Maternal Group B Streptococcal (GBS) Genital Tract Colonization at Term in Women who Have Asymptomatic GBS Bacteriuria

Objective: To determine the rate of positive group B streptococcus (GBS) cultures at 35–37 weeks gestation in women who have first trimester asymptomatic GBS bacteriuria. Methods: Pregnant women with asymptomatic first trimester GBS bacteriuria had genital cultures for GBS performed at 35–37 weeks gestational age. Serotyping was performed by the standard Lancefield capillary precipitin method. Results: Fifty-three women with positive urine cultures had genital cultures performed at 35–37 weeks. Sixteen of the 53 (30.2%; 95% confidence interval: 18.4–44.3%) third trimester vaginal cultures were positive for GBS. Five of eight (63%) of the women with typable urine serotypes had the same typable serotype in the third trimester genital culture. Conclusion: Genital tract cultures at 35–37 weeks for GBS correlate poorly with first trimester asymptomatic GBS bacteriuria. Recommendations for GBS prophylaxis in labor in women who have first trimester asymptomatic GBS bacteriuria should be investigated further and reconsidered

Patterns of smoking behavior among physicians in Yerevan, Armenia

BACKGROUND: Physicians can play an important role in smoking prevention and control. This study will identify smoking prevalence among physicians in Yerevan, Armenia. It will also explore how the smoking behaviors of physicians, their perceived ability to influence patient smoking behavior, and their knowledge about health outcomes related to smoking influence their interaction with patients. METHODS: A cross-sectional, self-administered, anonymous survey was conducted in July, 2004, among 12 healthcare facilities in Yerevan. Analyses are based on responses from 240 physicians, representing a 70% response rate. RESULTS: The percentage of current smokers was significantly higher in men than women (48.5% vs. 12.8% regular and 6.8% vs. 4.5% occasional). Among current smokers, 52.7% of men compared with 13.0% of women had previously smoked in the presence of patients. Only 35.3% felt well prepared to assist patients to quit smoking. Physicians who smoke are less likely to ask their patients about their smoking behavior or believe their example is likely to influence their patients. Level of perceived preparedness to assist patients to quit smoking was positively associated with knowledge about known health risks associated with smoking. CONCLUSION: Smoking prevalence is high among physicians in the 12 healthcare facilities in Yerevan, and a large percentage of physician smoke in the presence of their patients. Physician smoking behavior and knowledge of smoking related health outcomes in Yerevan influences whether they counsel patients regarding smoking

Bookselling online: an examination of consumer behaviour patterns.

Based upon empirical research, and using a range of methods, this paper examines the behaviour and experiences of consumers in online bookselling settings and offers comparison between online and offline (traditional) bookselling. The research finds that while the convenience of online bookshops is important, the key factors enticing consumers online are a combination of breadth of range, ease of access to obscure titles, as well as personalised recommendations and customer reviews. The research is of value to the book trade, highlighting consumer responses to widely adopted online marketing approaches. The research also contributes to scholarly knowledge in the fields of consumer behaviour, e-marketing and e-commerce in online bookselling, as well as providing findings which can be tested in other online settings, informing future theoretical research

Sexual behaviour of men that consulted in medical outpatient clinics in Western Switzerland from 2005-2006: risk levels unknown to doctors?

<p>Abstract</p> <p>Background</p> <p>To determine male outpatient attenders' sexual behaviours, expectations and experience of talking about their sexuality and sexual health needs with a doctor.</p> <p>Methods</p> <p>A survey was conducted among all male patients aged 18-70, recruited from the two main medical outpatient clinics in Lausanne, Switzerland, in 2005-2006. The anonymous self-administered questionnaire included questions on sexual behaviour, HIV/STI information needs, expectations and experiences regarding discussion of sexual matters with a doctor.</p> <p>Results</p> <p>The response rate was 53.0% (N = 1452). The mean age was 37.7 years. Overall, 13.4% of patients were defined as at STI risk - i.e. having not consistently used condoms with casual partners in the last 6 months, or with a paid partner during the last intercourse - regarding their sexual behaviour in the last year. 90.9% would have liked their physician to ask them questions concerning their sexual life; only 61.4% had ever had such a discussion. The multivariate analysis showed that patients at risk tended to have the following characteristics: recruited from the HIV testing clinic, lived alone, declared no religion, had a low level of education, felt uninformed about HIV/AIDS, were younger, had had concurrent sexual partners in the last 12 months. However they were not more likely to have discussed sexual matters with their doctor than patients not at risk.</p> <p>Conclusion</p> <p>Recording the sexual history and advice on the prevention of the risks of STI should become routine practice for primary health care doctors.</p

