News Article | June 21, 2017
Save the Children and the International Confederation of Midwives (ICM) presented International Midwifery Awards to Amina Sultani of Afghanistan and Loveluck Mwasha of Tanzania at a ceremony today at the ICM 31st Triennial Congress in Toronto, Canada. ICM President Frances Day-Stirk and Save the Children President and CEO Patricia Erb jointly presented the awards. Day-Stirk said the needs of midwifery across multiple settings – humanitarian, marginalized, or hard to reach – are remarkably similar. “Both Loveluck and Amina are working for the same goals in very different settings: for the recognition of their work, supportive policies, and the training and resources they need to enable mothers to give birth safely and their newborns to get a healthy start in life,” she said. Erb said she was impressed by level of interest in the awards this year. Of the more than 50 nominations from 18 countries, Erb said, “It’s heartening to see this clear evidence of midwives speaking up and making a difference in policies and practices that affect midwifery and the conditions under which midwives work.” Winners of the International Midwifery Award are key advocates, educating and mobilizing national and global stakeholders about the importance of midwifery in maternal and newborn care and of the critical need to support the midwifery profession, especially in countries where the morbidity and mortality burdens for mothers and newborns are highest. During her 30 years as a midwife providing quality care for mothers and newborns in Tanzania, Loveluck Mwasha has been a steadfast advocate for and mentor to midwives through her work on the board of the Tanzania Nursing and Midwifery Council and at the Aga Khan Hospital and University School of Nursing and Midwifery. Loveluck’s mentorship and advocacy support important improvements in policy, funding, and the practice of midwifery. “My work is an opportunity to advocate for better support and training of midwives,” Mwasha said. “We work with stakeholders to help them appreciate midwives’ role in supporting women’s reproductive health, from community groups to members of parliament.” Midwifery advocates have seen recent successes in Tanzania, including increases to the maternal and child health national budget. The Ministry of Health is also strengthening the midwifery training system and has agreed to recognize midwifery as a stand-alone profession. The country has also committed to increasing the number of qualified and competent midwives by 2020, particularly in hardest-to-reach rural areas. In Kabul, Afghanistan, Amina Sultani has been a steadfast advocate and leader in the field of midwifery since 2012, working with the Kabul Medical University, the Afghan Midwives Association (AMA), and the Afghan Midwifery and Nursing Council. In her current role at the Ministry of Public Health, Sultani is deeply committed to empowering midwives as leaders in health policy and programs. Sultani helped establish the first direct-entry midwifery bachelor’s degree in Afghanistan and teaches courses in the program. In her current role as vice president of AMA, she organizes advocacy events and meetings with civil society and stakeholders, promoting the midwifery profession and issues surrounding maternal and newborn health. Sultani said it was important for midwives to be “empowered and involved at every level, from the health facility to the Ministry of Public Health.” “I tell all midwives, ‘please believe in your ability and believe in your power,’” she said. “The midwife is the first person to touch the mother and baby. Midwives must believe in themselves so they can help and support the mother and baby. It's very important.” The Importance of Midwifery in Challenging Contexts Midwives are the single most important cadre for preventing maternal and newborn deaths and stillbirths. Especially in humanitarian contexts and for poor or hard-to-reach populations, midwives provide the majority of immediate care to mothers and newborns, often without support, materials, training, or recognition. The global shortage of midwives, estimated at 350,000, puts millions of women and babies at risk and is a major contributor to some grim statistics. Each year 1 million newborns die during their first day of life, 1.3 babies are stillborn, and 303,000 mothers die during pregnancy and childbirth. However, with proper care around the time of birth, more than 70 percent of these deaths could be averted. The International Confederation of Midwives (ICM) is highlighting some of the challenges midwifery faces at the policy and facility level this week at its 2017 Triennial Congress (http://www.midwives2017.org) in Toronto, Canada. ICM’s CEO, Sally Pairman said, “The aim is to call attention to what is needed to ensure that all women and their babies receive high-quality, woman-centered midwifery care, wherever they may be.” History and Purpose of the International Midwifery Awards Save the Children has partnered for with ICM since 2005 to recognize midwives who have made a difference in their countries by championing improved policies for funding and training skilled birth