bluuebunny/crossref_metadata_2025 huggingface dataset:
Ultrasound guided detection of position of post partum intra uterine contraceptive device and its relation to complications
Authors: Chawla Dolly , Bharti Puja , Verma Menka , Khatri Rashmi
Published: August 2017

Background: Worldwide, Intrauterine Contraceptive Device (IUCD) is one of the most commonly used reversible methods of contraception among married women of reproductive age. It is the second most commonly used forms of contraception, ranking second only to female sterilization. Proper positioning of Copper containing IUCD is of utmost importance for efficacy and safety. The immediate postpartum period, after a birth but prior to discharge from the hospital is an important but under utilized time frame to initiate contraceptives, specially long acting contraceptives such as intrauterine contraceptive device (IUCD). To study the location of Copper IUCD by ultrasound, relationship between position and complaints, failure rate and expulsion rate in post-partum IUCD cases.Methods: The study was prospective, analytical study conducted on 200 women for one year.  IUCD insertion was done in two groups; group A (normal delivery, postplacental) and group B (caesarean section, intracaesarean). On ultrasonography, position and distance of IUCD from fundus of uterus was measured. Outcome measures were expulsion, complication and failure rate upto six months. Informed consent was taken from each participant and ethical justification for the study was sought.Results: Majority of the patients were in age group of 21-25 years. Multigravidae patients had more acceptability of IUCD than primigravidae. More than half of IUCD insertion was done by senior residents (56%). Malpositions were more common in vaginal delivery (62%) than caesarean section (28%). Most common malposition was mid cavity and least common was oblique. Most common complaint was pain abdomen and least common was expulsion.Conclusions: Sonography can be used as an adjunct to clinical examination to examine the position of the IUCD. Ultrasonography done after PPIUCD insertion helps in determining, whether PPIUCDs are placed in normal position or malposition. Malpositioned PPIUCDs have more complications as compared to normally placed IUCDs
Assessment of knowledge and attitude about emergency contraception: a cross sectional study among medical students in North India
Authors: Kumar Gupta Rajiv , Singh Parveen , Kumari Rashmi , Langer Bhavna , Sharma Pawan , Gupta Riya
Published: August 2017

Background: Emergency contraception (EC) which is the only method indicated after the unprotected sexual intercourse prevents unintended pregnancies and its harmful consequences like unsafe abortion or unintended child delivery. Since medical students are the future medical professional and would be the main channel to provide preventive, promotive and curative services to the population at large, their knowledge and attitude towards EC is an important context in the overall health scenario of India. The study aimed to assess the knowledge and attitudes of medical students towards use of EC.Methods: This cross sectional questionnaire based study was conducted among 2nd professional MBBS students in a Government Medical College in North India. The self administered questionnaire intended to seek information on knowledge and attitude of the students. The data so collected was expressed in percentages and Chi square test was used as test of significance.Results: All the respondents had heard of EC with mass media as the main source of information. More than 90% of the respondents knew about the indications for use of EC as well as the timing of the use of EC. Female respondents had better knowledge about composition of EC as well mechanism of action (p<0.05). More than 90% would recommend EC in case of unprotected sexual intercourse and 83.5% had positive attitude towards EC.Conclusions: Although knowledge about EC was good on certain parameters, yet lack of in depth knowledge among future health care providers is a cause of concern. So, attention be given to special issues relating to EC from early years of medical education till internship.
The role of m-health in providing antenatal care in rural areas
Authors: Menaka Basavanapalli , Kamineni Vasundhara , Sree M. Vijaya
Published: August 2017

Background: The maternal mortality rate is high in India and many deaths are due to preventable causes related to pregnancy. Mobile-health is an innovative strategy wherein, mobile phones are used for pregnancy tracking and giving support during the antenatal period. Aims and objectives of the study was to know the role of m-Health in providing antenatal care in rural areas.Methods: This was a prospective, comparative study carried out at Kamineni Hospital, LB Nagar, Hyderabad and the Primary Health Centres (PHC) of Uppal and Narapally, Ranga Reddy district over a period of one year nine months and consisted of 204 registered antenatal cases divided into study and control groups. Both groups received routine antenatal support and the study group, in addition received mobile health support also. Various parameters were compared in both the groups.Results: The study group had more antenatal visits, better correction of anemia, less number of patients who were lost to follow-up, and more number of Caesarean deliveries.Conclusions: Mobile health helps in pregnancy tracking and increasing the antenatal visits. It helps in timely referrals for high-risk pregnancies in remote areas and it has the potential to provide obstetric care and consultations to both low risk and at-risk women in rural areas where specialist care is not always available.
Study of serum calcium and vitamin D levels with hormonal profile along with biochemical profile in women with polycystic ovary syndrome
Authors: Subashree Ilangovan , Valvekar Umakant Ramchandra , Prasad Geetha
Published: August 2017