Using hospital discharge data for determining neonatal morbidity and mortality: a validation study

<p>Abstract</p> <p>Background</p> <p>Despite widespread use of neonatal hospital discharge data, there are few published reports on the accuracy of population health data with neonatal diagnostic or procedure codes. The aim of this study was to assess the accuracy of using routinely collected hospital discharge data in identifying neonatal morbidity during the birth admission compared with data from a statewide audit of selected neonatal intensive care (NICU) admissions.</p> <p>Methods</p> <p>Validation study of population-based linked hospital discharge/birth data against neonatal intensive care audit data from New South Wales, Australia for 2,432 babies admitted to NICUs, 1994–1996. Sensitivity, specificity and positive predictive values (PPV) with exact binomial confidence intervals were calculated for 12 diagnoses and 6 procedures.</p> <p>Results</p> <p>Sensitivities ranged from 37.0% for drainage of an air leak to 97.7% for very low birthweight, specificities all exceeded 85% and PPVs ranged from 70.9% to 100%. In-hospital mortality, low birthweight (≤1500 g), retinopathy of prematurity, respiratory distress syndrome, meconium aspiration, pneumonia, pulmonary hypertension, selected major anomalies, any mechanical ventilation (including CPAP), major surgery and surgery for patent ductus arteriosus or necrotizing enterocolitis were accurately identified with PPVs over 92%. Transient tachypnea of the newborn and drainage of an air leak had the lowest PPVs, 70.9% and 83.6% respectively.</p> <p>Conclusion</p> <p>Although under-ascertained, routinely collected hospital discharge data had high PPVs for most validated items and would be suitable for risk factor analyses of neonatal morbidity. Procedures tended to be more accurately recorded than diagnoses.</p

Leptospirosis in the Asia Pacific region

<p>Abstract</p> <p>Background</p> <p>Leptospirosis is a worldwide zoonotic infection that has been recognized for decades, but the problem of the disease has not been fully addressed, particularly in resource-poor, developing countries, where the major burden of the disease occurs. This paper presents an overview of the current situation of leptospirosis in the region. It describes the current trends in the epidemiology of leptospirosis, the existing surveillance systems, and presents the existing prevention and control programs in the Asia Pacific region.</p> <p>Methods</p> <p>Data on leptospirosis in each member country were sought from official national organizations, international public health organizations, online articles and the scientific literature. Papers were reviewed and relevant data were extracted.</p> <p>Results</p> <p>Leptospirosis is highly prevalent in the Asia Pacific region. Infections in developed countries arise mainly from occupational exposure, travel to endemic areas, recreational activities, or importation of domestic and wild animals, whereas outbreaks in developing countries are most frequently related to normal daily activities, over-crowding, poor sanitation and climatic conditions.</p> <p>Conclusion</p> <p>In the Asia Pacific region, predominantly in developing countries, leptospirosis is largely a water-borne disease. Unless interventions to minimize exposure are aggressively implemented, the current global climate change will further aggravate the extent of the disease problem. Although trends indicate successful control of leptospirosis in some areas, there is no clear evidence that the disease has decreased in the last decade. The efficiency of surveillance systems and data collection varies significantly among the countries and areas within the region, leading to incomplete information in some instances. Thus, an accurate reflection of the true burden of the disease remains unknown.</p

Seismic structure of the Endeavour Segment, Juan de Fuca Ridge : correlations with seismicity and hydrothermal activity

