| 1. |
- Aktar, Shaki, et al.
(författare)
-
Trends and risk of recurrent preterm birth in pregnancy cohorts in rural Bangladesh, 1990-2019
- 2023
-
Ingår i: BMJ Global Health. - : BMJ Publishing Group Ltd. - 2059-7908. ; 8:11
-
Tidskriftsartikel (refereegranskat)abstract
- Introduction: A history of preterm birth reportedly increases the risk of subsequent preterm birth. This association has primarily been studied in high-income countries and not in low-income settings in transition with rapidly descending preterm birth figures. We evaluated the population-based trends of preterm births and recurrent preterm births and the risk of preterm birth recurrence in the second pregnancy based on prospectively studied pregnancy cohorts over three decades in Matlab, Bangladesh.Methods: A population-based cohort included 72 160 live births from 1990 to 2019. We calculated preterm birth and recurrent preterm birth trends. We assessed the odds of preterm birth recurrence based on a subsample of 14 567 women with live-born singletons in their first and second pregnancies. We used logistic regression and presented the associations by OR with a 95% CI.Results: The proportion of preterm births decreased from 25% in 1990 to 13% in 2019. The recurrent preterm births had a similar, falling pattern from 7.4% to 3.1% across the same period, contributing 27% of the total number of preterm births in the population. The odds of second pregnancy preterm birth were doubled (OR 2.18; 95% CI 1.96 to 2.43) in women with preterm birth compared with the women with term birth in their first pregnancies, remaining similar over the study period. The lower the gestational age at the first birth, the higher the odds of preterm birth in the subsequent pregnancy (test for trend p<0.001).Conclusion: In this rural Bangladeshi setting, recurrent preterm births contributed a sizeable proportion of the total number of preterm births at the population level. The increased risk of recurrence remained similar across three decades when the total proportion of preterm births was reduced from 25% to 13%.
|
|
| 2. |
- Bergström, Anna, 1983-, et al.
(författare)
-
A facilitated social innovation : stakeholder groups using Plan-Do-Study-Act cycles for perinatal health across levels of the health system in Cao Bang province, Vietnam
- 2023
-
Ingår i: Implementation Science Communications. - : BioMed Central (BMC). - 2662-2211. ; 4:1
-
Tidskriftsartikel (refereegranskat)abstract
- BackgroundUniversal coverage of evidence-based interventions for perinatal health, often part of evidence-based guidelines, could prevent most perinatal deaths, particularly if entire communities were engaged in the implementation. Social innovations may provide creative solutions to the implementation of evidence-based guidelines, but successful use of social innovations relies on the engagement of communities and health system actors. This proof-of-concept study aimed to assess whether an earlier successful social innovation for improved neonatal survival that employed regular facilitated Plan-Do-Study-Act meetings on the commune level was feasible and acceptable when implemented on multiple levels of the health system (52 health units) and resulted in actions with plausibly favourable effects on perinatal health and survival in Cao Bang province, northern Vietnam.MethodsThe Integrated Promoting Action on Research Implementation in Health Services (i-PARIHS) framework guided the implementation and evaluation of the Perinatal Knowledge-Into-Practice (PeriKIP) project. Data collection included facilitators’ diaries, health workers’ knowledge on perinatal care, structured observations of antenatal care, focus group discussions with facilitators, their mentors and representatives of different actors of the initiated stakeholder groups and an individual interview with the Reproductive Health Centre director. Clinical experts assessed the relevance of the identified problems and actions taken based on facilitators’ diaries. Descriptive statistics included proportions, means, and t-tests for the knowledge assessment and observations. Qualitative data were analysed by content analysis.ResultsThe social innovation resulted in the identification of about 500 relevant problems. Also, 75% of planned actions to overcome prioritised problems were undertaken, results presented and a plan for new actions to achieve the group’s goals to enhance perinatal health. The facilitators had significant roles, ensuring that the stakeholder groups were established based on principles of mutual respect. Overall, the knowledge of perinatal health and performance of antenatal care improved over the intervention period.ConclusionsThe establishment of facilitated local stakeholder groups can remedy the need for tailored interventions and grassroots involvement in perinatal health and provide a scalable structure for focused efforts to reduce preventable deaths and promote health and well-being.
|
|
| 3. |
- Igra, Annachiara Malin, et al.
