bluuebunny/crossref_metadata_2025 huggingface dataset:
Support Needs and Coping Strategies as Predictors of Stress Level among Mothers of Children with Autism Spectrum Disorder
Authors: Kiami Sheri R. , Goodgold Shelley
Published: December 2017

This study examined maternal stress, coping strategies, and support needs among mothers of children with Autism Spectrum Disorder (ASD). A convenience sample of 70 mothers completed the Parent Stress Index Short Form (PSI-SF), Coping Health Inventory for Parents (CHIP), and Modified Family Needs Questionnaire (FNQ). PSI-SF scores reflected clinically significant levels of stress for 77% of mothers, and mothers identified 62.4% of important needs as unmet. The five most frequently reported important unmet needs were (1) financial support; (2) break from responsibilities; (3) understanding of other after-school program children; (4) rest/sleep; (5) help remaining hopeful about the future. Most coping strategies (81%) were identified as helpful. Additionally, both coping strategies and support needs served as predictors for maternal stress. Maternal stress scores decreased by .402 points for each percent increase in helpful coping strategy, and stress scores increased by .529 points with each percent increase in unmet needs. Given large variation in questionnaire responses across participants and studies, utilization of user-friendly questionnaires, such as the PSI-SF, CHIP, and FNQ, is advocated to determine the evolving important needs unique to each family over the child’s lifetime as well as guide prioritization of care, compilation of resources, and referrals for additional services.
A Behavioural Approach to Ranking Academic Departments By Prestige: The Case Of Sociology in English-Speaking Canada
Authors: Goyder John
Published: December 2017

Academic prestige has, due to the 21st century culture of declining survey cooperation, become harder to measure accurately using reputational surveys. Even if the high nonresponse on a survey of professors were ignorable in terms of bias, the credibility of such a survey would be challenged. Within sociology, citation index counts are not as useful an alternative as in more consensual and article-based disciplines such as economics. Sociologists publish in an immense variety of outlets, with much of the most important work appearing in books. Reported herein is a behavioural approach to academic prestige, based on each department's profile of doctoral origins of staff members (termed a broad by fuzzy approach) and on dominance within the hiring exchange matrix (giving a narrow but clearer reading). The case study is departments of sociology within English-speaking Canada. Academic Prestige, Reputational Surveys, Departments of Sociology, Doctoral Origins, Hirings, Canada.
Finlands svenskspråkiga ungdomars dryckesvanor i Österbotten och huvudstadsregionen: En jämförelse med finskspråkiga ungdomar
Authors: Tigerstedt Christoffer , Jaana Markkula , Karlsson Thomas , Jukka Jokela , Minna Pietikäinen
Published: December 2017

There is some research evidence which suggests that drinking habits among Swedish-speaking Finns differ from those of Finnish-speaking Finns. The limited literature on this subject routinely lumps the minority of Swedish-speaking Finns into one single group. The assumption is that drinking habits in the Swedish-speaking population are less damaging to health than drinking habits in the Finnish-speaking majority.

In this study we use data from the nationwide School Health Promotion Study, which in principle covers all pupils in the 8th and 9th grade of comprehensive school and the 1st and 2nd grade of upper secondary school. We chose to focus on two areas with a sufficiently large number of Swedish-speaking residents and, by tradition, different drinking habits, i.e. Ostrobothnia and the metropolitan Helsinki area. All in all, the data consist of 5,698 Swedish-speaking and 29,708 Finnish-speaking adolescents aged ca. 14–18.

The results show that when the populations from the two areas are taken together, there are indeed differences between the two language groups. The almost ten-year downward trend in youthful drinking in Finland is clearly attributable to Finnish-speaking youth.

This is also true for the reductions seen in frequent drinking and binge drinking.

In a comparison of Ostrobothnia and the metropolitan Helsinki area, it turns out that the differences between Swedish-speaking youngsters are considerable: abstention, less frequent drinking and less binge drinking are clearly more prevalent in Ostrobothnia than in the Helsinki area. By comparison, the Finnish-speaking adolescents in the two regions differ less clearly from each other.

Conspicuous subgroups within the Swedish-speaking minority are the binge drinking upper secondary students in the Helsinki area, the abstaining girls from comprehensive schools in the almost exclusively Swedish-speaking Ostrobothnian municipalities, and the abstaining youngsters from the “bible zone” in Ostrobothnia.

In contrast to earlier findings, we found that in Ostrobothnia the drinking habits of the two language groups are quite similar.
Unregistered alcohol consumption and alcohol-related harm in Sweden, 2001–2005
Authors: Norström Thor , Ramstedt Mats
Published: December 2017

Background and Aim

During recent years unregistered alcohol consumption has increased markedly in Sweden, and the market share of the State Monopoly (Systembolaget) has decreased. The sales through Systembolaget are regulated by strict rules. Further, previous research suggests that the intake of unregistered alcohol is associated with a more risky drinking pattern. We test the hypothesis that the larger the market share of Systembolaget, the lower the prevalence of alcohol-related harm. We also address a related issue, namely whether alcohol-related harm responds differently to different components of total alcohol consumption (registered and various forms of unregistered).

