Traditional birth attendants lack basic information on HIV and safe delivery practices in rural Mysore, India

<p>Abstract</p> <p>Background</p> <p>There is little research on HIV awareness and practices of traditional birth attendants (TBA) in India. This study investigated knowledge and attitudes among rural TBA in Karnataka as part of a project examining how traditional birth attendants could be integrated into prevention-of-mother-to-child transmission of HIV (PMTCT) programs in India.</p> <p>Methods</p> <p>A cross-sectional survey was conducted between March 2008 and January 2009 among TBA in 144 villages in Mysore <it>Taluk</it>, Karnataka. Following informed consent, TBA underwent an interviewer-administered questionnaire in the local language of <it>Kannada </it>on practices and knowledge around birthing and HIV/PMTCT.</p> <p>Results</p> <p>Of the 417 TBA surveyed, the median age was 52 years and 96% were Hindus. A majority (324, 77.7%) had no formal schooling, 88 (21.1%) had up to 7 years and 5 (1%) had more than 7 yrs of education. Only 51 of the 417 TBA (12%) reported hearing about HIV/AIDS. Of those who had heard about HIV/AIDS, only 36 (72%) correctly reported that the virus could be spread from mother to child; 37 (74%) identified unprotected sex as a mode of transmission; and 26 (51%) correctly said healthy looking people could spread HIV. Just 22 (44%) knew that infected mothers could lower the risk of transmitting the virus to their infants. An overwhelming majority of TBA (401, 96.2%) did not provide antenatal care to their clients. Over half (254, 61%) said they would refer the woman to a hospital if she bled before delivery, and only 53 (13%) felt referral was necessary if excessive bleeding occurred after birth.</p> <p>Conclusions</p> <p>Traditional birth attendants will continue to play an important role in maternal child health in India for the foreseeable future. This study demonstrates that a majority of TBA lack basic information about HIV/AIDS and safe delivery practices. Given the ongoing shortage of skilled birth attendance in rural areas, more studies are needed to examine whether TBA should be trained and integrated into PMTCT and maternal child health programs in India.</p

Repair and Reconstruction of a Resected Tumor Defect Using a Composite of Tissue Flap–Nanotherapeutic–Silk Fibroin and Chitosan Scaffold

A multifaceted strategy using a composite of anti-cancer nanotherapeutic and natural biomaterials silk fibroin (SF) and chitosan (CS) blend scaffolds was investigated for the treatment of a tissue defect post-tumor resection by providing local release of the therapeutic and filling of the defect site with the regenerative bioscaffolds. The scaffold-emodin nanoparticle composites were fabricated and characterized for drug entrapment and release, mechanical strength, and efficacy against GILM2 breast cancer cells in vitro and in vivo in a rat tumor model. Emodin nanoparticles were embedded in SF and SFCS scaffolds and the amount of emodin entrapment was a function of the scaffold composition and emodin loading concentration. In vitro, there was a burst release of emodin from all scaffolds during the first 2 days though it was detected even after 24 days. Increase in emodin concentration in the scaffolds decreased the overall elastic modulus and ultimate tensile strength of the scaffolds. After 6 weeks of in vivo implantation, the cell density (p < 0.05) and percent degradation (p < 0.01) within the remodeled no emodin SFCS scaffold was significantly higher than the emodin loaded SFCS scaffolds, although there was no significant difference in the amount of collagen deposition in the regenerated SFCS scaffold. The presence and release of emodin from the SFCS scaffolds inhibited the integration of SFCS into the adjacent tumor due to the formation of an interfacial barrier of connective tissue that was lacking in emodin-free SFCS scaffolds. While no significant difference in tumor size was observed between the in vivo tested groups, tumors treated with emodin loaded SFCS scaffolds had decreased presence and size and similar regeneration of new tissue as compared to no emodin SFCS scaffolds

Measuring progress from 1990 to 2017 and projecting attainment to 2030 of the health-related Sustainable Development Goals for 195 countries and territories: a systematic analysis for the Global Burden of Disease Study 2017

