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Robert Clive Pattinson

Bio: Robert Clive Pattinson is an academic researcher from University of Pretoria. The author has contributed to research in topics: Population & Maternal death. The author has an hindex of 45, co-authored 211 publications receiving 9607 citations. Previous affiliations of Robert Clive Pattinson include Stellenbosch University & Kalafong Hospital.


Papers
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TL;DR: A simple, programme-relevant stillbirth classification that can be used with verbal autopsy would provide a basis for comparable national estimates, and a new focus on all deaths around the time of birth is crucial to inform programmatic investment.

761 citations

Journal ArticleDOI
TL;DR: The practical implementation of maternal near miss concept should provide an important contribution to improving quality of obstetric care to reduce maternal deaths and improve maternal health.
Abstract: Maternal mortality is still among the worst performing health indicators in resource-poor settings. For deaths occurring in health facilities, it is crucial to understand the processes of obstetric care in order to address any identified weakness or failure within the system and take corrective action. However, although a significant public health problem, maternal deaths are rare in absolute numbers especially within an individual facility. Studying cases of women who nearly died but survived a complication during pregnancy, childbirth or postpartum (maternal near miss or severe acute maternal morbidity) are increasingly recognized as useful means to examine quality of obstetric care. Nevertheless, routine implementation and wider application of this concept in reviewing clinical care has been limited due to the lack of a standard definition and uniform case-identification criteria. WHO has initiated a process in agreeing on a definition and developing a uniform set of identification criteria for maternal near miss cases aiming to facilitate the reviews of these cases for monitoring and improving quality of obstetric care. A list of identification criteria was proposed together with one single definition. This article presents the proposed definition and the identification criteria of maternal near miss cases. It also suggests procedures to make maternal near miss audits operational in monitoring/evaluating quality of obstetric care. The practical implementation of maternal near miss concept should provide an important contribution to improving quality of obstetric care to reduce maternal deaths and improve maternal health.

747 citations

Journal ArticleDOI
TL;DR: High coverage of essential interventions did not imply reduced maternal mortality in the health-care facilities the authors studied, and the maternal severity index (MSI) had good accuracy for maternal death prediction in women with markers of organ dysfunction.

533 citations

Journal ArticleDOI
TL;DR: Intrapartum‐related neonatal deaths (“birth asphyxia”) are a leading cause of child mortality globally, outnumbering deaths from malaria, yet there is a lack of consensus on what works, especially in weak health systems.

468 citations

Journal ArticleDOI
TL;DR: There is a clear need to set uniform criteria to classify patients as SAMM and an organ-system dysfunction/failure approach is the most epidemiologically sound as it is least open to bias, and thus could permit developing summary estimates.
Abstract: Aim: To determine the prevalence of severe acute maternal morbidity (SAMM) worldwide (near miss). Method: Systematic review of all available data. The methodology followed a pre-defined protocol, an extensive search strategy of 10 electronic databases as well as other sources. Articles were evaluated according to specified inclusion criteria. Data were extracted using data extraction instrument which collects additional information on the quality of reporting including definitions and identification of cases. Data were entered into a specially constructed database and tabulated using SAS statistical management and analysis software. Results: A total of 30 studies are included in the systematic review. Designs are mainly crosssectional and 24 were conducted in hospital settings, mostly teaching hospitals. Fourteen studies report on a defined SAMM condition while the remainder use a response to an event such as admission to intensive care unit as a proxy for SAMM. Criteria for identification of cases vary widely across studies. Prevalences vary between 0.80% – 8.23% in studies that use disease-specific criteria while the range is 0.38% – 1.09% in the group that use organ-system based criteria and included unselected group of women. Rates are within the range of 0.01% and 2.99% in studies using management-based criteria. It is not possible to pool data together to provide summary estimates or comparisons between different settings due to variations in case-identification criteria. Nevertheless, there seems to be an inverse trend in prevalence with development status of a country. Conclusion: There is a clear need to set uniform criteria to classify patients as SAMM. This standardisation could be made for similar settings separately. An organ-system dysfunction/failure approach is the most epidemiologically sound as it is least open to bias, and thus could permit developing summary estimates.

429 citations


Cited by
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Journal ArticleDOI
TL;DR: The meta-analyses indicate protection against child infections and malocclusion, increases in intelligence, and probable reductions in overweight and diabetes, and an increase in tooth decay with longer periods of breastfeeding.

4,291 citations

Journal ArticleDOI
TL;DR: Between 2003 and 2009, haemorrhage, hypertensive disorders, and sepsis were responsible for more than half of maternal deaths worldwide, and more than a quarter of deaths were attributable to indirect causes.

3,976 citations

Journal ArticleDOI
TL;DR: Worldwide, regional, and national estimates of preterm birth rates for 184 countries in 2010 with time trends for selected countries are reported, and a quantitative assessment of the uncertainty surrounding these estimates is provided.

3,742 citations

01 Aug 2001
TL;DR: The study of distributed systems which bring to life the vision of ubiquitous computing systems, also known as ambient intelligence, is concentrated on in this work.
Abstract: With digital equipment becoming increasingly networked, either on wired or wireless networks, for personal and professional use alike, distributed software systems have become a crucial element in information and communications technologies. The study of these systems forms the core of the ARLES' work, which is specifically concerned with defining new system software architectures, based on the use of emerging networking technologies. In this context, we concentrate on the study of distributed systems which bring to life the vision of ubiquitous computing systems, also known as ambient intelligence.

2,774 citations