whose scores vary from 20 to 80 points, and the higher the score, the higher the anxiety levels. Scores below 33 are considered mild; from 33 to 49, moderate and above 49, high. As for the total nocturnal sleep time, values between 7-9 hours of sleep were considered adequate for mothers, and values between 9-12 hours for the baby, according to the guidelines of the National Sleep Foundation. For the sleep latency time, a time equal to or less than 20 min was considered adequate. It is noteworthy that the latency time and the time of night sleep of the mother and the baby were obtained by the mother's subjective report. To correlate the data, Spearman's correlation was used in the statistical package R version 3.6.3. Results: 96 women and babies participated, aged 22 to 38 years (mean 30.8) and 10 to 24 months (mean 14.7), respectively. The average of maternal security was 2.89 (unsafe); Mean maternal state anxiety scores were 43.75 (moderate anxiety). The babies' average sleep latency time was 39.6 min (>20 min). The mean sleep times of the mother and baby were, respectively, 6h and 42min and 8h and 19min, both less than the recommended nocturnal sleep time. Maternal security was positively correlated with maternal state anxiety scores (rh=266, p=0.009) and negatively correlated with infant sleep latency (rh= -0.30. P=0.003). Baby sleep time was positively correlated with maternal sleep time. (rh 0.46, p<0.001). Conclusion: The more secure the mothers considered themselves, the higher the anxiety scores and the shorter the baby's sleep latency. Also, the longer the baby sleeps, the longer the mother sleeps. Thus, interventions are needed to promote the quality and efficiency of sleep for both mother and baby.

Keywords: sleep, anxiety, infant, mother-child relations

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Authors: Oluwayemisi Femi-Pius, Kazeem Arogundade, Eberechukwu Eke, Jimmy Eko

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Introduction: Globally, community involvement in improving their own health has been widely adopted as a strategy in Sub-Saharan Africa principally to ensure equitable access to essential health care as well as improve the uptake of maternal and newborn health services especially in poor-resource settings. Method: The Saving Mother Giving Life (SMGL) Initiative implemented by Pathfinder International with funding support from USAID conducted a Health Facility Assessment (HFA) and found out that maternal mortality ratio in Cross River State was 812 per 100,000 live birth and perinatal mortality was 160 per 1000 live birth. To reduce maternal and perinatal mortality, Pathfinder International mobilized, selected and trained community members as community volunteers, traditional birth attendants, and emergency transport service volunteer drivers mainly to address the delay in decision making and reaching the health facility among pregnant women. Results: The results showed that maternal mortality ratio in Cross River State decrease by 25% from 812 per 100,000 live birth at baseline to 206 per 100,000 live birth at June 2018 and perinatal mortality reduced by 35% from 160 per 100,000 at baseline to 58 per 1000 live birth at June 2018. Data also show that ANC visit increased from 7,451 to 11,344; institutional delivery increased from 8,931 at baseline to 10,784 in June 2018. There was also a remarkable uptake of post-partum family planning from 0 at baseline to 233 in June 2018. Conclusion: There is clear evidence that community involvement yields positive maternal outcomes and is pivotal for sustaining most health interventions.

Keywords: maternal mortality, Nigeria, pathfinder international, perinatal mortality, saving mother giving life

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Authors: Luh Eka Suryani, Purhadi

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Poisson regression is a non-linear regression model with response variable in the form of count data that follows Poisson distribution. Modeling for a pair of count data that show high correlation can be analyzed by Poisson Bivariate Regression. Data, the number of infant mortality and maternal mortality, are count data that can be analyzed by Poisson Bivariate Regression. The Poisson regression assumption is an equidispersion where the mean and variance values are equal. However, the actual count data has a variance value which can be greater or less than the mean value (overdispersion and underdispersion). Violations of this assumption can be overcome by applying Generalized Poisson Regression. Characteristics of each regency can affect the number of cases occurred. This issue can be overcome by spatial analysis called geographically weighted regression. This study analyzes the number of infant mortality and maternal mortality based on conditions in East Java in 2016 using Geographically Weighted Bivariate Generalized Poisson Regression (GWBGPR) method. Modeling is done with adaptive bisquare Kernel weighting which produces 3 regency groups based on infant mortality rate and 5 regency groups based on maternal mortality rate. Variables that significantly influence the number of infant and maternal mortality are the percentages of pregnant women visit health workers at least 4 times during pregnancy, pregnant women get Fe3 tablets, obstetric complication handled, clean household and healthy behavior, and married women with the first marriage age under 18 years.

