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Background: In low-income nations, high-risk fertility behavior is a prevalent public health concern that can be ascribed to unmet family planning needs, child marriage, and a weak health system. As a result, this study aimed to determine the factors that influence high-risk fertility behavior and its impact on child stunting and anemia. Method: This study relied on secondary data sources from recent demography and health surveys of nine east African countries. Relevant data were extracted from Kids Record (KR) files and appended for the final analysis; 31,873 mother-child pairs were included in the final analysis. The mixed-effect logistic regression model (fixed and random effects) was used to describe the determinants of high-risk fertility behavior (HRFB) and its correlation with child stunting and anemia. Result: According to the pooled study about 57.6% (95% CI: 57.7 to 58.2) of women had at least one high-risk fertility behavior, with major disparities found across countries and women's residences. Women who lived in rural areas, had healthcare access challenges, had a history of abortion, lived in better socio-economic conditions, and had antenatal care follow-up were more likely to engage in high-risk fertility practices. Consequently, Young maternal age at first birth (<18), narrow birth intervals, and high birth orders were HRFBs associated with an increased occurrences of child stunting and anemia. Conclusion: This study revealed that the magnitude of high-risk fertility behavior was higher in east Africa region. The finding of this study underscores that interventions focused on health education and behavioral change of women, and improvement of maternal healthcare access would be helpful to avert risky fertility behaviors. In brief, encouraging contraceptive utilization and creating awareness about birth spacing among reproductive-age women would be more helpful. Meanwhile, frequent nutritional screening and early intervention of children born from women who had high-risk fertility characteristics are mandatory to reduce the burden of chronic malnutrition. [ABSTRACT FROM AUTHOR]

Background. Diarrheal diseases are the leading cause of preventable death, especially among under-five children in developing countries, including Ethiopia. Although efforts have been made to reduce the morbidity and mortality resulting from diarrheal diseases, there is scarce information on the progress of the interventions against the burdens. Therefore, this study aimed to assess the prevalence of diarrhea and its associated factors in under-five children in Horo Guduru Wollega Zone, Oromia Region, Western Ethiopia. Methods. A community-based cross-sectional study was conducted. Of 12,316 households, 620 households that had under-five children were selected by simple random sampling technique from randomly selected kebeles. Before data collection, a pretest of the structured questionnaires was done on nonselected kebeles. Binary logistic regression was used to assess the association of the diarrheal diseases with independent variables. Finally, the odds ratio along with a 95% confidence interval was used to report the significant association between the outcome variable and its associated factors. A P value of ≤0.05 was considered statistically significant Results. The prevalence of diarrhea among under-five children was 149 (24%) (95% CI: 20.8, 27.3). Diarrhea was significantly associated with poor knowledge of mothers/caretakers on diarrhea prevention methods (AOR: 2.05, 95% CI (1.14, 3.69), being in the age group of 6–11(AOR = 1.546 (1.68, 3.52), and 12–23 months (AOR = 1.485 (1.84, 2.63)), families with poor wealth index (AOR: 2.41, 95% CI (1.29, 4.51)), children who were not vaccinated against measles (AOR: 4.73, 95% CI (2.43, 9.20)), unsafe child feces disposal (AOR = 3.75; 95% CI (1.91, 7.39)), inappropriate liquid waste disposal (AOR = 3.73 (1.94, 7.42)), and having two or more siblings (AOR: 3.11, 95% CI (1.81, 5.35)). Conclusion and Remarks. The prevalence of diarrhea among under-five children was high. There was a statistically significant association between diarrhea and age of the child (6–11 and 12–23), poor knowledge of mothers/caretakers on diarrhea prevention methods, families with poor wealth index, being unvaccinated against measles, improper liquid waste disposal, unsafe child feces disposal, and having at least two siblings. The findings have a significant policy inference for childhood diarrheal disease prevention programs. Therefore, educating mothers/caregivers on diarrheal disease prevention methods, child spacing, regular hand washing practice after disposing child feces, safely disposing liquid waste, and vaccinating all eligible children against measles should be a priority area of intervention for diarrheal disease prevention. Moreover, since these associated factors are preventable, the government needs to strengthen the health extension workers program implementations to reduce childhood diarrhea. [ABSTRACT FROM AUTHOR]

Objective: Dietary pattern analysis constitutes a suitable method for identifying complex food preferences as well as a useful tool for comparing dietary behaviour across individual populations. In addition to a lack of information on Central European dietary patterns, dietary data featuring a longitudinal aspect are likewise largely unavailable for the region. Our study thus strives to address this gap by analysing children's dietary patterns, their stability and possible changes at 7, 11 and 15 years in the Czech part of the European Longitudinal Study of Pregnancy and Childhood (ELSPAC-CZ).Design: We analysed dietary data based on the self-reported semi-quantitative FFQ obtained in 1998, 2002 and 2006. Dietary patterns were derived using factor analysis for each period, followed by the determination of dietary pattern stability across the individual periods.Setting: The analysis of dietary patterns was based on longitudinal children's dietary data from the geographical region that was undergoing massive socio-economic changes at the time of birth of the study subjects.Participants: All participants were children. At 7 years the analysis included 3220 children, at 11 years the analysis included 2509 children and at 15 years the analysis included 1589 children.Results: Two stable children's dietary patterns labelled as 'prudent' and 'junk food' were identified across all three time points (7, 11 and 15 years).Conclusions: This study identifies stable longitudinal trends in the dietary behaviour of children enrolled in the ELSPAC-CZ study. [ABSTRACT FROM AUTHOR]

Background. Promotion of health is vital for the optimal growth and development of every infant. Globally, many infants died due to common problems such as diarrhoea and respiratory infection; most of these problems are related to inadequate breast feeding, improper complimentary feeding, lack of immunization, and home accident. Infant and child health status depends upon mothers' knowledge and practice regarding health promotional measures. This study aimed to determine practice and its determinants regarding health promotional measures of infant with 6–12 months age amongst the mothers attending Pediatrics Outpatient Department of Universal College of Medical Science and Teaching Hospital, Bhairahawa, Rupandehi, Nepal. Methods. Hospital-based cross-sectional study was conducted in Universal College of Medical Science, Bhairahawa, Rupandehi, Nepal, among 414 mothers attending pediatrics outpatient department from September 2019–March 2020. Purposive sampling technique was used to select mothers of infants aged 6–12 months. Bivariate analysis was used primarily to assess the association between dependent and independent variables. Variables which were associated in bivariate analysis with p < 0.05 were entered into a multivariable logistic regression model to identify associated factors of health promotional measures. The goodness of fit of multivariate logistic regression was checked by Nagelkerke R square and variation inflation factor. Results. The mean age and family size was 25.89 ± 4.81 years and 5.94 ± 2.48, respectively. A total of 71.5% mothers have good practice of health promotional measures. Mothers from Dalit caste (adjusted odds ratio = 0.04, confidence interval: 0.005–0.30), mothers with below school leaving certificate education (AOR = 0.08, CI: 0.02–0.27), fathers engaged in nonagricultural work (AOR = 7.21, CI: 2.59–20.11), birth space of index child greater than 2 years (AOR = 12.88, CI: 3.49–47.58), and family monthly income greater than 20000 Nepalese rupees (AOR = 3.29, CI: 1.16–13.32 were significantly associated with good practice of health promotional measures. Conclusions. More than one-fourth of the mothers have poor practice of health promotional measures. Ethnicity, mothers' education, fathers' occupation, birth space of index child, and family monthly income were found to be independent determinants of practice of health promotion measures. Thus, policy makers should provide specific education regarding health promotional measures to both parents. [ABSTRACT FROM AUTHOR]

Cerebellar granule cells (GrCs) are usually regarded as a uniform cell type that collectively expands the coding space of the cerebellum by integrating diverse combinations of mossy fiber inputs. Accordingly, stable molecularly or physiologically defined GrC subtypes within a single cerebellar region have not been reported. The only known cellular property that distinguishes otherwise homogeneous GrCs is the correspondence between GrC birth timing and the depth of the molecular layer to which their axons project. To determine the role birth timing plays in GrC wiring and function, we developed genetic strategies to access early- and late-born GrCs. We initiated retrograde monosynaptic rabies virus tracing from control (birth timing unrestricted), early-born, and late-born GrCs, revealing the different patterns of mossy fiber input to GrCs in vermis lobule 6 and simplex, as well as to early- and late-born GrCs of vermis lobule 6: sensory and motor nuclei provide more input to early-born GrCs, while basal pontine and cerebellar nuclei provide more input to late born GrCs. In vivo multi depth two-photon Ca2+ imaging of axons of early- and late-born GrCs revealed representations of diverse task variables and stimuli by both populations, with modest differences in the proportions encoding movement, reward anticipation, and reward consumption. Our results suggest neither organized parallel processing nor completely random organization of mossy fiber→GrC circuitry but instead a moderate influence of birth timing on GrC wiring and encoding. Our imaging data also provide evidence that GrCs can represent generalized responses to aversive stimuli, in addition to recently described reward representations. [ABSTRACT FROM AUTHOR]