Background: The polycystic ovary syndrome (PCOS) is one of the commonest human endocrinopathies and is increasingly recognized as a variant of the metabolic syndrome in women with the characteristic features of insulin resistance, central obesity, impaired glucose metabolism, dyslipidemia, and hypertension.Methods: This study is mainly focused on study of parameters like gonadotropin hormonal profile, serum vitamin D and calcium levels in polycystic ovary disease (PCOD). The study comprised 45 clinically proven polycystic ovary disease patients in the age range of 19-34 years. The biochemical estimations carried out in the study were – Fasting Blood sugar, LH, FSH, prolactin, 25- OH vitamin D and calcium along with anthropometric data. The values obtained were compared with age matched equal number of healthy control female subjects from the same population.Results: The serum concentration of calcium and vitamin D levels are decreased significantly (P <0.001) when compared to controls. Insulin resistance is predominantly seen in PCOS subjects. The study outlines the importance of insulin resistance, dyslipidemia, decreased serum calcium and vitamin D levels in PCOS subjects may be a cause for the progression of polycystic ovary syndrome.Conclusions: In the present study vitamin D deficiency is highly prevalent in PCOS women from this area compared to control women. We also relations of vitamin D status with insulin sensitivity, HDL-C, and C-reactive protein in PCOS patients, which support the increasing evidence that vitamin D deficiency is associated with multiple metabolic risk factors in PCOS women. A high prevalence of vitamin D deficiency and low calcium levels were observed in PCOS women from our population when compared to controls. Insulin resistance was predominantly seen in PCOS subjects when compared with controls, indicating the association of vitamin D levels with insulin resistance.
Synergistic approach in diagnosing endometrial disease in women with postmenopausal bleeding
Authors: Sharma Jiten , Dhiman Bhishan , Sud Nishi , Kaushik Anupriya
Published: August 2017

Background: All women with postmenopausal uterine bleeding mandate examination for endometrial diseases especially endometrial carcinoma. In current scenario, hysteroscopy has replaced traditional Dilatation and Curettage as diagnostic procedure of choice. However, office endometrial sampling with pipelle combined with vaginal ultrasonography being easier and less expensive is recommended. Aim and objectives of the study was to evaluate the combined use of vaginal ultrasonography and office endometrial sampling for the diagnosis of endometrial disease in postmenopausal women with uterine bleeding.Methods: One hundred consecutive postmenopausal women presenting with uterine bleeding were enrolled in the study. Vaginal ultrasonography was used to measure the endometrial thickness. Endometrial sampling was done using endometrial biopsy pipelle, as office procedure, in the OPD examination room. The sample was sent for Histopathological Examination (HPE), The accuracy of vaginal ultrasound and pipelle was measured.Results: In 21% patients, endometrial carcinoma was found, endometrial hyperplasia in 26%, atrophic endometrium in 18%, endometrial polyp in 10% and no specific pathology in 20%. Endometrial thickness measured by Transvaginal ultrasound ranged from 1mm to 28mm with mean of 10.16mm and median of 11.5mm. The mean endometrial thickness in subgroup without disease was 5.26±3.8mm, with benign disease 12.8±3.1mm and in carcinoma 16.97±5.6mm. All cases with carcinoma had endometrial thickness exceeding 5mm (range 5.7mm to 28mm).Conclusions: The study illustrates that by combined use of Trans Vaginal Sonography (TVS) and office endometrial sampling, sufficient diagnostic information was obtained for women with postmenopausal bleeding, obviating the need for more invasive diagnostic procedures.
Placental pathology in maternal autoimmune diseases-new insights and clinical implications
Authors: T. Ramya , G. Umamaheswari , V. Chaitra
Published: August 2017

Background: Pregnancy in women with autoimmune diseases is frequently associated with placental insufficiency leading to adverse perinatal outcome. Aim of the study was to investigate the presence and possible clinical significance of placental lesions in mothers with different autoimmune disorders.Methods: In this retrospective study, 11 placentas from 10 mothers with diverse autoimmune diseases including systemic lupus Erythematosus (SLE), antiphospholipid antibodies (APLA), idiopathic thrombocytopenic purpura (ITP) and antinuclear antibodies (ANA) were studied.Results: Placental correlates were reduced placental weight, maternal vascular under perfusion, abruption, villitis of unknown etiology, multifocal chorangiomatosis, distal villous immaturity, massive perivillous fibrin deposition/maternal floor infarction and foetal thrombotic vasculopathy. Of the 11 pregnancies 3 were untreated (1 SLE, 2 APLA) and resulted in intrauterine foetal demise. The lesions were more severe in these cases. All the treated pregnancies resulted in live born babies (8), of which 3 were growth restricted, 2 were complicated with oligohydramnios and 3 were delivered preterm.Conclusions: In this group of diverse autoimmune disorders, placental lesions were not specific for each of them. Apart from maternal vascular under perfusion, lesions like villitis of unknown etiology, distal villous immaturity and massive perivillous fibrin deposition were identified and may recur in subsequent pregnancies and treatment should be directed towards modifying it. The placental examination should be mandatory in all cases of maternal autoimmunity and pregnancies with poor foetal outcome.
Use of letrozole versus clomiphene citrate combined with gonadotropins for ovulation induction in infertile women with polycystic ovary syndrome: a pilot study
Authors: Athwal Amitoj , Chakravorty Ratnabali , Sur Dipanshu , Saha Rupam
Published: August 2017