Keywords: adaptive bisquare kernel, GWBGPR, infant mortality, maternal mortality, overdispersion

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Authors: Gevorgianiene Violeta, Sumskiene Egle

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Background. Child removal is a profound and life-altering measure that significantly impacts both children and their mothers. Unfortunately, mothers with intellectual disabilities are disproportionately affected by the removal of their children. This action is often taken due to concerns about the mother's perceived inability to care for the child, instances of abuse and neglect, or struggles with addiction. In many cases, the failure to meet society's standards of a "good mother" is seen as a deviation from conventional norms of femininity and motherhood. From an institutional perspective, separating a child from their mother is sometimes viewed as a step toward restoring justice or doing what is considered "right." In another light, this act of child removal can be seen as the removal of a mother from her child, an attempt to shield society from the complexities and fears associated with motherhood for women with disabilities. This separation can be likened to the Greek legend of the Minotaur, a fearsome beast confined within an impenetrable labyrinth. By reimagining this legend, we can see the social fears surrounding 'mothering with intellectual disability' as deeply sealed within an unreachable place. The Aim of this Presentation. Our goal with this presentation is to draw from our research and the metaphors found in the Greek legend to delve into the profound challenges faced by mothers with intellectual disabilities in raising their children. These challenges often become entangled within an insurmountable labyrinth, including navigating complex institutional bureaucracies, enduring persistent doubts cast upon their maternal competencies, battling unfavorable societal narratives, and struggling to retain custody of their children. Coupled with limited social support networks, these challenges frequently lead to situations resulting in maternal failure and, ultimately, child removal. On a broader scale, this separation of a child from their mother symbolizes society’s collective avoidance of confronting the issue of 'mothering with disability,' which can only be effectively addressed through united efforts. Conclusion. Just as in the labyrinth of the Minotaur legend, the struggles faced by mothers with disabilities in their pursuit of retaining their children reveal the need for a metaphorical 'string of Ariadne.' This string symbolizes the support offered by social service providers, communities, and the loved ones these women often dream of but rarely encounter in their lives.

Keywords: motherhood, disability, child removal, support.

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Authors: Lea Stein, Sabine Rösner, Alessandra Lo Giudice, Beate Ditzen, Tewes Wischmann

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For many couples bearing children is a consistent life goal; however, it cannot always be fulfilled. Undergoing infertility treatment does not guarantee pregnancies and live births. Couples have to deal with miscarriages and sometimes even discontinue infertility treatment. Significant medical predictors for the outcome of infertility treatment have yet to be fully identified. To further our understanding, a cross-sectional five-year follow-up survey was undertaken, in which 95 women and 82 men that have been treated at the Women’s Hospital of Heidelberg University participated. Binary logistic regressions, parametric and non-parametric methods were used for our sample to determine the relevance of biological (infertility diagnoses, maternal and paternal age) and lifestyle factors (smoking, drinking, over- and underweight) on the outcome of infertility treatment (clinical pregnancy, live birth, miscarriage, dropout rate). During infertility treatment, 72.6% of couples became pregnant and 69.5% were able to give birth. Suffering from miscarriages 27.5% of couples and 20.5% decided to discontinue an unsuccessful fertility treatment. The binary logistic regression models for clinical pregnancies, live births and dropouts were statistically significant for the maternal age, whereas the paternal age in addition to maternal and paternal BMI, smoking, infertility diagnoses and infections, showed no significant predicting effect on any of the outcome variables. The results confirm an effect of maternal age on infertility treatment, whereas the relevance of other medical predictors remains unclear. Further investigations should be considered to increase our knowledge of medical predictors.

Keywords: advanced maternal age, assisted reproductive technology, female factor, male factor, medical predictors, infertility treatment, reproductive medicine

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Authors: Alaa A. Osman, Amgad M. Bayoumy Aly, Ismail El baialy, Osama E. Abdellatif, Essam E. Khallil

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In this paper, a numerical simulation of a finned store separating from a wing-pylon configuration has been studied and validated. A dynamic unstructured tetrahedral mesh approach is accomplished by using three grid sizes to numerically solving the discretized three dimensional, inviscid and compressible Navier-stokes equations. The method used for computations of separation of an external store assuming quasi-steady flow condition. Computations of quasi-steady flow have been directly coupled to a six degree-of-freedom (6DOF) rigid-body motion code to generate store trajectories. The pressure coefficients at four different angular cuts and time histories of various trajectory parameters during the store separation are compared for every grid size with published experimental data.

