Miracle-dz/UniFAR-FTUs huggingface dataset:
Birthing Practices of Traditional Birth Attendants in South Asia in the Context of Training Programmes

Traditional Birth Attendants (TBA) training has been an important component of public health policy interventions to improve maternal and child health in developing countries since the 1970s. More recently, since the 1990s, the TBA training strategy has been increasingly seen as irrelevant, ineffective or, on the whole, a failure due to evidence that the maternal mortality rate (MMR) in developing countries had not reduced. Although, worldwide data show that, by choice or out of necessity, 47 percent of births in the developing world are assisted by TBAs and/or family members, funding for TBA training has been reduced and moved to providing skilled birth attendants for all births. Any shift in policy needs to be supported by appropriate evidence on TBA roles in providing maternal and infant health care service and effectiveness of the training programmes. This article reviews literature on the characteristics and role of TBAs in South Asia with an emphasis on India. The aim was to assess the contribution of TBAs in providing maternal and infant health care service at different stages of pregnancy and after-delivery and birthing practices adopted in home births. The review of role revealed that apart from TBAs, there are various other people in the community also involved in making decisions about the welfare and health of the birthing mother and new born baby. However, TBAs have changing, localised but nonetheless significant roles in delivery, postnatal and infant care in India. Certain traditional birthing practices such as bathing babies immediately after birth, not weighing babies after birth and not feeding with colostrum are adopted in home births as well as health institutions in India. There is therefore a thin precarious balance between the application of biomedical and traditional knowledge. Customary rituals and perceptions essentially affect practices in home and institutional births and hence training of TBAs need to be implemented in conjunction with community awareness programmes.
Disability trends among older Americans: National Health And Nutrition Examination Surveys, 1988-1994 and 1999-2004.

OBJECTIVES We investigated trends in disability among older Americans from 1988 through 2004 to test the hypothesis that more recent cohorts show increased burdens of disability. METHODS We used data from 2 National Health and Nutrition Examination Surveys (1988-1994 and 1999-2004) to assess time trends in basic activities of daily living, instrumental activities, mobility, and functional limitations for adults aged 60 years and older. We assessed whether changes could be explained by sociodemographic, body weight, or behavioral factors. RESULTS With the exception of functional limitations, significant increases in each type of disability were seen over time among respondents aged 60 to 69 years, independent of sociodemographic characteristics, health status, relative weight, and health behaviors. Significantly greater increases occurred among non-Whites and persons who were obese or overweight (2 of the fastest-growing subgroups within this population). We detected no significant trends among respondents aged 70 to 79 years; in the oldest group (aged>or=80 years), time trends suggested lower prevalence of functional limitations among more recent cohorts. CONCLUSIONS Our results have significant and sobering implications: older Americans face increased disability, and society faces increased costs to meet the health care needs of these disabled Americans.
The frequency of Y chromosome microdeletions in infertile men from Chennai, a South East Indian population and the effect of smoking, drinking alcohol and chemical exposure on their frequencies

The aims of the study were to estimate the frequency of Y chromosome microdeletion in infertile men from a new geographical ethnic region, Chennai, South East India, to explore the effect of smoking, alcohol drinking, chemical exposure and cellular chromosomal aberration on the frequency of infertility in 34 azoospermia and 55 oligospermia patients. The frequency of Y chromosome microdeletion was estimated using 12 STS markers and the chromosomal aberrations were estimated in leukocyte cultures. In azoospermia the frequency of microdeletions in AZFa, AZFb, AZFc and AZFd were 27, 4, 56 and 13% respectively. In oligospermia they were 33, 7, 48 and 12% in the same order. These frequencies of Y chromosome microdeletion are significantly higher than that of European population. The chromosome aberrations per cell in azoospermia and oligospermia were higher than that of the control at the level of p > 0.001. The percentage of microdeletion observed in unexposed azoospermia had 15%, azoospermia smokers 22%, azoospermia smokers and alcoholics 25%; whereas the unexposed oligospermia had 7%, oligospermia smokers 12%, oligospermia smokers and alcoholics 37%. It seems that the etiology of male infertility may differ between ethnic populations and smoking, alcohol drinking and chemical exposure may have deleterious effect on human fertility. Key words: Y chromosome microdeletion, sequence-tagged site (STS), chemical exposure, chromosomal aberrations, ethnic region.
Evaluation of graft flow between on-pump and off-pump coronary artery bypass grafting