In this paper, we describe a population of mothers who are opioid dependent at the time of giving birth and neonates exposed to opioids in utero who experience withdrawal following birth. While there have been studies of national trends in this population, there remains a gap in studies of regional trends. Using data from the Arizona Department of Health Services Hospital Discharge Database, this study aimed to characterize the population of neonates with neonatal opioid withdrawal syndrome (NOWS) and mothers who were opioid dependent at the time of giving birth, in Arizona. We analyzed approximately 1.2 million electronic medical records from the Arizona Department of Health Services Hospital Discharge Database to identify patterns and disparities across socioeconomic, ethnic, racial, and/or geographic groupings. In addition, we identified comorbid conditions that are differentially associated with NOWS in neonates or opioid dependence in mothers. Our analysis was designed to assess whether indicators such as race/ethnicity, insurance payer, marital status, and comorbidities are related to the use of opioids while pregnant. Our findings suggest that women and neonates who are non-Hispanic White and economically disadvantaged, tend be part of our populations of interest more frequently than expected. Additionally, women who are opioid dependent at the time of giving birth are unmarried more often than expected, and we suggest that marital status could be a proxy for support. Finally, we identified comorbidities associated with neonates who have NOWS and mothers who are opioid dependent not previously reported. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effect of interpregnancy interval (IPI) on preterm birth (PTB) according to whether the previous birth was preterm or term. Design: Cohort study. Setting: USA (California), Australia, Finland, Norway (1980–2017). Population: Women who gave birth to first and second (n = 3 213 855) singleton livebirths. Methods: Odds ratios (ORs) for PTB according to IPIs were modelled using logistic regression with prognostic score stratification for potential confounders. Within‐site ORs were pooled by random effects meta‐analysis. Outcome measure: PTB (gestational age <37 weeks). Results: Absolute risk of PTB for each IPI was 3–6% after a previous term birth and 17–22% after previous PTB. ORs for PTB differed between previous term and preterm births in all countries (P‐for‐interaction ≤ 0.001). For women with a previous term birth, pooled ORs were increased for IPI <6 months (OR 1.50, 95% CI 1.43–1.58); 6–11 months (OR 1.10, 95% CI 1.04–1.16); 24–59 months (OR 1.16, 95% CI 1.13–1.18); and ≥ 60 months (OR 1.72, 95%CI 1.60–1.86), compared with 18–23 months. For previous PTB, ORs were increased for <6 months (OR 1.30, 95% CI 1.18–1.42) and ≥60 months (OR 1.29, 95% CI 1.17–1.42), but were less than ORs among women with a previous term birth (P < 0.05). Conclusions: Associations between IPI and PTB are modified by whether or not the previous pregnancy was preterm. ORs for short and long IPIs were higher among women with a previous term birth than a previous PTB, which for short IPI is consistent with the maternal depletion hypothesis. Given the high risk of recurrence and assuming a causal association between IPI and PTB, IPI remains a potentially modifiable risk factor for women with previous PTB. Short versus long interpregnancy intervals associated with higher ORs for preterm birth (PTB) after a previous PTB. Short versus long interpregnancy intervals associated with higher ORs for preterm birth (PTB) after a previous PTB. [ABSTRACT FROM AUTHOR]

The aims of the study were to explore the contraceptive practices of married adolescent girls in rural Upper Egypt and identify the determinants of their ever use of modern contraception. The study was a household survey of 729 married adolescent girls in 23 villages of two governorates in Upper Egypt. Listing and enumeration of all households in the selected villages were performed prior to data collection, to recruit married adolescent girls below 20 years of age. The girls were interviewed using a structured questionnaire. Only 6% of married adolescent girls were using a modern contraceptive method; 10.6% had ever used a modern contraceptive method, mostly a short-acting method. Considerable proportions of participants believed that using contraception would reduce a woman's fertility and that women should not delay their first pregnancy (34% and 54.3%, respectively); only 50.2% believed that contraception could be used for birth spacing. Predictors of the ever use of a modern method of contraception among married adolescent girls were: accepting that contraception could be used for birth spacing (B = 1.82, p <.001), older age (B = 0.42, p <.01), better reproductive health knowledge (B = 0.23, p <.05) and sharing in contraceptive decision making (B = 0.55, p <.05). Married adolescent girls' current use and ever use of modern contraception were very low in rural Upper Egypt. Changing the social norms to create the desire to delay first childbirth, improving adolescent girls' reproductive health knowledge, correcting myths about contraception and building girls' agency to use contraception may increase their contraceptive use. [ABSTRACT FROM AUTHOR]

Background: This study was designed with the objective to evaluate the fundamental risk factors of malnutrition among children in Lahore city and its outskirts, Pakistan. Methods: Data of four hundred and five children with age group less than 5 years was collected from Children hospital and Jinnah hospital, Lahore. We used weight-for-height anthropometric index, designed by World Health Organization (WHO), to measure the nutritional status of children. Preliminary analysis was performed by using Pearson Chi-square and Gamma statistics to check the association between factors (demographic, socio-economic and health related variables) and response variable i.e., nutritional status. Then, proportional odds model (POM) was fitted to the information collected. Results: Of 405 children included in the study, 33% (135) were found malnourished, whereas, approximately 67% (270) were found nourished. Findings of the study revealed that child's age, maternal education level, socioeconomic status, maternal age at the birth of child, low birth spacing, status of antenatal-postnatal care, incomplete vaccinations, exclusive breastfeeding, prevalence of fever, cough and recurrent episodes of diarrhea were the significant risk factors of malnutrition. Prevalence of acute respiratory infection (ARI) was turned out to be insignificant risk factor. In this study, parallel lines assumption was satisfied and proportional odds model was fitted well with pvalue greater than 5% level of significance. Conclusion: This paper highlights the significant risk factors that are affecting the child's health. Recognizing and understanding the identified risk factors would be very helpful in prevention of malnutrition in Pakistan. [ABSTRACT FROM AUTHOR]

Approximately 90% of tuberculosis (TB) cases among non-US-born persons in the United States are attributable to progression of latent TB infection to TB disease. Using survival analysis, we investigated whether birthplace is associated with time to disease progression among non-US-born persons in whom TB disease developed. We derived a Cox regression model comparing differences in time to TB diagnosis after US entry among 19 birth regions, adjusting for sex, birth year, and age at entry. After adjusting for age at entry and birth year, the median time to TB diagnosis was lowest among persons from Middle Africa, 128 months (95% CI 116-146 months) for male persons and 121 months (95% CI 108-136 months) for female persons. We found time to TB diagnosis among non-US-born persons varied by birth region, which represents a prognostic indicator for progression of latent TB infection to TB disease. [ABSTRACT FROM AUTHOR]

Contraceptive prevalence in Pakistan has plateaued near 34 percent for over a decade, suggesting that fertility levels are likely to stay high unless effective interventions are designed. We evaluate the Family Advancement for Life and Health 2007–2012 (FALAH), a family planning project implemented in 31 districts of Pakistan. Deviating from previous programs, FALAH emphasized birth spacing—as opposed to limiting family size—as the primary purpose of contraceptive use. We use Pakistan Demographic and Health Survey to evaluate FALAH's impact on continuous and binary measures of birth intervals. To estimate the causal effects of the project, we compare the outcomes for multiple children born to the same mother before and after the project. We find that FALAH increased interbirth intervals by 2.4 months on average and reduced the proportion of short birth intervals by approximately 7.1 percentage points. This finding suggests that birth spacing as a goal of contraceptive use may resonate better with Pakistani couples than limiting family size. The project's effects were more pronounced for women with high education, in rural areas, and in the middle of the wealth distribution. [ABSTRACT FROM AUTHOR]

