Search results for: early pregnancy assessment

Authors: Viola Hubačová Pirová

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The assessment of psychomotor development allows us to identify children with motor delays, helps us to monitor progress in time and prepare suitable intervention programs. The foundation of psychomotor development lies in pre-school age and is crucial for child´s further cognitive and social development. Many assessment tools of psychomotor development have been developed over the years. Some of them are easy screening tools; others are more complex and sophisticated. The purpose of this review is to describe the history of psychomotor assessment, specify preschool children´s psychomotor evaluation and review eight psychomotor development assessment tools for preschool children (Denver II., DEMOST-PRE, TGMD -2/3, BOT-2, MABC-2, PDMS-2, KTK, MOT 4-6). The selection of test depends on purpose and context in which is the assessment planned.

Keywords: assessment of psychomotor development, preschool children, psychomotor development, review of assessment tools

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Authors: Xin Chen, Xiao Yang, Rongrong Han, Lu Chen, Lingling Gao

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Background: Leisure time physical activity (LTPA) benefits both pregnant women and their fetuses. The guidelines recommended that pregnant women should do at least 150 minutes of moderate-intensity aerobic physical activity throughout the week. The aim of this study was to investigate the rate of LTPA participation among Chinese pregnant women and to identify its predictors based on the health belief model. Methods: A cross-sectional study was conducted from June 2019 to September 2019 in Changchun, China. A total of 225 pregnant women aged 18 years or older with no severe physical or mental disease were recruited in the obstetric clinic. Self-administered questionnaires were used to collect data. LTPA was assessed by a pregnant physical activity questionnaire (PPAQ). A revised pregnancy physical activity health belief scale and social-demographic and perinatal characteristics factors were collected and used to predict LTPA participation. Data were analyzed using descriptive statistics and multivariate logistic regression. Results: The participants had a high level of perceived susceptibility, perceived severity, perceived benefits, and action clues, with mean item scores above 3.5. The predictors of LTPA in Chinese pregnant women were pre-pregnancy exercise habits [OR 3.236 (95% CI:1.632, 6.416)], perceived susceptibility score [OR 2.083 (95% CI:1.002, 4.331)], and perceived barriers score [OR 3.113 (95%CI:1.462, 6.626)]. Conclusions: The results of this study will lead to better identification of pregnant women who may not participate in LTPA. Healthcare professionals should be cognizant of issues that may affect LTPA participation among pregnant women, including pre-pregnancy exercise habits, perceived susceptibility, and perceived barriers.

Keywords: pregnancy, health belief model., leisure time physical activity, factors

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Authors: Vanessa Bennemann, Gabriela Laste, Márcia Inês Goettert

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The gestational period is a phase in which the pregnant woman undergoes constant physiological and hormonal changes, which are part of the woman’s biological cycle, the development of the fetus, childbirth, and lactation. These are factors of response to the immunological adaptation of the human reproductive process that is directly related to the pregnancy’s well-being and development. Although most pregnancies occur without complications, about 15% of pregnant women will develop potentially fatal complications, implying maternal and fetal risk. Therefore, requiring specialized care for high-risk pregnant women (HRPW) with obstetric interventions for the survival of the mother and/or fetus. Among the risk factors that characterize HRPW are the women's age, gestational diabetes mellitus (GDM), autoimmune diseases, infectious diseases such as syphilis and HIV, hypertension (SAH), preeclampsia, eclampsia, HELLP syndrome, uterine contraction abnormalities, and premature placental detachment (PPD), thyroid disorders, among others. Thus, pregnancy has an impact on the thyroid gland causing changes in the functioning of the mother's thyroid gland, altering the thyroid hormone (TH) profiles and production as pregnancy progresses. Considering, throughout the gestational period, the interpretation of the results of the tests to evaluate the thyroid functioning depends on the stage in which the pregnancy is. Thyroid disorders are directly related to adverse obstetric outcomes and in child development. Therefore, the adequate release of TH is important for a pregnancy without complications and optimal fetal growth and development. Objective: Investigate the physiological effects caused by thyroid disorders in the gestational period. Methods: A search for articles indexed in PubMed, Scielo, and MDPI databases, was performed using the term “AND”, with the descriptors: Pregnancy, Thyroid. With several combinations that included: Melatonin, Thyroidopathy, Inflammatory processes, Cytokines, Anti-inflammatory, Antioxidant, High-risk pregnancy. Subsequently, the screening was performed through the analysis of titles and/or abstracts. The criteria were: including clinical studies in general, randomized or not, in the period of 10 years prior to the research, in the English literature; excluded: experimental studies, case reports, research in the development phase. Results: In the preliminary results, a total of studies (n=183) were found, (n=57) excluded, such as studies of cancer, diabetes, obesity, and skin diseases. Conclusion: To date, it has been identified that thyroid diseases can impair the fetus’s brain development. Further research is suggested on this matter to identify new substances that may have a potential therapeutic effect to aid the gestational period with thyroid diseases.

Keywords: pregnancy, thyroid, melatonin, high-risk pregnancy

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Authors: Kavita Khoiwal, Vatsla Dadhwal, K. Aparna Sharma, Dipika Deka, Plabani Sarkar