Background: The aim of the study was to evaluate the efficacy of letrozole and clomiphene citrate (CC) in gonadotropin-combined for ovulation stimulation in women with polycystic ovary syndrome (PCOS). It was a prospective pilot study.Methods: This prospective trial included 124 patients of infertile women with PCOS. Letrozole dose of 5 mg/day (n = 65) or a CC dose of 100 mg/day (n = 59) was given on day 3 to day 7 of the menstrual cycle, combined with gonadotropin i.e. follicle stimulating hormone (FSH) at a dose 75 IU every day starting on day 7 and continued to day 9. Main outcome measures were occurrence of ovulation, number of mature follicles, serum estradiol (E2) and endometrial thicknesses on the day of human chorionic gonadotropin (hCG), and pregnancy rates.Results: The clinical profile including mean age, duration of infertility, BMI, baseline FSH, LH and E2 of patients belonging to both groups were comparable. The numbers of mature follicles (4.3±0.3 vs. 2.9±0.7) were significantly higher in letrozole+FSH group. Serum E2 levels on the day of hCG (301.78±85.7 vs. 464.7±72.9 pg/mL) were significantly lower in the letrozole+FSH group. Significant differences were found in endometrial thickness measured on the day of hCG in letrozole+FSH group (p=<0.0001). The rate of ovulation was higher in letrozole+FSH group and it was marginally statistically significant (p=0.040). The rate of pregnancy was slightly greater in the letrozole+FSH group (17.85% versus 13.33%), although not statistically significant.Conclusions: Letrozole in combination with FSH appears to be a suitable ovulation inducing agent versus CC with FSH in PCOS. This combination may be more appropriate in patients who are particularly sensitive to gonadotropin.
Knowledge attitude and practice of contraceptives in married women in a tertiary care
Authors: Fareed Perveena , Siraj Farhana , Mahajan Neha
Published: August 2017

Background: To estimate the knowledge, attitude and practice of contraception among women attending postpartum OPD.Methods: This cross-sectional study was conducted in Obstetrics and Gynecology outpatient department Government medical college Srinagar. Sample size of 200 patients attending post-partum OPD were taken and questioned using a questionnaire. Questions were asked regarding age, educational status, parity, knowledge, practice of contraceptives and reasons for non-use of contraceptives.Results: 63% of patients were aware of any contraceptive. Among contraceptives most common known contraceptive was OCP’s (62%) followed by female sterilization (52%) and Intrauterine devices (51%). Only 21% were aware of male sterilization. Implants were known to only 5% of patients. Awareness of emergency contraceptives was seen in only 18.5% of patients. Among patients having awareness of contraceptives most common used method was OCP’s (73%) followed by barrier, IUD’s (48%) and injectable (44%).Conclusions: The study highlights that awareness does not always lead to the use of contraceptives. A lot of educational and motivational activities and improvement in family planning services are needed to promote the use of contraceptives and reduce the high fertility rate.
Rudimentary horn pregnancies: dilemmas in diagnosis
Authors: Gaur Yashodhara , Goswami Prakriti , Meravi Karuna
Published: August 2017

Rudimentary horn pregnancy is a rare obstetric entity and the diagnosis and management may pose some problems especially in a low-resource center. We report a case of G1P0 with pregnancy of 28 weeks gestation with diagnosed intrauterine fetal death, which was suspected as extra uterine pregnancy bases on failed attempts of termination of pregnancy and on laparotomy, a dead fetus of 16 weeks was found in left unruptured noncommunicating horn of unicornuate uterus. Diagnosis of rudimentary horn pregnancy is difficult and can be missed in ultrasound. It requires a high index of suspicion.
Case of extranodal non-hodgkins lymphoma involving the endometrium and the ovaries: a rare case report
Authors: Malempati Lakshmi Manjeera , Nandan Neetha , Babu Sagarika
Published: August 2017

Non-Hodgkin’s lymphoma(NHL) is most commonly encountered during childhood and rarely among the adults. Primary malignant lymphoma in the female genital tract are rare Moreover they present with non-specific symptoms and hence there may be delay in the diagnosis. It is difficult to distinguish this condition from the more common uterine neoplasm such as uterine fibroids or sarcoma. Diffuse large B-cell lymphoma (DLBCL) is most commonly seen among the cases of NHL, contributing to among one third of NHL in the western world. DLBCL is common in elderly population. A 69-year-old postmenopausal woman who came with watery discharge since, 15 days was evaluated clinically and radiologically and was found to have thickened endometrium and enlarged ovaries, for which endometrial biopsy was taken that showed non-secretory endometrium with atrophic changes. Tumor markers found to be normal. TAH+BSO was done and the histopathology showed Non-Hodgkin’s lymphoma, diffuse large B cell type of the endometrium and both ovaries which was confirmed by immune histochemical marker study. PET-CT was done that showed metabolically active para aortic and common iliac lymph nodes thereby she was diagnosed with stage II (Ann Arbor Staging) non-Hodgkin’s lymphoma, hence she received 6 cycles of R-CHOP. As evident in our case, non-Hodgkin’s Lymphoma of the endometrium and the ovaries being an extremely rare condition, high-degree of suspicion is required for its prompt diagnosis and treatment.
Aggressive angiomyxoma of the vulva: an uncommon entity
Authors: Prajapati Shradha , V. Meerabai , M. Jayalakshmi , M. Sredharan
Published: August 2017