Birth timing is a key life‐history characteristic that influences fitness and population performance. For migratory animals, however, appropriately timing birth on one seasonal range may be constrained by events occurring during other parts of the migratory cycle. We investigated how the use of capital and income resources may facilitate flexibility in reproductive phenology of migratory mule deer in western Wyoming, USA, over a 5‐yr period (2015–2019). Specifically, we examined how seasonal interactions affected three interrelated life‐history characteristics: fetal development, birth mass, and birth timing. Females in good nutritional condition at the onset of winter and those that migrated short distances had more developed fetuses (measured as fetal eye diameter in March). Variation in parturition date was explained largely by fetal development; however, there were up to 16 d of plasticity in expected birth date. Plasticity in expected birth date was shaped by income resources in the form of exposure to spring green‐up. Although individuals that experienced greater exposure to spring green‐up were able to advance expected birth date, being born early or late with respect to fetal development had no effect on birth mass of offspring. Furthermore, we investigated the trade‐offs migrating mule deer face by evaluating support for existing theory that predicts that births should be matched to local peaks in resource availability at the birth site. In contrast to this prediction, only long‐distance migrants that paced migration with the flush of spring green‐up, giving birth shortly after ending migration, were able to match birth with spring green‐up. Shorter‐distance migrants completed migration sooner and gave birth earlier, seemingly trading off more time for offspring to grow and develop over greater access to resources. Thus, movement tactic had profound downstream effects on birth timing. These findings highlight a need to reconsider classical theory on optimal birth timing, which has focused solely on conditions at the birth site. [ABSTRACT FROM AUTHOR]

From the 1960s, rising divorce rates forced a re-thinking of family dynamics beyond the nuclear. Traditionally, experts and the public had presumed that children from 'broken homes' typically drifted into juvenile delinquency and crime. Children of divorce were blamed for a plethora of social problems. The increasingly common nature of divorce meant that this model was no longer sustainable. Post-war children of divorce were more likely to be framed as 'emotionally vulnerable' and studied in more nuanced ways, not least because it seemed increasingly obvious that not all affected children grew up delinquent. However, a new consensus emerged that problems could only be avoided if parents created appropriate emotional conditions while separating and divorcing, and if parents and children openly communicated their feelings throughout the process. Children themselves were actively encouraged, through a new genre of divorce manuals often aimed at them, to express their emotions with parents and friends. Using Britain as a case study, this article argues that emotions became central to discussion of divorce in the post-war period, placing onuses on breaking down families to create a positive emotional space for affected children. [ABSTRACT FROM AUTHOR]

Interpregnancy interval (IPI) is associated with adverse perinatal outcomes, but its contribution to severe maternal morbidity (SMM) remains unclear. We examined the association between IPI and SMM, using data linked across sequential pregnancies to women in California during 1997–2012. Adjusting for confounders measured in the index pregnancy (i.e. the first in a pair of consecutive pregnancies), we estimated adjusted risk ratios for SMM related to the subsequent pregnancy. We further conducted within-mother comparisons and analyses stratified by parity and maternal age at the index pregnancy. Compared with an IPI of 18–23 months, an IPI of <6 months had the same risk for SMM in between-mother comparisons (adjusted risk ratio (aRR) = 0.96, 95% confidence interval (CI): 0.91, 1.02) but lower risk in within-mother comparisons (aRR = 0.76, 95% CI: 0.67, 0.86). IPIs of 24–59 months and ≥60 months were associated with increased risk of SMM in both between-mother (aRR = 1.18 (95% CI: 1.13, 1.23) and aRR = 1.76 (95% CI: 1.68, 1.85), respectively) and within-mother (aRR = 1.22 (95% CI: 1.11, 1.34) and aRR = 1.88 (95% CI: 1.66, 2.13), respectively) comparisons. The association between IPI and SMM did not vary substantially by maternal age or parity. In this study, longer IPI was associated with increased risk of SMM, which may be partly attributed to interpregnancy health. [ABSTRACT FROM AUTHOR]

Translanguaging has become a popular concept in educational contexts. However, it has not been discussed much in the kindergarten context of Norway. Many studies on translanguaging have been carried out in specific bilingual classrooms. In kindergartens in Norway, Norwegian is usually the common and majority language whilst a growing number of children attending kindergarten are multilingual with diverse linguistic background, and kindergarten teachers often have limited knowledge in the children's languages. The article elaborates on the concept of translanguaging from an educational and linguistic perspective. The concept of translanguaging is used as a theoretical lens to discuss kindergarten teachers' pedagogical practice with multilingual children and parents, as well as discourses in the kindergarten curriculum. The subsequent discussion focuses on the challenges and possibilities that translanguaging brings in its encounter with the kindergarten context in Norway. Whilst translanguaging may bring important challenges on existing views on language and multilingualism and create heteroglossic linguistic spaces for communication with children and their parents, it also encounters boundaries in the complex communication reality in kindergartens in Norway. [ABSTRACT FROM AUTHOR]

Folk tales, a type of narrative in which we can closely follow the reflections of thought that appear in the scriptures with the discourse" there was a word first "and base the birth of the word on a time before the existence of Man, are undoubtedly verbal accumulations that arise from the people;which convey the oral and cultural heritage to us form. Based on folk tales, it is possible that we can make a number of socio-cultural, traditional, religious inferences about the area to which these stories belong. When Uyghur folk literature is examined, the existence and formation of a rich folk tale draws attention. When these stories are examinedin terms of the beliefs elements they contain, it is seen that there are certain elements of belief in almost every folk story. The effects and reflections of belief elements on Uyghur folk tales are more observable from an Islamic perspective and it is seen that certain sacrednesses and some natural elements that have become cults among the people over time. In the study, based on the influence of belief elements on Uyghur folk tales the said belief elements were tried to be determined through four Uyghur folk tales and the interaction between belief and literature was revealed based on the stories. [ABSTRACT FROM AUTHOR]

Introduction: Family planning methods are used to promote safer sexual practices, reduce unintended pregnancies and unsafe abortion, and control population. Young people aged 15–24 years belong to a key reproductive age group. However, little is known about their engagement with the family planning services in Nepal. Our study aimed to identify the perceptions of and barriers to the use of family planning among youth in Nepal. Methods: A qualitative explorative study was done among adolescents and young people aged 15–24 years from the Hattimuda village in eastern Nepal. Six focus group discussions and 25 in-depth interviews were conducted with both male and female participants in the community using a maximum variation sampling method. Data were analyzed using a thematic framework approach. Results: Many individuals were aware that family planning measures postpone pregnancy. However, some young participants were not fully aware of the available family planning services. Some married couples who preferred 'birth spacing' received negative judgments from their family members for not starting a family. The perceived barriers to the use of family planning included lack of knowledge about family planning use, fear of side effects of modern family planning methods, lack of access/affordability due to familial and religious beliefs/myths/misconceptions. On an individual level, some couples' timid nature also negatively influenced the uptake of family planning measures. Conclusion: Women predominantly take the responsibility for using family planning measures in male-dominated decision-making societies. Moreover, young men feel that the current family planning programs have very little space for men to engage even if they were willing to participate. Communication in the community and in between the couples seem to be influenced by the presence of strong societal and cultural norms and practices. These practices seem to affect family planning related teaching at schools as well. This research shows that both young men and women are keen on getting involved with initiatives and campaigns for supporting local governments in strengthening the family planning programs in Nepal. [ABSTRACT FROM AUTHOR]

Objectives: Our objectives were to analyze how pregnancy outcomes varied by cesarean birth as compared to vaginal birth across varying interpregnancy intervals (IPI) and determine if IPI modified mode of birth. Methods: This secondary analysis used data from a prospective registry of home and hospital births in Chimaltenango, Guatemala from January 2017 through April 2020, through the Global Network for Women's and Children's Health Research. Bivariate comparisons and multivariable logistic regression were used to answer our study question, and the data was analyzed with STATA software v.15.1. Results: Of 26,465 Guatemalan women enrolled in the registry, 2794 (10.6%) had a history of prior cesarean. 560 (20.1%) women delivered by vaginal birth after cesarean with the remaining 2,233 (79.9%) delivered by repeat cesarean. Repeat cesarean reduced the risk of needing a dilation and curettage compared to vaginal birth after cesarean, but this association did not vary by IPI, all p-values > p = 0.05. Repeat cesarean delivery, as compared to vaginal birth after cesarean, significantly reduced the likelihood a woman breastfeeding within one hour of birth (AOR ranged from 0.009 to 0.10), but IPI was not associated with the outcome. Regarding stillbirth, repeat cesarean birth reduced the likelihood of stillbirth as compared to vaginal birth (AOR 0.2), but again IPI was not associated with the outcome. Conclusion: Outcomes by mode of delivery among a Guatemalan cohort of women with a history of prior cesarean birth do not vary by IPI. Plain English Summary: During a qualitative study where providers at one public hospital in Guatemala were interviewed about their beliefs, attitudes, and general practices regarding mode of delivery among women with a history of prior cesarean birth, providers reported that women with a short interval pregnancy (less than 18 or 24 months depending on provider interviewed) were not candidates for trial of labor after cesarean in their facility due to risk of adverse outcomes. We wished to test the hypothesis that adverse pregnancy outcomes are no more likely with an interval of shorter than 18 or 24 months compared to a longer interval, regardless of whether a woman delivers by vaginal or cesarean birth. This analysis suggests that outcomes can be worse for infants with vaginal birth after cesarean as compared to elective repeat cesarean birth, but these outcomes do not vary by interpregnancy interval. Therefore, our hypothesis was correct, and we look forward to disseminating this information to providers in the region in effort to improve evidence-based obstetric care. [ABSTRACT FROM AUTHOR]

