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A prospective study of the effects of frequent infection on the energy metabolism of Gambian infantsEccles, M. January 1987 (has links)
No description available.
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The development of the infant faecal floraRoberts, A. K. January 1988 (has links)
No description available.
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The cerebral circulation of the newborn studied by electrical impedance plethysmographyColditz, P. B. January 1988 (has links)
No description available.
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'BestaÌŠndiger Trost Wider die schrecklichen Hiobs=Posten' : German Lutheran occasional verse for bereaved parents in the seventeenth centuryLinton, Anna January 2002 (has links)
No description available.
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Death and later disability in children of low birth weightMarlow, N. January 1985 (has links)
No description available.
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Looking with the head and eyes : a developmental studyDaniel, Brigid January 1987 (has links)
No description available.
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The development of the object concept in infancyWishart, Jennifer G. January 1979 (has links)
Piaget first observed and described the problems which young infants have in understanding the nature of objects forty years ago. Both his description and his analysis of the development of the object concept are still widely supported today. This thesis, while accepting the Piagetian description of the behaviours involved, suggests that Piaget's account of the underlying cognitive processes is no longer tenable. Alternative theories of object concept development which have been put forward in recent years are also examined and rejected. An identity theory of object concept development is proposed and a series of six interlinked experiments presented in an attempt to provide support for this theory. On the basis of these and the many other experiments reported in the literature, it is suggested that an identity theory alone can adequately cover the variety of appropriate and inappropriate object-related behaviours seen in the first two years of life.
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Thesis on ricketsOsler, William David January 1896 (has links)
The subject of rickets is one to which I have given much thought during several years of an intimate experience in the management of the disease. I have been particularly impressed by its great prevalence amongst the more crowded districts and lower classes of our city population as compared with the less populous, but not necessarily less fortunately circumstanced country localities. I have likewise observed marked differences in physique between the parents of the city and those of the country; also the apparent contempt of the citizen parent for the health-giving influences of fresh air. Even more so have I noticed the crass ignorance exhibited in the choice of proper articles of diet for the rearing of children of tender years. Another striking factor is the appalling death-rate amongst young children from this disease and its protean consequences, a death-rate which, in this so called enlightened age, is not showing the diminution it should do: largely, in my opinion, owing to the invincible ignorance and obstinacy of the lower-class mother. She, in not a few instances, insists in bringing up her infant in the same faulty way as she herself was reared. In these cases the fussy grandmother is the bugbear of every family practitioner. "Children are not reared nowadays as they were in my time," she says. Granted; and it is well for the present-day pediatric prospects that usually they are not. The grandmother-empiric, when inclined to practice her domestic medicine with its nonsensical basis, is an everyday evil, and should be fought at every turn. There is too great a tendency on the part of some practitioners to agree with her for the sake of peace and popularity and recommendation: this fact, particularly in slum experience, I have from time to time observed. "Look at me," she commands the anxious mother, "I was reared on such and such a food or in this or that way, and what's good enough for your mother should be good enough for your bairn." Authority has spoken and nothing more can be said.
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Does place of delivery affect neonatal mortality in Rufiji Tanzania?Ajaari, Justice 29 April 2009 (has links)
Introduction
The fourth Millennium Development Goal (MDG) calls for a reduction in newborn
mortality but newborn mortality is one of the world’s most neglected health problems.
While there has been significant progress in reducing deaths among children under age
five over the past decade, the proportion of under five mortality that occur in the
neonatal period, an estimated 38% in 2000, is increasing. Therefore the Millennium
Development Goal for child survival cannot be met without substantial reductions in
neonatal mortality. It is therefore extremely important to make available the much
needed epidemiological information regarding the time, place and causes of neonatal
deaths which will enable greater attention to policies aimed at reducing levels of
mortality and programme planning.
Objectives
The objective of this study was to investigate the relationship between neonatal
mortality and place of delivery in Rufiji in rural Tanzania. The specific objectives were:
1.to measure and compare the neonatal mortality rates among neonates born in and
outside health facilities, 2. to compare the maternal characteristics of those who deliver
in and outside health facilities, 3. to compare cause-specific neonatal mortality among
neonates born in and outside health facilities and 4.to measure the association between
place of delivery and neonatal mortality.
Methods
Data from the Rufiji Demographic Surveillance System (RDSS), Tanzania, was used for
the analysis. A total of 5124 live births and 166 neonatal deaths were recorded from 1st
January, 2005 to 31st December, 2006.
Place of delivery and place of death were categorized as either health facility or outside
health facility. Neonatal mortality rates were calculated by dividing the number of
neonatal deaths to the total number of live births and multiplied by 1000.
Data on causes of death were collected using verbal autopsies. Cause specific mortality
was determined by using physician coding according to a list of causes of death based
on the 10th revision of International Classification of Diseases. Household
characteristics and assets ownership of the mothers of the neonates were used to
construct a wealth index as proposed by Filmer and Pritchett in 20011. The index was
calculated using Principal Component Analysis (PCA) in Stata version 10 software. A
chi-square (x2) test at 5% significant level was also used to compare the maternal
characteristics by place of delivery and neonatal characteristics and place of delivery.
Univariate and multivariate logistic regression models were also used to assess the
association between neonatal mortality and place of delivery as well as between
neonatal mortality and maternal risk factors, while adjusting for potential confounders.