AA is a rare locally invasive mesenchymal tumor predominantly presenting in women of reproductive age group, having a moderate to high risk for local relapse. Hence, it needs to be differentiated from another mesenchymal tumor occuring in this region. We present a case of a 50 year old female with a large, polypoidal, spongy mass on the right labia majora.
Cervical fibroid: an uncommon presentation
Authors: Mendiratta Sumanlata , Dash Soumya , Mittal Rajni , Dath Suman , Sharma Manisha , N. Sahai Rajiv
Published: August 2017

Fibroids arising from cervix are rare tumours accounting for 2% of all fibroids. A cervical leiomyoma is commonly single and is either interstitial or subserous, rarely it becomes submucous and polypoidal. Anterior cervical fibroid may press on urinary bladder and urethra and displace the urethro-vesical junction giving rise to urinary frequency and retention. Management of symptomatic cervical fibroid is hysterectomy or myomectomy and need an expert hand. Here we report a case of huge anterior cervical fibroid of 15x15x7cm with an unusual presentation of menorrhagia of only 2 days and no urinary symptoms. Inspite of the fibroid being huge and impacted, hysterectomy was done successfully without any injury to bladder and ureters.
Gartner duct cyst in pregnancy: a case report
Authors: Virmani Smritee , Kaul Pushpa
Published: August 2017

Gartner duct cysts are remnants of the Wolffian duct. They are located in the anterior or lateral wall of vagina and may be associated with renal and ureteral anomalies. We present a case report of 28 years old primigravida with 28 weeks gestational age with complaint of a mass protruding through vagina. A diagnosis of Gartner duct cyst was made by the location of the cyst, TVS and histopathological examination following excision of the cyst.
Estrategia de uno en uno para mejorar la técnica correcta de higiene de manos
Authors: Hernández-Orozco Hilda Guadalupe , Castañeda- Narváez José Luis , Lucas-Reséndiz María Esperanza , Rosas-Ruiz Aurora , Aparicio- Santiago Guadalupe Leticia , Sandoval-Medina María del Carmen
Published: August 2017

INTRODUCCIÓN: la higiene de las manos es considerada la estrategia más importante para prevenir infecciones asociadas con la atención de la salud. En nuestra institución, un estudio previo mostró que 93% del personal del hospital dijo conocer la técnica de higiene de manos, pero las observaciones de vigilancia activa no reflejaban estos resultados. OBJETIVO: mejorar la técnica de higiene de manos apropiada a través de una estrategia de "uno a uno".MATERIAL Y MÉTODOS: estudio comparativo de antes y después, prospectivo, longitudinal, realizado entre 2012-2013, con personal de enfermería de cinco servicios. El estudio se realizó en tres etapas: la primer etapa consistió en observar la realización de higiene de manos reforzando verbalmente si era incorrecta; en la segunda etapa se pidió que se realizara la higiene de manos, si era incorrecta se pidió se repitiera realizándola al mismo tiempo con el observador; la tercera etapa fue la evaluación final de higiene de manos, después de al menos 15 días de la segunda etapa. Analizamos frecuencias de eventos correctos y realizamos comparaciones entre grupos por McNemar para evaluar si el efecto de la intervención se sostenía a pesar del tiempo; se evaluaron las mismas variables un año después del inicio del estudio.RESULTADOS: la prueba de McNemar mostró diferencias estadísticamente significativas entre la realización de la higiene de manos correcta entre la etapa 1 en comparación con las siguientes 35 versus 85%; p < 0.001. CONCLUSIONES: se confirmó que la intervención dirigida logra mayor cooperación por parte del personal e incrementa la técnica correcta de higiene de manos a  orto plazo.
Crisis neuropática por suspensión de nitisinona en una paciente con tirosinemia: informe de un caso
Authors: Ibarra-González Isabel , Belmont-Martínez Leticia , Cervantes-Bustamante Roberto , Zárate-Mondragón Flora , Guillén-López Sara , Fernández-Lainez Cynthia , Revilla-Estivil Nuria , Vela-Amieva Marcela
Published: August 2017

Se presenta el caso de una paciente con tirosinemia hepatorrenal (TYR- 1) que, debido a la interrupción por cuatro semanas de tratamiento con nitisinona, tuvo una grave crisis neurológica de pseudoporfiria caracterizada por vómito, dolor abdominal, irritabilidad e hipertensión arterial, con gran elevación de la succinilacetona y alfafetoproteína. La crisis requirió tratamiento intrahospitalario. Una semana después de reiniciar la administración del fármaco revirtió totalmente. Este caso enfatiza la importancia de mantener el tratamiento ininterrumpido con nitisinona en pacientes con tirosinemia hepatorrenal. También es útil para reconocer el cuadro clínico y la fisiopatología de las crisis neurológicas características de esta enfermedad.
Asociación VACTERL. Presentación de un caso en sesión anatomopatológica y consideraciones generales
Authors: Ávila-Iglesias María del Carmen , Rojas-Maruri Carlos Mauricio
Published: August 2017