In sub-Saharan Africa (SSA), every 1 in 12 children under five dies every year compared with 1 in 147 children in the high-income regions. Studies have shown an association between birth intervals and pregnancy outcomes such as low birth weight, preterm birth, and intrauterine growth restriction. In this study, we examined the association between birth interval and under-five mortality in eight countries in West Africa. A secondary analysis of the Demographic and Health Survey (DHS) data from eight West African countries was carried out. The sample size for this study comprised 52,877 childbearing women (15-49 years). A bivariate logistic regression analysis was carried out and the results were presented as crude odds ratio (cOR) and adjusted odds ratios (aOR) at 95% confidence interval (CI). Birth interval had a statistically significant independent association with under-five mortality, with children born to mothers who had >2 years birth interval less likely to die before their fifth birthday compared to mothers with ≤2 years birth interval [ cOR = 0.56 ; CI = 0.51 − 0.62 ], and this persisted after controlling for the covariates [ aOR = 0.55 ; CI = 0.50 − 0.61 ]. The country-specific results showed that children born to mothers who had >2 years birth interval were less likely to die before the age of five compared to mothers with ≤2 years birth interval in all the eight countries. In terms of the covariates, wealth quintile, mother's age, mother's age at first birth, partner's age, employment status, current pregnancy intention, sex of child, size of child at birth, birth order, type of birth, and contraceptive use also had associations with under-five mortality. We conclude that shorter birth intervals are associated with higher under-five mortality. Other maternal and child characteristics also have associations with under-five mortality. Reproductive health interventions aimed at reducing under-five mortality should focus on lengthening birth intervals. Such interventions should be implemented, taking into consideration the characteristics of women and their children. [ABSTRACT FROM AUTHOR]

The evolutionary benefits of reproductive seasonality are often measured by a single-fitness component, namely offspring survival. Yet different fitness components may be maximized by different birth timings. This may generate fitness trade-offs that could be critical to understanding variation in reproductive timing across individuals, populations and species. Here, we use long-term demographic and behavioural data from wild chacma baboons (Papio ursinus) living in a seasonal environment to test the adaptive significance of seasonal variation in birth frequencies. We identify two distinct optimal birth timings in the annual cycle, located four-month apart, which maximize offspring survival or minimize maternal interbirth intervals (IBIs), by respectively matching the annual food peak with late or early weaning. Observed births are the most frequent between these optima, supporting an adaptive trade-off between current and future reproduction. Furthermore, infants born closer to the optimal timing favouring maternal IBIs (instead of offspring survival) throw more tantrums, a typical manifestation of mother–offspring conflict. Maternal trade-offs over birth timing, which extend into mother–offspring conflict after birth, may commonly occur in long-lived species where development from birth to independence spans multiple seasons. Our findings therefore open new avenues to understanding the evolution of breeding phenology in long-lived animals, including humans. [ABSTRACT FROM AUTHOR]

Background: Childhood under-nutrition is a major global health problem. Although the rate of under-nutrition in Ethiopia has declined in the last decade, but it still remains being the major causes of morbidity and mortality of children under-five years. The problem is even worse in rural areas. The prevalence of underweight among rural children was 25% compared with 13% among urban children. To alleviate this problem, it is necessary to determine the magnitude and determinants of underweight. The study models non-Gaussian data analysis to identify risk factors associated with underweight among under-five children in rural Ethiopia. Methodology: The data source for this study was secondary data, which was retrieved from EDHS 2016 database. It was analyzed using two model families; one with marginal models (GEE and ALR) in which responses are modeled and marginalized overall other responses, and the other is random effects model (GLMM) which is useful when the interest of the analyst lies in the individual's response profiles as well as to evaluate within and between regional variations of underweight. Result: From fitting non-Gaussian data analysis to identify risk factors associated with underweight among under five children in rural Ethiopia, the independent variable which have significant effect on underweight were:—Age of child, birth interval, mothers education, fathers education, wealth index, diarrhea in last two weeks, fever in last two weeks are significant and also father's work status shows that difference in significance among the category. Conclusion: Child age, preceding birth interval, mother's education, household's wealth index, fever, diarrhea, father's education and father's work status were associated with child underweight. Furthermore, there is both within and between regional heterogeneity of underweight among children in rural Ethiopia. Therefore, rigorous community-based interventions (such as uplifting mother's education by providing formal education and preventing infectious diseases that cause diarrhea and fever) should be developed and executed throughout the country to improve this grave situation of underweight prevalence in rural areas of Ethiopia. [ABSTRACT FROM AUTHOR]

We use a mixed time model to study the dynamics of a system consisting of two consumers that reproduce only in annual birth pulses, possibly at different times, with interaction limited to competition for a resource that reproduces continuously. Ecological theory predicts competitive exclusion; this expectation is met under most circumstances, the winner being the species with the greater 'power', defined as the time average consumer level at the fixed point. Instability of that fixed point for the stronger competitor slightly weakens its domination, so that a resident species with an unstable fixed point can sometimes be invaded by a slightly weaker species, leading ultimately to coexistence. Differences in birth pulse times can lead to qualitatively different long-term coexistence behaviour, including cycles of different lengths or chaos. We also determine conditions under which the timing of an annual pulse of a toxin can change the balance of power. [ABSTRACT FROM AUTHOR]

A majority of the existing narratives on studying civil society in India are flooded with empirical findings, without much emphasis on theoretical understanding of the subject. Thus, the article tries to provide a historical overview of the development of notion of civil society and its research in "uncivil" Indian tradition from different dominant theoretical angles in the field. After finding their limitations, the study attempts to provide an alternative understanding of emergence of civil society in colonial India. It also aims to explore, how the lineage of traditional inform civic assocciationalism combined with modern institutionalized associational space gave birth to liberal-minded individuals and the conscious public in colonial India. Moreover, the present research further reveals that how civic awareness inculcated among the marginal's along with the educated Indian middle class and how interactions between the state, society, and religion helped in development of spirit of civility among individuals, awareness among the public and voice of protest among community in "uncivil" colonial India which was unique from its western counterpart both in the process of formation and the forms of manifestations. [ABSTRACT FROM AUTHOR]

Comparing individual contributions in a strongly interacting system of stochastic growth processes can be a very difficult problem. This is particularly the case when new growth processes are initiated depending on the state of previous ones and the growth rates of the individual processes are themselves random. We propose a novel technique to deal with such problems and show how it can be applied to a broad range of examples where it produces new insight and surprising results. The method relies on two steps: In the first step, which is highly problem dependent, the growth processes are jointly embedded into continuous time so that their evolutions after initiation become approximately independent while we retain some control over the initiation times. Once such an embedding is achieved, the second step is to apply a Poisson limit theorem that enables a comparison of the state of the processes initiated in a critical window and therefore allows an asymptotic description of the extremal process. In this paper we prove a versatile limit theorem of this type and show how this tool can be applied to obtain novel asymptotic results for a variety of interesting stochastic processes. These include (a) the maximal degree in different types of preferential attachment networks with fitnesses like the well-known Bianconi–Barabási tree and a network model of Dereich, (b) the most successful mutant in branching processes evolving by selection and mutation, and (c) the ratio between the largest and second largest cycles in a random permutation with random cycle weights, which can also be interpreted as a disordered version of Pitman's Chinese restaurant process. [ABSTRACT FROM AUTHOR]

Background: Maternal age < 18 or > 34 years, short inter-pregnancy birth interval, and higher birth order are considered to be high-risk fertility behaviours (HRFB). Underfive mortality being disproportionately concentrated in Asia and Africa, this study analyses the association between HRFB and underfive mortality in selected Asian and African countries.Methods: This study used Integrated Public Microdata Series-Demographic and Health Surveys (IPUMS-DHS) data from 32 countries in sub-Saharan Africa, Middle East, North Africa and South Asia from 1986 to 2017 (N = 1,467,728). Previous evidence hints at four markers of HRFB: women's age at birth of index child < 18 or > 34 years, preceding birth interval < 24 months and child's birth order > 3. Using logistic regression, we analysed change in the odds of underfive mortality as a result of i) exposure to HRFB individually, ii) exposure to any single HRFB risk factor, iii) exposure to multiple HRFB risk factors, and iv) exposure to specific combinations of HRFB risk factors.Results: Mother's age at birth of index child < 18 years and preceding birth interval (PBI) < 24 months were significant risk factors of underfive mortality, while a child's birth order > 3 was a protective factor. Presence of any single HRFB was associated with 7% higher risk of underfive mortality (OR 1.07; 95% CI 1.04-1.09). Presence of multiple HRFBs was associated with 39% higher risk of underfive mortality (OR 1.39; 95% CI 1.36-1.43). Some specific combinations of HRFB such as maternal age < 18 years and preceding birth interval < 24 month significantly increased the odds of underfive mortality (OR 2.07; 95% CI 1.88-2.28).Conclusion: Maternal age < 18 years and short preceding birth interval significantly increase the risk of underfive mortality. This highlights the need for an effective legislation to curb child marriages and increased public investment in reproductive healthcare with a focus on higher contraceptive use for optimal birth spacing. [ABSTRACT FROM AUTHOR]