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Introduction: About 2.4 million (1.93 - 3.04 million) people are living with HIV/AIDS in India. Of all HIV infections, 39% (9,30,000) are among women. 5.4% of infections are from mother to child transmission (MTCT), 25,000 infected children are born every year. Besides the risk of mother to child transmission of HIV, these women are at risk of the higher adverse pregnancy outcome. The objectives of the study were to compare the obstetric and neonatal outcome in women who are HIV positive with low-risk HIV negative women and effect of antiretroviral drugs on preterm birth and IUGR. Materials and Methods: This is a retrospective case record analysis of 212 HIV-positive women delivering between 2002 to 2015, in a tertiary health care centre which was compared with 238 HIV-negative controls. Women who underwent medical termination of pregnancy and abortion were excluded from the study. Obstetric outcome analyzed were pregnancy induced hypertension, HIV positive intrauterine growth restriction, preterm birth, anemia, gestational diabetes and intrahepatic cholestasis of pregnancy. Neonatal outcome analysed were birth weight, apgar score, NICU admission and perinatal transmission.HIV-positiveOut of 212 women, 204 received antiretroviral therapy (ART) to prevent MTCT, 27 women received single dose nevirapine (sdNVP) or sdNVP tailed with 7 days of zidovudine and lamivudine (ZDV + 3TC), 15 received ZDV, 82 women received duovir and 80 women received triple drug therapy depending upon the time period of presentation. Results: Mean age of 212 HIV positive women was 25.72+3.6 years, 101 women (47.6 %) were primigravida. HIV positive status was diagnosed during pregnancy in 200 women while 12 women were diagnosed prior to conception. Among 212 HIV positive women, 20 (9.4 %) women had preterm delivery (< 37 weeks), 194 women (91.5 %) delivered by cesarean section and 18 women (8.5 %) delivered vaginally. 178 neonates (83.9 %) received exclusive top feeding and 34 neonates (16.03 %) received exclusive breast feeding. When compared to low risk HIV negative women (n=238), HIV positive women were more likely to deliver preterm (OR 1.27), have anemia (OR 1.39) and intrauterine growth restriction (OR 2.07). Incidence of pregnancy induced hypertension, diabetes mellitus and ICP was not increased. Mean birth weight was significantly lower in HIV positive women (2593.60+499 gm) when compared to HIV negative women (2919+459 gm). Complete follow up is available for 148 neonates till date, rest are under evaluation. Out of these 7 neonates found to have HIV positive status. Risk of preterm birth (P value = 0.039) and IUGR (P value = 0.739) was higher in HIV positive women who did not receive any ART during pregnancy than women who received ART. Conclusion: HIV positive pregnant women are at increased risk of adverse pregnancy outcome. Multidisciplinary team approach and use of highly active antiretroviral therapy can optimize the maternal and perinatal outcome.

Keywords: antiretroviral therapy, HIV infection, IUGR, preterm birth

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Authors: Elnaz Lalezari, Ramin Ghasemi Shaya

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The birth way is influenced by a fracture within the quiet care handle, making a brokenness of this final one. The pregnant lady has got to interface with numerous experts, both amid the pregnancy, the childbirth, and the puerperium. Be that as it may, amid the final ten a long time, there has been an expanding of the pregnancy care worked by the midwife, who is considered to be the administrator with the correct competences, who can beware of each pregnancy and may profit herself of other professionals' commitments in arrange to make strides the results of maternal and neonatal health. To confirm whether there are proofs of viability that bolster the caseload birthing assistance care show, and in case it is conceivable to apply this show within the birth way in Italy. A amendment of writing has been done utilizing a few look motor (Google, Bing) and particular databases (MEDLINE, CINAHL, Embase, Domestic - ClinicalTrials.gov). There has, too, been a discussion of the Italian directions, the national rules, and the proposals of WHO. Results: The look string, legitimately adjusted to the three databases, has given the taking after comes about: MEDLINE 64 articles, CINAHL 94 articles, Embase 88 articles. From this choice, 14 articles have been extricated: 1 orderly survey, 3 controlled arbitrary trial, 7 observational ponders, 3 subjective studies. The caseload maternity care appears to be an successful and dependable organisational/caring strategy. It reacts to the criterions of quality and security, to the requirements of ladies not as it were amid the pregnancy but moreover amid the post-partum stage. For these reasons, it appears exceptionally valuable also for the birth way within the Italian reality.

Keywords: midwifery, care, caseload, maternity

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Authors: Akinwumi Omotayo, Badu-B Apraku, Joseph Olobasola, Petra Abdul Saghir, Yinka Sobowale

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In southwestern Nigeria, climate change has led to loss of at least two months of rainfall. Consequently, only one cycle of maize can now be grown because of the shorter duration of rainy season as against two cycles in the past. The Early and Extra-early maturing varieties of maize were originally developed for the semi-arid and arid zones of West and Central Africa where there are seasonal challenges of water threatening optimum performance of the traditional maize grown, which are commonly late in maturity (115 to 120 days). The early varieties of maize mature in 90 to 95 days; while the Extra-Early maize varieties reach physiological maturity in less than 90 days. It was broadly hypothesized that the extra early varieties of maize could mitigate the effects of climate change in southwestern Nigeria with higher levels of rainfall by reinstating the original two cycles of rain-fed maize crop. Trials were therefore carried out in southwestern Nigeria on the possibility of adapting the extra early maize to mitigate the effects of climate change. The trial was the Mother/Baby design. The mother trial involves the evaluation of extra-early varieties following ideal recommendations and closely supervised centrally at the University research farm and the Agricultural Development Programmes (ADPs). This requires farmers to observe and evaluate the technology and the management regime meant to precede the second stage of evaluation at several satellite farmers field managed by selected farmers. The Baby Trial is expected to provide a realistic assessment of the technology by farmers in their own environment. A stratified selection of thirty farmers for the Baby Trial ensured appropriate representation across the different categories of the farming population by age and gender. Data from the trials indicate that extra early maize can be grown in two cycles rain fed in south west Nigeria and a third and fourth cycle could be obtained with irrigation. However the long duration varieties outyielded the extra early maize in both the mother and baby trials. When harvested green, the extra early maize served as source of food between March and May when there was scarcity of food. This represents a major advantage. The study recommends that further work needs to be done to improve the yield of extra early maize to encourage farmers to adopt.