Data and Method

Data on consumption of various forms of unregistered alcohol consumption were obtained from monthly surveys. Registered consumption was gauged by sales data from Systembolaget. The harm indicators included two alcohol-related crime indicators (police-reported assaults and drink driving offences), and two indicators on admission to treatment for alcohol-related diagnoses. The montly data were aggregated into quarterly observations separately for southern Sweden, mid-Sweden and northern Sweden. The study period was Q1 2001- Q4 2005. In addition to regional analyses, the data were analyzed by means of time-series analyses (ARIMA-models).

Findings

The findings did not suggest that a high market share for Systembolaget would be associated with lower rates of alcohol-related harm. As to the effects of the various components of total consumption on harm, there was no systematic pattern implying that any specific component would carry a greater risk than any other – most of the estimates were insignificant. However, all harm indicators responded significantly to the comprehensive consumption indicator (including unregistered consumption as well as Systembolaget's sales), suggesting that total consumption still matters.
Finnish, Norwegian, and Swedish alcohol policy after the seminal year of 2004
Authors: Karlsson Thomas
Published: December 2017

Aim

To assess how Finland, Norway and Sweden reorganised their alcohol policies after the travellers import quotas for alcoholic beverages were abolished in 2004.

Data & Methods

Alcohol taxation, alcohol programs and other alcohol policy changes, as well as common alcohol policy initiatives by the Nordic Alcohol monopoly countries are examined. In addition to relevant research literature, the main sources used are public reports and documents as well as interviews with nine key informants in the field of alcohol policy.

Results

Finland is characterized as the country with the highest alcohol consumption and an alcohol policy that is different from the policies in Norway and Sweden. Typical for Norway, apart from an increased availability of alcoholic beverages, is an active engagement in international alcohol policy issues, whereas Sweden is characterized by big administrative alcohol policy changes, and by the rulings of the EC-court in alcohol policy matters.

Conclusions

Alcohol policy in Finland has not been as prioritized as in Norway and Sweden, and there has not been an active political support for restrictive social alcohol policy in Finland. Despite clear similarities, the differences in Finland's, Norway's and Sweden's alcohol policies have increased since 2004, and it has become increasingly difficult to talk about a common Nordic alcohol policy.
Alkohol och äldre
Authors: Abrahamson Maria
Published: December 2017

M. Abrahamson: Old people's values and ideals in the public call for writing “Alcohol in my life”

The aim was to investigate how old people – who during their lives have experienced the displacement of drinking's moral border from soberness to moderate drinking – are presenting themselves, and their values, and attitudes towards alcohol. Thirty-one answers to the autobiographical question list “Alcohol in my life” from informants born between 1914 and 1930 were scrutinized using a qualitative thematic analysis. The results displayed two different repertoires for writing about the shifting experiences of alcohol during the life course: the sober repertoire and the moderate repertoire. Within the sober repertoire alcohol was important and abstention was an organizing principle for life. Within the moderate repertoire, however, alcohol was presented as natural and unimportant. In common for both repertoires was the significance of alcohol in the context of social intercourse. In the sober repertoire it was crucial to show the sobriety in such a way that it should not bother people around. In the moderate repertoire it was crucial to take part in the social drinking without seemingly being affected by alcohol and at the same time stress the personal lack of need for alcohol. Even though both repertoires were filled with moral values of right and wrong they were characterized by an absence of moralistic judgements of others’ alcohol habits, with the exception of young people's drinking habits. Then values appeared which put forward young people's life in former times as good examples.
Nya Grepp i Preventionsarbetet? – En Granskning av Alkoholkommitténs och Mobilisering mot Narkotikas Massmediekampanjer
Authors: Karlsson Patrik , Bergmark Anders
Published: December 2017

Aims

To analyze how “pleasure” and similar recreational motives for drug use permeate and are handled in contemporary drug preventive massmedia campaigns in Sweden.

Design

Three campaigns were included in the analysis. Two campaigns were developed by the Alcohol Committee (entitled “Basic course for you who like to be drunk” and “The Party Method”) and one campaign by Mobilization against Narcotics (entitled “There are many reasons not to try narcotics”).

Results

Recreational motives for drug use are recognized in all three campaigns. The reason for this, it seems, is to facilitate the overall trustworthiness of the campaigns. No campaign attempts to counteract the validity of the positive sides of drug use. Instead, they try to make people aware that the negative sides of drug use far outweigh positive sides.

Conclusion

The campaigns partly employ a novel approach to dealing with drug problems but their “core” content resembles traditional elements in drug preventive interventions.
Socialtjänstens Användning av Standardiserade Klientbedömningsinstrument – ASI som Retorik och Praktik i Två Svenska Kommuner
Authors: Abrahamson Maria , Tryggvesson Kalle
Published: December 2017

Aim

The aim of the paper is to study how the Addiction Severity Interview (ASI) is integrated in the ordinary work of social services in two Swedish towns that use ASI regularly. According to an ideal model for using ASI, it should fulfil three functions: to be a structured tool for assessing client problems, to facilitate the follow-up of treatment measures for each client, and to form a basis for the systematic follow-up of treatment units. This paper asks specifically how ASI is used compared to this ideal ASI model, how ASI is viewed by the different hierarchical levels within the social service organisation, how the social worker's tasks are perceived, and how the use of ASI is followed up.

Methods

Qualitative interviews were undertaken with staff at different levels within the social service organization in the two towns, which were chosen from a county known for its extensive use of ASI.

