Factors affecting prenatal care use and pregnancy outcome in Texas: A comparative study among and within Black, Anglo, and Hispanic populations

This research project is a study in the field of public health to test the relationships of demographic, socioeconomic, behavioral, and biological factors with (1) prenatal care use and (2) pregnancy outcome, measured by birth weight. It has been postulated that demographic, socioeconomic, and behavioral factors are associated with differences in the use of prenatal care services. It has also been postulated that differences in demographic, socioeconomic, behavioral, and biological factors result in differences in birth weight. This research attempts to test these two basic conceptual frameworks. At the same time, an attempt is made to determine the population groups and subgroups that are at increased risk (1) of using fewer prenatal care visits, and (2) of displaying a higher incidence of low birth weight babies. An understanding of these relationships of the demographic, socioeconomic, behavioral, and biological factors in the use of prenatal care visits and pregnancy outcome, measured by birth weight, will potentially offer guidance in the planning and policy development of maternal and child health services. The research considers four major components of maternal characteristics: (1) Demographic factors. Ethnicity, household size, maternal parity, and maternal age; (2) Socioeconomic factors. Maternal education, family income, maternal employment, health insurance coverage, and household dwelling; (3) Behavioral factors. Maternal smoking, attendance at child development classes, mother's first prenatal care visit, total number of prenatal care visits, and adequacy of care; and, (4) Biological factors. Maternal weight gain during pregnancy.^ The research considers 16 independent variables and two dependent variables.^ It was concluded that: (1) Generally, differences in demographic, socioeconomic, and behavioral factors were associated with differences in the average number of prenatal care visits between and within population groups and subgroups. The Hispanic mothers were the lowest users of prenatal care services. (2) In some cases, differences in demographic, socioeconomic, behavioral, and biological factors demonstrated differences in the average birth weight of infants between and within population groups and subgroups. (3) Differences in demographic, socioeconomic, behavioral, and biological factors resulted in differences in the rates of low birth weight babies between and within population groups and subgroups. The Black mothers delivered the highest incidence of low birth weight infants.^ These findings could provide guidance in the formulation of public health policies such as MCH services, an increase in the use of prenatal care services by prospective mothers, resulting in reduction of the incidence of low birth weight babies, and consequently aid in reducing the rates of infant mortality. ^

The relationship between calcium and fluoride intake, pregnancy and lactation and the risk of height loss in white women

This study was designed to investigate the effect of calcium and fluoride intake, and parity and lactation on the risk of spinal osteoporosis. Height loss was used as a surrogate measure for spinal fractures by taking advantage of documented changes in height found during the 25-year follow-up of the Charleston Heart Study cohort. Women who had lost 2-4" in height or who had no change in height during the follow-up period were defined as case and comparison subjects respectively. Calcium intake when the subjects were "about 25" and in the recent past, average intake of fluoride over 25 years, and parity and history of breastfeeding were ascertained by questionnaire from 54 case and 77 comparison subjects. Low calcium intake in the past decreased the risk of height loss (age-adjusted OR = 0.3, 95%CI: 0.1-0.96) although several potentially important confounding variables could not be adjusted for. There was no association between risk of height loss and present calcium intake (OR = 0.8, 95%CI: 0.3-2.6 for low versus high intake) after adjustment for past calcium intake. High fluoride intake decreased the risk of height loss (adjusted OR = 0.4, 95%CI: 0.1-1.2). The effect of fluoride or calcium intake in the present was modified by the level of the other nutrient. Compared to a low intake of both calcium and fluoride, a high intake of one increased the risk of height loss (crude OR = 3.3 for high fluoride/low calcium, crude OR = 6.0 for high calcium/low fluoride) although a high intake of both was slightly protective (crude OR = 0.7). It is estimated that a "high" nutrient intake in this population was greater than 850mg/day for calcium and 2mg/day for fluoride. After adjustment for age, increasing parity decreased the risk of height loss in women who had never breastfed (OR = 0.2, 95%CI: 0.01-1.7 for 4 or more children). Women who had breastfed were also at lower risk of height loss than nulliparous women (OR = 0.3, 95%CI: 0.1-1.2 for 4 or more children) although at any level of parity, breastfeeding women had a greater risk of height loss than did non-breastfeeding women. ^

The use of the computerized and revised vital record in conducting etiologic studies on neural tube defects