Keywords: adaptation, climate change, extra early, maize varieties, mitigation

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Authors: Maureen Montalban

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The military is a predominantly male-dominated organisation that has entrenched hierarchical and patriarchal norms. Since 1975, women have been allowed to continue active service in the Australian Defence Force during pregnancy and after the birth of a child; prior to this time, pregnancy was grounds for automatic termination. The military and family, as institutions, make great demands on individuals with respect to their commitment, loyalty, time and energy. This research explores what it means to serve in the Australian Army as a woman through a gender lens, overlaid during a specific time period of their service; that is, during pregnancy, birth, and being a mother. It investigates the external demands faced by servicewomen who are mothers, whether it be from society, the Army, their teammates, their partners, or their children; and how they internally make sense of that with respect to their own identity and role as a mother, servicewoman, partner and as an individual. It also seeks to uncover how Australian Army servicewomen who are also mothers attempt to manage the dilemma of serving two greedy institutions when both expect and demand so much and whether this is, in fact, an impossible dilemma.

Keywords: women's health, gender studies, military culture, identity

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Authors: Wendy Lee

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From the mid-twentieth century onward, the notion of ‘attachment’ has been used to define the optimum relationship between young children and their carers; first applied to parents and young children and more recently with early childhood educators and children in their care. However, it is seldom, if ever, asked whether the notion of ‘attachment’ and more especially so-called Attachment Theory, as propounded by John Bowlby and others, provides a sound basis for conceptualising child-adult relationships in early years. Even if appropriate in the context of family, the use of the term raises a number of questions when used in early childhood education. Research has shown that our youngest children (infants) in early childhood centre based care settings, are given the utmost priority to build 'attachments' with their educators. But exactly when, how and why does this priority diminish - and should it (for preschoolers)? This presentation will elaborate on such issues and will argue that there is a need to reconceptualise and redefine how 'quality relationships' should be measured and implemented in the daily practices and pedagogical methods adopted by early childhood educators. Moreover, this presentation will include data collected from the empirical study conducted, that observed various early childhood educators and children in Australian early childhood centres. Lastly, the thoughts, feelings and desires of parents of children in early childhood centre-based care, regarding the term 'attachment' and 'quality relationships' will be shared in the hope that we can take one step closer in bridging the needs of families, children, early childhood centres, educators, and the wider community.

Keywords: attachment, early childhood education, pedagogy, relationships

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Authors: Tessa Sellis, Marike A. Wierda, Elke Tichelman, Mirjam T. Van Lohuizen, Marjolein Berger, François Schellevis, Claudi Bockting, Lilian Peters, Huib Burger

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Introduction: Most women develop a healthy bond with their children, however, adequate mother-to-infant bonding cannot be taken for granted. Mother-to-infant bonding refers to the feelings and emotions experienced by the mother towards her child. It is an ongoing process that starts during pregnancy and develops during the first year postpartum and likely throughout early childhood. The prevalence of inadequate bonding ranges from 7 to 11% in the first weeks postpartum. An impaired mother-to-infant bond can cause long-term complications for both mother and child. Very little research has been conducted on the direct relationship between the personality of the mother and mother-to-infant bonding. This study explores the associations between maternal personality and postnatal mother-to-infant bonding. The main hypothesis is that there is a relationship between neuroticism and mother-to-infant bonding. Methods: Data for this study were used from the Pregnancy Anxiety and Depression Study (2010-2014), which examined symptoms of and risk factors for anxiety or depression during pregnancy and the first year postpartum of 6220 pregnant women who received primary, secondary or tertiary care in the Netherlands. The study was expanded in 2015 to investigate postnatal mother-to-infant bonding. For the current research 3836 participants were included. During the first trimester of gestation, baseline characteristics, as well as personality, were measured through online questionnaires. Personality was measured by the NEO Five Factor Inventory (NEO-FFI), which covers the big five of personality (neuroticism, extraversion, openness, altruism and conscientiousness). Mother-to-infant bonding was measured postpartum by the Postpartum Bonding Questionnaire (PBQ). Univariate linear regression analysis was performed to estimate the associations. Results: 5% of the PBQ-respondents reported impaired bonding. A statistically significant association was found between neuroticism and mother-to-infant bonding (p < .001): mothers scoring higher on neuroticism, reported a lower score on mother-to-infant bonding. In addition, a positive correlation was found between the personality traits extraversion (b: -.081), openness (b: -.014), altruism (b: -.067), conscientiousness (b: -.060) and mother-to-infant bonding. Discussion: This study is one of the first to demonstrate a direct association between the personality of the mother and mother-to-infant bonding. A statistically significant relationship has been found between neuroticism and mother-to-infant bonding, however, the percentage of variance predictable by a personality dimension is very small. This study has examined one part of the multi-factorial topic of mother-to-infant bonding and offers more insight into the rarely investigated and complex matter of mother-to-infant bonding. For midwives, it is important recognize the risks for impaired bonding and subsequently improve policy for women at risk.

Keywords: mother-to-infant bonding, personality, postpartum, pregnancy

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Authors: Yirui Wang

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In the past few decades, patient safety has been the focus of much attention in the global medical and health field. As medical standards continue to improve and develop, the demand for patient safety is also growing. As one of the important dimensions in assessing patient safety, the Patient Perception Patient Safety Assessment Tool provides unique and valuable information from the patient's own perspective and plays an important role in promoting patient safety. This article aims to summarize and analyze the assessment content, assessment methods and applications of currently commonly used patient-perceived patient safety assessment tools at home and abroad, with a view to providing a reference for medical staff to select appropriate patient-perceived patient safety assessment tools.