Results

Although rhetorically the social workers have adopted the use of ASI, in practice, however, the use of ASI seemed rather far from ideal. The foremost advantage the social workers perceived with ASI was that it supplied basic information in an initial investigation of client needs. The problems connected to the use of ASI were that it is not suitable for all clients and that some clients are subjected to too many ASIs. Other problems were that it was hard to maintain sufficient quality in the use of ASI due to too high staff turnover and too few opportunities to conduct interviews. In spite of the well-known obstacles for efficient use of ASI, little control was undertaken to monitor use or how information from the interviews is used.

Conclusions

The demand on social work to meet politician's expectations for service development can be in direct conflict with the practical considerations of the social service work, which may explain the shortfall between rhetoric and practice. From a political legitimacy point of view, it is more important that the social service organization is supported by the political funding sources than to meet demands for treatment efficiency. A loose coupling between rhetoric and practice allows for ASI to be adopted only rhetorically, while the regular work can continue to meet the practical considerations. The use of ASI cannot therefore be seen as a simple solution to the problems that the Swedish treatment system is struggling with.
Norway at the Border of EU – Cross-Border Shopping and its Implications
Authors: Lavik Randi , Nordlund Sturla
Published: December 2017

Cross-border shopping has for many years been an issue in the political debate in Norway, and it remains so. The focus of the media is mostly on alcohol and tobacco shopping, but shopping for other goods such as meat and other groceries are at least as important.

Aim

The aim of this article is to present estimates of the total cross-border shopping, especially from Sweden, with a special focus on alcohol and tobacco.

Data

Data are collected from different sources, mainly from the two research institutes SIFO and SIRUS.

Results

The total private import by travelers to Norway has increased, and so has special cross-border shopping from Sweden. An obvious reason is the price differences on alcohol, tobacco and meat in particular, which have been increasing since the neighbouring countries Sweden and Finland became members of the EU in 1995. Another reason is the general increase in travelling, especially by airplanes, during later years. People living near the border are, not surprisingly, much more often border-shoppers than people living far away. Border-shopping also has an illegal side, since some people violate the quite restrictive Norwegian quotas on travelers import e.g. of alcohol and tobacco. Around 20 per cent of the of the Norwegian travellers see such “small-scale smuggling” of spirits as a serious crime, and 25 percent had brought too much alcohol. The total private import by travelers, legal as well as illegal, represents a considerable revenue loss to Norway.
What is the Worst Thing you could get Hooked on?: Popular Images of Addiction Problems in Contemporary Sweden
Authors: Blomqvist Jan
Published: December 2017

Aims

To investigate potentially crucial aspects of Swedes' perceptions of nine different addictions.

Data and Methods

Population survey, sent out to 2,000 adult Swedes (18–74 years), focusing on the perceived severity of, responsibility for, options to recover from, and character of addiction to cigarettes, snuff, alcohol, cannabis, amphetamine, cocaine, heroin, medical drugs, and gambling.

Results

There are large differences in the ways in which various addiction problems are perceived. Whereas tobacco use, and to some extent gambling, are seen as relatively harmless “habits”, not particularly easy to get hooked on but easy to quit, the use of drugs such as heroin, amphetamine, and cocaine is seen as a major societal problem, and users are seen both as “sinners” who need to mend their ways and as powerless “victims”. In between comes the use and misuse of alcohol, cannabis and medical drugs, about which perceptions are more divided.

Conclusions

Respondents tend to downplay the risks and dangers with addictive habits that are common and familiar in mainstream culture, and to dramatise the risks and dangers with such habits that are uncommon or “strange”. This may have unfortunate consequences for addicts' options to find a path out of their predicaments.
Fluorescent Metal Nano-Clusters as Next Generation Fluorescent Probes for Cell Imaging and Drug Delivery
Authors: Bhattacharyya Kankan , Mukherjee Saptarshi
Published: December 2017

Fluorescent metal nano-clusters with size-dependent properties have emerged as the next generation fluorophores with versatile applications. In this article, we give a brief overview on three fluorescent metal nano-clusters, (gold, silver and copper). Because of their non-toxicity and solubility in water they are highly suitable for biological systems and in particular, live cell imaging. We show that they may be used for distinguishing cancer and non-cancer cells and selective killing of cancer cells. We also discuss their effect on enzyme catalysis.
VERIFICATION OF INTEGRATED SOIL FERTILITY MANAGEMENT AND WEED INTERFERENCE ON NERICA RICE IN THE GUINEA SAVANNA UPLANDS
Authors: Dzomeku I.K. , Amegbor I. K. , Ayittah P.
Published: December 2017