The purpose of this study was to evaluate the adequacy of computerized vital records in Texas for conducting etiologic studies on neural tube defects (NTDs), using the revised and expanded National Centers for Health Statistics vital record forms introduced in Texas in 1989.^ Cases of NTDs (anencephaly and spina bifida) among Harris County (Houston) residents were identified from the computerized birth and death records for 1989-1991. The validity of the system was then measured against cases ascertained independently through medical records and death certificates. The computerized system performed poorly in its identification of NTDs, particularly for anencephaly, where the false positive rate was 80% with little or no improvement over the 3-year period. For both NTDs the sensitivity and predictive value positive of the tapes were somewhat higher for Hispanic than non-Hispanic mothers.^ Case control studies were conducted utilizing the tape set and the independently verified data set, using controls selected from the live birth tapes. Findings varied widely between the data sets. For example, the anencephaly odds ratio for Hispanic mothers (vs. non-Hispanic) was 1.91 (CI = 1.38-2.65) for the tape file, but 3.18 (CI = 1.81-5.58) for verified records. The odds ratio for diabetes was elevated for the tape set (OR = 3.33, CI = 1.67-6.66) but not for verified cases (OR = 1.09, CI = 0.24-4.96), among whom few mothers were diabetic. It was concluded that computerized tapes should not be solely relied on for NTD studies.^ Using the verified cases, Hispanic mother was associated with spina bifida, and Hispanic mother, teen mother, and previous pregnancy terminations were associated with anencephaly. Mother's birthplace, education, parity, and diabetes were not significant for either NTD.^ Stratified analyses revealed several notable examples of statistical interaction. For anencephaly, strong interaction was observed between Hispanic origin and trimester of first prenatal care.^ The prevalence was 3.8 per 10,000 live births for anencephaly and 2.0 for spina bifida (5.8 per 10,000 births for the combined categories). ^

AN ESTIMATION OF IN UTERO DRUG EXPOSURE BY DETERMINANTS OF FREQUENCY AND DISTRIBUTION OF MATERNAL DRUG CONSUMPTION

Data derived from 1,194 gravidas presenting at the observation unit of a city/county hospital between October 11, 1979 through December 7, 1979 were evaluated with respect to the proportion ingesting drugs during pregnancy. The mean age of the mother at the time of the interview was 22.0 years; 43.0 percent were Black; 34.0 percent Latin-American, 21.0 percent White and 2.0 percent other; mean gravida was 2.5 pregnancies; mean parity was 1.0; and mean number of previous abortions was 0.34. Completed interview data was available for 1,119 gravida, corresponding urinalyses for 997 subjects. Ninety and one-tenth percent (90.1 percent) of the subjects reported ingestion of one or more drug preparation(s) (prescription, OTC, or substances used for recreational purposes) during pregnancy with a range of 0 to 11 substances and a mean of 2.7. Dietary supplements (vitamins and minerals) were most frequently reported followed by non-narcotic analgesics. Seventy-six and one tenth percent (76.1 percent) of the population reported consumption of prescription medication, 42.5 percent reported consumption of over-the-counter medications, 45.7 percent reported consumption of a substance for recreational purposes and 4.3 percent reported illicit consumption of a substance. For selected substances, no measurable difference was found between obtaining the information from the interview method or from a urinalysis assay. ^

AMERICAN TRYPANOSOMIASIS (CHAGAS') DISEASE - A STUDY OF FETO-MATERNAL MORBIDITY AND MORTALITY

The possibility of a relationship between American Trypanosomiasis (Chagas') disease and pregnancy outcome was analyzed measuring feto-maternal morbidity and mortality in a sample of 604 pregnant women and their offspring seen at the Hospital Universitario de Maternidad y Neonatologia in Cordoba, Argentina during 1979.^ A cross-sectional, "case-comparison" investigation was employed to determine the degree of risk between having a reactive chagasic serologic test and a negative pregnancy outcome as determined by abortion, stillbirth, and infant death prior to one week of age. Patients were selected using a dichotomous, 0-1 scale with either the presence or the absence of a reactive Machado-Guerreiro complement fixation serologic blood test result.^ The data obtained were analyzed using appropriate statistical techniques for measuring the comparisons between the case and control groups under various demographic and socioeconomic variables such as, age, marital status, educational attainment, and residence. Similarly, additional biological variables of birth order, maternal and fetal complications, and prematurity were examined.^ From the analysis of the data obtained in this investigation, no definite conclusions can be reached regarding the risk of having an unsuccessful pregnancy outcome in the presence of a reactive serologic finding because the study design was a cross-sectional one and the number of events were too few for an adequate analysis. Notwithstanding these limitations, the results obtained, after statistical adjustments were employed, demonstrated that women with a reactive test result were older, were of a higher parity, and were less educated. Marital status and residence were not significant variables. The risk of pregnancy wastage, however, was almost twice as frequent in the reactive group as in the non-reactive group of women. Statistically significant differences in maternal morbidity involved two complications, polyhydramnios and varicosities of the lower extremities and vulva; while in the newborn, infection was higher in infants whose mothers exhibited a reactive serologic test result.^ In summary, what this research study has shown is the need for engaging in a larger, longitudinal study for an in-depth exploration of feto-maternal morbidity and mortality--an investigation that would corraborate or refute the findings of this study.^