Background: Macrocephaly is a common finding in infants and is often idiopathic or familial. In the absence of clinical signs and symptoms, it can be difficult to determine when concern for underlying pathology is justified. Objectives: The objectives of this study were to determine the utility of screening head ultrasound (US) in asymptomatic infants with macrocephaly and to identify clinical factors associated with significant US findings. Materials and methods: A 20-year retrospective review was performed of infants undergoing head US for macrocephaly or rapidly increasing head circumference. Data collected included age, gender, head circumference at birth and at the time of US, specialty of the ordering physician, US findings, computed tomography (CT) or magnetic resonance imaging (MRI) findings, and clinical course including interventions. Results: Four hundred and forty infants met inclusion criteria. Two hundred and eighty studies (64%) were found to be normal, 137 (31%) had incidental findings, 17 (3.8%) had indeterminate but potentially significant findings, and 6 (1.4%) had significant findings. Twenty of the 23 infants with indeterminate or significant findings had subsequent CT or MRI. This confirmed significant findings in eight infants (1.8%): three subdural hematomas, two intracranial tumors, two aqueductal stenoses, and one middle fossa cyst. Five of the eight infants required surgical procedures. The only statistically significant association found with having a significant finding on head US was head circumference at birth. Conclusion: Ultrasound is a useful initial study to evaluate infantile macrocephaly, identifying several treatable causes in our study and, when negative, effectively excluding significant pathology. [ABSTRACT FROM AUTHOR]

Context: Development is an ongoing process through which an individual acquires competence to function adequately. Developmental delay is said to occur when a child fails to reach the age-appropriate anticipated milestones. This imparts long-term direct as well as indirect effects on the health of a community obviating routine measurement of its prevalence especially in high-risk populations. Aim: To find out the prevalence and correlates of developmental delay among children under two years of age in slums of Burdwan Municipality, West Bengal. Settings and Design: A community-based descriptive cross-sectional study. Methods and Materials: This study was conducted between September-November 2019 among 240 study subjects selected by multistage simple random sampling. Data were collected by interviewing the respondents using a predesigned, pretested schedule. Developmental status was assessed by applying Trivandrum Developmental Screening Chart (TDSC). Chi-square test and logistic regression was done to find associations. Results: Prevalence of developmental delay was 6.6%(95%CI 3.6-9.8) and proportion was more among male infants. Chi square test revealed gender (p = 0.03), mothers' education (p = 0.00), socio-economic status (p = 0.00), parity (p = 0.02), birth spacing (p = 0.01) birth weight (p = 0.00) to be significantly associated with developmental delay and multivariable analysis showed all the factors to be significant predictors except gender, parity and birth spacing. Gestational duration, maternal age at delivery, mode of delivery was not found to be significantly associated with developmental delay. Conclusion: Developmental delay is considerably high in the study area. A larger study using appropriate tool and follow-up may elicit the burden and associated determinants. [ABSTRACT FROM AUTHOR]

Using a queer theoretical lens, this conceptual paper explores the complexities of working with queer youth in leisure spaces by using genderplay to explore gender identity. Given the current social and political climate in Canada, researchers in this area face considerable professional road blocks from gatekeepers, despite providing often life-saving access for youth to queer mentors, community, and health resources. This paper, therefore, provides insight into the pervasiveness of the image of the child that informs the anxiety present in current political, social, and cultural discourses about queer children and the danger that image is putting these actual children in by limiting access to the above stated resources. Moreover, we expose how the image of the child is always invested in ideals of middle and upper-class whiteness, able-bodiedness, and imagined straightness from the outset, which further limits access to leisure spaces for queer children who may be otherwise marginalized. [ABSTRACT FROM AUTHOR]

Aim: Enterovirus is a common pathogen. Although mostly asymptomatic, this infection has the potential to be life-threatening in neonates. This article aims to describe the early neonatal outcomes in peripartum infection.Methods: We performed a retrospective cohort study in a tertiary hospital between 1/2014 and 5/2019. The enterovirus infection was established by real-time polymerase chain reaction analysis.Results: Out of 161 neonates tested for the enterovirus infection 13 (8%) were positive. Maternal fever was the most common sign (n = 8, 66.7%). The mean gestational age at delivery was 36 + 5 (range 30 + 5 to 40 + 6 weeks). The mean time interval from birth to neonatal manifestations of infection was 5.2 (0-9) days. The most common presenting sign in the neonates was fever (n = 8, 61.5%). All neonates required the neonatal intensive care unit. The neonatal mortality rate was 3/13 (23%).Conclusion: The neonatal morbidity and mortality from the enterovirus infection may have been associated with the severity of maternal presentation at the time of admission. Enterovirus real-time polymerase chain reaction analysis should be considered as part of the maternal evaluation in cases of maternal fever of unknown origin. Deferral of the induction of delivery for term pregnancies with confirmed enterovirus infections should be considered. [ABSTRACT FROM AUTHOR]

Purpose: To explore how the assisted reproductive technology (ART) laboratories can be optimized and standardized to enhance embryo culture and selection, to bridge the gap between standard practice and the new concept of shortening time to healthy singleton birth. Methods: A Delphi consensus was conducted (January to July 2018) to assess how the ART laboratory could be optimized, in conjunction with existing guidelines, to reduce the time to a healthy singleton birth. Eight experts plus the coordinator discussed and refined statements proposed by the coordinator. The statements were distributed via an online survey to 29 participants (including the eight experts from step 1), who voted on their agreement/disagreement with each statement. Consensus was reached if ≥ 66% of participants agreed/disagreed with a statement. If consensus was not achieved for any statement, that statement was revised and the process repeated until consensus was achieved. Details of statements achieving consensus were communicated to the participants. Results: Consensus was achieved for all 13 statements, which underlined the need for professional guidelines and standardization of lab processes to increase laboratory competency and quality. The most important points identified were the improvement of embryo culture and embryo assessment to shorten time to live birth through the availability of more high-quality embryos, priority selection of the most viable embryos and improved cryosurvival. Conclusion: The efficiency of the ART laboratory can be improved through professional guidelines on standardized practices and optimized embryo culture environment, assessment, selection and cryopreservation methodologies, thereby reducing the time to a healthy singleton delivery. [ABSTRACT FROM AUTHOR]

Previous research details women's career launch and childbearing timing strategies without fully theorizing how such work–family plans may be developed alongside men. Overlooking men's role in this process obscures how women's partners can shape their work–family experiences. This study examines how young dual-professional couples plan two careers while timing childbearing. Interviews with 40 partners from 21 mostly White different-sex couples reveal that partners plan simultaneous career launches; sequence men's career launches before women's; or independently pursue career plans. These career launch strategies are not tightly linked to whether couples agree to forgo parenthood; delay childbearing; or initiate childbearing soon. In some couples, women had thought in more detail about childbearing timing in relation to the partners' careers than men had. These couple-level data show that men's career plans more directly shape women's career plans than childbearing plans do because men and women can view childbearing as separate from career planning. [ABSTRACT FROM AUTHOR]