Results
The highest number of neonatal deaths occurred during the first week of life 111(67%),
the remainder occurred from the second week to the fourth weeks of life 55(33%). The
overall neonatal mortality rate was 32/1000 live births. Neonatal mortality rate was
higher in children born outside heath facilities 43/1000 live births compared with those
born in health facilities 27/1000 live births. The two major causes of deaths in both
health facility deliveries and outside health facility deliveries were birth injury or
asphyxia n=29 (26%) and prematurity/low birth weight n=25 (22%). Mothers who
delivered out-side a health facility were 1.6 times more likely to have experienced
neonatal death [unadjusted OR=1.6, p-value = 0.002, 95% CI 1.2, 2.2] compared to
mothers who delivered in health facility and this was statistically significant. After
adjusting for maternal risk factors, mothers who delivered outside a health facility were
1.7 times more likely to have experienced neonatal death [adjusted OR=1.7, p-value =
0.002, 95% CI 1.2, 2.4] compared to mothers who delivered in a health facility and this
was statistically significant. Maternal household socio-economic status and parity were
the only other factors that were found to be statistically significantly associated with
neonatal mortality in the multivariate analysis. For instance, least poor mothers were
found to be 40% less likely to have experienced neonatal death [adjusted OR = 0.6, pvalue
= 0.046, 95% CI 0.4, 1.1] compared to the poorest mothers and this was
statistically significant. Less poor mothers were also found to be 50% less likely to
experience neonatal mortality [adjusted OR =0.5, p-value = 0.002, 95% CI 0.3, 0.8]
compared to the poorest mothers. Mothers who had parity of three to four (3-4) were
found to be 40% less likely to have experienced neonatal death compared to mothers
who had parity of one to two (1-2). Mothers who had parity of five (5) and above were
also found to be 50% less likely to have experienced neonatal death compared to those
who had parity of one to two (1-2).
Conclusion
Place of delivery has a very important role in neonatal survival in this rural setting. In
order to reduce neonatal mortality, pregnant women should be encouraged and
supported to give birth to their newborns in a health facility while discouraging
deliveries that occurred outside health facility. Infrastructure, such as emergency
transport, to facilitate health facility deliveries requires attention.
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Household socio-economic status as a determinant of under five mortality at Rufiji DSS TanzaniaNattey, Cornelius 22 May 2009 (has links)
Background
Disparities in health outcomes between the poor and the rich are increasingly attracting
attention from researchers and policy-makers. However, policies aimed at reducing
inequities need to be based on a sound assessment of the nature, magnitude and
determinants of the problem, as policy decisions based on intuition are likely to be
misguided.
Objective
The work investigates the relationship between household socio-economic status and
under-five mortality at Rufiji DSS in year 2005. The specific objectives were; 1.To
construct wealth and concentration indices for households with children under age five. 2.
To measure health inequality by poorest / least poor mortality rate ratio and the use of
concentration index 3. To determine significance in gradient of mortality rates across
wealth index quintiles by a trend test (chi-square) 4. To assess the magnitude of association
between socio-economic status of households and under-five mortality.
Methods
Data from Rufiji DSS, Tanzania was used for the analysis. Out of 11,189 children under five
years of age from 7298 households, 251 died in the year 2005. These yielded a total of
9341.6 PYO in 2005 which was used in the analysis. Household wealth index was
constructed by use of Principal Component Analysis (PCA), as a proxy measure of each
household SES. From this index households were categorized into five quintiles (i.e.,
poorest, poorer, poor, less poor and least poor). Kaplan-Meier (K-M) survival estimates of
incidence rates were used to estimate mortality rates per 1000 PYO for infants (0-1),
children (1-4) and under-fives. Health inequality was measured by poorest to least poor
mortality rate ratio and by computing mortality concentration indices. Trend test chi-square
was used to determine significance in gradient of mortality rates across wealth index
quintiles. Risk factors of child mortality were assessed by the use of Poisson regression
taking into account potential confounders.
Results
The result indicates that the mortality rate was higher for infants (123.4 per 1000 PYO,
95% CI (104.3, 146.1)) than for children aged 1-4 years (17.3 per 1000 PYO, 95% CI
(14.3, 20.9)). Under-five mortality was 26.9 per 1000 PYO (95% CI (23.7, 30.4)). The
poorest to least poor ratio were 1.5, 3.8 and 2.4 for infants, children, and under-five year
olds, respectively indicating that children in the poorest quintile were more likely to die as
compared to those in the least poor household. Computed values for concentration indices
were negative (infant C= -0.07, children C= -0.24 and under-five C= -0.16) indicating a
disproportionate concentration of under-five mortality among the poor. The mortality rates
trend test chi-square across wealth index quintiles were significant for both children
(P<0.001) and under-five year old children (P<0.001) but not for infants (P=0.10).
In univariate Poisson regression, children in the least poor households were shown to have
a 58% significantly reduced risk of dying as compared to the poorest households [crude
RR=0.42, P < 0.001, 95% CI (0.27 - 0.62)]. The effect of household socio-economic status
attenuated after adjusting for maternal education, maternal age and occupation. Children in
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the least poor households had a 52% significantly reduced risk of dying as compared to the
poorest households [adjusted RR=0.48, P = 0.002, 95% CI (0.30 - 0.80)].
Conclusion
The study shows that household socio-economic inequality is associated with under-five
mortality in Rufiji DSS in 2005 and that the survival advantage of under-five year old
children is associated with maternal education. Reducing poverty and making essential
health services more available to the poor are critical to improving overall childhood
mortality in rural Tanzania.
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