Background Efforts to establish the 2015 baseline and monitor early implementation of the UN Sustainable Development Goals (SDGs) highlight both great potential for and threats to improving health by 2030. To fully deliver on the SDG aim of “leaving no one behind”, it is increasingly important to examine the health-related SDGs beyond national-level estimates. As part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017), we measured progress on 41 of 52 health-related SDG indicators and estimated the health-related SDG index for 195 countries and territories for the period 1990–2017, projected indicators to 2030, and analysed global attainment. Methods We measured progress on 41 health-related SDG indicators from 1990 to 2017, an increase of four indicators since GBD 2016 (new indicators were health worker density, sexual violence by non-intimate partners, population census status, and prevalence of physical and sexual violence [reported separately]). We also improved the measurement of several previously reported indicators. We constructed national-level estimates and, for a subset of health-related SDGs, examined indicator-level differences by sex and Socio-demographic Index (SDI) quintile. We also did subnational assessments of performance for selected countries. To construct the healthrelated SDG index, we transformed the value for each indicator on a scale of 0–100, with 0 as the 2·5th percentile and 100 as the 97·5th percentile of 1000 draws calculated from 1990 to 2030, and took the geometric mean of the scaled indicators by target. To generate projections through 2030, we used a forecasting framework that drew estimates from the broader GBD study and used weighted averages of indicator-specific and country-specific annualised rates of change from 1990 to 2017 to inform future estimates. We assessed attainment of indicators with defined targets in two ways: first, using mean values projected for 2030, and then using the probability of attainment in 2030 calculated from 1000 draws. We also did a global attainment analysis of the feasibility of attaining SDG targets on the basis of past trends. Using 2015 global averages of indicators with defined SDG targets, we calculated the global annualised rates of change required from 2015 to 2030 to meet these targets, and then identified in what percentiles the required global annualised rates of change fell in the distribution of country-level rates of change from 1990 to 2015. We took the mean of these global percentile values across indicators and applied the past rate of change at this mean global percentile to all health-related SDG indicators, irrespective of target definition, to estimate the equivalent 2030 global average value and percentage change from 2015 to 2030 for each indicator. Findings The global median health-related SDG index in 2017 was 59·4 (IQR 35·4–67·3), ranging from a low of 11·6 (95% uncertainty interval 9·6–14·0) to a high of 84·9 (83·1–86·7). SDG index values in countries assessed at the subnational level varied substantially, particularly in China and India, although scores in Japan and the UK were more homogeneous. Indicators also varied by SDI quintile and sex, with males having worse outcomes than females for non-communicable disease (NCD) mortality, alcohol use, and smoking, among others. Most countries were projected to have a higher health-related SDG index in 2030 than in 2017, while country-level probabilities of attainment by 2030 varied widely by indicator. Under-5 mortality, neonatal mortality, maternal mortality ratio, and malaria indicators had the most countries with at least 95% probability of target attainment. Other indicators, including NCD mortality and suicide mortality, had no countries projected to meet corresponding SDG targets on the basis of projected mean values for 2030 but showed some probability of attainment by 2030. For some indicators, including child malnutrition, several infectious diseases, and most violence measures, the annualised rates of change required to meet SDG targets far exceeded the pace of progress achieved by any country in the recent past. We found that applying the mean global annualised rate of change to indicators without defined targets would equate to about 19% and 22% reductions in global smoking and alcohol consumption, respectively; a 47% decline in adolescent birth rates; and a more than 85% increase in health worker density per 1000 population by 2030. Interpretation The GBD study offers a unique, robust platform for monitoring the health-related SDGs across demographic and geographic dimensions. Our findings underscore the importance of increased collection and analysis of disaggregated data and highlight where more deliberate design or targeting of interventions could accelerate progress in attaining the SDGs. Current projections show that many health-related SDG indicators, NCDs, NCD-related risks, and violence-related indicators will require a concerted shift away from what might have driven past gains—curative interventions in the case of NCDs—towards multisectoral, prevention-oriented policy action and investments to achieve SDG aims. Notably, several targets, if they are to be met by 2030, demand a pace of progress that no country has achieved in the recent past. The future is fundamentally uncertain, and no model can fully predict what breakthroughs or events might alter the course of the SDGs. What is clear is that our actions—or inaction—today will ultimately dictate how close the world, collectively, can get to leaving no one behind by 2030