attendants; improving training, mentoring, and supportive supervision; or making an impact at scaling up midwifery at the national or regional level. (For a list of previous winners see http://www.healthynewbornnetwork.org/international-midwifery-award-2017.) Every day in Afghanistan, 188 women and their babies die due to complications of pregnancy or childbirth. This is 68,500 deaths each year, 70 percent or more of which are preventable with proven and effective interventions. Total population: 32,526,000 Mothers, Newborns & Children Annual births: 1,080,600 Maternal mortality ratio per 100,000 births: 396 Annual maternal deaths: 4,300 Neonatal mortality rate per 1,000 live births: 36 Annual number of newborn deaths: 36,200 Under 5 mortality rate per 1,000 live births: 91 Annual number of under 5 deaths: 94,300 Annual number of stillbirths: 28,000 Proportion of under-5 deaths that occur in the neonatal period (%): 38 Total fertility rate: 4.7 Adolescent pregnancy (% of women aged 20–24 who gave birth before age 18): 25.6 Health System Health worker density (per 10,000) – doctors, nurses, midwives: 7 Percentage births in facility (%): 43 Percentage of postnatal care for mothers within 2 days (%): 23 Percentage of postnatal care for newborns within 2 days (%): N/A Early initiation of breastfeeding (%): 54 Every day in Tanzania, 257 women and their babies die due to complications of pregnancy or childbirth. This is 93,800 deaths each year, 70 percent or more of which are preventable with proven and effective interventions. Total population: 53,470,000 Mothers, Newborns and Children Annual births: 2,064,400 Maternal mortality ratio per 100,000 births: 398 Annual maternal deaths: 8,200 Neonatal mortality rate per 1,000 live births: 19 Annual number of newborn deaths: 38,600 Under 5 mortality rate per 1,000 live births: 49 Annual number of under 5 deaths: 98,200 Annual number of stillbirths: 47,100 Proportion of under-5 deaths that occur in the neonatal period (%): 39 Total fertility rate: 5.1 Adolescent pregnancy (% of women aged 20–24 who gave birth before age 18): 28 Health System Health worker density (per 10,000) – doctors, nurses, midwives: 4.7 Percentage births in facility (%): 50 Percentage of postnatal care for mothers within 2 days (%): 31 Percentage of postnatal care for newborns within 2 days (%): 2 Early initiation of breastfeeding (%): 51 Source for both countries: HNN Newborn Numbers (http://www.healthynewbornnetwork.org/numbers). Data is from 2015, the most recent available. About ICM: Founded in 1919, the International Confederation of Midwives (ICM) is an accredited nongovernmental organization that represents midwives’ associations worldwide to achieve common goals in the care of mothers and newborns. Currently, there are 130 ICM member associations in 113 countries. For more information visit http://www.internationalmidwives.org About Save the Children: Save the Children invests in childhood – every day, in times of crisis and for our future. Around the world, we give children a healthy start, the opportunity to learn and protection from harm. By transforming children’s lives now, we change the course of their future and ours. For more information visit http://www.savethechildren.org.
Roca L.,ICM |
Dieras V.,University Pierre and Marie Curie |
Roche H.,Institute Claudius Regaud |
Lappartient E.,University Pierre and Marie Curie |
And 10 more authors.
Breast Cancer Research and Treatment | Year: 2013
The purpose of this study was to investigate, in the context of a prospective node-positive-breast cancer trial HER2 containing-regimen (UNICANCER-PACS 04 trial), the predictive value of HER2, FCGRIIA, and FCGRIIIA gene polymorphisms for cardiac toxicity and efficacy of trastuzumab. We analyzed HER2-I655V, FCGR2A-H131R, and FCGR3A-V158F single nucleotide polymorphisms in patients in adjuvant setting treated by six courses of either fluorouracil 500 mg/m2, epirubicin 100 mg/m2 and cyclophosphamide 500 mg/m2, or epirubicin 75 mg/m2 and docetaxel 75 mg/m 2 every 3 weeks then randomly assigned, in case of HER2 overexpressing tumor, to either trastuzumab for 1 year or nothing. Left ventricular ejection fraction and clinical examination were monitored in each patient, seven times throughout the study to detect congestive heart failure or asymptomatic subclinical cardiac toxicity. All genotypes were analyzed in relation to cardiac toxicity, EFS, and OS. One hundred and thirty-two HER2-positive breast cancer patients were analyzed. The HER2-I655V genotype was significantly associated with cardiac toxicity (p = 0.025). The FCGR2A-131 H/H genotype was significantly correlated with a shorter EFS (p = 0.027). The FCGR3A-158 V/V genotype was not correlated with EFS nor OS. These results might be useful in making a treatment choice of HER2 blockers in adjuvant setting by with an increase in efficacy and decrease in toxicity. © 2013 Springer Science+Business Media New York.
Bauchet L.,French Institute of Health and Medical Research |
Zouaoui S.,French Institute of Health and Medical Research |
Darlix A.,French Brain Tumor DataBase |
De Champfleur N.M.,Montpellier University Hospital Center |
And 4 more authors.