Improving soil amendment and reducing weed-crop competition in rice cultivation could increase production of the crop under upland conditions. A field study was conducted to verify integrated soil fertility management and weed interference on NERICA 1 in the Guinea savannah uplands of Ghana to determine their interactive effects and examine the synergy between organic and inorganic soil amendments on yield components and grain yield. Four levels of soil amendment and six weeding regimes laid in Randomized Complete Block Design with four replications were studied. Results indicated full rate of NPK (60-60-30 kg/ha) combined with hand weeding at 3 and 6WAP maximized most growth and yield parameters of NERICA 1 with grain yield of 3000kg/ha. The same treatments minimized weed index (WI) followed by weeding once at 3WAP when combined with either full dose of NPK or organic manure. The best timing for one hand weeding as practiced by some farmers was 3WAP to obtain appreciable yield in rice. Tillering at 50 DAP and productive tillering were maximised by both full rate of NPK and half doses of NPK and organic manure applications with 250 tillers/m2 respectively 200 productive tillers/m2. The synergy between inorganic and organic manure at half doses was exemplified and could be exploited by farmers for increased crop performance. Full rate of NPK maximised LAI and straw biomass followed by half doses of manure and NPK fertilizer. Notably twice weeding at 3 and 6 WAP recorded the highest LAI, tillering and productive tillers, and reduced straw biomass only by 20% relative to the weed-free control. 1000 seed weight of NERICA 1 was reduced only by weedy control below 25g, even in the presence of soil amendments. Weed flora was dominated by annuals and consisted of 55% broadleaves, 25% grasses, 12% shrubs and 6% sedges.
Evaluation of Local Weed Flora of South Gujarat for Dry Flower Products
Authors: Singh Alka , Bhandari Ankit , Chhatrola H.N. , Patel B. N.
Published: December 2017

An investigation was carried out to explore and evaluate the weed flora to obtain dried ornamentals for making of dry flower products. Nine species of weeds viz., Dinebra arabica, Argyreia speciosa, Setaria verticillata, Dactyloctenium aegyptium, Cyperus rotundus, Celosia argentea, Digitaria sanguinalis, Echinochloa colonum and Eragrostis pilosa growing locally in the south Gujarat region were evaluated for the study. Either inflorescence or leaves of the weeds employing press drying method were evaluated for their dried ornamental value in the year 2015-2017. Among different weeds, maximum percent loss in weight after drying was observed in the leaves of Argyreia speciosa followed by the inflorescence of Echinochloa colonum after drying. No shattering was observed in the dried leaves of Argyreia speciosa and dried inflorescence of Celosia argentea and Cyperus rotundus while maximum shattering in the inflorescence was observed in the dried inflorescence of Echinochloa colonum. Maximum time taken for drying (5.87-6.1 days) was required in Argyreia speciosa (leaves) followed by inflorescence of Celosia argentea (4.3- 4.41 days) and Setaria verticillata (4.3-4.37 days) in both the years and pooled data. Maximum shelf life after drying (more than 170 days) was observed in the dried leaves of Argyreia speciosa which was at par with dried inflorescence of Celosia argentea. Ornamental value was found to be the best in the dried leaves of Argyreia speciosa and dried inflorescence of Celosia argentea and Setaria verticillata with highest visual score of (5), followed by Echinochloa colonum and Eragrostis pilosa with 4 as visual score as observed in both the years.
Inheritance of Monocrotophos Resistance in Egg Parasitoid Trichogramma Chilonis (Ishii) (Hymenoptera:Trichogrammatidae)
Authors: Kerima Ondara Zablon , Niranjana Pathappa , Lalitha Yadavalli , K. Jalali Sushil , R. Ballal Chandish
Published: December 2017

Inheritance of monocrotophos resistance was studied in the laboratory population of T. chilonis. After 10 cycles of selection pressure under laboratory condition, the resistant strain acquired LC50 value of 0.346mL compared toLC50 value of 0.114 mL in the susceptible strain. Evidence from bioassay of F1 reciprocal hybrid crosses backcrossed with respective resistant 'R' and susceptible 'S'parentalstrains of T. chilonis, aimed to determine mode of inheritance of insecticide tolerance indicated that F1 crosses exhibited a complete dominant response to monocrotophos, with degree of dominance value (D) of 1.62. The resistance factor (Rf) of resistant strain was 3.04 folds and of F1 crosses were 3.675 folds over susceptible strain. Result of this study suggests resistance to the insecticide was probably controlled by a single gene. These results provide the basic information for designing successful management programmes for the control of Lepidopteran pests using resistant strain as a component of IPM.
FINANCIAL FEASIBILITY OF PRECISION FARMING IN PADDY- A CASE STUDY
Authors: K Shruthi , Hiremath G. M. , T. Joshi Amrutha
Published: December 2017

Precision farming is an emerging, highly promising technology that helps in dealing with the present agricultural challenges by proper and effective management of soil and crop variability with the use of information technology. In order to initiate precision farming in India through state agricultural universities, the precision farming project in selected field crops was implemented in University of Agricultural Sciences, Raichur, Karnataka. The objective of the study was to assess the financial feasibility of project implementation at farm level in paddy. Primary data was collected with the aid of a well-structured, pre tested schedule. Findings showed that the project of precision farming in paddy which was implemented by the University was economically viable and financially feasible. The cost incurred in cultivation of paddy by adopting precision farming practices was ` 75,825.35/ha and gross returns were ` 1,22,656.30/ha. Results of financial feasibility measures showed that the Net Present Value at 12 per cent discount rate, at the end of ten years was found to be positive, Benefit-Cost ratio was more than one and Internal Rate of Returns of the precision farming in paddy was more than discount rate (12 %). It was also revealed that payback period was 6.84 months and profitability index due to adoption of precision farming was found to be 8.83. Hence it was concluded that investment on precision farming in paddy at farm level was feasible to operate at farm level with the technical assistance from University. Considering the adoption strategy of precision farming and its benefits, there is a need to bring awareness among farming community by the joint effort of public and private sectors through the extension agencies, non-governmental organizations and state agricultural universities
Antimycotic Activity of Important Medicinal Plants Against Wilt Pathogen of Pigeon Pea and Leaf Spot Pathogen of Tomato
Authors: Jalander V. , Mamatha M.
Published: December 2017