Abstract Background: Coronary artery bypass grafting (CABG) is an effective method to afford sufficient blood flow for that ischemic myocardium. Off-pump coronary bypass surgery (OPCAB) has been rediscovered and refined to avoid cardiopulmonary bypass. However, it’s a high technique demanding skill. And evaluation of the blood flow should be reliable. Transit time flow measurement (TTFM) is introduced to evaluate graft flow and anastomosis patency intraoperatively. The accuracy of graft flow depends on how to explain the parameters of TTFM. Here, we introduce our experiences on the explanation of TTFM parameters. Objective: We compared the graft patency of off-pump coronary artery bypass grafting with those of on-pump coronary artery bypass grafting by intraoperative transit time flow measurement (TTFM). Methods: Three hundred patients were divided into off-pump group and on-pump group. TTFM was routinely performed for assessment of graft patency during operation. Revision of the grafts depends on the TTFM findings. Results: One patient in OPCAB group was converted to conventional CABG group due to ventricular fibrillation. One patient died of multiple organ failure 21 days post-operation. Seven grafts were revised based on unsatisfactory TTFM findings. There was no statistical difference in the variables between the two groups except for anastmosis to right coronary artery. Conclusions: Off-pump surgery can provide the same flow of grafts as that of on-pump surgery. TTFM is an effective tool to decide if a well-function graft is or not, and it allows for revision of failure graft during operation.
The relationship between discrimination and substance use disorders among lesbian, gay, and bisexual adults in the United States.

OBJECTIVES We examined the associations between 3 types of discrimination (sexual orientation, race, and gender) and substance use disorders in a large national sample in the United States that included 577 lesbian, gay, and bisexual (LGB) adults. METHODS Data were collected from wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions, which used structured diagnostic face-to-face interviews. RESULTS More than two thirds of LGB adults reported at least 1 type of discrimination in their lifetimes. Multivariate analyses indicated that the odds of past-year substance use disorders were nearly 4 times greater among LGB adults who reported all 3 types of discrimination prior to the past year than for LGB adults who did not report discrimination (adjusted odds ratio = 3.85; 95% confidence interval = 1.71, 8.66). CONCLUSIONS Health professionals should consider the role multiple types of discrimination plays in the development and treatment of substance use disorders among LGB adults.
Changing patterns in health behaviors and risk factors related to cardiovascular disease among American Indians and Alaska Natives.

OBJECTIVES We assessed changes in cardiovascular disease-related health outcomes and risk factors among American Indians and Alaska Natives by age and gender. METHODS We used cross-sectional data from the 1995 to 1996 and the 2005 to 2006 Behavioral Risk Factor Surveillance System. The respondents were 2548 American Indian and Alaska Native women and men aged 18 years or older in 1995-1996 and 11 104 women and men in 2005-2006. We analyzed the prevalence of type 2 diabetes, obesity, hypertension, cigarette smoking, sedentary behavior, and low vegetable or fruit intake. RESULTS From 1995-1996 to 2005-2006, the adjusted prevalence of diabetes among American Indians and Alaska Natives increased by 26.9%, from 6.7% to 8.5%, and obesity increased by 25.3%, from 24.9% to 31.2%. Hypertension increased by 5%, from 28.1% to 29.5%. Multiple logistic models showed no meaningful changes in smoking, sedentary behavior, or intake of fruits or vegetables. In 2005-2006, 79% of the population had 1 or more of the 6 risk factors, and 46% had 2 or more. CONCLUSIONS Diabetes, obesity, and hypertension and their associated risk factors should be studied further among urban, rural, and reservation American Indian and Alaska Native populations, and effective primary and secondary prevention efforts are critical.
A network assessment of community-based participatory research: linking communities and universities to reduce cancer disparities.