La asociación VACTERL es un conjunto de malformaciones congénitas que tiene una baja prevalencia en la población general; sin embargo, está asociada a una elevada morbi-mortalidad. Se caracteriza por la presencia de diversas malformaciones en varias combinaciones, por lo que se cataloga como una asociación y no como síndrome con etiología única establecida.
Impétigo ampolloso
Authors: Pérez-De la O Alma Delfina , García Romero María Teresa
Published: August 2017

El impétigo es la enfermedad infecto-contagiosa más común en la piel.1 Existen dos tipos: no ampolloso, que es el más frecuente, y ampolloso. Es causado principalmente por Streptococcus pyogenes (Streptococcus β-hemolítico del grupo A) y Staphylococcus aureus. El impétigo no ampolloso es producido principalmente por S. pyogenes y se caracteriza por vesículas pequeñas que rápidamente se rompen y originan un exudado que al secarse forma costras melicéricas. El impétigo ampolloso siempre es causado por S. aureus y es el resultado de la acción de una toxina epidermolítica que genera lisis entre las conexiones intercelulares de los queratinocitos formando una ampolla flácida sobre la epidermis superficial. Se clasifica en primario, que es el que tiene lugar sobre piel previamente sana; secundario, que aparece en piel lesionada, principalmente sobre piel con dermatitis o eccema.
The Untapped Potential in Our Communities to Assist Youth Engaged in Risky Behaviour.
Authors: Reid Susan Alice
Published: August 2017

By drawing upon what is known about risk factors and protective factors with respect to at-risk youth, the author discusses how communities can become more actively involved and supportive of young people, and thereby work towards a model where the community actively promotes resilience among children and youth. She provides a detailed review of the research around resilience to support her contention that many resources, already present in communities but largely untapped, have the potential to encourage vulnerable young people to avoid developing an aggressive posture towards others, dropping out of school, drifting into a criminal lifestyle, or being victimized. She notes the growing and consistent evidence that poverty, unemployment, abuse, family and school problems correlate to crime, and argues that while one cannot say with any certainty that these factors are the causes of crime, they certainly are the causes of disadvantage. It is the disadvantaged, she states, who are the “most thoroughly processed” by the criminal justice system.
Book Review: Challenges for Child and Youth Care: A German-Israeli Dialogue
Authors: Anglin Jim
Published: August 2017

                                                                                                                                                      
Cree Women Speak: Intergenerational Perspectives on Weight Gain during Pregnancy and Weight Loss after Pregnancy
Authors: Vallianatos Helen , Brennand Erin A. , Raine Kim , Stephen Queenie , Petawabano Beatrice , Dannenbaum David , Willows Noreen D.
Published: August 2017

Obesity is prevalent among the First Nations population in Canada, with serious associated health risks. Recent studies also indicate that a high percentage of First Nations women are overweight or obese at the start of their pregnancies, with a tendency to retain weight after their children are born. In response to these concerns, a community-based study was conducted in two Cree communities, using qualitative methods to investigate young mothers’ perceptions and concerns about weight gain during pregnancy and challenges to postpartum weight loss. Female Elders were also interviewed to provide some historical context and to give some insight into culturally appropriate responses to the current weight-related health challenges being faced by young mothers. Overall, the study showed that most of the participants—young and old— associated “healthy foods” with traditional foods and “healthy living” with bush life. However, while Elders recounted staying active and eating traditional foods throughout their pregnancies, the younger women tended not to put their knowledge of what constitutes a healthy lifestyle into practice, mainly due to various individual and societal barriers. Some of the barriers identified related to lifestyle changes, including increased consumption of “white man’s foods” and decreased physical activity, as well as to larger social changes, such as the medicalization of pregnancy and diminished community support networks for young mothers. Participants provided insight into how traditional practices could be intertwined with the benefits of contemporary life to help address some of the health issues currently affecting young Cree mothers.
Tradition and Culture: An Important Determinant of Inuit Women’s Health
Authors: Healey Gwen K.
Published: August 2017

This exploratory qualitative study used a case study method to explore Inuit women’s perspectives on their health and well-being. Data were gathered using face-to-face interviews from a purposive sample of women in one Nunavut community who self-identified as Inuit. Data analysis and interpretation were guided by an established approach in qualitative research called “immersion/crystallization.” Various strategies, including methods of verification and validition, were employed to ensure the scientific rigour and reliability of the study’s findings. The mechanisms through which culture and tradition affected women’s perceptions of health and well-being were clearly illustrated and clearly significant to the interview subjects. Women used examples of teenage pregnancy and parenting issues to illustrate traditional practices in Nunavut communities and their significance in an increasingly non-traditional society. Women stressed the importance of speaking Inuktitut and teaching it to their children. Many associated their ability to speak Inuktitut with their ties to Inuit traditions. Women described the grief experienced from loss of culture leading to problems related to identity, social inclusion and wellness. Culture and traditional knowledge were identified as key determinants of health for Canadian Inuit women. This study provides important information to inform and guide health promotion and illness prevention planning. The study will also help decision-makers and health professionals address some of the health issues affecting Inuit women by providing them with some insight into Inuit women’s local and contemporary circumstances. The results of this work can support local efforts to identify priorities for policy and program development relevant to Inuit women’s specific needs. Finally, the relevance of insight gained through the health perspectives of Inuit women in Nunavut deserves further investigation in relation to other Arctic regions, both in Canada and in the larger circumpolar community.
Meeting the Health Care Needs of Elderly Métis Women in Buffalo Narrows, Saskatchewan
Authors: Krieg Brigette , Martz Diane
Published: August 2017