Aqueous and ethanolic leaf extracts of six different medicinal plants such as Adhatoda vasica Nees, Azadirachta indica A. Juss., Catharanthus roseus (L.) G. Don., Cymbopogon citratus (DC.) Stapf., Eucalyptus globules Labill. and Ocimum sanctum L., were tested for their antifungal activity against Fusarium oxysporum f.sp. udum Butler, a wilt pathogen of pigeon pea [Cajanus cajan (L.) Millsp.] and Alternaria solani, a leaf spot pathogen of tomato (Lycopersicon esculentum Mill.). The leaf extracts (aqueous and ethanolic) prepared from six different plant leaves at different level of concentrations i.e. 5,10, 15 & 20% were incorporated in glucose nitrate liquid medium. The results were indicated that the ethanolic leaf extracts found good inhibitory activity than aqueous leaf extracts against plant pathogenic fungi tested. The ethanolic leaf extract prepared from Azadirachta indica was showed better efficacy against wilt pathogenic fungus and extract from E. globules found good inhibitory activity against leaf spot pathogen of tomato.
Effect of Traditional Agronomic Practices on White Rust of Rapeseed – Mustard under Organic Farming System in Manipur
Authors: Premlata Devi Yengkhom
Published: December 2017

Rapeseed – mustard is one of the most important cruciferous oilseed crops basically raise for oils and vegetables to meet domestic consumption of marginal farmers during rabi season in Manipur. Field experiments were conducted under organic condition for two consecutive years ( 2014 & 2015) during rabi seasons at Kakching. Weekly surveys detected white rust of rapeseed –mustard on the four varieties used. Amendments of agronomic practices including sowing dates, intercropping and plant density besides addition of soil with FYM (Farmyard Manure) were found effective on fungal disease of the crop. The disease parameters were monitored through disease incidence (DI) and disease severity (DS) assessment technique. The least disease severity (9.57%) was found in plant density followed by date of sowing (11.06%) and intercropping (12.29%). White rust caused by Albugo candida attacked the crop from mild to severe form and the effect of agronomic practices applied were significant in controlling the white rust disease of the crop.
Boulevard da República: espaço republicano construído na Baía do Guajará (Belém, PA).
Authors: Nunes Marcia Cristina Ribeiro Gonçalves
Published: December 2017

Neste trabalho iremos entender a urbanização às margens da Baía do Guajará, antigo espaço destinado a acostamento de embarcações da Província do Grão Pará, denominado de rua Nova do Imperador até a sua transformação no Boulevard da República, hoje denominado Boulevard Castilhos França.  Como essa rua que fica ao lado de um porto vai adquirindo sentidos diferentes em momentos diversos na vida da cidade.  Uma rua que não está desvinculada do rio, a qual se liga a diversos pontos de desembarque onde se transaciona quase todo o comércio local, tomará nova forma se transformando num boulevard que é cais, mantendo suas atividades com o rio e dialogando com pessoas que entram e saem das mais diferentes posições sociais em frente a pequenos negócios, lojas de todos os tipos e novos equipamentos urbanos. Um boulevard que está inserido na modernidade de sua época carregado de significados, se sobrepondo à cidade imperial e se pondo à uma cidade civilizada como o próprio período republicano.
CHARACTERISTICS OF DEPRESSION IN PATIENTS WITH DIFFERENT CHRONOTYPES
Authors: Gerasimchuk M. Yu.
Published: December 2017

Background: Approximately 30−40% of depressive patients does not improve or show a partial response. Since biological rhythm involved in the pathogenesis of mood disorders is regarded as a unique characteristic of a person, it opens new opportunities for personalized medicine.Aim: to evaluate clinical characteristics and treatment effectiveness in depressive patients with different chronotypes.Materials and methods: In prospective, hospital-based study MADRS was performed weekly (dMADRS), therapeutic response (R) was defined as a 50% or greater decrease from baseline in the score. Chronotype was evaluated using the Morningness−Eveningness Questionnaire (MEQ). Participants completed a questionnaire package: HDRS-21, PSQI, ТОВ, «individual minute». Statistical analysis was performed using Excel for Windows, Statistica 13.0.Results: All patients (n=100, mean age 48±16 yrs) were divided into groups based on their circadian type: evening types (ETs) had more severe condition; antidepressants (SSRIs; R=72%) were effective given at morning in ETs, at evening (other; R=100%) ― in morning types (MTs) (p0.00001) with a greater reduction in depressive symptoms (p0.05). Prescribing drugs with balanced potency were effective in both groups (F=4.62, p=0.032). Cluster analysis on 25 clinical, biological, and therapeutic variables to establish the role of chronotype as a factor important for identifying patients with similar socio-demographic, clinical, and health characteristics was conducted. Cluster 1 achieved a reduction of depression severity (19% MTs; R=81%; 43.4±17.7 yrs; single episode; dMADRS 16.9±2.7; 23% monotherapy). Cluster 3 (80% ETs; R=50%; 40.4±15.2; early onset dMADRS 15.23±2.29; 7% monotherapy) was the most unfavorable prognostic group.Conclusions: Depressive patients with morning/evening chronotypes have significant differences in clinical presentation, the course of the illness and efficacy of antidepressants. Evening chronotype was found to be associated with poor prognosis. Circadian typology should be considered when choosing the appropriate therapeutic options.
Carbetocin versus Oxytocin and Misoprostol in prevention of atonic post-partum hemorrhage in high risk patients planed for cesarean delivery
Authors: Ali Abd El-Naser Abd El-Gaber , Nasr Ahmed Ali M. , Ahmed Hazem H. , El- Rasheedy Mahmoud I. , Badawy Mahmoud
Published: December 2017