Keywords: patients, patient safety, perception, assessment tools, review

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Authors: Kun Chen, Yan Wang, Yangyu Zhao, Shufang Li, Lian Chen, Xiaoyue Guo, Jue Zhang, Jing Fang

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The coupling strength between uterine electromyography (UEMG) and Fetal heart rate (FHR) signals during peripartum reflects the fetal biophysical activities. Therefore, UEMG-FHR coupling characterization is instructive in assessing placenta function. This study introduced a physiological marker named elevated frequency of UEMG-FHR coupling (E-UFC) and explored its predictive value for pregnancies complicated by pre-eclampsia and small for gestational age (SGA). Placental insufficiency patients (n=12) and healthy volunteers (n=24) were recruited and participated. UEMG and FHR were recorded non-invasively by a trans-abdominal device in women at term with singleton pregnancy (32-37 weeks) from 10:00 pm to 8:00 am. The product of the wavelet coherence and the wavelet cross-spectral power between UEMG and FHR was used to weight these two effects in order to quantify the degree of the UEMG-FHR coupling. E-UFC was exacted from the resultant spectrogram by calculating the mean value of the high-coherence (r > 0.5) frequency band. Results showed the high-coherence between UEMG and FHR was observed in the frequency band (1/512-1/16Hz). In addition, E-UFC in placental insufficiency patients was weaker compared to healthy controls (p < 0.001) at group level. These findings suggested the proposed approach could be used to quantitatively characterize the fetal biophysical activities, which is beneficial for early detection of placental insufficiency and reduces the occurrence of adverse pregnancy.

Keywords: uterine electromyography, fetal heart rate, coupling analysis, wavelet analysis

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Authors: Marian Lissett Olaya

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This article examined the factors associated with incorporating peer assessment into English language classes in a public university in Colombia. This is done in the context of writing English class for 4th-semester students. The research instruments consisted of peer assessment questionnaires, student diaries, and interviews. Findings showed that among the factors, motivation, frustration, anxiety, and lack of confidence appeared. Data revealed that peer assessment enables students to write competencies through training, teachers' guidance, and the provision of a collaborative environment.

Keywords: writing skills, peer assessment, formative assessment, language acquisition

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Authors: Candace Kaye

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After a theoretical explanation of Third Space, the paper introduces the concept of art museum settings as third spaces for early inquiry-based core curriculum teaching/learning, Next follows a discussion of phenomenological research that explores how an art museum in Mexico is introducing a wide spectrum of teaching-learning experiences that would otherwise be inaccessible in the second space of the traditional public kindergarten classroom settings. The presentations focus on the research findings that indicate an early arts education in museum transitions from being a pedagogy of only geographical out-of-classroom space to a pedagogy of a true educational Third Space. The presentation concludes with an argument for the importance of using art museums as a Third Space for creatively teaching early core curriculum..

Keywords: early arts museum education, early childhood education, third space in education, phenomenological research

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Authors: Chia-Yi Wu, Jung-Chen Chang, Wen-Yu Hu, Ming-Been Lee

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In nearly all physical health conditions, suicide risk is increased compared to healthy people even after adjustment for age, gender, mental health, and substance use diagnoses. In order to highlight the importance of suicide risk assessment for the inpatients and early identification and engagement for inpatients’ mental health problems, a study was designed aiming at developing a comprehensive psychosomatic nursing engagement (PSNE) model with standardized operation procedures informing how nurses communicate, assess, and engage with the inpatients with emotional distress. The purpose of the study was to promote the gatekeeping role of clinical nurses in performing brief assessment and interventions to detect depression and anxiety symptoms among the inpatients, particularly in non-psychiatric wards. The study will be carried out in a 2000-bed university hospital in Northern Taiwan in 2019. We will select a ward for trial and develop feasible procedures and in-job training course for the nurses to offer mental health care, which will also be validated through professional consensus meeting. The significance of the study includes the following three points: (1) The study targets at an important but less-researched area of PSNE model in the cultural background of Taiwan, where hospital service is highly accessible, but mental health and suicide risk assessment are hardly provided by non-psychiatric healthcare personnel. (2) The issue of PSNE could be efficient and cost-effective in the identification of suicide risks at an early stage to prevent inpatient suicide or to reduce future suicide risk by early treatment of mental illnesses among the high-risk group of hospitalized patients who are more than three-times lethal to suicide. (3) Utilizing a brief tool with its established APP ('The Five-item Brief Symptom Rating Scale, BSRS-5'), we will invent the standardized procedure of PSNE and referral steps in collaboration with the medical teams across the study hospital. New technological tools nested within nursing assessment/intervention will concurrently be invented to facilitate better care quality. The major outcome measurements will include tools for early identification of common mental distress and suicide risks, i.e., the BSRS-5, revised BSRS-5, and the 9-item Concise Mental Health Checklist (CMHC-9). The main purpose of using the CMHC-9 in clinical suicide risk assessment is mainly to provide care and build-up therapeutic relationship with the client, so it will also be used to nursing training highlighting the skills of supportive care. Through early identification of the inpatients’ depressive symptoms or other mental health care needs such as insomnia, anxiety, or suicide risk, the majority of the nursing clinicians would be able to engage in critical interventions that alleviate the inpatients’ suffering from mental health problems, given a feasible nursing input.

Keywords: mental health care, clinical outcome improvement, clinical nurses, suicide prevention, psychosomatic nursing

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Authors: C. Pacheco, A. Cipriano

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A new concept of response system is proposed for filling the gap that exists in reducing vulnerability during immediate response to natural disasters. Real Time Early Response Systems (RTERSs) incorporate real time information as feedback data for closing control loop and for generating real time situation assessment. A review of the state of the art works that fit the concept of RTERS is presented, and it is found that they are mainly focused on manmade disasters. At the same time, in response phase of natural disaster management many works are involved in creating early warning systems, but just few efforts have been put on deciding what to do once an alarm is activated. In this context a RTERS arises as a useful tool for supporting people in their decision making process during natural disasters after an event is detected, and also as an innovative context for applying well-known automation technologies and automatic control concepts and tools.