Keywords: CFD modelling, transonic store separation, quasi-steady flow, moving-body trajectories

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Authors: Sizhu Wang, Cuisong Tang, Lin Zhang, Guangyu Tang

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Objective: We aimed to detect the composition of bone marrow fatty acids early after ovariectomized (OVX) surgery and explore the potential mechanism. Methods: Thirty-two female Sprague-Dawley (SD) rats (12 weeks) were randomly divided into OVX group and Sham group (N=16/group), and received ovariectomy or sham surgery respectively. After 3 and 28 days, eight rats in each group were sacrificed to detect the composition of bone marrow fatty acids by gas chromatography–mass spectrometry (GC–MS) and evaluate the trabecular bone microarchitecture by micro-CT. Significant different fatty acids in the early stage of post-menopausal osteoporosis were selected by OPLS-DA and t test. Then selected fatty acids were further studied in the process of osteogenic differentiation through RT-PCR and Alizarin Red S staining. Results: An apparent sample clustering and group separation were observed between OVX group and sham group three days after surgery, which suggested the role of bone marrow fatty acids in the early stage of postmenopausal osteoporosis. Specifically, myristate, palmitoleate and arachidonate were found to play an important role in classification between OVX group and sham group. We further investigated the effect of palmitoleate and arachidonate on osteogenic differentiation and found that palmitoleate promoted the osteogenic differentiation of MC3T3-E1 cells while arachidonate inhibited this process. Conclusion: Profound bone marrow fatty acids changes have taken place in the early stage of post-menopausal osteoporosis. Bone marrow fatty acids may begin to affect osteogenic differentiation shortly after deficiency of estrogen.

Keywords: bone marrow fatty acids, GC-MS, osteoblast, osteoporosis, post-menopausal

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Authors: Leila Kharrat, Younes Boujelbene

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In recent decades, solid waste management (SWM) has become a global concern because rapid population growth and overexploitation of non-renewable resources have generated enormous amounts of waste far exceeding carrying capacity; too, it poses serious threats to the environment and health. However, it is still difficult to combat the growing amount of solid waste before assessing the condition of people. Therefore, this study was conducted to assess the knowledge, attitudes, perception, and practices on the separation of solid waste in Sfax City. Nowadays, GDS is essential for sustainable development, hence the need for intensive research. Respondents from seven different districts in the city of Sfax were analyzed through a questionnaire survey with 342 households. This paper presents a qualitative exploratory study on the behavior of the citizens in the field of waste separation. The objective knows the antecedents of waste separation and the representation that individuals have about sorting waste on a specific territory which presents some characteristics regarding waste management in Sfax city. Source separation is not widely practiced and people usually sweep their places throwing waste components into the streets or neighboring plots. The results also indicate that participation in solid waste separation activities depends on the level of awareness of separating activities in the area, household income and educational level. It is, therefore, argued that increasing quality of municipal service is the best means of promoting positive attitudes to solid waste separation activities. One of the effective strategies identified by households that can be initiated by policymakers to increase the rate of participation in separation activities and eventually encourage them to participate in recycling activities is to provide a financial incentive in all residential areas in Sfax city.

Keywords: solid waste management, waste separation, public policy, econometric modelling

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Authors: Samia Rabet, Rachida Chemini, Gerhard Schäfer, Farid Aiouache

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The textile industry generates large quantities of wastewater, which poses significant environmental problems due to its complex composition and high levels of pollutants loaded principally with heavy metals, large amounts of COD, and dye. Separation treatment methods are often known for their effectiveness in removing contaminants whereas membrane separation techniques are a promising process for the treatment of textile effluent due to their versatility, efficiency, and low energy requirements. This study focuses on the modeling and simulation of membrane separation technologies with a cross-flow filtration process for textile effluent treatment. It aims to explore the application of mathematical models and computational simulations using ASPEN Plus Software in the prediction of a complex and real effluent separation. The results demonstrate the effectiveness of modeling and simulation techniques in predicting pollutant removal efficiencies with a global deviation percentage of 1.83% between experimental and simulated results; membrane fouling behavior, and overall process performance (hydraulic resistance, membrane porosity) were also estimated and indicating that the membrane losses 10% of its efficiency after 40 min of working.