Background: Post-partum hemorrhage prevention (PPH) is considered a major issue due to its effect on maternal morbidity and mortality. The objective of this study was to compare efficacy of Carbetocin in prevention of atonic post-partum hemorrhage in high risk patients undergoing elective caesarean section in comparison to Oxytocin and Misoprostol.Methods: 150 pregnant women prepared for elective caesarean section were classified into 3 groups; Group I (50 patients received Carbetocin 100 mg I.V infusion), Group II (50 patients received 20 IU of Oxytocin infusion on 1000 ml of normal saline solution) and Group III (50 cases received Misoprostol 400 µg per rectum immediately before induction of anaesthesia). Assessment of PPH and its degree was determined according to amount of blood loss during and for first 24 hours of caesarean delivery, also further need for haemostatic measures were also assessed.Results: There was a statistically significant difference in PPH among the three groups 6, 14 and 12% for group I, II and III respectively (P <0.001), major PPH was 0, 4 and 6% for the same groups respectively (P <0.001). The need for additional uterotonic agents was significantly lesser in Group I compared to Group II and III (2% versus 8 and 12% respectively P = 0.02) also the need for additional surgical measures was significantly lesser among the three groups (P= 0.00). The drop in Hb level and haematocrit value was significantly lesser in group I compared to group II& III (P <0.05). The need for blood transfusion was significantly lesser in Group I compared to group II and III (0% versus 12% p <0.0001)Conclusions: Carbetocin was superior to Oxytocin and Misoprostol in prevention of atonic PPH in high risk patients underwent elective caesarean delivery. Carbetocin should be administered for all cases undergoing elective CS and carry a risk factor for postpartum hemorrhage.
Improving fetal dystocia management using simulation in Senegal: midterm results
Authors: Gueye Mamour , Moreira Philippe Marc , Diallo Moussa , Gasama Omar , Diadhiou Mohamed , Gueye Mame Diarra Ndiaye , Gueye Serigne Modou Kane , Dieme Marie Edouard Faye , Diouf Abdoul Aziz , Niang Mouhamadou Mansour , Dieng Dior , Ndiaye Ousmane , Diouf Alassane , Moreau Jean Charles
Published: December 2017

Background: Maternal mortality, which constitutes the extreme point of the existing inequality between women in poor and rich countries, remains very high in Africa south of the Sahara. The objective of this study was to introduce a new training approach in Emergency Obstetric and Neonatal Care (EmONC) entered in Senegal to strengthen the skills of healthcare providers.Methods: The approach was based on the skills training using the so-called "humanist" method and "lifesaving skills". Simulated practice took place in the classroom through thirteen clinical stations summarizing the clinical skills on EmONC. The evaluation was done in all phases and the results were recorded in a database to document the progress of each learner.Results: With this approach, 432 providers were trained in 10 months. The increase in technical achievements of each participant was documented through the database. The combination of training based on the model “learning by doing” has ensured learning and mastering all EmONC skills and reduced missed learning opportunities as observed in former EmONC trainings.Conclusions: The impact of training on EmONC indicators and the introduction of this learning modality in basic training are the two major challenges in terms of prospects.
Correlation of Vitamin D levels with feto-maternal outcome
Authors: Chauhan Nidhi , Pahuja Nikita , Kalra Vinita
Published: December 2017

Background: Vitamin D deficiency in adult females may increase risk of pre-eclampsia, gestational diabetes, bacterial vaginosis. Various malpresentation, cephalo-pelvic disproportion and difficult deliveries increases the risk of caesarean section. It may also increase the risk of fetal hypovitaminosis D, neonatal rickets and tetany, lower respiratory tract infections, low birth weight, the largest cause of infant mortality in India. This study was under taken to study the impact of vitamin D deficiency on feto-maternal outcome.Methods: The study was conducted in the Department of Obstetrics and Gynaecology, Himalayan Institute of Medical Sciences (HIMS), Swami Ram Nagar, Dehradun, over a period of 12 months. Sample size was 100 pregnant females attending antenatal clinic.Results: Out of 100 subjects, pre-eclampsia was seen in 15, among which 5 (23.80%) had deficient, 9 (13.04%) had insufficient and 1 (10%) had sufficient vitamin D levels. Eclampsia was seen in 3 subjects, out of which 1 (4.76%) had deficient, 2 (2.89%) had insufficient vitamin D status. IUGR was seen in 8 subjects, out of which 4 (19.04%) had deficient vitamin D levels, 4 (5.79%) had insufficient vitamin D status. Neither of the two had sufficient vitamin D status. Deficient vitamin D status with birth weight ≤2.5 kg was seen in 9 (42.85%) subjects and 12 (57.14%) subjects with >2.5 kg Insufficient Vitamin D status was seen in 22 (31.88%) subjects with birth weight ≤2.5 kg and 48 (69.56%) with birth weight >2.5 kg.Conclusions: Prevalence of vitamin D deficiency and insufficiency was noted in this region and its association with pre-eclampsia (23.80%, 13.04% and 10% in deficient, insufficient and sufficient group respectively) was seen. Higher incidence of LSCS was also present among the deficient and the insufficient group.
A comparative study of feto-maternal outcome in expectant management versus active management in pre-labor rupture of membranes at term
Authors: S. Savitha T. , S. Pruthvi , C. P. Sudha , Nadig Vikram S.
Published: December 2017