There is limited data, including health data, specific to the Métis population in Canada. As a result, the health issues and concerns of Métis communities—in particular Métis women—have largely been ignored in health research and in program and policy development. To address this dearth of information, a community-based research committee made up of Métis women initiated the Buffalo Narrows Métis Women’s Health Research Project. The goals of the project were to investigate the health care needs of elderly women and their caregivers in a northern and remote Saskatchewan Métis community. The project looked at barriers to health care service access in terms of accessibility, affordability, availability, acceptability and accommodation. Results showed that elderly Métis women experienced multiple, interconnected barriers to accessing health care services, making it difficult to isolate one variable as being more important than another. However, the Métis women interviewed did identify a number of recommendations to help in meeting the complex service needs of elderly women in the community. If implemented, these recommendations would help to ease the pressure put on extended family members who act as informal caregivers to elderly residents as well as giving elderly patients more independence and improving elderly women’s access to primary health care services.
The Intersecting Risks of Violence and HIV for Rural Aboriginal Women in a Neo-Colonial Canadian Context
Authors: Varcoe Colleen , Dick Sheila
Published: August 2017

An ethnographic study looking at the intersecting risks of violence and human immunodeficiency virus (HIV) for rural women shows that the neo-colonial and racist context of Canadian society creates particular challenges for Aboriginal women. This article focuses on the experiences of the Aboriginal women who took part in the study. These women’s experiences of violence occurred within a rural context of poverty and declining economic resources, and within a historical context of colonial abuses and cultural disruptions. Consequently, the women’s lives were often characterized by disconnection from family and community, making them vulnerable to further violence and exploitation. Social support programs in this rural setting were limited and access was sometimes problematic. Understanding how the intersecting dynamics of gender, rural living, poverty, racism, and colonialism create risk for Aboriginal women provides a basis for developing policies that aim to strengthen the well-being of women, particularly their economic well being. It also highlights the need for an anti-racist agenda within the social service and health care sectors and at all levels of government.
Aboriginal Midwifery: A Model for Change
Authors: Skye Amber D.
Published: August 2017

This paper will discuss indigenous knowledge and epistemologies of health and well-being as essential practices to improving the health status of Aboriginal communities. These methods will be illustrated through the practice of Aboriginal midwifery and birthing practices currently being revitalized in Aboriginal communities. Indigenous knowledge of health, well-being, medicine, and healing practices have historically sustained the health and well-being of Aboriginal communities for centuries pre-contact. However, these traditional epistemologies of health and healing have been eroded through centuries of colonial oppression and the imposition of western scientific methodologies and legislation. Through decades of acculturation, much of the traditional knowledge of health, medicine and healing has been lost. However, a recent resurgence of traditional Aboriginal midwifery has occurred in an effort to retain, revive and restore the indigenous knowledge of Aboriginal communities. The revival of traditional Aboriginal midwifery has resulted in the development of Aboriginal birthing centres that blend traditional knowledge, medicine and healing practices with contemporary medical services, to provide culturally significant maternal care services for Aboriginal women and families. Currently, there are Aboriginal birthing centres and services in, Nunavut, Quebec and Ontario. The high quality of community-based maternal care, access to culturally significant health services - utilizing traditional medicine and employing traditionally trained Aboriginal midwives has shown improved outcomes, impacting community healing, cultural revival, and community capacity building. The traditional methodologies employed by Aboriginal birthing centres will be detailed to exemplify the significance of indigenous knowledge and epistemologies of health in providing improved health care services to Aboriginal communities.
Tuberculosis and Colonialism: Current Tales about Tuberculosis and Colonialism in Nunavut
Authors: Møller Helle
Published: August 2017

The objective of this study was to examine Inuit experience and make meaning of tuberculosis (TB) and how this may relate to the prevalence of TB in Nunavut. The study was conducted through seven months of fieldwork in two Nunavut communities using ethnographic methods for data collection including interviews, observation, participant observation, and document review. The study found that Inuit participants made meaning of TB through a combination of biomedical and traditionally Inuit holistic explanations. The theme of colonialism recurred as an influence shaping the Inuit experience of TB, through socio-political effects of colonization, such as poverty and substance abuse, and through continuing colonialism, including offering public health education in culturally incongruent ways. Examples of discrimination within and outside the healthcare system were also described as effecting the Inuit experience of TB. In order to decrease the incidence of TB in Nunavut, decolonizing measures are necessary. Decolonizing measures include embracing Inuit ways and values in educational, health and political matters. In order for this to be possible and to reduce poverty, an infusion of funds from the federal government is needed. Euro Canadians working in the Nunavut healthcare system must also examine the assumptions, motivations and values that inform their work.
What Are the Odds? Community Readiness for Smoke-Free Bingos in First Nation Communities
Authors: Hutchinson Peter James , Bottorff Joan L. , Chambers Natalie , Mowatt Roberta , Wardman Dennis , Sullivan Debbie , Williams Wanda
Published: August 2017