Keywords: membrane separation, ultrafiltration, textile effluent, modeling, simulation

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Authors: Sumiti Saharan, Pallav Patankar, Lily W. Lee

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Understanding the health-seeking behaviors and attitudes of women towards maternal health in the context of gender roles and family dynamics is tremendously crucial for designing effective and impactful interventions aimed at improving maternal and child health outcomes. Further, as the digital world becomes more accessible and affordable, it is imperative to scope the potential of digital technology in enabling access to maternal health information in different socio-economic groups (SEGs). In the summer of 2017, we conducted a study with 500 women across different SEGs in urban India who were pregnant or had had a delivery in the last year. The study was undertaken to assess their maternal health information seeking behavior with a particular focus on probing their use of digital technology for health-related information. The study also measured women's decision-making autonomy in the context of maternal health, awareness of their rights to quality and respectful maternal healthcare, and agency to voice their rights. We probed the impact of key variables including education, age, and socioeconomic status on all outcome variables. In terms of health-seeking behaviors, we found that women heavily relied on medical professionals and/or their mothers and mothers-in-law for all maternal health advice. Digital adoption was found to be high across all SEGs, with around 70% of women from all populations using the internet several times a week. On the other hand, use of the internet for both accessing maternal health information and choosing maternity hospitals were both significantly dependent on SEG. The key reasons reported for not using the internet for health purposes were lack of awareness and lack of trust on content accuracy. Decisions around health practices and type of delivery were found to be jointly made by women and other family members. Almost all women reported their husbands to play a key role in all maternal health decisions and for decisions with a clear financial implication like choice of hospital for delivery, husbands were reported to be the sole decision maker by a majority of women. The agency of women was also found to be low in interactions with maternal healthcare providers with a third of respondents not comfortable with voicing their opinions and preferences to their doctors. Interestingly, we find that this relatively low agency was prominent in both lower middle class and middle-class SEGs. Recognition of the sociocultural determinants of behavior is the first step in developing actionable strategies for improving maternal health outcomes. Our study quantifies the agency and autonomy of women in urban India and the variables that impact them. Our findings emphasize the value of gender normative approaches that factor in the key role husbands play in guiding maternal health decisions. They also highlight the power of digital approaches for catalyzing access to maternal health information. These insights into the attitude and behaviors of mothers in context of their sociocultural environments—and their relationship with digital technology—can help pave the way towards designing effective, scalable maternal and child health programs in developing nations like India.

Keywords: access to healthcare information, behavior, digital health, maternal health

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Authors: Sunaitan Al Mutairi, Kumar Vallatharasu, Batool Ismaeel

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The Water Knock-Out (WKO) facility project is to handle the undesirable impact of the increasing water production rate in South and East Kuwait (S&EK) areas and break the emulsions and ensure sufficient separation of water at the new upstream facility, to reduce the load on the existing separation equipment in the Gathering Centers (GC). As the existing separation equipment in the Gathering Centers are not efficient to separate the emulsions, the Compact Electrostatic Coalescer (CEC) and Vessel Internal Electrostatic Coalescer (VIEC) technologies have been selected for enhancing the liquid-liquid separation by using the alternating voltage/frequency on electrical fields, to handle the increasing water-cut in S&EK. In the Compact Electrostatic Coalescer (CEC) technology method, the CEC equipment is installed downstream of the inlet separator externally, whereas in the Vessel Internal Electrostatic Coalescer (VIEC) technology method, the VIEC is built inside the treater vessel, downstream of the inlet separator with advanced internals for implementing electrocoalescence of water particles and hence enhancing liquids separation. The CEC and VIEC technologies used in the Water Knockout Facility project has the ability to resolve the increasing water cut in the S&EK area and able to enhance the liquid-liquid separation in the WKO facility separation equipment. In addition, the WKO facility is minimizing the load on the existing Gathering Center’s separation equipment, by tackling the high water-cut wells, upstream of each GC. The required performances at the outlet of the WKO facility are Oil in Water 100ppmv, Water in Oil 15% volume, liquid carryover in gas 0.1 US gal/MMSCFD, for the water cut ranging from 37.5 to 75% volume. The WKO facility project is used to sustain, support and maintain Greater Burgan production at 1.7 Million Barrels of Oil Per Day (MMBOPD), by handling the increasing water production rate.