Author Posting. © American Geophysical Union, 2007. This article is posted here by permission of American Geophysical Union for personal use, not for redistribution. The definitive version was published in Journal of Geophysical Research 112 (2007): B02401, doi:10.1029/2005JB004210.Multichannel seismic reflection data collected in July 2002 at the Endeavour Segment, Juan de Fuca Ridge, show a midcrustal reflector underlying all of the known high-temperature hydrothermal vent fields in this area. On the basis of the character and geometry of this reflection, its similarity to events at other spreading centers, and its polarity, we identify this as a reflection from one or more crustal magma bodies rather than from a hydrothermal cracking front interface. The Endeavour magma chamber reflector is found under the central, topographically shallow section of the segment at two-way traveltime (TWTT) values of 0.9–1.4 s (∼2.1–3.3 km) below the seafloor. It extends approximately 24 km along axis and is shallowest beneath the center of the segment and deepens toward the segment ends. On cross-axis lines the axial magma chamber (AMC) reflector is only 0.4–1.2 km wide and appears to dip 8–36° to the east. While a magma chamber underlies all known Endeavour high-temperature hydrothermal vent fields, AMC depth is not a dominant factor in determining vent fluid properties. The stacked and migrated seismic lines also show a strong layer 2a event at TWTT values of 0.30 ± 0.09 s (380 ± 120 m) below the seafloor on the along-axis line and 0.38 ± 0.09 s (500 ± 110 m) on the cross-axis lines. A weak Moho reflection is observed in a few locations at TWTT values of 1.9–2.4 s below the seafloor. By projecting hypocenters of well-located microseismicity in this region onto the seismic sections, we find that most axial earthquakes are concentrated just above the magma chamber and distributed diffusely within this zone, indicating thermal-related cracking. The presence of a partially molten crustal magma chamber argues against prior hypotheses that hydrothermal heat extraction at this intermediate spreading ridge is primarily driven by propagation of a cracking front down into a frozen magma chamber and indicates that magmatic heat plays a significant role in the hydrothermal system. Morphological and hydrothermal differences between the intermediate spreading Endeavour and fast spreading ridges are attributable to the greater depth of the Endeavour AMC and the corresponding possibility of axial faulting.E.V.A. was supported by a National Science Foundation Graduate Research Fellowship, the WHOI-MIT Joint Program, and the WHOI Deep Ocean Exploration Institute. This work was also supported by OCE-0002551 to the Woods Hole Oceanographic Institution, OCE-0002488 to Lamont-Doherty Earth Observatory, and OCE-0002600 to Scripps Institution of Oceanography

Myanmar: The Key Link between South Asia and Southeast Asia

This paper examines the road and railway links in Myanmar connecting northeast India on the one side with the rest of Southeast Asia on the other. It also discusses the importance of new deep-sea ports in creating alternative shipping routes, essential for Myanmar's international links. It also reviews the country's external trade patterns, and analyzes issues related to trade facilitation, exchange rate policy, financial sector reform, and private sector development. The extent to which these gaps can be addressed will depend on the costs and benefits. South Asia-Southeast Asia connectivity can only be accomplished if Myanmar improves the hard and soft infrastructure aspects of connectivity

Is There Evidence to Show that Fetal Alcohol Syndrome can be Prevented?

Fetal Alcohol Syndrome (FAS) is currently the major cause of mental retardation in the Western world. Since FAS is not a natural phenomenon and is created by mixing alcohol and pregnancy, the solution to decreasing the incidence of all alcohol-related birth defects is therefore entirely preventable. To date, little is known about the effectiveness of prevention programs in reducing the incidence of FAS. Therefore, it is the intention of this article to review the effectiveness of prevention programs in lowering the incidence of FAS. The present review revealed that prevention programs, to date, have been successful in raising awareness of FAS levels across the groups examined. However, this awareness has not been translated into behavioral changes in 'high risk' drinkers as consumption levels in this group have decreased only marginally, indicating prevention programs have had minimal or no impact in lowering the incidence of FAS. Urgent steps must now be taken to fully test prevention programs, and find new strategies involving both sexes, to reduce and ultimately eliminate the incidence of FAS

Stigma and labour market outcomes: sex work and domestic work in India

In this paper, we examine whether the earnings of sex workers in India are significantly different from those in domestic work, a trade that is also gendered in nature and can be done with similarly low levels of training and education. We analyse this using data collected during fieldwork in the cities of Kolkata and Delhi in India. Our results confirm that there is a significant difference in wages between the two groups of workers. We consider the extent to which the stigma attached to sexwork contributes to the higher wages in this occupation relative to domestic work. To do this, we control for endogeneity caused by selection on unobservables. We find that stigma is a significant contributory factor to the wage differential. We also preliminarily consider an alternate explanation – that of violence in the trade. We find that the experience of violence in the trade does not affect the take home earnings of the individuals