(författare)
-
Early Life Environmental Exposure to Cadmium, Lead, and Arsenic and Age at Menarche : A Longitudinal Mother-Child Cohort Study in Bangladesh
- 2023
-
Ingår i: Journal of Environmental Health Perspectives. - : Environmental Health Perspectives. - 0091-6765 .- 1552-9924. ; 131:2
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Several metals act as endocrine disruptors, but there are few large longitudinal studies about associations with puberty onset.OBJECTIVES: We evaluated whether early life cadmium, lead, and arsenic exposure was associated with timing of menarche. METHODS: In a mother-child cohort in rural Bangladesh (n = 935), the exposure was assessed by concentrations in maternal erythrocytes in early pregnancy and in girls' urine at 5 and 10 years of age using inductively coupled plasma mass spectrometry. The girls were interviewed twice, at aver-age ages 13.3 [standard deviation eth SD THORN = 0.43] and 13.8 (SD = 0.43) y, and the date of menarche, if present, was recorded. Associations were assessed using Kaplan-Meier analysis and multivariable-adjusted Cox regression.RESULTS: In total, 77% of the girls (n = 717) had reached menarche by the second follow-up. The median age of menarche among all girls was 13.0 y (25th-75th percentiles: 12.4-13.7 y). At 10 years of age, median urinary cadmium was 0.25 mu g/L (5th-95th percentiles: 0.087-0.72 mu g/L), lead 1.6 mu g/L (0.70-4.2 mu g/L), and arsenic 54 mu g/L (19-395 mu g/L). Given the same age, girls in the highest quartile of urinary cadmium at 5 and 10 years of age had a lower rate of menarche than girls in the lowest quartile, with an adjusted hazard ratio of (HR) 0.80 (95% CI: 0.62, 1.01) at 5 years of age, and 0.77 (95% CI: 0.60, 0.98) at 10 years of age. This implies that girls in the highest cadmium exposure quartile during childhood had a higher age at menarche. Comparing girls in the highest to the lowest quartile of urinary lead at 10 years of age, the former had a higher rate of menarche [adjusted HR = 1.23 (95% CI: 0.97, 1.56)], implying lower age at menarche, whereas there was no association with urinary lead at 5 years of age. Girls born to mothers in the highest quartile of erythrocyte arsenic during pregnancy were less likely to have attained menarche than girls born to mothers in the low-est quartile [adjusted HR = 0.79 (95% CI: 0.62, 0.99)]. No association was found with girls' urinary arsenic exposure.DISCUSSION: Long-term childhood cadmium exposure was associated with later menarche, whereas the associations with child lead exposure were inconclusive. Maternal exposure to arsenic, but not cadmium or lead, was associated with later menarche. https://doi.org/10.1289/EHP11121
|
|
| 4. |
- Adane, Abyot, et al.
(författare)
-
Routine health management information system data in Ethiopia : consistency, trends, and challenges
- 2021
-
Ingår i: Global Health Action. - : Taylor & Francis. - 1654-9716 .- 1654-9880. ; 14:1
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Ethiopia is investing in the routine Health Management Information System. Improved routine data are needed for decision-making in the health sector.Objective: To analyse the quality of the routine Health Management Information System data and triangulate with other sources, such as the Demographic and Health Surveys.Methods: We analysed national Health Management Information System data on 19 indicators of maternal health, neonatal survival, immunization, child nutrition, malaria, and tuberculosis over the 2012-2018 time period. The analyses were conducted by 38 analysts from the Ministry of Health, Ethiopia, and two government agencies who participated in the Operational Research and Coaching for Analysts (ORCA) project between June 2018 and June 2020. Using a World Health Organization Data Quality Review toolkit, we assessed indicator definitions, completeness, internal consistency over time and between related indicators, and external consistency compared with other data sources.Results: Several services reported coverage of above 100%. For many indicators, denominators were based on poor-quality population data estimates. Data on individual vaccinations had relatively good internal consistency. In contrast, there was low external consistency for data on fully vaccinated children, with the routine Health Management Information System showing 89% coverage but the Demographic and Health Survey estimate at 39%. Maternal health indicators displayed increasing coverage over time. Indicators on child nutrition, malaria, and tuberculosis were less consistent. Data on neonatal mortality were incomplete and operationalised as mortality on day 0-6. Our comparisons with survey and population projections indicated that one in eight early neonatal deaths were reported in the routine Health Management Information System. Data quality varied between regions.Conclusions: The quality of routine data gathered in the health system needs further attention. We suggest regular triangulation with data from other sources. We recommend addressing the denominator issues, reducing the complexity of indicators, and aligning indicators to international definitions.
