1,720,969 research outputs found
Effect of Antenatal Depressive Symptoms on Women’s Access to Healthcare and Perinatal Complications: A Population-Based Study in Rural Ethiopia
No full textBackground
Maternal Mortality in Low and Middle Income Countries (LMICs) remains a major public
health challenge despite the encouraging achievement of the fifth Millennium Development
Goal (MDG-5). Almost all (99.0%) of the global maternal deaths occur in LMICs where
there are high resource constraints and low access to health care services. In Sub-Saharan
Africa, more than half of perinatal women have no access to maternal healthcare services.
The situation is reflected in Ethiopia where only 34% of women attended for antenatal care
(ANC) and skilled practitioners attended only 26% of deliveries in 2015. Mental disorders,
especially depressive disorders, are also common affecting about one in seven perinatal
women. Perinatal depression has been shown to be an independent risk factor for maternal
healthcare service utilisation on behalf of the child but there has been little exploration of its
potential impact on utilisation of maternal healthcare services.
Objective
The main objective of this study was to investigate the impact of antenatal depressive
symptoms on utilisation of maternal healthcare services (antenatal care, uptake of
institutional delivery and postnatal care use) and its effect on perinatal complications.
Methods
Study Design: The study that formed the basis of this thesis was a population-based study
that comprises three sub-studies linked to three main outcomes. Sub-study-I was a crosssectional study carried out at the initiation of the prospective study. Sub-study-II and III were
prospective follow-ups of participants identified with probable depression in sub-study-I to
assess impact of depressive symptoms on (a) institutional delivery and postnatal care use; b)
perinatal complications respectively.
Participants: The participants were pregnant women in their second and third trimester
residing in Sodo District, Gurage Zone, Southern Nations, Nationalities and Peoples Region
of Ethiopia. Eligibility Criteria included: (1) Age 15 years and above; (2) permanent
residence as defined by continuous residence in the area for at least the preceding six months;(3) Able to provide informed consent; (4) Not having hearing or cognitive impairment to the
extent of impairing capacity to give informed consent or to communicate adequately.
Assessments: During baseline assessment, at the second and third trimesters of pregnancy,
participants were screened for antenatal depressive symptoms and background demographic
and socio-economic information along with other potential confounders such as intimate
partner violence, social support, history of chronic medical conditions and adverse perinatal
outcomes. Antenatal depressive symptoms were assessed using a locally validated version of
the Patient Health Questionnaire-9 (PHQ-9). Participants scoring five or more on the PHQ-9
were considered to have probable antenatal depression. ANC attendance and pregnancy
related emergency healthcare visits were cross-sectional outcomes that were assessed as part
of the initial baseline assessment. At a median of eight weeks after childbirth, the
participants were re-interviewed about their place of delivery, attendance of postnatal care
services and whether they had experienced an of perinatal and postpartum complications.
Statistical Analysis: Poisson and Negative binomial regression models were used for crosssectional evaluation of the association of antenatal depressive symptoms with antenatal
service use and pregnancy related emergency healthcare provider visits. Binary logistic
regression was used to examine the association of antenatal depressive symptoms with early
initiation and adequacy of ANC services. Binary logistic regression was also used to
examine association of antenatal depressive symptoms with uptake of institutional delivery,
having assisted delivery and women’s experience of perinatal complications.
Results
Participant Characteristics: Among study participants, 98.7% were married, 67.5% were
non-literate, 92.2% were rural residents and the mean age of the participants was 26.8 years.
The majority (64.8%) of women initiated ANC visits (37.0% by 16 weeks gestation) and
nearly two-thirds (62.3%) delivered in healthcare institutions.
Baseline (Cross-sectional) Study: At PHQ-9 cut-off of five or more, 29.5% of baseline
participants and 28.7% of followed up participants had probable antenatal depression.
Women with depressive symptoms had an increased risk of having greater number of unscheduled ANC visits (adjusted Risk Ratio (aRR)=1.41, 95% CI: 1.20, 1.65). These group of
women also had an increased number of emergency healthcare provider visits to bothtraditional healthcare providers (aRR=1.64, 95% CI: 1.17, 2.31) and biomedical healthcare
providers (aRR=1.31, 95% CI: 1.04, 1.69) for pregnancy-related emergencies.
