Effect of facilitation of local maternal-and-newborn stakeholder groups on neonatal mortality : cluster-randomized controlled trial

BACKGROUND: Facilitation of local women's groups may reportedly reduce neonatal mortality. It is not known whether facilitation of groups composed of local health care staff and politicians can improve perinatal outcomes. We hypothesised that facilitation of local stakeholder groups would reduce neonatal mortality (primary outcome) and improve maternal, delivery, and newborn care indicators (secondary outcomes) in Quang Ninh province, Vietnam. METHODS AND FINDINGS: In a cluster-randomized design 44 communes were allocated to intervention and 46 to control. Laywomen facilitated monthly meetings during 3 years in groups composed of health care staff and key persons in the communes. A problem-solving approach was employed. Births and neonatal deaths were monitored, and interviews were performed in households of neonatal deaths and of randomly selected surviving infants. A latent period before effect is expected in this type of intervention, but this timeframe was not pre-specified. Neonatal mortality rate (NMR) from July 2008 to June 2011 was 16.5/1,000 (195 deaths per 11,818 live births) in the intervention communes and 18.4/1,000 (194 per 10,559 live births) in control communes (adjusted odds ratio [OR] 0.96 [95% CI 0.73-1.25]). There was a significant downward time trend of NMR in intervention communes (p = 0.003) but not in control communes (p = 0.184). No significant difference in NMR was observed during the first two years (July 2008 to June 2010) while the third year (July 2010 to June 2011) had significantly lower NMR in intervention arm: adjusted OR 0.51 (95% CI 0.30-0.89). Women in intervention communes more frequently attended antenatal care (adjusted OR 2.27 [95% CI 1.07-4.8]). CONCLUSIONS: A randomized facilitation intervention with local stakeholder groups composed of primary care staff and local politicians working for three years with a perinatal problem-solving approach resulted in increased attendance to antenatal care and reduced neonatal mortality after a latent period. TRIAL REGISTRATION: Current Controlled Trials ISRCTN44599712. Please see later in the article for the Editors' Summary.

Deadly Desire : A Psychoanalytical Reading of Desire and Death in the Poetry of Dylan Thomas

Dylan Thomas' work is often explored in light of the poet himself, and he has been referred to as modernism's l'enfant terrible or even described as a late romanticist. The aim in this essay is to explore the poetry without regard to his personal life as well as highlight previously ignored oedipal elements in said poetry. The main goal is to assert Thomas' place amongst the modernist literati, of which most were heavily influenced by Freud, as well as to be an acknowledgement of his work without considering his biography.

The Place of Writing in the Poetry of W. B. Yeats and Patrick Kavanagh

Abstract This article addresses the theme of place in the poetry of W. B. Yeats and Patrick Kavanagh, focusing on the concept of place as a physical and psychological entity. The article explores place as a creative force in the work of these two poets, in relation to the act of writing. Seamus Heaney, in his essay “The Sense of Place,” talks about the “history of our sensibilities” that looks to the stable element of the land for continuity: “We are dwellers, we are namers, we are lovers, we make homes and search for our histories” (Heaney 1980: 148-9). Thus, in a physical sense, place is understood as a site in which identity is located and defined, but in a metaphysical sense, place is also an imaginative space that maps the landscapes of the mind. This article compares the different ways in which Yeats and Kavanagh relate to their place of writing, physically and artistically, where place is understood as a physical lived space, and as a liberating site for an exploration of poetic voice, where the poet creates his own country of the mind.

La confrontation de la laideur avec la beauté dans lesromans Mercure et Attentat. Une étude sur lareprésentation de la dualité thématique laideur-beautéchez Amélie Nothomb. : "Where there is Quasimodo, there is also Esmeralda." The confrontationbetween ugliness and beauty in the novels Mercure and Attentat. Astudy on the representation of the duality beauty-ugliness in the worksof Amélie Nothomb.

This paper studies one of the recurrent topics of writing found in Amélie Nothomb’snovels: beauty and ugliness. The novels Mercure and Attentat are analyzed in detail,with respect to figures of speech used to describe the extreme physical appearance ofthe protagonists and the role of the duality beauty-ugliness in the advancement of theplot.

The place of writing in the poetry of W.B Yeats and Patrick Kavanagh

This article addresses the theme of place in the poetry of W. B. Yeats and Patrick Kavanagh, focusing on the concept of place as a physical and psychological entity. The article explores place as a creative force in the work of these two poets, in relation to the act of writing. Seamus Heaney, in his essay “The Sense of Place,” talks about the “history of our sensibilities” that looks to the stable element of the land for continuity: “We are dwellers, we are namers, we are lovers, we make homes and search for our histories” (Heaney 1980: 148-9). Thus, in a physical sense, place is understood as a site in which identity is located and defined, but in a metaphysical sense, place is also an imaginative space that maps the landscapes of the mind. This article compares the different ways in which Yeats and Kavanagh relate to their place of writing, physically and artistically, where place is understood as a physical lived space, and as a liberating site for an exploration of poetic voice, where the poet creates his own country of the mind.