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Not AvailableTHE PAPER DISCUSSES THE METHOD OF PROPOGATION AND MANAGEMENT OF NAPIER AND HYBRID GRASSES IN DOON VALLEY AND ADJOINING HILLS. NAPIER GRASS YIELDED ABOUT 300 TO 350 sq/ha OF GREEN FODDER/CUT ON AN ANNUAL BASIS WHICH AT RS 2 /- CAN FETCH AN ANNUAL INCOME OF RS 600 TO 700 /ha DEPENDING UPON THE PROXIMITY OF THE PLANTING SITE TO THE MARKET. NAPIER AND HYBRID NAPIER GRASSES ARE EXCELLENT RAW MATERIALS FOR STABILIZING THE LAND SLIDES, RECLAIMED TORRENT BEDS, ERODED LAND AND GULLIED LANDS.Not Availabl

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Not AvailableDISCUSSES IMPORTANT FACTORS WHICH INFLUENCE RUNOFF AND SOIL LOSS EROSION ARE RAINFALL , SLOPE OF LAND , SOIL CHARACTERISTICS AND VEGETAL COVER AND LAND USE. THE DATA COLLECTED IN ALLUVIAL SOILS , RED SOILS AND BLACK SOILS ON DIFFERENT SLOPES AND CLIMATIC CONDITIONS HAVE BEEN PRESENTED. IMPORTANT GRASSES AND LEGUMES FOR SOIL AND WATER CONSERVATION AND ALSO PRODUCTION OF FORAGES HAVE ALSO BEEN ELBORATED.Not Availabl

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Not AvailableTHE PAPER PROVIDES USEFUL INFORMATION ON LANDSLIDES IN HIMALAYAN REGION. IT HAS BEEN SUGGESTED THAT THE TECHNOLOGY DEVELOPED BY CSWCRTI , DEHRADUN CAN BE SUCCESSFULLY ADOPTED IN TACKLING LANDSLIDE PROBLEMS IN OTHER AREAS WITH SUITABLE MODIFICATIONS.Not Availabl

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Not AvailableTHE PAPER DESCRIBES HOW KUDZU ( PUERARIA THUMBERGIANA) HAS SUCCESSFULLY BEEN INTRODUCED AT SELAKUI ( DOON VALLEY) AND NALOTA NALA ( MUSSOORIE HILLS) FOR LANDSLIDE CONTROL. THE PLANT NOT ONLY PROVIDES PROTECTION AGAINST SOIL EROSION TO THE SITE WHERE IT GROWS BUT ALSO PROVIDES GOOD NUTRITIVE FODDER FOR THE CATTLE FROM ITS LUXURIANT FOLIAGE TO THE TUNE OF 110 TO 650 qlts/ha ANNUALLY DEPENDING UPON THE SITE CONDITIONS. ONE TO TWO YEAR OLD THICKER SHOOTS WHICH ARE NOT SUITED FOR FODDER CONSUMPTION WERE FOUND TO HAVE GOOD USE AS RAW MATERIAL FOR MANUFACTURE OF HAND MADE PAPER. GROWTH AND YIELD DATA SHOWED THAT THIS PLANT CAN YIELD ABOUT 100 TO 160 qlts/ha OF THICK SHOOTS ( MEANT FOR PAPER INDUSTRY) WHICH WILL YIELD ABOUT 60 TO 95 qlts/ha OF BARK FIBRE.Not Availabl

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Not AvailableTHE PAPER HIGHLIGHTS THE USEFULNESS OF BHABAR GRASS AND SUGGESTS THAT IT COULD BE SUCCESSFULLY RAISED IN WASTELANDS AND SHALLOW AND BOULDERY OR ROCKY SOILS. THE STUDIES CONDUCTED AT THE SOIL CONSERVATION RESEARCH STATION , SELAKUI ( DEHRADUN) HAVE SHOWN THAT CULTIVATION OF BHABAR GRASS ON THESE OTHERWISE UNPRODUCTIVE WASTELANDS CAN PROVIDE AN AVERAGE YIELD OF 60 qlts OF DRY GRASS PER ha WITH A NET ANNUAL RETURN OF ABOUT RS 900 /ha . THE GRASS COVER WOULD PROVIDE AN ADDED BENEFIT OF PROTECTION OF THE SOIL AGAINST EROSION. THE METHODS OF RAISING THE BHABAR PLANTATIONS, THEIR MANAGEMENT AND THE ECONOMICS HAVE BEEN PRESENTED.Not Availabl