|
|
| 5. |
-
Engaging with Work in English Studies : An Issue-Based Approach
- 2021
-
Samlingsverk (redaktörskap) (övrigt vetenskapligt/konstnärligt)abstract
- This edited book focuses on practices of work in late modern society, taking an ‘issue-based’ and interdisciplinary approach to English Studies which acknowledges the impact of globalization on the position of English in the daily existence of millions of people around the world. Envisioning English as “a diverse yet unified subject” where the study of literature, language, and education can be pursued thematically, it constitutes part of an ongoing transformation and revitalization of English Studies. It will be of interest to readers with backgrounds in linguistics, literature and education, as well as fields normally seen as lying ‘beyond’ English Studies such as psychology, sociology, philosophy, urban studies, political science and childhood studies.
|
|
| 6. |
- Henry, Alastair, 1963-, et al.
(författare)
-
Introduction : Engaging with Worki n Worlds of Change
- 2021
-
Ingår i: Engaging with Work in English Studies. - Cham : Springer Publishing Company. - 9783030697198 - 9783030697204 ; , s. 1-17
-
Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- In a globalized world, English Studies is in need of transformation. Serving as an introduction to the anthology, this chapter makes the case for an issue-based approach to English Studies where engagement is sought with fields beyond traditional disciplinary boundaries. From the position that English Studies can be understood as a form of participatory action — where English Studies is brought into the world and the world is brought into English Studies — the chapter examines practices of work in contemporary society, and previews the volume’s contributions.
|
|
| 7. |
- Pérez, Wilton, 1979-, et al.
(författare)
-
Trends and factors related to adolescent pregnancies : an incidence trend and conditional inference trees analysis of northern Nicaragua demographic surveillance data
- 2021
-
Ingår i: BMC Pregnancy and Childbirth. - : BioMed Central. - 1471-2393 .- 1471-2393. ; 21:1
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: We aimed to identify the 2001-2013 incidence trend, and characteristics associated with adolescent pregnancies reported by 20-24-year-old women.METHODS: A retrospective analysis of the Cuatro Santos Northern Nicaragua Health and Demographic Surveillance 2004-2014 data on women aged 15-19 and 20-24. To calculate adolescent birth and pregnancy rates, we used the first live birth at ages 10-14 and 15-19 years reported by women aged 15-19 and 20-24 years, respectively, along with estimates of annual incidence rates reported by women aged 20-24 years. We conducted conditional inference tree analyses using 52 variables to identify characteristics associated with adolescent pregnancies.RESULTS: The number of first live births reported by women aged 20-24 years was 361 during the study period. Adolescent pregnancies and live births decreased from 2004 to 2009 and thereafter increased up to 2014. The adolescent pregnancy incidence (persons-years) trend dropped from 2001 (75.1 per 1000) to 2007 (27.2 per 1000), followed by a steep upward trend from 2007 to 2008 (19.1 per 1000) that increased in 2013 (26.5 per 1000). Associated factors with adolescent pregnancy were living in low-education households, where most adults in the household were working, and high proportion of adolescent pregnancies in the local community. Wealth was not linked to teenage pregnancies.CONCLUSIONS: Interventions to prevent adolescent pregnancy are imperative and must bear into account the context that influences the culture of early motherhood and lead to socioeconomic and health gains in resource-poor settings.
|
|
| 8. |
- Persson, Åke, 1959-
(författare)
-
'Imagine being so suddenly useless' : Unemployment, Vulnerability and the Irish Financial Crash in Donal Ryan's The Spinning Heart
- 2021
-
Ingår i: Engaging with Work in English Studies. - Cham : Springer. - 9783030697198 - 9783030697204 ; , s. 21-44
-
Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- The economic boom in Ireland, referred to as the Celtic Tiger, resulted in a financial merry-go-round, where there were few restrictions controlling the financial institutions. This in turn created a financial bubble that ultimately burst, resulting in the financial crash in 2008. At both the individual and collective levels, the crash was devastating, causing severe unemployment and economic hardship, even poverty among many segments of the population, re-shaping the landscape of work in Ireland. This chapter explores the pain and vulnerability following the crash as represented in Donal Ryan’s novel The Spinning Heart (2012). The novel offers a hard-hitting critique of irresponsible constructors and employers, a reality ultimately made possible by a corrupt and dysfunctional political culture.
|
|
| 9. |
- Rahman, Anisur, 1962-, et al.