Background: Short birth interval is associated with adverse perinatal, maternal, and infant outcomes, although evidence on actionable factors underlying short birth interval remains limited. We explored women and community views on short birth intervals to inform potential solutions to promote a culturally safe child spacing in Northern Uganda. Methods: Gendered fuzzy cognitive mapping sessions (n = 21), focus group discussions (n = 12), and an administered survey questionnaire (n = 255) generated evidence on short birth intervals. Deliberative dialogues with women, their communities, and service providers suggested locally relevant actions promote culturally safe child spacing. Results: Women, men, and youth have clear understandings of the benefits of adequate child spacing. This knowledge is difficult to translate into practice as women are disempowered to exercise child spacing. Women who use contraceptives without their husbands' consent risk losing financial and social assets and are likely to be subject to intra-partner violence. Women were not comfortable with available contraceptive methods and reported experiencing well-recognized side effects. They reported anxiety about the impact of contraception on the health of their future children. This fear was fed by rumors in their communities about the effects of contraceptives on congenital diseases. The women and their communities suggested a home-based sensitization program focused on improving marital relationships (spousal communication, mutual understanding, male support, intra-partner violence) and knowledge and side-effects management of contraceptives. Conclusions: The economic context, gender power dynamics, inequality, gender bias in land tenure and ownership regulations, and the limited contraceptive supply reduce women's capacity to practice child spacing. Plain language summary: The evidence on what increases birth spacing remains limited. This study explored community views on influences on short birth interval to promote a culturally safe child spacing in Northern Uganda. A participatory research process began by collating perspectives of causes of short birth intervals through fuzzy cognitive mapping. Focus group discussions clarified concepts emerging from the fuzzy cognitive mapping exercise. Fieldworkers administered a household survey to quantify reproductive health outcomes. In deliberative dialogue sessions involving women and their communities, shared and discussed these results and suggested potential actions to promote culturally safe child spacing. Women, men, and youth showed clear understandings of the benefits of adequate child spacing. This knowledge is difficult to translate into practice, however, as women feel they are unable to exercise child spacing. Women who use contraceptives without their husbands' consent risk losing financial and social resources and are likely to face intra-partner violence. Women were not comfortable with contraceptive methods and reported experiencing side effects. The deliberative dialogues suggested a home-based sensitization program focused on improving marital relationships (spousal communication, mutual understanding, male support, intra-partner violence) and knowledge and side-effects management of contraceptives. [ABSTRACT FROM AUTHOR]

Background: Birth cultures have been transforming in recent years mainly affecting birth care and its socio-political contexts. This situation has affected the feeling of well-being in women at the time of giving birth. Aim: For this reason, our objective was to analyse the social meaning that women ascribe to home births in the Chilean context. Method: We conducted thirty semi-structured interviews with women living in diverse regions ranging from northern to southern Chile, which we carried out from a theoretical-methodological perspective of phenomenology and situated knowledge. Qualitative thematic analysis was used to analyse the information collected in the field work. Findings: A qualitative thematic analysis produced the following main theme: 1) Home birth journeys. Two sub-categories: 1.1) Making the decision to give birth at home, 1.2) Giving birth: (re)birth. And four sub-categories also emerged: 1.1.1) Why do I need to give birth at home? 1.1.2) The people around me don't support me; 1.2.1) Shifting emotions during home birth, 1.2.2) I (don't) want to be alone. Conclusion: We concluded that home births involve an intense and diverse range of satisfactions and tensions, the latter basically owing to the sociocultural resistance surrounding women. For this reason, they experienced home birth as an act of protest and highly valued the presence of midwives and their partners. [ABSTRACT FROM AUTHOR]

Background: Short birth intervals, defined by the World Health Organization as less than 33 months, may damage the health and wellbeing of children, mothers, and their families. People in northern Nigeria recognise many adverse effects of short birth interval (kunika in the Hausa language) but it remains common. We used fuzzy cognitive mapping to systematize local knowledge of causes of kunika to inform the co-design of culturally safe strategies to address it. Methods: Male and female groups in twelve communities built 48 maps of causes and protective factors for kunika, and government officers from the Local Government Area (LGA) and State made four maps. Each map showed causes of kunika or no-kunika, with arrows showing relationships with the outcome and between causes. Participants assigned weights for the perceived strength of relationships between 5 (strongest) and 1 (weakest). We combined maps for each group: men, women, and government officers. Fuzzy transitive closure calculated the maximum influence of each factor on the outcome, taking account of all relationships in the map. To condense the maps, we grouped individual factors into broader categories and calculated the cumulative net influence of each category. We made further summarised maps and presented these to the community mapping groups to review. Results: The community maps identified frequent sex, not using modern or traditional contraception, and family dynamics (such as competition between wives) as the most influential causes of kunika. Women identified forced sex and men highlighted lack of awareness about contraception and fear of side effects as important causes of kunika. Lack of male involvement featured in women's maps of causes and in the maps from LGA and State levels. Maps of protective factors largely mirrored those of the causes. Community groups readily appreciated and approved the summary maps resulting from the analysis. Conclusions: The maps showed how kunika results from a complex network of interacting factors, with culture-specific dynamics. Simply promoting contraception alone is unlikely to be enough to reduce kunika. Outputs from transitive closure analysis can be made accessible to ordinary stakeholders, allowing their meaningful participation in interpretation and use of the findings. Plain English summary: For people in Bauchi State, northern Nigeria, kunika describes a short interval between successive births, understood as becoming pregnant again before the previous child is weaned. They recognise it is bad for children, mothers and households. We worked with 12 communities in Bauchi to map their knowledge of the causes and protective factors for kunika. Separate groups of men and women built 48 maps, and government officers at local and state level built four maps. Each group drew two maps showing causes of kunika or of no-kunika with arrows showing the links between causes and the outcome. Participants marked the strength of each link with a number (between 5 for the strongest and 1 for the weakest). We combined maps for women, men and government officers. We grouped similar causes together into broader categories. We calculated the overall influence of each category on kunika or no-kunika and produced summary maps to communicate findings. The maps identified the strongest causes of kunika as frequent sex, not using modern or traditional contraception, and family dynamics. Women indicated forced sex as an important cause, but men focused on lack of awareness about contraception and fear of side effects. The maps of protective factors mirrored those of the causes. The groups who created the maps approved the summary maps. The maps showed the complex causes of kunika in Bauchi. Promoting contraception is unlikely to be enough on its own to reduce kunika. The summary maps will help local stakeholders to co-design culturally safe ways of reducing kunika. [ABSTRACT FROM AUTHOR]

Background: Early neonatal death caused by preterm birth contributes the most for perinatal death. The prevalence of preterm birth continues to rise and is a significant public health problem. The exact cause of preterm birth is yet unanswered, as mostly preterm birth happens spontaneously. Predictors of preterm birth in developing countries like Ethiopia were not well investigated, and no study was conducted before this in the study area. Objectives: To identify predictors of preterm birth in Western Ethiopia, 2017/2018. Methods: Health facility-based unmatched case-control study was conducted from October 20/2017-march 20/2018 in 4 Hospitals. A total sample size of 358 women was recruited. From this 72 were cases and 286 were controls. Cases were mothers who gave Preterm birth, and controls were mothers who gave birth at term. Ethical clearance was obtained from Wollega University ethical review committee. A pre tested, structured questionnaire was used to collect data. Data entry and analysis was done using Epi Data 3.1 and SPSS version 21, respectively. Logistic regression was done to identify predictors of preterm birth. Result: Three hundred fifty-eight women participated in this study of which 72 were cases and 286 were controls; making the overall response rate of 100%. Lack of antenatal care visit [AOR = 3.18, 95% CI 1.37–7.38]),(Having 1–2 antenatal care visit [AOR = 2.27, 95% CI 1.18–4.35]),history of previous preterm)[AOR = 5.19, 95% CI1.29–20.88],Short Interpregnancy Interval [AOR = 4.41.95% CI 2.05–9.47],Having Reproductive tract infections [AOR = 2.54, 95% CI 1.02–6.32] and having Obstetric complications [AOR = 2.48,95% CI 1.31–4.71] were found to be predictors of preterm birth. Conclusion and recommendation: Risk factors of preterm delivery are multifactorial and depend on geographical and demographic features of the population studied. Hence results of studies from one area might not be applicable to another area. Antenatal care visits are unique opportunities for early diagnosis and treatment of problems. Therefore, antenatal care should be strengthened, and appropriate counseling should be given at each antenatal care follow up. Maintainning optimum birth interval through family planning, and early identification and treatment of reproductive tract infections are mandatory. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study is to determine frequency of short interpregnancy interval in female with preterm labour. Study Design: Descriptive Cross Sectional study. Setting: Department of Obstetrics and Gynecology Bacha Khan Medical Complex Swabi. Period: 01July 2018 to 31-December 2018. Material & Methods: After meeting inclusion criteria a total of 212 females with preterm birth as per operational definition were taken. Birth interval ≤ 6 months was labeled as short interpregnancy interval. Results: The mean age of patients in this study was 29.00±6.37 years with mean parity in this study was observed to be 3.23±2.31 with minimum and maximum parity of 1 and 9 respectively. The mean gravida in this study was 2.17±2.25 with minimum and maximum of 0 and 8. The mean gestational age among patients was 29.83±3.29 weeks with minimum and maximum gestational ages of 24.00 weeks and 36.00 weeks respectively. The mean inter-pregnancy interval observed in this study was 7.39±6.14 months with minimum and maximum intervals of 2.00 months and 14.00 months respectively. According to definition, 155 (73.1%) patients had short inter-pregnancy interval. Conclusion: Through this study we found high frequency of short inter pregnancy interval. We must have to establish more and effective family planning awareness to increase birth gap to avoid poor fetomaternal outcome as it is clear that short IPI may directly or indirectly influence the maternal and perinatal health and can potentially increase risk of preterm birth. [ABSTRACT FROM AUTHOR]