Prospective Studies: Women with probable antenatal depression also had increased odds of
reporting institutional birth [adjusted Odds Ratio (aOR) =1.42, 95% Confidence Interval
(CI): 1.06, 1.92] and increased odds of reporting having had an assisted delivery (aOR=1.72,
95% CI: 1.10, 2.69) than women without these symptoms. In sub-group analysis of women
with institutional deliveries, the increased odds of institutional delivery was associated with
emergency reasons during labour (aOR = 1.62, 95% CI: 1.09, 2.42) rather than pre-planning
to deliver in healthcare institutions. Furthermore, there was increased odds of pregnancy
(OR=2.44, 95% CI: 1.84, 3.23), labour (OR= 1.84 95% CI: 1.34, 2.53) and postpartum
(OR=1.70, 95% CI: 1.23, 2.35) complications among these group of women compared to
women without antenatal depressive symptoms. However, antenatal depressive symptoms
were not significantly associated with early initiation of ANC or postnatal care visits,
pregnancy loss or neonatal mortality.
Conclusion
Establishment of a system for detection, referral and treatment of antenatal depression,
integrated within existing antenatal care, has the potential to reduce treatment costs and
promote efficiency of the health care system through increased use of scheduled ANC and
planned uptake of institutional delivery. It also has potential to reduce perinatal
complications, thus contributing to a reduction in maternal morbidity and mortality, as well
as improved neonatal health. But, further studies should ensure whether early detection and
treatment of depressive symptoms may reduce the risk of perinatal complications
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Full text linkWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
koamabayili/VECTRON-author-checklist: VECTRON author checklist
No full textWe have done our best to complete the author checklist relating to the use of animals in the hut study. Note that the objective for the hut study was to evaluate the IRS treatment applications for residual efficacy against Anopheles mosquitoes, including the local An. coluzzii mosquito population. Cows were only used to attract mosquitoes into the huts and no tests were carried out directly on the cows. The author checklist is intended for use with studies where experiments are carried out on animals, which is why we have had such difficulty in completing this for the hut study, as many of the questions do not relate to how the cows were used
Author-wise bibliometric analysis based on entropy.
No full textAuthor-wise bibliometric analysis based on entropy.</p
Author Under Sail The Imagination of Jack London, 1893-1902
No full textIn Author Under Sail, Jay Williams offers the first complete literary biography of Jack London as a professional writer engaged in the labor of writing. It examines the authorial imagination in London's work, the use of imagination in both his fiction and nonfiction, and the ways he defined imagination in the creative process in his business dealings with his publishers, editors, and agents. In this first volume of a two-volume biography, Williams traverses the years 1893 to 1902, from London's "Story of a Typhoon" to The People of the Abyss. The Jack London who emerges in the pages of Author Under Sail is a writer whose partnership with publishers, most notably his productive alliance with George Brett of Macmillan, was one of the most formative in American literary history. London pioneered many author models during the heyday of realism and naturalism, blurring the boundaries of these popular genres by focusing on absorption and theatricality and the representation of the seen and unseen. London created an impassioned, sincere, and extremely personal realism unlike that of other American writers of the time. Author Under Sail is a literary tour de force that reveals the full range of London as writer, creative citizen, and entrepreneur at the same time it sheds light on the maverick side of machine-age literature.Intro -- Title Page -- Copyright Page -- Dedication -- Contents -- Acknowledgments -- Introduction -- 1. Spirit Truth -- 2. From Absorption to Theatricality and Back Again -- 3. "I Will Build a New Present" -- 4. Sons as Authors -- 5. Fathers as Publishers -- 6. The Daughter as Author -- 7. Lovers as Authors -- 8. At Sea with the Family -- 9. Yellow News, Yellow Stories -- 10. The Return Home -- Notes -- Bibliography -- Index -- About Jay WilliamsIn Author Under Sail, Jay Williams offers the first complete literary biography of Jack London as a professional writer engaged in the labor of writing. It examines the authorial imagination in London's work, the use of imagination in both his fiction and nonfiction, and the ways he defined imagination in the creative process in his business dealings with his publishers, editors, and agents. In this first volume of a two-volume biography, Williams traverses the years 1893 to 1902, from London's "Story of a Typhoon" to The People of the Abyss. The Jack London who emerges in the pages of Author Under Sail is a writer whose partnership with publishers, most notably his productive alliance with George Brett of Macmillan, was one of the most formative in American literary history. London pioneered many author models during the heyday of realism and naturalism, blurring the boundaries of these popular genres by focusing on absorption and theatricality and the representation of the seen and unseen. London created an impassioned, sincere, and extremely personal realism unlike that of other American writers of the time. Author Under Sail is a literary tour de force that reveals the full range of London as writer, creative citizen, and entrepreneur at the same time it sheds light on the maverick side of machine-age literature.Description based on publisher supplied metadata and other sources.Electronic reproduction. Ann Arbor, Michigan : ProQuest Ebook Central, YYYY. Available via World Wide Web. Access may be limited to ProQuest Ebook Central affiliated libraries
- …