Epidemiology of perinatal mortality: Birthweight, crown -heel length, gestational age, and weight -for -height

Studies suggest that slim infants (low weight-for-height) experienced higher mortality rates than average or high weight-for-height infants (Miller and Hassanein, 1973; Hoffman, Meirik, and Bakketeig, 1984). In this study, the 1980 National Natality Survey and the National Fetal Mortality Survey were used to examine the association of weight, height and perinatal mortality. All singleton births to white married mothers, between 18 and 34 years of age and of parity less than 4, for whom both mother's and hospital questionnaires were completed in those two surveys (3796 live births and 2043 fetal deaths) were selected for analysis. Overall, low weight and height infants had excess mortality rates. However, after adjustment for low birthweight and preterm birth status, low weight and height infants had only slightly higher mortality rates than their medium or high weight and height counterparts. The current study consists of relatively well-educated white married mothers of optimal reproductive age and low parity. Therefore, lower than expected mortality rates for slim infants may be attributed to these favorable demographic factors in this sample as compared with previous studies, or because of advances in perinatal medicine, slim infants may be prevented from achieving the high mortality seen in earlier studies. ^

El pensamiento binario y sus salidas : hibridez, pluricultura, paridad y mestizaje

Tal como lo han analizado autores contemporáneos como E. Grüner, E. Lander y A. Mbembe, la forma que adopta el pensamiento occidental es binaria, es decir que se encuentra constituida por dos categorías exclusivas y excluyentes, por pares antagónicos, por polos opuestos. Binaria asimismo es la construcción de las identidades en Occidente, sean éstas identidades de género, de clase, étnicas o políticas. En el presente trabajo nos concentraremos en las teorizaciones de algunos autores del pensamiento poscolonial que, al cruzar las dimensiones ontológica, epistemológica y política de las cosmovisiones y de las identidades, aportaron elementos para la deconstrucción de este binarismo. H. Bhabha, R. Segato, R. Paiva y G. Anzaldúa delinearon, a nuestro entender, posibles salidas a esta cosmovisión identitaria, muy especialmente a través de sus conceptos clave de 'hibridez', pluricultura', 'paridad' y 'mestizaje'.

Relación entre la composición química corporal, la fertilidad y la prolificidad en conejas primíparas.

En este trabajo se ha estudiado el efecto de la composición química corporal, estimada mediante el método de impedancia bioeléctrica (BIA) en la primera y segunda inseminación artificial (IA), sobre la fertilidad y la prolificidad de conejas primíparas. Se utilizaron los datos de 137 conejas procedentes de dos granjas que utilizaban dos genéticas distintas (UPV e Hyplus) y tres ritmos reproductivos (R4: inseminación a los 4 días tras el parto y destete a los 28 días, R11: inseminación a los 11 días postparto y destete a 35 días y R14: inseminación a los 14 días tras el parto y destete a los 42 días). La fertilidad media observada en el segundo parto fue de un 56,2% y el porcentaje de nacidos vivos, sobre los nacidos totales, fue de un 87,5%, no encontrándose diferencias entre los ritmos utilizados. El aumento de la proporción de proteína corporal, grasa y energía en la primera IA tuvieron un efecto positivo (P=0,007; P=0,03 y P<0,001, respectivamente) sobre la fertilidad del segundo parto. Igualmente, un mayor contenido en grasa (P<0,001) y energía (P<0,001) en la segunda IA también incrementaron la fertilidad del segundo parto. El incremento del ratio proteína/energía corporal de las conejas, determinado en las dos IA, tuvo un efecto negativo sobre la fertilidad en el segundo parto (P<0,001), observándose mejores resultados en conejas con 12 g proteína/MJ respecto a otras con valores superiores. El porcentaje de nacidos vivos (P<0,001), sobre los nacidos totales, aumentó con la proporción de proteína de las conejas en el momento de la segunda IA, pero esta última no tuvo efecto sobre la fertilidad. This study evaluated the effect of chemical body composition at first and second artificial inseminations (AI), determined by bioelectric impedance technique (BIA), on fertility and prolificacy of primiparous rabbit does. Data of 137 does from two farms using two different genetics (UPV and Hyplus) and three breeding systems were analyzed. Fertility was 56.2 % and the percentage of kits born alive over total born was 87.5 %. Breeding system had no effect on fertility or the percentage of kits born alive. Higher body protein, fat and energy of the rabbit doe at first artificial insemination (AI) increased the fertility in the second parity (P=0.007, P=0.03 and P<0.001 respectively). Fat and energy content of the doe at the second AI affected positively fertility in the second parity (P<0.001 and P<0.001 respectively), while protein influenced positively only prolificacy (P<0.001). The increase of the ratio protein/energy in both AI moments had a negative influence on fertility in the second parity (P<0.001), rabbit does with 12 g protein/MJ showed a higher fertility than those with higher values