(författare)
-
A cohort study of the association between prenatal arsenic exposure and age at menarche in a rural area, Bangladesh
- 2021
-
Ingår i: Environment International. - : Elsevier. - 0160-4120 .- 1873-6750. ; 154
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Millions of individuals worldwide, particularly in Bangladesh, are exposed to arsenic, mainly through drinking water from tube wells. Arsenic is a reproductive toxicant, but there is limited knowledge of whether it influences pubertal development.Objectives: We evaluated the association between prenatal arsenic exposure and age at menarche.Methods: This prospective study was based on data from two studies conducted in Matlab, Bangladesh-the Maternal and Infant Nutrition Interventions in Matlab (MINIMat) trial and the Health Consequences of Arsenic in Matlab (AsMat) study. We included 809 MINIMat girls who participated in assessing age at menarche from July 2016 to June 2017 and had prenatal arsenic exposure data through the AsMat study via measurements in tube well water used by the mothers during pregnancy. The exposure was categorized into <10, 10-49, 50-99, 100-199, and >= 200 mu g/L. We used Kaplan-Meier and Cox proportional hazards analyses with adjustment for potential confounders to evaluate the association between arsenic exposure and age at menarche. The results were presented by adjusted hazards ratio (aHR) with a 95% confidence interval (CI).Results: The median arsenic concentration in tube well water consumed by pregnant women was 80 mu g/L (interquartile range 2-262 mu g/L), and 55% drank water with concentrations above Bangladesh's acceptable value of 50 mu g/L. The median age at menarche was 13.0 years. The unadjusted analysis revealed 3.2 months delay in menarche for girls exposed to arsenic concentrations >= 200 mu g/L compared with the girl exposed to arsenic concentrations <10 mu g/L. Girls exposed to the same higher arsenic concentrations were 23% (aHR 0.77, 95% CI: 0.63-0.95) less likely to have reached menarche than girls exposed to low arsenic concentrations.Conclusions: Increased levels of prenatal arsenic exposure were associated with older age at menarche. This delay may indicate endocrine disruptions that could potentially result in adverse health consequences in later life. This finding, along with other severe adverse health reinforces the need for arsenic mitigation at the population level.
|
|
| 10. |
- Källestål, Carina, 1954-, et al.
(författare)
-
Assessing the Multiple Dimensions of Poverty : Data Mining Approaches to the 2004-14 Health and Demographic Surveillance System in Cuatro Santos, Nicaragua
- 2020
-
Ingår i: Frontiers In Public Health. - : FRONTIERS MEDIA SA. - 2296-2565. ; 7
-
Tidskriftsartikel (refereegranskat)abstract
- We identified clusters of multiple dimensions of poverty according to the capability approach theory by applying data mining approaches to the Cuatro Santos Health and Demographic Surveillance database, Nicaragua. Four municipalities in northern Nicaragua constitute the Cuatro Santos area, with 25,893 inhabitants in 5,966 households (2014). A local process analyzing poverty-related problems, prioritizing suggested actions, was initiated in 1997 and generated a community action plan 2002-2015. Interventions were school breakfasts, environmental protection, water and sanitation, preventive healthcare, home gardening, microcredit, technical training, university education stipends, and use of the Internet. In 2004, a survey of basic health and demographic information was performed in the whole population, followed by surveillance updates in 2007, 2009, and 2014 linking households and individuals. Information included the house material (floor, walls) and services (water, sanitation, electricity) as well as demographic data (birth, deaths, migration). Data on participation in interventions, food security, household assets, and women's self-rated health were collected in 2014. A K-means algorithm was used to cluster the household data (56 variables) in six clusters. The poverty ranking of household clusters using the unsatisfied basic needs index variables changed when including variables describing basic capabilities. The households in the fairly rich cluster with assets such as motorbikes and computers were described as modern. Those in the fairly poor cluster, having different degrees of food insecurity, were labeled vulnerable. Poor and poorest clusters of households were traditional, e.g., in using horses for transport. Results displayed a society transforming from traditional to modern, where the forerunners were not the richest but educated, had more working members in household, had fewer children, and were food secure. Those lagging were the poor, traditional, and food insecure. The approach may be useful for an improved understanding of poverty and to direct local policy and interventions.
|
|