The present paper focuses on the changes undergone by news discourse towards its current multisemiotic, digital nature. It is divided into three main sections; in the first one I will focus on how multimodal/multisemiotic developments have been gradually entrenched in news reporting, from 17th-century woodblock engravings in the early news texts to contemporary convergent journalism, with special reference to the increasing interconnection between verbal output and visuals. Secondly, I will illustrate the shift in topics and methodologies undergone by studies on news discourse particularly over the last few years, with attention to (a) news dissemination and consumer perception (b) the new language(s) of news. Finally, I will present and discuss a pilot case study of multimodality in news reporting, focussing on the coverage by The New York Times of the birth and development of the European Union between 1946 and 2009. The study will attempt to bring to the fore the role played by the dynamic interrelationship between image and verbal text in conveying the news stories and, possibly, the underlying perspective of the newspaper itself when informing readers on the steps leading to the shaping of the EU. • News dissemination has been shaped by historical technological innovations. • Multimodal journalism is rooted in the interplay between verbals and visuals. • Studies on news discourse and transmission have shifted in topics and methodologies. • Co-occurring features in the news output trigger semiotic and pragmatic factors. [ABSTRACT FROM AUTHOR]

Background: Breast cancer is the most common histological type and it is a frequent cause of death in Peruvian women. Objective: To demonstrate that birth interval is a risk factor for ductal breast carcinoma. Material and Methods: This case-control study included 304 Peruvian women with histological diagnosis of breast carcinoma. They were divided into two groups, one with ductal carcinoma and another with non-ductal carcinoma (control). Besides birth interval; parity, age at first delivery, age at last delivery, age at histological diagnosis, interval from last delivery to diagnosis and molecular subtype were also evaluated. Results: The frequency of Ductal breast cancer was 78% in patients with short birth interval. The ratio between presence of short birth interval versus absence of short birth interval is 1.86 times higher in ductal breast cancer patients (CI 95%: 1,12-3,08). Additionally, there was significant association in age at first delivery = 20 years (p<0,001) and interval from last delivery to diagnosis >10 years (p<0,001). Conclusion: short birth interval is a risk factor for ductal breast cancer, which can also be modified and used as a prevention element, so it should be included in the medical record. [ABSTRACT FROM AUTHOR]

This article posits that analyses of (cyber)bullying among digitally connected young people need to explore the interdependences, intersections and cON/FFlation of bullying in ONline and OFFline spaces. It combines digital geographers' works on relationalities between digital and offline spaces with studies on children's and young people's geographies and digitization as well as with interdisciplinary work on cyberbullying and traditional bullying in the school context. Drawing on narratives written by young people in Austria, the article lets participants speak through their own voices. There is an urgent need for disparate research examining either or both traditional and cyberbullying, to take note not only of each of their inimitable spatialities, but also their intersections. Through taking a perspective of cON/FFlating spaces we seek to produce a better understanding of the cON/FFlating nature and spaces of bullying in the digital era and to deepen the conceptualization of these interlinked and entangled socio-material-technological spaces. [ABSTRACT FROM AUTHOR]

Purpose: The improvement of clinical outcome provided by time-lapse technology (TLT) in IVF over conventional incubation (CI) still remains controversial. This study aimed at evaluating whether the exclusive use of time-lapse technology (TLT) during whole IVF care improves total cumulative live birth rate (TCLBR) and shortens time to live birth (TTLB) as compared to the use of CI in couples undergoing ICSI. Methods: This retrospective cohort study was conducted in couples with male infertility undergoing their first ICSI cycle in 2014–2015 and for whom embryo culture system remained the same during their whole IVF care, i.e., TLT or CI. Couples were followed up up to 2020, including all following frozen-embryo transfers and ICSI cycles (if any). Survival analysis was used to compare clinical outcome and time-related endpoints between both groups. Results: A total of 151 and 250 couples underwent their whole IVF care with the exclusive use of TLT and CI, respectively. Survival analysis showed that TCLBR after whole IVF care was significantly higher in TLT than in CI group (66.9 vs 56.4%, p=0.02, log-rank test). Median live birth time was significantly shorter in TLT than CI group (464 vs 596 days, p=0.01). Conclusions: We found that TCLBR and TTLB were significantly improved with TLT over CI in couples undergoing ICSI for male factor. This study fuels the debate on the clinical benefit of using TLT. The use of time-related endpoints adds important information for both patients and practitioners. [ABSTRACT FROM AUTHOR]

Twinning costs the dairy industry an estimated $96 million each year. Twin pregnancy occurrence in high-producing dairy cows is primarily a result of multiple ovulations associated with low circulating concentrations of progesterone due to high milk production. The present retrospective observational study aimed to identify associations between (1) previous parity milk yield and subsequent twin birth prevalence, (2) twin birth with same parity milk production and calving interval (CInt), and (3) twin birth and the subsequent twin calving. The final data set included almost 2.9 million US dairy calving and production records between 2001 and 2020. Variables considered were parity, breed, milk production, CInt, calving month, and year. Logistic and linear regression modeling were used to assess the effects of predictors on outcomes. Herd within state was used as a random effect for all regression models. Twin birth probability increased for cows with increased previous parity milk yield independent of breed or parity. Third and greater parity (3+) compared with second parity (2) and all breeds compared with Jerseys were associated with greater twin probability. Calving between April and September that corresponded to conceiving in July through December was associated with greater twin birth probability. Twin births were associated with decreased milk production following the birth event in Holsteins and parity 2 cows and in the calving months between June and September. Surprisingly, twin births in parity 3+ cows were associated with an increased 305-d milk yield. Cows that had a twin birth were more likely to calve twins in the subsequent parity and had a greater risk of having a CInt between 413 and 600 d. The hazard to subsequent calving after single births was greater compared with twin births. These data can be instrumental in guiding research focus on reducing twinning in lactating dairy cows. [ABSTRACT FROM AUTHOR]

Objective: Chronic undernutrition is a common phenomenon in Bangladesh. However, information is grossly lacking to report the correlation between chronic undernutrition trajectory and lung function in children. The aim of the current study was to understand the association between early-childhood chronic undernutrition trajectory and lung function at preadolescence.Design: The current study is a part of the 9-year follow-up of a large-scale cohort study called the Maternal and Infant Nutrition Interventions in Matlab.Settings: The current study was conducted in Matlab, a sub-district area of Bangladesh that is located 53 km south of the capital, Dhaka.Participants: A total of 517 children participated in lung function measured with a spirometer at the age of 9 years. Weight and height were measured at five intervals from birth till the age of 9 years.Results: Over half of the cohort have experienced a stunting undernutrition phenomenon up to 9 years of age. Children who were persistently or intermittently stunted showed lower forced expiratory volume (ml/s) than normal-stature children (P < 0·05). Children who exhibited catch-up growth throughout 4·5 years from the stunted group showed similar lung function with normal counterparts, and a better lung function than in children with the same growth velocity or who had faltering growth. In the multivariable models, similar associations were observed in children who experienced catch-up growth than their counterparts after adjusting for covariates.Conclusion: Our data suggest that catch-up growth in height during early childhood is associated with a better lung function at preadolescence. [ABSTRACT FROM AUTHOR]