Keywords: disaster management, emergency response system, natural disasters, real time

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Authors: Vallejo Michael, Acuña Edgar, Roa Juan David, Peñuela Rosa, Parra Alejandra, Casallas Daniela, Rodriguez Sheyla

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Congenital Zika Virus Syndrome is an entity composed by a variety of birth defects presented in newborns that have been exposed to the Zika Virus during pregnancy. The syndrome characteristic features are severe microcephaly, cerebral tissue abnormalities, ophthalmological abnormalities such as uveitis and chorioretinitis, arthrogryposis, clubfoot deformity and muscular tone abnormalities. The confirmatory test is the Reverse transcription polymerase chain reaction (RT-PCR) associated to the physical findings. Here we present the case of a newborn with microcephaly whose mother presented a confirmed Zika Virus infection during the third trimester of pregnancy, despite of the evident findings and the history of Zika infection the RT-PCR in amniotic and cerebrospinal fluid of the newborn was negative. RT-PCR has demonstrated a low sensibility in samples with low viral loads, reason why, we propose a clinical diagnosis in patients with clinical history of Zika Virus infection during pregnancy accompanied by evident clinical manifestations of the child.

Keywords: congenital, Zika virus, microcephaly, reverse transcriptase polymerase chain reaction

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Authors: Mohamed Chabi

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The purpose of this study is to determine Whether paper assessment especially in the subject mathematics will ever be completely replaced by online assessment using Learning Management System and Content Management System such as blackboard. In the subject mathematics, the assessment is the exercise of judgment on the quality of students’ work, as a way of supporting student learning and appraising its outcomes. Testing students has moved from the traditional scribbling and sketching on paper towards working online on a screen and keyboard.

Keywords: paper assessment, online assessment, learning management system, content management system, mathematics

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Authors: Swati Srivastava, Ashish Kumar Upadhyay

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Using longitudinal data from three waves of Young Lives Study and Ordinary Least Square methods, study has investigated the effect of birth order and arrival of younger siblings on child development in India. Study used child’s height for age z-score, weight for age z-score, BMI for age z-score, Peabody Picture Vocabulary Test (PPVT-Score)c, maths score, Early Grade Reading Assessment Test (ERGA) score, and memory score to measure the physical and cognitive development of child during wave-3. Findings suggest that having a high birth order is detrimental for child development and the gap between adjacent siblings is larger for children late in the birth sequences than early in the birth sequences. Study also reported that not only older siblings but arrival of younger siblings before assessment of test also reduces the development of a child. The effects become stronger in case of female children than male children.

Keywords: height for age z-score, weight for age z-score, BMI for z-score, PPVT score, math score, EGRA score, memory score, birth order, siblings, Young Lives Study, India

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Authors: Olusola Omolola Olafuyi, Michael Coleman, Raj Kumar Singh Badhan

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Introduction: Malaria in pregnancy has morbidity and mortality implication on both mother and unborn child. Piperaquine (PQ) based antimalarial treatment is emerging as a choice antimalarial for pregnant women in the face of resistance to current antimalarial treatment recommendation in pregnancy. Physiological and biochemical changes in pregnant women may affect the pharmacokinetics of the antimalarial drug in these. In malaria endemic regions other infectious diseases like HIV/AIDs are prevalent. Pregnant women who are co-infected with malaria and HIV/AID are at even more greater risk of death not only due to complications of the diseases but also due to drug-drug interactions (DDIs) between antimalarials (AMT) and antiretroviral (ARVs). In this study, physiologically based pharmacokinetic (PBPK) modelling was used to investigate the effect of physiological and biochemical changes on the impact of ARV mediated DDIs in pregnant women in three countries. Method: A PBPK model for PQ was developed on SimCYP® using published physicochemical and pharmacokinetic data of PQ from literature, this was validated in three customized population groups from Thailand, Sudan and Papua New Guinea with clinical data. Validation of PQ model was also done in presence of interaction with efavirenz (pre-validated on SimCYP®). Different albumin levels and pregnancy stages was simulated in the presence of interaction with standard doses of efavirenz and ritonavir. PQ day 7 concentration of 30ng/ml was used as the efficacy endpoint for PQ treatment.. Results: The median day 7 concentration of PQ remained virtually consistent throughout pregnancy and were satisfactory across the three population groups ranging from 26-34.1ng/ml; this implied the efficacy of PQ throughout pregnancy. DDI interaction with ritonavir and efavirenz resulted in modest effect on the day 7 concentrations of PQ with AUCratio ranging from 0.56-0.8 and 1.64-1.79 for efavirenz and ritonavir respectively over 10-40 gestational weeks, however, a reduction in human serum albumin level reflective of severe malaria resulted in significantly reduced the number of subjects attaining the PQ day 7 concentration in the presence of both DDIs. The model demonstrated that the DDI between PQ and ARV in pregnant women with different malaria severities can alter the pharmacokinetic of PQ.

Keywords: antiretroviral, malaria, piperaquine, pregnancy, physiologically-based pharmacokinetics

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Authors: Nur Azemah Aminludin, Osman Mohd Tahir

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A dynamic landscape development is important for providing healthy ecosystem which supports all life. Nowadays, many initiatives towards sustainable development have been published. They lead to better living and more efficient use of natural resources in sustaining long-term ecological, economics and social benefits. To date, many assessment tools related to built environment have been established and practiced in this region, which mostly has the purpose assessing the environment performance of buildings. Hence, an assessment tool focusing on the sustainable landscape development itself is a necessity. This paper reviews the assessment criteria and indicators that are suitable for sustainable landscape development practices. The local and global assessment tools for landscape development are investigated, analyzed and discussed critically. Consideration also is given to the integration of the assessment tools with the surrounding environmental, social, and economical aspects. In addition, the assessment criteria and indicators for assessing the landscape development in Malaysia are also reviewed and discussed. In conclusion, this paper reviews, analyzes and discusses on available local and global landscape development assessment tools for sustainability.