Keywords: emulsion, increasing water-cut, production, separation equipment

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Authors: Anh Vo Van Ha, Yun Zhao, Luat Cong Nguyen, Tan Khac Chu, Phung Hoang Nguyen, Minh Ngoc Pham, Colin W. Binns, Andy H. Lee

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This study aims to study longitudinal changes in blood pressure (BP) during the 1-year postpartum period and to evaluate the influence of parity, maternal age at delivery, prepregnancy BMI, gestational weight gain, gestational age at delivery and postpartum maternal weight. A prospective longitudinal cohort study of 883 singleton Vietnamese women was conducted in Hanoi, Haiphong, and Ho Chi Minh City, Vietnam during 2015-2017. Women diagnosed with gestational diabetes mellitus at 24-28 weeks of gestation, pre-eclampsia, and hypoglycemia was excluded from analysis. BP was repeatedly measured at discharge, 6 and 12 months postpartum using automatic blood pressure monitors. Linear mixed model with repeated measures was used to describe changes occurring during pregnancy to 1-year postpartum. Parity, self-reported prepregnancy BMI, gestational weight gain, maternal age and gestational age at delivery will be treated as time-invariant variables and measured maternal weight will be treated as a time-varying variable in models. Women with higher measured postpartum weight had higher mean systolic blood pressure (SBP), 0.20 mmHg, 95% CI [0.12, 0.28]. Similarly, women with higher measured postpartum weight had higher mean diastolic blood pressure (DBP), 0.15 mmHg, 95% CI [0.08, 0.23]. These differences were both statistically significant, P < 0.001. There were no differences in SBP and DBP depending on parity, maternal age at delivery, prepregnancy BMI, gestational weight gain and gestational age at delivery. Compared with discharge measurement, SBP was significantly higher in 6 months postpartum, 6.91 mmHg, 95% CI [6.22, 7.59], and 12 months postpartum, 6.39 mmHg, 95% CI [5.64, 7.15]. Similarly, DBP was also significantly higher in 6 and months postpartum than at discharge, 10.46 mmHg 95% CI [9.75, 11.17], and 11.33 mmHg 95% CI [10.54, 12.12]. In conclusion, BP measured repeatedly during the postpartum period (6 and 12 months postpartum) showed a statistically significant increase, compared with after discharge from the hospital. Maternal weight was a significant predictor of postpartum blood pressure over the 1-year postpartum period.

Keywords: blood pressure, maternal weight, postpartum, Vietnam

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Authors: Sadia Munir, Diana White, Aya Albahri, Pratiwi Hastania, Eltahir Mohamed, Mahmood Khan, Fathima Mohamed, Ayat Kadhi, Haila Saleem

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Preeclampsia is a major complication of pregnancy. Prediction and management of preeclampsia is a challenge for obstetricians. To our knowledge, no major progress has been achieved in the prevention and early detection of preeclampsia. There is very little known about the clear treatment path of this disorder. Preeclampsia puts both mother and baby at risk of several short term- and long term-health problems later in life. There is huge health service cost burden in the health care system associated with preeclampsia and its complications. Preeclampsia is divided into two different types. Early onset preeclampsia develops before 34 weeks of gestation, and late onset develops at or after 34 weeks of gestation. Different genetic and environmental factors, prognosis, heritability, biochemical and clinical features are associated with early and late onset preeclampsia. Prevalence of preeclampsia greatly varies all over the world and is dependent on ethnicity of the population and geographic region. To authors best knowledge, no published data on preeclampsia exist in Qatar. In this study, we are reporting the incidence of preeclampsia in Qatar. The purpose of this study is to compare the incidence and risk factors of both early onset and late onset preeclampsia in Qatar. This retrospective longitudinal cohort study was conducted using data from the hospital record of Women’s Hospital, Hamad Medical Corporation (HMC), from May 2014-May 2016. Data collection tool, which was approved by HMC, was a researcher made extraction sheet that included information such as blood pressure during admission, socio demographic characteristics, delivery mode, and new born details. A total of 1929 patients’ files were identified by the hospital information management when they apply codes of preeclampsia. Out of 1929 files, 878 had significant gestational hypertension without proteinuria, 365 had preeclampsia, 364 had severe preeclampsia, and 188 had preexisting hypertension with superimposed proteinuria. In this study, 78% of the data was obtained by hospital electronic system (Cerner) and the remaining 22% was from patient’s paper records. We have gone through detail data extraction from 560 files. Initial data analysis has revealed that 15.02% of pregnancies were complicated with preeclampsia from May 2014-May 2016. We have analyzed difference in the two different disease entities in the ethnicity, maternal age, severity of hypertension, mode of delivery and infant birth weight. We have identified promising differences in the risk factors of early onset and late onset preeclampsia. The data from clinical findings of preeclampsia will contribute to increased knowledge about two different disease entities, their etiology, and similarities/differences. The findings of this study can also be used in predicting health challenges, improving health care system, setting up guidelines, and providing the best care for women suffering from preeclampsia.