Background: Premature rupture of the membranes at term is spontaneous rupture of the membranes after 37 weeks of gestation and before the onset of the regular painful uterine contractions, complicates 5-10% of pregnancies, 80% of cases of PROM occur at term. It complicates the pregnancy leading to maternal and fetal complications, immediate risks such as cord prolapse, cord compression and placental abruptions, and later risks such as maternal or neonatal infection and the interventions such as caesarean section and instrumental vaginal delivery. These cases are either managed conservatively or by immediate induction of labour. Objective of present study is to compare the efficacy and safety of induction of labor versus expectant management at term PROM, in terms of maternal and fetal outcome.Methods: A randomized control trial of 100 women coming to KIMSH from 01 /04 /2015 to 01 /05 /2016 with PROM at term with duration of leak ≤6 hours and a Bishop score ≤5 were assigned to group A immediate induction group and group B expectant management group with 50 cases in each group.Results: The mean interval from PROM to delivery was significantly shorter in the induction Group 15.62±4.97 as compared with expectant group 17.58±4.78. Incidence of maternal morbidity and neonatal morbidity was comparable in both the groups. Intrapartum complications and mode of delivery were similar in both groups.Conclusions: Immediate induction of labour in cases of PROM at term using oral misoprostol resulted in shorter induction delivery interval and hospital stay. Maternal morbidity and neonatal morbidity was comparable in both groups. It is concluded that immediate induction is better than expectant management. With active management many patients delivered vaginally within 24 hours without increase in the Caesarean section rate and decreased the need for oxytocin augmentation.
Feasibility and accuracy of fetal echocardiography at routine 11 to 13 weeks 6 days ultrasound performed on unselected obstetric population in a tertiary maternity centre with high patient turnover
Authors: Poojari Vidyashree G. , Reddy Arevidya , Vasudeva Akhila
Published: December 2017

Background: Congenital heart defects (CHD) remain the most prevalent congenital malformations, with an estimated prevalence of 6-8 per 1000 live births. Routinely, fetal echo is performed around 18-22 weeks among high risk cases. A dedicated early fetal echo (EFEC) performed by experts between 11-16 weeks is emerging as an excellent screening tool among high risk cases. However, feasibility of obtaining such cardiac views during routine Nuchal Translucency scan by trained obstetricians, is yet to be known as there is limited time available with high patient turn over. Present study aimed to know the feasibility and accuracy of EFEC in unselected obstetric population in a tertiary maternity centre with high patient turnover.Methods: This was an observational cohort study from March 2015 to April 2017 at a tertiary maternity referral hospital. Singleton pregnant women undergoing routine 11-13+6 weeks scanning (NT scan) were recruited in the study including both high and low risk pregnancies. Possibility of obtaining 4 basic cardiac views within this limited time was assessed.Results: A total of 180 early fetal ECHO’s were performed during the course of this study. The 4-chamber view (79.44%) of the heart was the easiest parameter to visualize. RVOT (28.88%) was the most difficult view to be obtained. Complete visualization of all the cardiac views was possible in only 34 women (18.88%). The visualization rates of the cardiac views improved as the gestational age increased. TVS was essential to obtain cardiac views in 5 cases out of 138 (3.6%) in 12-13+6 scans. Whereas, TVS was essential to visualize cardiac views in 34 cases out of 42 (80.95%) between 11 weeks to 11 weeks 6 days. A total of 7 cardiac anomalies were detected during this study. There were 3 major and 4 minor cardiac malformations. Out of the 3 major anomalies, 2 were AVSDs which were diagnosed by EFEC. Minor defects were undetected.Conclusions: It is feasible to get the basic cardiac views in the limited time available to perform NT scan among unselected obstetric population in a tertiary maternity centre with a high turnover. Gestational age of 12 weeks and above seems to increase the accuracy. TVS is a useful adjunct throughout 11-14 weeks scan.
Vitamin D levels in pregnant women in Uttarakhand, India
Authors: Pahuja Nikita , Chauhan Nidhi , Kalra Vinita
Published: December 2017