Keywords: assessment tool, sustainable landscape development, assessment criteria, assessment indicator

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Authors: Elena Even-Simkin

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Attention Deficit Hyperactivity Disorder (ADHD) is one of the most frequently diagnosed disorders in children, but in many cases, the diagnosis is not provided until adulthood. Diagnosing adults with ADHD faces different obstacles due to numerous factors, such as educational or under-resourced familial environment, high intelligence compensating for stress-inducing difficulties, and additional comorbidities. Undiagnosed children and adolescents with ADHD may become undiagnosed adults with ADHD, who miss out on the early treatment and may experience significant social and pragmatic difficulties, leading to functional problems that subsequently affect their lifestyle, education, and occupational functioning. The proposed study presents a cost-effective and unique consideration of the pragmatic aspect among adults with ADHD. It provides a systematic and standardized evaluation of the pragmatic level in adults with ADHD, based on a comprehensive approach introduced by Arcara & Bambini (2016) for the assessment of pragmatic abilities in neuro-typical individuals. This assessment tool can promote the inclusion of pragmatic skills in the cognitive profile in the diagnostic practice of ADHD, and, thus, the proposed instrument can help not only identify the pragmatic difficulties in the ADHD population but also advance effective intervention programs that specifically focus on pragmatic skills in the targeted population.

Keywords: ADHD, adults, assessment, pragmatics

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Authors: Vaibhavi Birle

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Posterior reversible encephalopathy syndrome is a rare clinic-radiological syndrome associated with acute changes in blood pressure during pregnancy. It is characterized symptomatically by headache, seizures, altered mental status, and visual blurring with radiological changes of white matter (vasogenic oedema) affecting the posterior occipital and parietal lobes of the brain. It is being increasingly recognized due to increased institutional deliveries and advances in imaging particularly magnetic resonance imaging (MRI). In spite of the increasing diagnosis the prediction of PRES and patient factors affecting susceptibility is still not clear. Hence, we conducted the retrospective study to analyse the factors associated with PRES at our tertiary centre.

Keywords: pres syndrome, eclampsia, maternal outcome, fetal outcome

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Authors: Zakieh Rostamzadeh Khameneh, Nariman Sepehrvand, Khalkhali-Zahra Shirmohamadi

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Background: Although the hepatitis E virus mostly causes a self-limited disease in general population, the disease is more severe in pregnant women. Hepatitis E accounts for about 10% of pregnancy-associated deaths in southern Asia. Methods: 136 pregnant women who referred to urban health centers of Urmia for pursuing pregnancy-related health services were selected randomly and enrolled in a descriptive, cross-sectional study. Each subject was tested for the presence of anti-HEV IgG antibody using an enzyme-linked immunosorbent assay (ELISA, Dia.Pro). Results: The mean age among 136 pregnant women was 25.12±4.91 years old (range of 14-39 years). Only five cases (3.6%) among all 136 subjects were demonstrated to be seropositive for anti-HEV IgG using ELISA method. There was no significant difference between age (P=0.88), income level (P=0.19) of two seropositive and seronegative groups. All seropositive cases were from urban areas. Conclusion: The seroprevalence of anti-HEV IgG is low in the population of pregnant women in Urmia, Iran. Because of limited sample size in this study, we recommend to perform further studies with larger sample size in other regions of Iran in order to be able to systematically generalize the findings of studies to the population of Iranian pregnant women.

Keywords: pregnancy, hepatitis E, women, ELISA

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Authors: Yosi Maria Wijaya, Florisma Arista Riti Tegu

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Background: Hypertension in pregnancy can be prevented by controlling the lifestyle. However, the majority of research on this topic has been conducted on lifestyle in women with normal pregnancy. Few studies of lifestyle have focused on Indonesian pregnant women with hypertension. Aim: The purpose of this study is to determine the association of demographic characteristics and the lifestyle of pregnant women who have hypertension. Methods: In this cross-sectional study, 76 women with hypertension during pregnancy were recruited from primary health care, West Java, Indonesia. Inclusion criteria were gestational age ≥ 28 weeks with the blood pressure systole ≥ 140 mmHg and diastole ≥ 90 mmHg. Data were collected using two instruments: demographic data and Health Promoting Life Style Profile (HPLP II). Data were analyzed with descriptive statistic and linear regression analysis. Results: The majority of participants were married, mean age was 27.96 years old (SD=6.77) with the mean of gestational age 33.21 (SD=3.49), most of them unemployed (94.7%) and more than a half participants have an education less than twelve years (59.2%). The total score of lifestyle was 2.44 (SD=0.34), more than a half participants experience unhealthy lifestyle (59.2%). Lifestyle was predicted by income, education years, occupation, and access to health care services, accounting for 20.8% of the total variance. Conclusion: Pregnant women with hypertension with low income, low level of education, non-occupational and hard to access health care services were related to unhealthy lifestyle. Understanding the lifestyle and associated factors contributes to health care providers ability to design effective interventions intended to improve healthy lifestyle among pregnant women with hypertension.

Keywords: demographic characteristics, hypertension, lifestyle, pregnancy

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Authors: Bidisha Chatterjee, Sonal Grover, Rekha Gurung