OBJECTIVES We sought to determine whether a community-based initiative designed to reduce cancer disparities among Pacific Islanders in Southern California increased communications between community-based organizations and university researchers. METHODS We conducted network analysis among 11 community-based organizations (CBOs) and 5 universities by interviewing 91 and 56 members of these organizations, respectively, at 2 points in time. We estimated random effects probit regression and stochastic actor-oriented network dynamic models. RESULTS We found that, during the 2-year study period, CBOs increased their connectedness with one another (b= 0.44; P < .05) and to the universities (b = 0.46; P < .05), but that university researchers did not increase their connectedness to each other or to CBOs. CONCLUSIONS Cancer awareness, cancer education, and access to cancer services are low among Pacific Island groups, and this study provides an initial attempt to reduce these disparities. Community-based initiatives can strengthen a CBO network, creating the potential for increased community-informed cancer research and improved community access to cancer research resources.
Bacteriology and Antibiotic Sensitivity Patterns of Urine and Biofilm in Patientswith Indwelling Urinary Catheter in a Tertiary Hospital in Bangladesh

Catheter-Associated Urinary Tract Infection (CAUTI) is a common health care associated infection worldwide and is result of wide spread use of urinary catheter and inappropriate antibiotics use. Cause of CAUTI is formation of pathogenic biofilm in the inner surface of indwelling urinary catheters and its early detection prevents various hazards as well as economic impact. This observational prospective study was done to see relationship between the pattern of microorganism in urine and biofilm and their antibiotic sensitivity patterns in 100 patients in Comilla medical college hospital, Comilla, Bangladesh. Selected patients had undergone catheterization for urinary retention or incontinence. The urine collected by suprapubic puncture and biofilm from indwelling catheter for culture and sensitivity. 90% of urine samples and 100% biofilm showed growth of uropathogens. E.coli was the most frequently isolated pathogen (60%), followed by Klebsiella spp (14%). Multibacterial isolates was found from biofilm in 15 samples with long term catheterization. Biofilm strains displayed relatively high resistance against tested antibiotics. Highest sensitivity pattern found for E.coli in urine and biofilm for imipenem (95% vs. 92%), lowest for ciprofloxacin (20% vs. 16%). Catheter biofilm resistant to all tested drugs were found for E.coli in 6.95% and klebsiella in 5.55%. Urine samples resistant to all tested antibiotics only in E.coli 3.33%. E.coli was the most frequent isolate which showed the higher sensitivity to carbapenems, and lowest to the quinolones. Correlation was observed between biofilm production and multidrug resistance. A large-scale prospective studies suggested to make a guideline to manage UTI specially CAUTI.
Comparison of Functional Reach in Fallers and Nonfallers in an Independent Retirement Community

The older population in America is steadily increasing. Additionally, falls increase dramatically with age. Balance disorders and postural control changes have been found to contribute to falls sustained by the elderly. Functional Reach (FR) has been proposed as a simple balance assessment tool which is valid, reliable, and sensitive to changes in balance. The aim of this study was to compare the FR of fallers and nonfallers living independently in a retirement community. Fifty-two subjects were divided into three age groups and categorized by fall status. The first three correctly performed FR trials were measured and recorded. After the age of 84 years, FR significantly decreases. There were no significant differences in the FR between fallers and nonfallers among community dwelling seniors. A simple standardized balance assessment tool needs to be developed to identify those older people at risk for falling. Functional Reach has the potential to be such a tool. However, FR needs to be standardized acco.
AN ELEVATED PULSE PRESSURE: A MAJOR RISK FACTOR FOR CARDIOVASCULAR DISEASES