Neuro-Oncology | Year: 2014
Glioblastoma (GBM) is the most common malignant primary brain tumor. Its incidence continues to increase in the elderly because the older segment of the population is growing faster than any other age group. Most clinical studies exclude elderly patients, and "standards of care" do not exist for GBM patients aged.70 years. We review epidemiology, tumor biology/molecular factors, prognostic factors (clinical, imaging data, therapeutics), and their assessments as well as classic and specific endpoints plus recent and ongoing clinical trials for elderly GBM patients. This work includes perspectives and personal opinions on this topic. Although there are no standards of care for elderly GBM patients, we can hypothesize that (i) Karnofsky performance status (KPS), probably after steroid treatment, is one of the most important clinical factors for determining our oncological strategy; (ii) resection is superior to biopsy, at least in selected patients (depending on location of the tumor and associated comorbidities); (iii) specific schedules of radiotherapy yield a modest but significant improvement; (iv) temozolomide has an acceptable tolerance, even when KPS <70, and could be proposed for methylated elderly GBM patients; and (v) the addition of concomitant temozolomide to radiotherapy has not yet been validated but shows promising results in some studies, yet the optimal schedule of radiotherapy remains to be determined. In the future, specific assessments (geriatric, imaging, biology) and use of new endpoints (quality of life and toxicity measures) will aid clinicians in determining the balance of potential benefits and risks of each oncological strategy. © The Author(s) 2014.
PubMed | University of Technology, Sydney, Womens Health and Development, ICM, UNFPA and 2 more.
Type: | Journal: Midwifery | Year: 2015
The 2014 State of the Worlds Midwifery report included a new framework for the provision of woman-centred sexual, reproductive, maternal, newborn and adolescent health care, known as the Midwifery2030 Pathway. The Pathway was designed to apply in all settings (high-, middle- and low-income countries, and in any type of health system). In this paper, we describe the process of developing the Midwifery2030 Pathway and explain the meaning of its different components, with a view to assisting countries with its implementation. The Pathway was developed by a process of consultation with an international group of midwifery experts. It considers four stages of a womans reproductive life: (1) pre-pregnancy, (2) pregnancy, (3) labour and birth, and (4) postnatal, and describes the care that women and adolescents need at each stage. Underpinning these four stages are ten foundations, which describe the systems, services, workforce and information that need to be in place in order to turn the Pathway from a vision into a reality. These foundations include: the policy and working environment in which the midwifery workforce operates, the effective coverage of sexual, reproductive, maternal, newborn and adolescent services (i.e. going beyond availability and ensuring accessibility, acceptability and high quality), financing mechanisms, collaboration between different sectors and different levels of the health system, a focus on primary care nested within a functional referral system when needed, pre- and in-service education for the workforce, effective regulation of midwifery and strengthened leadership from professional associations. Strengthening of all of these foundations will enable countries to turn the Pathway from a vision into reality.
PubMed | ICS Integrare, University of Technology, Sydney, Womens Health and Development, ICM and UNFPA
Type: Journal Article | Journal: Human resources for health | Year: 2016
Education, regulation and association (ERA) are the supporting pillars of an enabling environment for midwives to provide quality care. This study explores these three pillars in the 73 low- and middle-income countries who participated in the State of the Worlds Midwifery (SoWMy) 2014 report. It also examines the progress made since the previous report in 2011.A self-completion questionnaire collected quantitative and qualitative data on ERA characteristics and organisation in the 73 countries. The countries were grouped according to World Health Organization (WHO) regions. A descriptive analysis was conducted.In 82% of the participating countries, the minimum education level requirement to start midwifery training was grade 12 or above. The average length of training was higher for direct-entry programmes at 3.1years than for post-nursing/healthcare provider programmes at 1.9years. The median number of supervised births that must be conducted before graduation was 33 (range 0 to 240). Fewer than half of the countries had legislation recognising midwifery as an independent profession. This legislation was particularly lacking in the Western Pacific and South-East Asia regions. In most (90%) of the participating countries, governments were reported to have a regulatory role, but some reported challenges to the role being performed effectively. Professional associations were widely available to midwives in all regions although not all were exclusive to midwives.Compared with the 2011 SoWMy report, there is evidence of increasing effort in low- and middle-income countries to improve midwifery education, to strengthen the profession and to follow international ERA standards and guidelines. However, not all elements are being implemented equally; some variability persists between and within regions. The education pillar showed more systematic improvement in the type of programme and length of training. The reinforcement of regulation through the development of legislation for midwifery, a recognised definition and the strengthening of midwives associations would benefit the development of other ERA elements and the profession generally.
Hasson A.,Toulouse 1 University Capitole |
Hasson A.,Jet Propulsion Laboratory |
Delcroix T.,Toulouse 1 University Capitole |
Boutin J.,LOCEAN |
And 2 more authors.