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Postpartum dissection of the internal carotid artery is a relatively rare condition and is considered as an underlying aetiology in 5% to 25% of strokes under the age of 30 to 45 years. However, 86% of these cases recover completely and 14% have mild focal neurological symptoms. Prognosis is generally good with early intervention. The risk quoted for a repeat carotid artery dissection in subsequent pregnancies is less than 2%. 36-year Caucasian primipara presented on postnatal day one of forceps delivery with tachycardia. In the intrapartum period she had a history of prolonged rupture of membranes and developed intrapartum sepsis and was treated with antibiotics. Postpartum ECG showed septal inferior T wave inversion and a troponin level of 19. Subsequently Echocardiogram ruled out post-partum cardiomyopathy. Repeat ECG showed improvement of the previous changes and in the absence of symptoms no intervention was warranted. On day 4 post-delivery, she had developed symptoms of droopy right eyelid, pain around the right eye and itching in the right ear. On examination, she had developed right sided ptosis, unequal pupils (Rt miotic pupil). Cranial nerve examination, reflexes, sensory examination and muscle power was normal. Apart from migraine, there was no medical or family history of note. In view of Horner’s on the right, she had a CT Angiogram and subsequently MR/MRA and was diagnosed with dissection of the cervical portion of the right internal carotid artery. She was discharged on a course of Aspirin 75mg. By 6 week post-natal follow up patient had recovered significantly with occasional episodes of unequal pupils and tingling of right toes which resolved spontaneously. Cervical artery dissection, including VAD and carotid artery dissection, are rare complications of pregnancy with an estimated annual incidence of 2.6–3 per 100,000 pregnancy hospitalizations. Aetiology remains unclear though trauma during straining at labour, underlying arterial disease and preeclampsia have been implicated. Hypercoagulable state during pregnancy and puerperium could also be an important factor. 60-90% cases present with severe headache and neck pain and generally precede neurological symptoms like ipsilateral Horner’s syndrome, retroorbital pain, tinnitus and cranial nerve palsy. Although rare, the consequences of delayed diagnosis and management can lead to severe and permanent neurological deficits. Patients with a strong index of suspicion should undergo an MRI or MRA of head and neck. Antithrombotic and antiplatelet therapy forms the mainstay of therapy with selected cases needing endovascular stenting. Long term prognosis is favourable with either complete resolution or minimal deficit if treatment is prompt. Patients should be counselled about the recurrence risk and possibility of stroke in future pregnancy. Coronary artery dissection is rare and treatable but needs early diagnosis and treatment. Post-partum headache and neck pain with neurological symptoms should prompt urgent imaging followed by antithrombotic and /or antiplatelet therapy. Most cases resolve completely or with minimal sequelae.

Keywords: postpartum, dissection of internal carotid artery, magnetic resonance angiogram, magnetic resonance imaging, antiplatelet, antithrombotic

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Authors: Nana Yaw Ofori Gyasi

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Under the Common Law, there was a procedure called pleading the belly which allowed a woman who had reached the advanced stage of pregnancy to receive a reprieve of her death sentence until after she had put to bed. The plea was replaced with a legislation, which provides that a pregnant woman would automatically have her death sentence commuted to life imprisonment with hard labour. This Common Law principle has been continued and enacted into law by the various countries where the Common Law is practiced. This paper takes a look at what it terms as Pregnancy Legislations in some selected Common Law countries such as United States of America, Canada, England and Wales, Ghana and India to examine the scope, procedure and effect of such legislations. The paper adopts a comparative study approach to ascertain the country with the widest scope, non-complicated procedure and far-reaching effects of the Pregnancy Legislations. It is observed that some legislations make provision for the conversion of death penalty to life imprisonment for capital offences and also prescribe non-custodial sentence for non-capital offences. There are other legislations that merely suspend the death penalty while the convict is found to be pregnant. In terms of the procedure, some of the legislations make the issue of pregnancy a question of fact to be determined by a jury and in other legislations, the trial judge makes that determination after the judge is satisfied on the question of the convict being pregnant. The effects of the Pregnancy Legislation are observed to be varying. Women who give birth in prison are highly at risk of having stillbirth. Most of the prisons do not have adequate facilities to support expectant and lactating mothers while in prison. It has also been observed that with the number of female prisoners increasing over the years, custodial sentence for convicted pregnant women has a wider societal effect. The paper identifies certain gaps left in some of the legislations which relate to the procedure to be followed after custodial sentence is suspended for a convicted pregnant woman. The time the accused person got pregnant- whether before her arrest or during trial- and the effect of the timing of the pregnancy are gaps left in some of the legislations. The paper argues that such gaps should be filled by the legislator to prevent accused persons taking undue advantage of the Pregnancy Legislations. It is further argued that if convicted pregnant women will have to spend time in prison at all for very heinous crimes, the prison facilities should be improved so that expectant and lactating mothers can comfortably care for their babies and themselves to prevent dire health consequences for such mothers and the society at a whole.

Keywords: sentence of pregnant women, custodial sentence, , pregnant women, , common law

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Authors: Osvaldo Collazo, Cristiano Valerio Dos Santos

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Early maternal separation has been shown to bring about many negative effects on behavior in rats. In the present study, we evaluated the effects of early maternal separation on risky choice in rats. One group of male and female Wistar rats was exposed to an early maternal separation protocol while a control group was left undisturbed. Then both groups were exposed to a series of behavioral tests, including a test of risky choice, where one alternative offered a constant reward while the other offered a variable reward. There was a difference between groups when they chose between a variable and a constant reward delay, but no other difference was significant. These results suggest that early maternal separation may be related to a greater preference for shorter delays, which is characteristic of more impulsive choices.

Keywords: early maternal separation, impulsivity, risky choice, variability

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Authors: Pushp Lata Sankhwar

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INTRODUCTION: Maternal Hypothyroidism is the most frequent endocrine disorder in pregnancy and varies from 2.5% in the west to 11.0% in India. Maternal Hypothyroidism can have detrimental maternal effects like increased risk of preterm labor, PPROM leading to increased maternal morbidity and also on the neonate in the form of prematurity and its complications, prolonged hospital stay, neurological developmental problems, delayed milestones and mental retardation etc. Henceforth, the study was planned to evaluate the role of Hypothyroidism in preterm labor and its effect on neonates. AIMS AND OBJECTIVES: To Correlate Overt Hypothyroidism, Subclinical Hypothyroidism and Isolated Hypothyroxinemia With Preterm Labor and the neonatal outcome. Material and Methods: A case-control study of singleton pregnancy was performed over a year, in which a total of 500 patients presenting in the emergency with preterm labor were enrolled. The thyroid profile of these patients was sent at the time of admission, on the basis of which they were divided into Cases – Hypothyroidic mothers and Controls – Euthyroid mothers. The cases were further divided into subclinical, overt Hypothyroidism and isolated hypothyroxinemia. The neonatal outcome of these groups was also compared on the basis of the incidence and severity of neonatal morbidity, neonatal respiratory distress, the incidence of neonatal Hypothyroidism and early complications. The feto-maternal data was collected and analysed. RESULTS: In the study, a total of 500 antenatal patients with a history of preterm labor were enrolled, out of which 67 (13.8%) patients were found to be hypothyroid. The majority of the mothers had Subclinical Hypothyroidism (12.2%), followed by Overt Hypothyroidism seen in 1% of the mothers and isolated hypothyroxinemia in 0.6% of cases. The neonates of hypothyroid mothers had higher levels of cord blood TSH, and the mean cord blood TSH levels were highest in the case of neonates of mothers with Overt Hypothyroidism. The need for resuscitation of the neonates at the time of birth was higher in the case of neonates of hypothyroid mothers, especially with Subclinical Hypothyroidism. Also, it was found that the requirement of oxygen therapy in the form of oxygen by nasal prongs, oxygen by a hood, CPAP, CPAP along with surfactant therapy and mechanical ventilation along with surfactant therapy was significantly higher in the case of neonates of hypothyroid mothers. CONCLUSION: The results of our study imply that uncontrolled and untreated maternal Hypothyroidism may also lead to preterm delivery. The neonates of mothers with Hypothyroidism have higher cord blood TSH levels. The study also shows that there is an increased incidence and severity of respiratory distress in the neonates of hypothyroid mothers with untreated subclinical Hypothyroidism. Hence, we propose that routine screening for thyroid dysfunction in pregnant women should be done to prevent thyroid-related feto-maternal complications.