PV self-consumption optimization with storage and Active DSM for the residential sector

With the rising prices of the retail electricity and the decreasing cost of the PV technology, grid parity with commercial electricity will soon become a reality in Europe. This fact, together with less attractive PV feed-in-tariffs in the near future and incentives to promote self-consumption suggest, that new operation modes for the PV Distributed Generation should be explored; differently from the traditional approach which is only based on maximizing the exported electricity to the grid. The smart metering is experiencing a growth in Europe and the United States but the possibilities of its use are still uncertain, in our system we propose their use to manage the storage and to allow the user to know their electrical power and energy balances. The ADSM has many benefits studied previously but also it has important challenges, in this paper we can observe and ADSM implementation example where we propose a solution to these challenges. In this paper we study the effects of the Active Demand-Side Management (ADSM) and storage systems in the amount of consumed local electrical energy. It has been developed on a prototype of a self-sufficient solar house called “MagicBox” equipped with grid connection, PV generation, lead–acid batteries, controllable appliances and smart metering. We carried out simulations for long-time experiments (yearly studies) and real measures for short and mid-time experiments (daily and weekly studies). Results show the relationship between the electricity flows and the storage capacity, which is not linear and becomes an important design criterion.

Blind reconiliation

Information reconciliation is a crucial procedure in the classical post-processing of quantum key distribution (QKD). Poor reconciliation e?ciency, revealing more information than strictly needed, may compromise the maximum attainable distance, while poor performance of the algorithm limits the practical throughput in a QKD device. Historically, reconciliation has been mainly done using close to minimal information disclosure but heavily interactive procedures, like Cascade, or using less e?cient but also less interactive ?just one message is exchanged? procedures, like the ones based in low-density parity-check (LDPC) codes. The price to pay in the LDPC case is that good e?ciency is only attained for very long codes and in a very narrow range centered around the quantum bit error rate (QBER) that the code was designed to reconcile, thus forcing to have several codes if a broad range of QBER needs to be catered for. Real world implementations of these methods are thus very demanding, either on computational or communication resources or both, to the extent that the last generation of GHz clocked QKD systems are ?nding a bottleneck in the classical part. In order to produce compact, high performance and reliable QKD systems it would be highly desirable to remove these problems. Here we analyse the use of short-length LDPC codes in the information reconciliation context using a low interactivity, blind, protocol that avoids an a priori error rate estimation. We demonstrate that 2×103 bits length LDPC codes are suitable for blind reconciliation. Such codes are of high interest in practice, since they can be used for hardware implementations with very high throughput.

Theoretical Stark broadening parameters for spectral lines arising from the 2p5ns, 2p5np and 2p5nd electronic configurations of MgIII

In the present work we report theoretical Stark widths and shifts calculated using the Griem semi-empirical approach, corresponding to 237 spectral lines of MgIII. Data are presented for an electron density of 1017 cm?3 and temperatures T = 0.5?10.0 (104 K). The matrix elements used in these calculations have been determined from 23 configurations of MgIII: 2s22p6, 2s22p53p, 2s22p54p, 2s22p54f and 2s22p55f for even parity and 2s22p5ns (n = 3?6), 2s22p5nd (n = 3?9), 2s22p55g and 2s2p6np (n = 3?8) for odd parity. For the intermediate coupling (IC) calculations, we use the standard method of least-squares fitting from experimental energy levels by means of the Cowan computer code. Also, in order to test the matrix elements used in our calculations, we present calculated values of 70 transition probabilities of MgIII spectral lines and 14 calculated values of radiative lifetimes of MgIII levels. There is good agreement between our calculations and experimental radiative lifetimes. Spectral lines of MgIII are relevant in astrophysics and also play an important role in the spectral analysis of laboratory plasma. Theoretical trends of the Stark broadening parameter versus the temperature for relevant lines are presented. No values of Stark parameters can be found in the bibliography.

