世界経済・社会統計 = World development indicators

https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(15)01024-7.pdf

Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect

https://www.thelancet.com/pdfs/journals/langlo/PIIS2214-109X%2814%2970227-X.pdf

Global causes of maternal death: a WHO systematic analysis

https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(12)60820-4.pdf

National regional and worldwide estimates of preterm birth rates in the year 2010 with time trends since 1990 for selected countries: a systematic analysis and implications.

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.

반도체 공정 overview

Objective. To develop and pilot an audit system usable by medical officers in peripheral hospitals for deaths of children under 5 years to: (i) identify and classify all causes of deaths; and (ii) to identify substandard care and missed opportunities for intervention and to classify these as modifiable factors. 
Setting. The four public sector hospitals in Mafikeng health region in North West province. 
Method. An action research methodology was used. The system for classifying under-5 deaths was based on the International Classification of Diseases 10 (ICD-10), but modified for practical application in peripheral hospitals. Each death was analysed at a mortality meeting and factors related to the family, administration or actions or omissions by health care workers that could have contributed to the death were recorded. These factors were later grouped and categorised. During the last month of the pilot participating health care workers evaluated the audit system and completed a semistructured questionnaire. 
Study period. 1 November 2000 - 31 October 2001. 
Results. Two hundred and thirty-nine under-5 deaths occurred and were discussed during 61 mortality meetings. A workable system to identify and classify causes of deaths and modifiable factors occurring within the health system was developed and tested. A simple, user-friendly one-page data sheet encompassing the whole audit was developed. Overall the health care workers were positive about the mortality meetings and were confident that the classification systems developed could be applied in other peripheral hospitals. 
Conclusion. The audit system (called the Under-5 Health Care Problem Identification Programme (U5PIP)), was piloted under normal service conditions and is usable and acceptable for peripheral hospitals. 
S Afr Med J 2004; 94: 198-202.p

Saving children--an audit system to assess under-5 health care.

Aim To evaluate the impact of the Choice on Termination of Pregnancy Act on maternal morbidity and mortality in the west of Pretoria. Setting Indigent South Africans managed in two public hospitals in the west of Pretoria. Method Data were collected on all abortions (incomplete or induced) treated in the hospitals in the study area in 1997 - 1998 and 2003 - 2005. All cases of severe acute maternal morbidity and maternal deaths due to abortion were identified for these time periods. Data exclude referrals from outside the west of Pretoria. Outcome measures The case fatality rate (CFR), mortality index (MI) and maternal mortality ratio (MMR) due to abortions. Results In 1997 - 1998 there were 2 050 abortions, of which 80.2% were regarded as being incomplete, and in 2003 - 2005 there were 3 999 abortions, of which 42.8% were regarded as incomplete. Twenty-four women who were critically ill due to complications of abortion presented in 1997 - 1998 (a rate of 3.05/1 000 births), compared with 50 (2.76/1 000 births) in 2003 - 2005. There were 5 deaths in 1997 - 1998 (CFR of 2.4/1 000 abortions) compared with 1 death in 2003 - 2005 (CFR 0.25/1 000 abortions) (p = 0.01, relative risk (RR) 0.1, 95% confidence interval (CI) 0.01 - 0.89). The MI fell from 21.7% to 2.0% (p = 0.02, RR 0.1, 95% CI 0.01 - 0.89). The MMR was 63.6/100 000 births in 1997 - 1998 compared with 5.54/100 000 in 2003 - 2005 (p = 0.017, RR 0.09, 95% CI 0.01 - 0.74). Conclusion The introduction of the Choice on Termination of Pregnancy Act has been associated with a massive reduction in women presenting with incomplete abortions. The prevalence of critically ill women due to complications of abortion has not changed, but the CFR, MI and MMR have declined significantly. South African Medical Journal Vol. 96(11) November 2006: 1196-1198

/pdf/impact-of-the-choice-on-termination-of-pregnancy-act-on-47fkuxildg.pdf

Impact of the Choice on Termination of Pregnancy Act on maternal morbidity and mortality in the west of Pretoria.

Quality of life 1 year after a maternal near-miss event.

Aim: To describe the effect of HIV infection on maternal and perinatal disease in south west Tshwane.

Setting: Southwest Tshwane has a low to low-middle income urban population and is served by Pretoria West and Laudium Midwife-Obstetric Units (MOUs) and Kalafong Hospital and fourteen primary care clinics which refer to those institutions. These are all public health institutions.

Methods: Only data from women from southwest Tshwane between 1 January 2006 and 30 September 2008 was used in the study. As part of routine audit, the maternal HIV status was recorded as well as major maternal antenatal and intrapartum complications. All perinatal deaths along with their HIV status were recorded in the Perinatal Problem Identification Programme (PPIP) and the primary obstetric cause and final neonatal cause of deaths. The causes of perinatal deaths from HIV infected, negative and unknown were analysed.

Results: There were 17184 births in southwest Tshwane in the time period analysed, of which mothers (86.1%) were counselled and (81.9%) were tested, and of these 21.5% HIV infected.

The incidence of hypertension in the HIV infected women was 3.2% significantly lower than the 5.0% in the HIV negative group (OR 0.63, 95% CI 0.50, 0.79). There was a trend to more HIV infected women had a PPH (OR 1.21, 95% CI 0.99, 1.47). The overall caesarean section rate was 28.3% with significantly more HIV infected women having both elective and emergency caesarean sections (OR 1.21, 95% CI 1.10, 1.31).

The perinatal mortality rate was 33.8/1000 births (> 500 g) in the HIV infected group and 26.1/1000 births in the HIV negative group (OR 1.30, 95% CI 1.03, 1.65) mainly due to the increased neonatal death rate. The low birth weight (LBW) rate for HIV infected women was 19.8% compared with 14.3% with HIV negative women (p < 0.0000); OR1.47, 95% CI 1.32, 1.64). There significantly more perinatal deaths due to spontaneous preterm birth, infection and intrapartum asphyxia in the HIV infected mothers.

Conclusion: In southwest Tshwane a HIV infected mother has a decreased risk of hypertension, a trend towards increased postpartum haemorrhage and a thirty percent increased risk of having a perinatal death compared to an HIV negative mother, this is due mainly to spontaneous preterm birth, infections and intrapartum asphyxia.

The effect of maternal HIV infection on maternal conditions and perinatal deaths in southwest Tshwane.

CITATION: Odendaal, H. J. et al. 1988. Frequent fetal heart-rate monitoring for early detection of abruptio placentae in severe proteinuric hypertension. South African Medical Journal, 74:19-21.

Robert Clive Pattinson

Papers

Saving children--an audit system to assess under-5 health care.

Impact of the Choice on Termination of Pregnancy Act on maternal morbidity and mortality in the west of Pretoria.

Quality of life 1 year after a maternal near-miss event.

The effect of maternal HIV infection on maternal conditions and perinatal deaths in southwest Tshwane.

Frequent fetal heart-rate monitoring for early detection of abruptio placentae in severe proteinuric hypertension.