Keywords: preeclampsia, incidence, risk factors, maternal

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Authors: Neel K. Shah

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Wind tunnel tests have been performed at The University of Manchester to investigate the impact of surface grooves of a trapezoidal planform on flow separation on a symmetrical aerofoil. A spanwise array of the grooves has been applied around the maximum thickness location of the upper surface of an NACA-0015 aerofoil. The aerofoil has been tested in a two-dimensional set-up in a low-speed wind tunnel at an angle of attack (AoA) of 3° and a chord-based Reynolds number (Re) of ~2.7 x 105. A laminar separation bubble developed on the aerofoil at low AoA. It has been found that the grooves shorten the streamwise extent of the separation bubble by shedding a pair of counter-rotating vortices. However, the increase in leading-edge suction due to the shorter bubble is not significant since the creation of the grooves results in a decrease of surface curvature and an increase in blockage (increase in surface pressure). Additionally, the increased flow mixing by the grooves thickens the boundary layer near the trailing edge of the aerofoil also contributes to this limitation. As a result of these competing effects, the improvement in the pressure-lift and pressure-drag coefficients are small, i.e., by ~1.30% and ~0.30%, respectively, at 3° AoA. Crosswire anemometry shows that the grooves increase turbulence intensity and Reynolds stresses in the wake, thus indicating an increase in viscous drag.

Keywords: aerofoil flow control, flow separation, grooves, vortices

Procedia PDF Downloads 287

Authors: Richard Abel

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In the United States, increased incarceration rates have caused many adolescents to feel the strain of parental absence. This absence is then manifest through adolescent feelings of parental rejection. Additionally, upon reentry maternal incarceration may be related to adolescents experienced perceived excessive disciple. It is possible parents engage in this manner of discipline attempting to prevent the child from taking the same path to incarceration as the parent. According to General Strain Theory, adolescents encountering strain are likely to experience negative emotions. The emotion that is most likely to lead to delinquency is anger through reduced inhibitions and motivation to act. Additionally, males are more likely to engage in delinquent behavior, regardless of experiencing strain. This is not the case for every male who experiences maternal incarceration, parental rejection, excessive discipline, or anger. There are protective factors that enable agency within individuals. One such protective factor is mastery, or the perception that one is in control of his or her own future. The model proposed in this research suggests maternal incarceration is associated with increased parental rejection and excessive discipline in males. Males experiencing parental rejection and excessive discipline are likely to experience increased anger, which is then associated with increases in delinquent behavior. This model explores whether agency, in the form of mastery, mediates the relationship between strains and negative emotions, or between negative emotions and delinquent behavior. The Kaplan Longitudinal and Multigenerational Study (KLAMS) dataset is uniquely situated to analyze this model providing longitudinal data collected from both parents and their offspring. Maternal incarceration is constructed using parental responses such that the mother was incarcerated after the child’s birth, and any incarceration that happened prior to birth is excluded. The remaining variables of the study are all constructed from varying waves of the adolescent survey. Parental rejection, along with control variables for age, race, parental socioeconomic status, neighborhood effects, delinquent peers, and prior delinquent behavior are all constructed using Wave I data. To increase causal inference, the negative emotion of anger and the mediating variable of mastery are measured during Wave II. Lastly, delinquent behavior is measured at Wave III. Results of the analysis show expected relationships such that adolescent males encountering maternal incarceration show increased perception of parental rejection and excessive discipline. Additionally, there is a positive relationship between parental rejection and excessive discipline at Wave I and feelings of anger at Wave II for males. For males experiencing either of these strains in Wave I, feelings of anger in Wave II are found to be associated with increased delinquent behavior in Wave III. Mastery was found to mediate the relationship between both parental rejection and excessive discipline and anger, but no such mediation occurs in the relationship between anger and delinquency, regardless of the strain being experienced. These findings suggest adolescent males who feel they are in control of their own lives are less likely to experience negative emotions produced by the occurrence of strain, thereby decreasing male engagement in delinquent behavior later in life.

Keywords: delinquency, mastery, maternal incarceration, strain

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