Community members have identified second-hand smoke exposure among young women and children within First Nations communities as a concern. As part of a community-based research project, we analyzed experiences related to establishing smoke-free public spaces and the challenges related to smoking and bingo. The purpose of this study was to a) describe and compare community smoking at bingo in First Nations communities, and b) draw implications for assessing and supporting community readiness for comprehensive tobacco control policies (TCPs). Data were collected using individual interviews, group discussions, and observations in the community. The establishment of smoke-free public spaces in communities evolved out of concern by people traditionally responsible for the well-being of the community. Despite close proximity and similar socioeconomic contexts, readiness to extend these successes to bingos held in community halls was influenced by three main factors: a) economic drivers, b) the smoking majority, and c) grassroots support. Although models for assessing community readiness provide a useful starting point for understanding local TCP development and implementation in First Nations communities, other factors also need to be considered. Using a comprehensive approach to assessing  community readiness has the potential to increase success in extending TCPs and practices in First Nations communities in ways that are culturally relevant, address local conditions, and build on existing efforts.
Idealism “Must Not Blind Us”: British Legislators and the Palestine Mandate, 1929-1934
Authors: Ayers Amber
Published: August 2017

In Mandate Palestine during the 1920s and 1930s, the British sought to establish a legal system for the new political entity. This task was fraught with difficulty, as the British soon discovered. Events in Palestine often occurred in such an extreme manner that the British officials could not establish control. As a result of the failure of the legal system to address the new realities on the ground, these officials were often in a position where all they could do was respond to emergencies, as was the case following the Arab Revolt in August of 1929. Despite the fact that much of what occurred on the ground in Mandate Palestine, particularly with regard to land transactions and dispossessions, often occurred outside of British control, officials were acutely aware of the realities facing the Arab agricultural cultivators being threatened with dispossession. The difficulty the British had in suppressing the violence drew attention to their lack of authority over the land question that was creating tensions between the Arab and the Jewish populations. In examining minute sheets of the Colonial Office and correspondence between British officials, it becomes clear that these officials were aware of the impossibility of resolving the contradiction inherent in their position. This paper seeks to examine British responses immediately following the 1929 Revolt to show that the British accurately perceived the problems as they existed on the ground in Palestine but were unable to take actions against them. This will demonstrate the extent to which the failures of the Mandate, with regard to preventing dispossessions, was a failure of the legal system as a whole rather than the result of any individual shortcomings of the officials in control of the territory.
Romanticizing the Land: Agriculturally Imagined Communities in Palestine-Israel
Authors: Shutek Jennifer
Published: August 2017

This paper argues that images, and specifically agricultural images, play a significant role in the imaginings of the Israeli and Palestinian communities. Agriculture has symbolic and material value among Palestinians and Israelis, and contributes to identities and land claims made by Zionist and Palestinian organizations. Anderson’s discussion of nation building emphasizes the primacy of print in the imagination of a community; this paper highlights non-textual elements of nation building via case studies of the creation and dissemination of propaganda posters by the Jewish National Fund and the Popular Front for the Liberation of Palestine. A survey of propagandistic agricultural images reveals the shared symbols used by Palestinians and Israelis in forging identities and exclusive claims to land. Despite being common symbols from a shared past, agricultural images are crucial in creating and perpetuating a divide between Israelis and Palestinians, and in arguing for organic links between each group and the land of Palestine-Israel.
The Notion of Subhuman Identity in the War on Terror
Authors: Singh Jessica
Published: August 2017

Foreign policies in the global political arena continue to demonstrate the consequential after-effects of the terrorist attacks in New York on September 11, 2001. Propagations of a “terrorist threat” are strategically used by Western political actors to achieve a multiplicity of ends. In some cases, these ends supersede accepted international precedents, both in the realms of international law and convention. In particular, United States President George W. Bush’s War on Terror, and President Barak Obama’s continuing drone operations in the Middle East exemplify instances of political transcendence. Through the strategic enactment of ambiguous laws and through intimate utilizations of notions of “state sovereignty” and “national self-defense,” the American Government has gained unprecedented authority in the treatment of suspected terrorists. This article examines the legal, theoretical, and ethical elements of the War on Terror and the American drone operation in the Middle East to illustrate the exceptionalness of Al-Qaeda and Taliban combatants in American legal understanding.
CONFLITO, IDENTIDADE E DOIS SISTEMAS DE CLASSIFICAÇÕES: A INSTALAÇÃO DO ITA/CTA EM SÃO JOSÉ DOS CAMPOS
Authors: Da Silva Helena Alves , Papali Maria Aparecida Chaves Ribeiro , Guimarães Antonio Carlos Machado
Published: August 2017

Este trabalho tem como objetivo explorar as consequências da instalação do Instituto Técnico Aeronáutico – ITA e o CTA – Centro Técnico Aeronáutico na cidade de São José dos Campos no final da década de 1940. Por meio de depoimentos de homens e mulheres que viviam na cidade neste período e publicações de jornais, foi possível concluir que a instalação do ITA-CTA na cidade teve como consequência um conflito entre os moradores e os recém-chegados, em sua maioria estrangeiros, que impactaram a cidade causando um conflito de identidade e resultando em dois sistemas de classificação, percebido principalmente nos mercados, em que eram oferecidos preços diferentes para os moradores e os recém-chegados.
O PODER EM RELAÇÃO: REVISITANDO O CONCEITO DE PODER EM MICHEL FOUCAULT, NORBERT ELIAS E PIERRE BOURDIEU
Authors: Braghin Simone
Published: August 2017