Keywords: high-risk pregnancy, thyroid, dysfunction, hypothyroidism, Preterm labor

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Authors: Dipendra Kumar Yadav, Nabaraj Paudel, Anjana Yadav

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Background: Low Birth weight (LBW) is defined as the weight at birth less than 2500 grams, irrespective of the period of their gestation. LBW is an important indicator of general health status of population and is considered as the single most important predictors of infant mortality especially of deaths within the first month of life that is birth weight determines the chances of newborn survival. Objective of this study was to identify the maternal risk factors associated with low birth weight neonates. Materials and Methods: A hospital based case-control study was conducted in maternity ward of Manipal Teaching Hospital, Pokhara, Nepal from 23 September 2014 to 12 November 2014. During study period 59 cases were obtained and twice number of control group were selected with frequency matching of the mother`s age with ± 3 years and total controls were 118. Interview schedule was used for data collection along with record review. Data were entered in Epi-data program and analysis was done with help of SPSS software program. Results: From bivariate logistic regression analysis, eighteen variables were found significantly associated with LBW and these were place of residence, family monthly income, education, previous still birth, previous LBW, history of STD, history of vaginal bleeding, anemia, ANC visits, less than four ANC visits, de-worming status, counseling during pregnancy, CVD, physical workload, stress, extra meal during pregnancy, smoking and alcohol consumption status. However after adjusting confounding variables, only six variables were found significantly associated with LBW. Mothers who had family monthly income up to ten thousand rupees were 4.83 times more likely to deliver LBW with CI (1.5-40.645) and p value 0.014 compared to mothers whose family income NRs.20,001-60,000. Mothers who had previous still birth were 2.01 times more likely to deliver LBW with CI (0.69-5.87) and p value 0.02 compared to mothers who did not has previous still birth. Mothers who had previous LBW were 5.472 times more likely to deliver LBW with CI (1.2-24.93) and p value 0.028 compared to mothers who did not has previous LBW. Mothers who had anemia during pregnancy were 3.36 times more likely to deliver LBW with CI (0.77-14.57) and p value 0.014 compared to mothers who did not has anemia. Mothers who delivered female newborn were 2.96 times more likely to have LBW with 95% CI (1.27-7.28) and p value 0.01 compared to mothers who deliver male newborn. Mothers who did not get extra meal during pregnancy were 6.04 times more likely to deliver LBW with CI (1.11-32.7) and p value 0.037 compared to mothers who getting the extra meal during pregnancy. Mothers who consumed alcohol during pregnancy were 4.83 times more likely to deliver LBW with CI (1.57-14.83) and p value 0.006 compared to mothers who did not consumed alcohol during pregnancy. Conclusions: To reduce low birth weight baby through economic empowerment of family and individual women. Prevention and control of anemia during pregnancy is one of the another strategy to control the LBW baby and mothers should take full dose of iron supplements with screening of haemoglobin level. Extra nutritional food should be provided to women during pregnancy. Health promotion program will be focused on avoidance of alcohol and strengthen of health services that leads increasing use of maternity services.

Keywords: low birth weight, case-control, risk factors, hospital based study

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Authors: Rafika Bayu Kusumandari, Istyarini, Ispen Safrel

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Character education will be more meaningful if carried out since early childhood. This is because early childhood education is the foundation of the formation of character. This study intends to find a model of character education in early childhood based on Javanese culture. In keeping with the focus of the study, long-term goals to be achieved through this research is to find once described the development of a model of character education in early childhood Javanese culture based in Semarang are then applied across early childhood education institutions in Semarang City. The specific objective of the study is: Describe the character models and management education in early childhood Java-based culture in Semarang City. The benefits of this research are; Provide an overview of the model and describe the management of character education in early childhood Java-based culture in Semarang City. Referring to the objectives of the research program was designed with a "Research and Development", meaning that a program of research followed by development programs for improvement or refinement. To produce a prototype model of character education in early childhood Java-based culture in the city, taken systematic measures in the form of the action, reflection, evaluation and innovation by applying qualitative research methods, descriptive, development, experimentation, and evaluation. This study aims to gain in-depth description of the model of character education in early childhood Java-based culture in the city of Semarang. The reason for the use of the use of qualitative methods researcher's knowledge, no study results and empirical research specifically about the model of character education in early childhood Java-based culture in the city of Semarang. On the implementation of character education early childhood adapted to the characteristics of each school and the emphasis of each agency arrangements for early childhood education, culture-based Java. Javanese culture should be introduced early in order not to erode the cultural lost outside the entrance as the era of globalization. In addition, Java is promoting a culture of courtesy and manners are very appropriate for the character formation of children of early age.

Keywords: education character, Javanese culture, childhood, character

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