Pulse pressure (PP) is a predictor and major risk factor for cardiovascular (CV) diseases as left ventricular hypertrophy, myocardial infarction, carotid hypertrophy, atherosclerosis, congestive heart failure and stroke as well as chronic renal failure progression. PP has been proved a strong forecaster of CV risk, particularly when it is higher than 60 mm Hg and more strongly relates to carotid hypertrophy and extent of atherosclerosis than systolic pressure. Isolated systolic hypertension (ISH) is common among the elderly and is accompanied by elevated pulse pressure. However, treatment of ISH may further raise the PP if diastolic pressure is lowered to a greater extent than systolic pressure. Several drugs for hypertension have the side effect of increasing resting PP irreversibly, other antihypertensive drugs, such as ACE inhibitors, have been shown to lower the PP. Various approaches made by researchers for the maintenance of normal PP to reduce the mortality caused due to CV events based on the abnormal PP. We briefly review the therapeutic consequences for the attenuation of elevated PP associated with various CV events KEYWORDS Pulse pressure, Cardiovascular diseases, Arterial stiffness, Antihypertensive therapy
Estimated autism risk, older reproductive age, and parameterization.

In their recent article, King et al.1 seemed to dismiss the conclusion supported by previous epidemiologic studies (including 1 authored by us)2,3 that increasing maternal age and paternal age are both independently associated with autism risk. Based on their analysis of California Department of Disabilities Services (DDS) data, King et al. argued that the previously observed paternal age effect is an artifact of pooling data across successive birth cohorts during a period in which both the prevalence of children receiving services for autism and the proportion of births to older parents have increased, essentially asserting that observed paternal age effects are confounded by birth cohort effects. Although King et al. acknowledge that our study,2 based on a single birth year showing significant independent effects of both parents' ages on autism risk, is not subject to this artifact and, although the other study they reference found a paternal age effect after controlling for birth year,3 they still conclude that “analyses that do not suffer from the statistical fallacies produced by pooling demonstrate that advanced maternal age, rather than paternal age, may pose a greater risk. ”1(p1678) Moreover, much of King et al.'s own analysis of DDS data does not support a conclusion that confounding by birth cohort explains the paternal age effect. The relative risks that they calculated show similar-magnitude effects for fathers aged 40 years and older in each birth cohort (falling between 1.29 and 1.71). These do not differ drastically from the pooled estimate, suggesting no confounding. It is only when King et al. move to estimating age effects on a continuous scale that they show birth cohort-specific age effects that are consistently stronger for mothers than they are for fathers.1 Consequently, any shift in thinking about which parental age effect might be stronger in these data appears driven by the choice of parameterization of the parental age terms, and not confounding by birth cohort. Using a continuous parameterization assumes that a fixed increment change in parental age beginning anywhere in the age range leads to the same percent change in autism risk. This approach diminishes the ability to detect threshold effects and will force the estimated percent change in risk for, say, a parent aged 35 years compared with a parent aged 25 years to be the same as that for a parent aged 45 years compared with a parent aged 35 years. The question of what parameterization—continuous or categorical—is more appropriate for understanding the true role of parental age in autism is legitimate and, by all indications, seems more important in these DDS data than does the issue of confounding by birth cohort, or reversal paradox, that King et al. make much of in their article.
Workplace assaults on nursing assistants in US nursing homes: a multilevel analysis.

OBJECTIVES We examined risk factors for injuries to nursing assistants from assaults by nursing home residents at both the individual and the organizational level. METHODS We analyzed data from the 2004 National Nursing Assistant Survey that were linked to facility information from the 2004 National Nursing Home Survey by use of multilevel modeling that accounted for the complex survey design effect. RESULTS Thirty-four percent of nursing assistants surveyed reported experiencing physical injuries from residents' aggression in the previous year. Mandatory overtime (odds ratio [OR] = 1.65; 95% confidence interval [CI] = 1.22, 2.24) and not having enough time to assist residents with their activities of daily living (OR = 1.49; 95% CI = 1.25, 1.78) were strongly associated with experiencing injuries from assaults. Nursing assistants employed in nursing homes with Alzheimer care units were more likely to experience such injuries, including being bitten by residents. CONCLUSIONS Reducing mandatory overtime and having a less demanding workload may reduce the risk of workplace violence. In particular, prevention activities should be targeted at those nursing homes that care for cognitively impaired patients.
The management of brain necrosis as a result of SRS treatment for intra-cranial tumors