O que é poder? Essa simples pergunta pode ter diversas respostas. Esse termo está em constante evidência social. Observamos discussões fabricadas sobre os poderes políticos, sobre “quem pode mais”, quem tem domínio, força, “direito” sobre algo. Em nível semântico, podemos encontrar mais de trinta definições de poder. Poder é um termo polissêmico; e sua utilização requer certo cuidado. Além disso, o poder é uma categoria analítica central nas ciências humanas. Ele não pode ser entendido como um termo fechado e imóvel pois conforme a ciência avança em níveis teóricos e empíricos, ele se movimenta. Desse modo, o objetivo desse trabalho é revisitar o conceito de poder nas obras de Michel Foucault, Norbert Elias e Pierre Bourdieu. Para isso, observamos os usos e disposições dessa categoria analítica, em cada autor, comparando o entendimento desse conceito em três eixos de relação de forças e dominação: entre sujeitos, grupos e campos.
Analysis of Third Party Loan Guarantee and Performance of Non-Prime Household Loans in Microfinance Banks in Kenya
Authors: Wachira Bernard Ndirangu , Omondi Humphrey Opiyo , Kinyanjui Josphat K. ,   Department of Business Management and Entrepreneurship, Karatina University, Karatina, Kenya.,   Department of Business Management and Entrepreneurship, Karatina University, Karatina, Kenya.,   Department of Mathematics and Actuarial Sciences, Karatina University, Karatina, Kenya.
Published: August 2017

Household loans remain the engine to productivity and economic growth globally. Non-prime household loan is essential, because it enables the borrowers with no collateral to access credit from Microfinance Banks. The survival and sustainability of non-prime household loans globally is therefore significant. Credit risk however remains the main deterrent of the soundness of Microfinance Banks. This leads to the poor performance of microfinance institutions in many economies in the world. Several countries globally are making inroad in reducing the credit risks, which lead to the poor performance of Microfinance Banks. It is still unknown why the credit risk affects the performance of non-prime household loans in the Microfinance Banks domiciled in Kenya. The reason for conducting this study is to determine the level at which the third party loan guarantee and the performance of non-prime household loans relate to the Microfinance Banks in Kenya. Particularly, this study is to determine how the amount secured by guarantee, recoveries from guarantors, percentage of loan secured, and percentage recoveries from guarantors relate to the performance of nonprime household loans in the Microfinance Banks in Kenya. The population was 516 senior management employees of the banks. The researcher conducted a multiple regression analysis for determining the relationship between the amount secured by guarantee—recoveries from guarantors, percentage granted, and percentage recoveries—and the performance of non-prime household loans. The R and R2 were used for determining the strength of the relationship and the coefficient of determination at 0.05 level of significance of variables. The result of this study reveals that there exists a strong relationship between the dependent and independent variables, thereby contradicting the null hypothesis, which states that the relationship does not exist. The percentage of the recoveries from the guarantors over the total recoveries did not have a strong relationship and was not significant. This study recommends the enhancement of the loan guarantee processes to reduce high loan default geared toward good performance of this loan so that it can be accessible to many people.
Successful Management of Early Peri‐Implant Infection and Bone Loss Using a Multidisciplinary Treatment Approach
Authors: Neely Anthony L. , Maalhagh‐Fard Ahmad
Published: August 2017

Introduction

Peri‐implant infections can occur any time postloading. Although management of peri‐implant infections has been described extensively in the literature, no consensus exists on the best approach to its treatment. Infections and bone loss can also occur around implants prior to loading, leading to early implant loss. Little has been reported on the management of peri‐implant infections occurring prior to loading. This report describes the identification as well as the surgical and restorative management of infection and bone loss around a preloaded dental implant.

Case Presentation

A 52‐year‐old systemically healthy, non‐smoking white female had severe inflammation with bleeding on probing and bone loss around implant #28 (Universal Numbering System) 7 weeks after placement and augmentation with autogenous and deproteinized bovine bone and a resorbable collagen membrane (RCM). Surgical exposure revealed a deep bony crater around the entire implant. The implant was cleaned for 4 to 5 minutes with a tetracycline and saline slurry. Guided bone regeneration was performed with demineralized freeze‐dried bone allograft and an RCM. Azithromycin, ibuprofen 800 mg three times daily, and 0.12% chlorhexidine gluconate rinse were given post‐surgery. Postoperative healing was uneventful. Nearly complete bone fill was noted at 1 year of observation when implants were permanently restored. A combination of screw‐ and cement‐retained restorations were placed. Tissues remained healthy 5.5 years postloading with maximum 3‐mm probing depth and no changes in bone levels.

Conclusions

This case shows that it is possible to arrest early peri‐implant infection, regenerate bone, and maintain health over 5.5 years postloading. Early detection and multidisciplinary care resulted in long‐term success.