Adaptive protection scheme for MVC-encoded stereoscopic video streaming in IP-based networks

We present an adaptive unequal error protection (UEP) strategy built on the 1-D interleaved parity Application Layer Forward Error Correction (AL-FEC) code for protecting the transmission of stereoscopic 3D video content encoded with Multiview Video Coding (MVC) through IP-based networks. Our scheme targets the minimization of quality degradation produced by packet losses during video transmission in time-sensitive application scenarios. To that end, based on a novel packet-level distortion model, it selects in real time the most suitable packets within each Group of Pictures (GOP) to be protected and the most convenient FEC technique parameters, i.e., the size of the FEC generator matrix. In order to make these decisions, it considers the relevance of the packet, the behavior of the channel, and the available bitrate for protection purposes. Simulation results validate both the distortion model introduced to estimate the importance of packets and the optimization of the FEC technique parameter values.

Reconciliación de errores mínimamente interactiva en distribución cuántica de claves

Algunos trabajos recientes han desarrollado varias alternativas a Cascade, entre las cuales destacan aquellas basadas en el uso de técnicas de codificación modernas. Por ejemplo, a través del uso de códigos Low-Density Parity-Check (LDPC) hoy día encontramos varias propuestas que permiten mejorar la eficiencia de la reconciliación de clave para ratios de error elevados. Al utilizar códigos LDPC tan sólo se requiere un único uso del canal de comunicación. Estas propuestas se basan en una técnica conocida como “codificación de síndrome” que permite aplicar métodos de corrección de errores para reconciliar cadenas aleatorias correlacionadas. En una de estas propuestas aplicamos dos técnicas conocidas en codificación, cómo son la perforación y el acortado de símbolos, para adaptar en tiempo real el ratio de información proporcionado por el síndrome intercambiado.

Information reconciliation for Quantum Key Distribution

Secret-key agreement, a well-known problem in cryptography, allows two parties holding correlated sequences to agree on a secret key communicating over a public channel. It is usually divided into three different procedures: advantage distillation, information reconciliation and privacy amplification. The efficiency of each one of these procedures is needed if a positive key rate is to be attained from the legitimate parties? correlated sequences. Quantum key distribution (QKD) allows the two parties to obtain correlated sequences, provided that they have access to an authenticated channel. The new generation of QKD devices is able to work at higher speeds and in noisier or more absorbing environments. This exposes the weaknesses of current information reconciliation protocols, a key component to their performance. Here we present a new protocol based in low-density parity-check (LDPC) codes that presents the advantages of low interactivity, rate adaptability and high efficiency,characteristics that make it highly suitable for next generation QKD devices.

Reproductive long-term effects, endocrine response and fatty acid profile of rabbit does fed diets supplemented with n-3 fatty acids

The effect of a diet enriched with polyunsaturated n -3 fatty acids (PUFA) on endocrine, reproductive, and productive responses of rabbit females and the litters has been studied. Nulliparous does ( n = 125) were fed ad libitum from rearing to second weaning two diets supplemented with different fat sources: 7.5 g/kg lard for the control diet (group C; n = 63) or 15 g/kg of a commercial supplement containing a 50% ether extract and 35% of total fatty acids (FAs) as PUFA n -3 (Group P; n = 62). Dietary treatments did not affect apparent digestibility coefficients of nutrients, or reproductive variables of does including milk pro- duction, mortality and average daily gain of kits over two lactations. However, on Day 5 and 7 post-induction of ovulation, progesterone of Group P tended to increase to a greater extent than in does of Group C. Total PUFAs, n -6 and n -3 and eicosapentanoic (EPA) contents were greater in adipose tissues of does in Group P than in Group C. Docosapentaenoic acid (DPA), EPA, and docosahexaenoic acid (DHA) concentrations were greater in peri-ovarian than in scapular fat with abdominal fat being intermediate in concentration. In PUFA sup- plemented does, kit mortality at the second parturition tended to be less than in control does. Also, kits born to does of the PUFA-supplemented group weighed more and were of greater length than from does of control group. In conclusion, effectiveness of dietary intervention on reproductive and performance response is greater in the second parity, which suggests an accumulative long-term beneficial effect of n -3 FA supplementation in reproductive rabbit does