Background: High maternal and child death with high fertility rate have been reported in Ethiopia. Extreme age at first birth is linked with both maternal and child morbidity and mortality. However, literatures showed there were limited studies on the timing of the first birth and its predictors in the area so far. Therefore, determining the time to first birth and its predictors will help to design strategies to improve maternal and child survival.Methods: A community-based cross-sectional study was conducted among reproductive-age women in Ethiopia using the Ethiopian demographic health survey, 2016 data. Stratified two-stage cluster sampling technique was used for sampling. The Kaplan-Meier method was used to estimate time to first birth. Inverse Weibull gamma shared frailty model applied to model the data at 95% confidence interval (CI), adjusted hazard ratio (AHR) and median hazard ratio (MHR) were reported as effect size. Proportional hazard assumption checked using Schoenfeld residual test. Information Criteria were applied to select a parsimonious model. Stratified analysis performed for the interaction terms and statistical significance was declared at p value < 0.05.Results: The overall median age at first birth was found to be 20 years (IQR, 16-24 years). The independent predictors of time to first birth were: married 15-17 years (AHR = 2.33, 95% CI 2.08-2.63), secondary education level (AHR = 0.84, 95% CI 0.78-0.96), higher education level (AHR = 0.75, 95% CI 0.65-0.85), intercourse before 15 years in the married stratum (AHR = 23.81, 95% CI 22.22-25.64), intercourse 15-17 years in married stratum (AHR = 5.56, 95% CI 5.26-5.88), spousal age difference (AHR = 1.11, 95% CI 1.05-1.16),and use of contraceptives (AHR = 0.91, 95% CI 0.86-0.97). The median increase in the hazard of early childbirth in a cluster with higher early childbirth is 16% (MHR = 1.16, 95% CI 1.13-1.20) than low risk clusters adjusting for other factors.Conclusion: In this study, first birth was found to be at an early age. Early age at first marriage, at first sexual intercourse and their interaction, high spousal age difference, being Muslim were found to increase early motherhood. Conversely, living in the most urban region, secondary and higher women education were identified to delay the first birth. Investing on women education and protecting them from early marriage is required to optimize time to first birth. The contextual differences in time to first birth are an important finding which requires more study and interventions. [ABSTRACT FROM AUTHOR]

Covid-19 disease caused by SARS-COV-2 has been a pandemic throughout the world including India. It affects all age groups including children. The disease is much milder among children compared to adults. In neonates, the disease is often mild and has good prognosis. It is still doubtful whether there is vertical transmission to the neonates from infected mothers. Also, it is not proved whether the disease can be transmitted through breast milk. Here we present case reports of three neonates, two of which were born to COVID-19 positive mothers. Rest one got infected at 25days of life. None of the two infants born to COVID-19 positive were positive at the time of birth. Our observation is similar to the previous studies that COVID-19 has not yet been proved to transmit vertically. One of them contracted the disease on day 7 of life from the mother in spite of strict precautions. It could not be proved whether it was transmitted from breast milk or faulty practice. One of the infants presented with late onset sepsis. All of the infants recovered well and was thriving well on follow up. [ABSTRACT FROM AUTHOR]

Background: Low birth weight (LBW) is one of the major determinants of perinatal survival, infant morbidity, and mortality, as well as the risk of developmental disabilities and illnesses in future lives. Though studies were conducted to assess the magnitude and associated factors of low birth weight, most of the studies were at a single center and little information on the regional level. Hence, this study assessed the prevalence and associated factors of low birth weight in Sub-Saharan countries. Method: This study was based on secondary data sources from 35 Sub-Saharan countries' Demography and Health Survey (DHS). For this study, we used the Kids Record (KR file) data set. In the KR file, all under-five children who were born in the last five years preceding the survey in the selected enumeration area who had birth weight data were included for the study. To identify determinants of low birth weight multivariable mixed-effect logistic regression model fitted. Adjusted Odds Ratios (AOR) with a 95% Confidence Interval (CI) and p-value ≤0.05 in the multivariable model were used to declare significant factors associated with low birth weight at birth. Result: The pooled prevalence of newborn babies' low birth weight measured at birth in Sub-Saharan Africa was 9.76% with (95% CI: 9.63% to 9.89%). Female child, women not participated in healthcare decision making, and wider birth intervals, divorced/ separated women, and twin pregnancies associated with increased occurrences of low birth weight, while some level of woman and husband education, antenatal care visits, older maternal age, and multiparity associated with reduced occurrence low birth weight. Conclusion: This study revealed that the magnitude of low birth weight was high in sub-Saharan Africa countries. Therefore, the finding suggests that more emphasis is important for women with a lack of support, multiples, and healthcare decision-making problems. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has spread to more than 200 countries and territories, despite governments' efforts to 'flatten the curve'. The measures to respond to the COVID-19 outbreak have been perceived as retrogressive for children and young people's rights to participation. A common denominator across countries and regions is the reduced spaces for children and young people to influence decision-making processes and policy responses associated with COVID-19. This article critically examines the meanings and implications of children and young people's participation rights in the time of COVID-19. In particular, it explores how lockdowns and other physical distancing measures have a negative impact on social interactions, leaving behind hard-to-reach children and young people and undermining some children and young people's rights to participate on the premise that their protection is more relevant in crisis situations. This article discusses children and young people's perspectives on how their opportunities to be listened to during the pandemic have been restricted. The article considers children and young people's ability to communicate online, considering how those without access to the Internet – practically half the world – are left out, and, in the end, demonstrating that this pandemic is producing and exacerbating existing inequalities. [ABSTRACT FROM AUTHOR]

Objectives: Very short interpregnancy intervals are associated with negative health outcomes for mothers and children, and pregnancies with very short interpregnancy intervals are more likely to be unintended than pregnancies that are more widely spaced. The objective of this study was to improve understanding of women's motivations regarding pregnancy spacing.Methods: In 2017, we conducted 8 focus group discussions with 49 English- and Spanish-speaking postpartum women in central North Carolina. The groups explored participants' preferences for birth spacing and factors that influenced their decisions. We recorded, transcribed, and coded the discussions and analyzed these data for core themes.Results: Participants' ideas about when and whether to have more children were fluid-some had specific ideas during pregnancy or after delivery that changed over time; others had no definite plans. The primary reason for close birth spacing was to promote their children's having a closer relationship. Reasons for wider spacing included recovery from the previous pregnancy, challenges related to having 2 babies concurrently, and desire to wait for more favorable life circumstances. Participants did not mention health risks to children of short interpregnancy intervals and said that no health care providers discussed these risks with them. They had mixed perspectives about whether this information would influence their own child-spacing preferences but agreed that it should be shared with women to promote informed decision-making.Conclusion: This study adds to limited research regarding the factors that women consider when determining pregnancy spacing. Better understanding of women's motivations can help inform counseling to help women achieve their desired pregnancy spacing. [ABSTRACT FROM AUTHOR]

The Maresh data are commonly used in bioarcheological growth studies as a representation of diaphyseal growth in a modern and healthy group of children. However, several problems with the way the data were reported have limited its use in quantitative analyses of growth. In this paper, we present updated and interpolated values for long bone length for age for use in calculating z‐scores, percentages of expected length, and other quantitative measures of growth. The Maresh mean and mean + 1 standard deviation values for the sexes separately and combined were first corrected for radiographic magnification. Several modeling approaches were then evaluated. This testing suggested that the best fit was provided by two third‐order polynomials fit to data ≤24 and ≥24 months, respectively. The resulting regressions were used to calculate age‐specific mean and standard deviation values in 1‐month intervals from birth until 12 years (0–144 months). Differences between the original and new values are minimal and do not exceed 1 mm. However, as the old Maresh values required rounding age down to the last attained threshold by as much as 5 months, there are differences between z‐scores calculated with original versus new values of up to 2 z‐score units, especially in children under 3 years of age where growth velocity is highest. Although these updated values do not solve the problems that made age estimation from the Maresh data unadvisable, they will be of use to researchers in conducting more precise growth studies in bioarcheological contexts. [ABSTRACT FROM AUTHOR]

This study explores how the distinctive Korean age reckoning, the Confucian age culture, and the school-entry-cutoff date affect the decisions of parents on both birth and school-entry timing for their children in Korea. There is a traditional method of age calculation in Korea that all people get one year older on January 1. Korea also has a distinctive age culture influenced by Confucianism. I find a substantial amount of birth and school-entry timing selections around the Korean age-cutoff date, January 1. The estimation results show that children born in January and February delayed school entry by 18.2–21.2 percentage points more than those born in November and December and 24% of births moved from one week before January 1 to one week after when the school-entry cutoff was March 1. After the school-entry cutoff has changed to January 1, children barely delay school enrollment, while more births are moved from December to January: 42% of births are shifted within the 7-day window. These behaviors are made by two motives: (1) parents want their children to have the same Korean age with their classmates because of the Confucian age culture; (2) they also want their children to be relatively older to have academic advantages. [ABSTRACT FROM AUTHOR]

Examining the critical potential of everyday practices within early childhood spaces, this article builds on a growing body of pedagogical research that challenges researchers 'to use theory to think with data' and create new concepts that are born out of the possibilities of the theory–practice relationship. By aligning Deleuze and Guattari's theory of immanence with the concept of 'an attitude of research', it is argued that an inherent quality of this concept is that it is shaped by the subjectivities, values and processes of children's spaces. It is in the critical potential of one's engagement with quotidien practices that the identity of an attitude of research is created. By identifying the aesthetic qualities that guide interactions, visibility is brought to the patterns of thinking that are contextual and therefore unique to an early childhood space. This article demonstrates that practice and an attitude of research constitute one another, creating a new theory – 'research as lingering' in the threshold of the everyday. [ABSTRACT FROM AUTHOR]