Background: A balanced, nutritious diet is an important aspect of a healthy pregnancy and its outcome. Vitamin D plays an important role in regular bone growth and in adequate function of innate immune system, including barrier function of mucous membrane. Vitamin D deficiency in adult females may increase risk of pre-eclampsia, gestational diabetes, bacterial vaginosis. The present study was undertaken to find the prevalence of Vitamin D deficiency in the women of Uttarakhand, India.Methods: The study was conducted in the Department of Obstetrics and Gynecology, Himalayan Institute of Medical Sciences (HIMS), Swami Ram Nagar, Dehradun, India over a period of 12 months. Sample size was 100 pregnant females attending antenatal clinic.Results: Out of 100 subjects, 21 (21%) had deficient, 69 (69%) had insufficient and 10 (10%) had sufficient vitamin D status. Out of 21 deficient subjects, 18 (85.71%) were Hindus, 2 (9.52%) were Muslims, 1 (4.76%) was Sikh and no deficiency was seen in Christian. In the present study, deficient vitamin D status was seen in 1 (4.76%) in lower, 16 (76.19%) in middle and 4 (19.04%) subjects in upper socioeconomic status.Conclusions: It is concluded from our study that there is serious vitamin D deficiency and insufficiency in the women of Uttarakhand, India.
Enhancing awareness of STIs and cervical cancer among husbands in an urban slum of Mumbai, India: a comparative study focusing on General, OBC and SC/ST/NT population
Authors: Naik D. D. , Donta Balaiah
Published: December 2017

Background: Globally, cervical cancer is one of the most common cancers among women, 80 percent of cervical cancer cases present with an advanced stage of the disease when cure is impossible.  This may be due to lack of awareness and knowledge, and lack of access to proper treatment including screening facility. Involvement of husband for understanding and supporting the wife may be more effective in reproductive health related matters.Methods: An intervention study was undertaken in an urban slum of Mumbai with the objectives to investigate the awareness, knowledge and perceptions about STIs and cervical cancer and to identify programme strategies contributing to effective participation of husbands in three different categories. Baseline data was obtained from 1020   married men followed by interventions for 18 months and endline data was collected from 1013 married men to evaluate the impact of intervention. Descriptive statistics and Chi-square test was used for data analysis.Results: The results indicate significant increase in awareness about STIs, cervical cancer and Pap smear with low awareness about symptoms, abnormal discharge from vagina and abnormal vaginal bleeding in all the three groups.Conclusions: Study concludes that intervention strategy adopted at community as well as clinic level can play better role as a source of information of STIs and cervical cancer. Similar changes observed in all three categories suggest, programmes need to focus on general population rather than specific categories in a metropolitan city like Mumbai as population in urban slums of Mumbai is ethnically mixed in nature.
Study of obstetric factors in perinatal morbidity and mortality at a tertiary centre
Authors: Tambe Sanjaykumar G. , Thawal Yogesh A. , Anand Tania , Kolate Dipak Suresh
Published: December 2017

Background: Safe motherhood and child survival have always been a concern for the policymakers but perinatal mortality, especially stillbirths, have not received due attention. There are 5.9 million perinatal deaths worldwide, almost all of which occur in developing countries. Stillbirths account for over half of all perinatal deaths. This study was aimed to determine perinatal mortality rate and related obstetrics risk factors. Perinatal mortality is only a tip of the iceberg, morbidity being much higher. Vital statistics obtained through this study may serve an important source of information to guide the public health policy makers and health care providers in future.Methods: Present observational study was undertaken in a tertiary center to look into various maternal factors and possible cause of perinatal death. All perinatal deaths including stillbirths (SBs) and early neonatal deaths (ENNDs) within 0-7 days of birth after 28 weeks of gestation were analysed. The data was collected through a pre-designed proforma.Results: Perinatal mortality is 66.27/1000 births in our centre, where 37% were intrauterine deaths, 34% were neonatal deaths and 29% were still births. Preterm, pregnancy induced hypertension; abruptio placentae remain the most important factors for perinatal loss.Conclusions: One of the reasons for high perinatal mortality in tertiary centres is because of poor antenatal care at peripheral centres and late referrals. Early detection of obstetric complications and aggressive treatment is one of golden rule to reduce perinatal loss.
Comparing WHO C-Model generated C-Section probabilities to actual delivery outcomes in a tertiary care centre
Authors: Ray Amita , Gopi Arun , Ray Sujoy
Published: December 2017

Background: A model which takes into account several relevant factors and gives the probability of C-Section in a woman would have the advantage of preparing for such an event. The identification of women at high risk of C-Section (>50% risk) would provide the opportunity for understanding risks involved in pursuing a vaginal delivery whereas if the risk of C-Section was less (<50%) it would prove useful in counselling for a vaginal delivery. We used the WHO C-Model with the aim to find the predictability of this model in our facility and the overuse of C-section in the 10 Robson’s Groups.Methods: A retrospective observational study in which all women who gave birth at our hospital from June 2016 to May 2017 were included and C-Section probability was calculated using the C-Model. Comparison with the actual mode of delivery was done to find the sensitivity, specificity, positive and negative predictive value of the model and the overuse of C-Section in the Robson’s Groups.Results: Out of the 314 C-Sections done only 45 women had a >50% probability, giving the model a sensitivity of 14.33%, specificity of 98.8%, positive predictive value of 90% and negative predictive value of 60.56%. Robson’s Groups 5 and 3 demonstrated the greatest overuse of C-Sections.Conclusions: The WHO Model when applied to this centre showed a high positive predictive value for C-Sections but the negative predictive value or the ability to correctly predict a vaginal delivery was much less.