Background: Stereotactic radiosurgery (SRS) is now a standard of care for recurrent malignant, metastatic and non-malignant brain tumors. Fortunately only a small number of tumors treated will result in asymptomatic or symptomatic necrosis. Radiographic determination of necrosis and then the implementation of treatment are important to alleviate new neurological symptoms. This article will review the identification and treatment for brain necrosis. Methods: Although asymptomatic necrosis rarely needs treatment, brain necrosis resulting in neurologic change can be treated with steroids, surgery, bevacizumab and/or hyperbaric oxygen therapy. Results: All the above methods have been used successfully in the treatment for SRS induced neurological complications from brain necrosis. Conclusions: Corticosteroids, surgery, bevacizumab and HBO are all possible good treatment options for symptomatic RN. The treatment goal is to provide the patient with resolution of neurologic systems with the least toxicity and invasiveness.
Trends in fatalities from distracted driving in the United States, 1999 to 2008.

OBJECTIVES We examined trends in distracted driving fatalities and their relation to cell phone use and texting volume. METHODS The Fatality Analysis Reporting System (FARS) records data on all road fatalities that occurred on public roads in the United States from 1999 to 2008. We studied trends in distracted driving fatalities, driver and crash characteristics, and trends in cell phone use and texting volume. We used multivariate regression analysis to estimate the relation between state-level distracted driving fatalities and texting volumes. RESULTS After declining from 1999 to 2005, fatalities from distracted driving increased 28% after 2005, rising from 4572 fatalities to 5870 in 2008. Crashes increasingly involved male drivers driving alone in collisions with roadside obstructions in urban areas. By use of multivariate analyses, we predicted that increasing texting volumes resulted in more than 16,000 additional road fatalities from 2001 to 2007. CONCLUSIONS Distracted driving is a growing public safety hazard. Specifically, the dramatic rise in texting volume since 2005 appeared to be contributing to an alarming rise in distracted driving fatalities. Legislation enacting texting bans should be paired with effective enforcement to deter drivers from using cell phones while driving.
The impact of Massachusetts' smoke-free workplace laws on acute myocardial infarction deaths.

OBJECTIVES We examined the rate of acute myocardial infarction (AMI) deaths in Massachusetts before and after the implementation of a comprehensive smoke-free workplace law in July 2004. METHODS We used Poisson regression models to examine the impact of the state law in cities and towns with and without previous local smoking bans and the effect of the local laws for the period of 1999 through 2006. RESULTS The AMI mortality rate decreased by 7.4% (95% confidence interval [CI] = 3.3%, 11.4%) after implementation of the state law. The state ban had an impact in cities and towns with no prior local smoking ban (9.2% decrease; P < .001) but not cities and towns with a prior local smoking ban. However, there was a nonsignificant 4.9% (95% CI = -5.0%, 13.9%) decrease associated with the local smoking ban that preceded the effect of the state ban. The effect of the state ban was modest (-1.6%) in the first 12 months after implementation but much larger after the first 12 months (-18.6%; P < .001). CONCLUSIONS Comprehensive statewide smoke-free workplace laws in Massachusetts were associated with an estimated 270 fewer AMI deaths per year. These results add to the evidence suggesting that smoke-free air laws are associated with lower rates of AMI.
The Effects of Cement Dust on Haematological Parameters of Cement Workers in Asaba, Delta State, Nigeria

Cement Dust And Haematological Parameters. Summary: The effect of cement dust on exposed workers was conducted in Asaba Delta state Nigeria, to delineate the occupational hazards posed by cement dust on haematological parameters. The assessment of haematological parameters was performed in forty workers occupationally exposed to cement dust and forty matched unexposed control. The accepted level of significance was p 0.05). There was a significantly lower platelet count, lymphocytes and total white blood cell count in the exposed workers relative to the control (p< 0.05). Apart from the white blood cell count, the number of years of exposure did not significantly affect the other parameters. The results from this study has shown that occupational exposure to cement dust has significant effects on some haematological parameters while years of exposure was not a significant factor on the haematological parameters of cement depot workers.