Journal of Geophysical Research: Oceans | Year: 2014
The tropical Pacific Ocean remained in a La Niña phase from mid-2010 to mid-2012. In this study, the 2010-2011 near-surface salinity signature of ENSO (El Niño-Southern Oscillation) is described and analyzed using a combination of numerical model output, in situ data, and SMOS satellite salinity products. Comparisons of all salinity products show a good agreement between them, with a RMS error of 0.2-0.3 between the thermosalinograph (TSG) and SMOS data and between the TSG and model data. The last 6 months of 2010 are characterized by an unusually strong tripolar anomaly captured by the three salinity products in the western half of the tropical Pacific. A positive SSS anomaly sits north of 10°S (>0.5), a negative tilted anomaly lies between 10°S and 20°S and a positive one south of 20°S. In 2011, anomalies shift south and amplify up to 0.8, except for the one south of 20°S. Equatorial SSS changes are mainly the result of anomalous zonal advection, resulting in negative anomalies during El Niño (early 2010), and positive ones thereafter during La Niña. The mean seasonal and interannual poleward drift exports those anomalies toward the south in the southern hemisphere, resulting in the aforementioned tripolar anomaly. The vertical salinity flux at the bottom of the mixed layer tends to resist the surface salinity changes. The observed basin-scale La Niña SSS signal is then compared with the historical 1998-1999 La Niña event using both observations and modeling. Key Points The well-marked signature of the 2010-2011 La Nina is described and analyzed In situ, modeled and SMOS surface salinity products show good overall agreement The processes for the western Pacific strong tripolar anomaly shift are studied © 2014. American Geophysical Union. All Rights Reserved.
Lana A.,ICM |
Simo R.,ICM |
Vallina S.M.,Massachusetts Institute of Technology |
Biogeochemistry | Year: 2012
During the last decade the number of seawater dimethylsulfide (DMS) concentration measurements has increased substantially. The importance this gas, emitted from the ocean to the atmosphere, may have in the cloud microphysics and hence in the Earth albedo and radiation budget, makes it necessary to accurately reproduce the global distribution. Recently, the monthly global DMS climatology has been updated taking advantage of the threefold increased size and better resolved distribution of the observations available in the DMS database. Here, the emerging patterns found with the previous versions of the database and climatology are explored with the updated versions. The statistical relationships between the seasonalities of DMS concentrations and other variables are re-examined. The positive correlation previously found between surface seawater DMS and the daily-averaged climatological solar radiation dose in the upper mixed layer of the open ocean is confirmed with both the updated DMS database and climatology. Re-examination of the latitudinal match-mismatch between the seasonalities of DMS and phytoplankton, represented by the chlorophyll a concentration, reveals that they are highly positively correlated in latitudes higher than 40°, but anti-correlated in the 20°-40° latitudinal bands of both hemispheres. Overall, these global emerging patterns provide key information to further understanding the factors that control the emission of volatile sulfur from the ocean. The large uncertainties associated with the methodologies used in global computations, however, call for caution in using these emerging patterns as predictive tools, and prompt to the design of time series and process-oriented studies aimed at testing the validity of the observed relationships. © 2011 Springer Science+Business Media B.V.
Bonhomme V.,University of Liège |
Boveroux P.,ICM |
Boveroux P.,University of Liège |
Hans P.,University of Liège |
And 5 more authors.
Current Opinion in Anaesthesiology | Year: 2011
PURPOSE OF REVIEW: To describe recent studies exploring brain function under the influence of hypnotic anesthetic agents, and their implications on the understanding of consciousness physiology and anesthesia-induced alteration of consciousness. RECENT FINDINGS: Cerebral cortex is the primary target of the hypnotic effect of anesthetic agents, and higher-order association areas are more sensitive to this effect than lower-order processing regions. Increasing concentration of anesthetic agents progressively attenuates connectivity in the consciousness networks, while connectivity in lower-order sensory and motor networks is preserved. Alteration of thalamic sub-cortical regulation could compromise the cortical integration of information despite preserved thalamic activation by external stimuli. At concentrations producing unresponsiveness, the activity of consciousness networks becomes anticorrelated with thalamic activity, while connectivity in lower-order sensory networks persists, although with cross-modal interaction alterations. SUMMARY: Accumulating evidence suggests that hypnotic anesthetic agents disrupt large-scale cerebral connectivity. This would result in an inability of the brain to generate and integrate information, while external sensory information is still processed at a lower order of complexity. © 2011 Wolters Kluwer Health | Lippincott Williams &Wilkins.
Oncologie | Year: 2013
Gastric and esophageal adenocarcinomas (GEA) are among the leading causes of cancer-related death worldwide. Despite a decline in the incidence of gastric adenocarcinomas, incidence of oesophagogastric junction adenocarcinoma is rising rapidly in occidental countries. Surgical resection being the only curative treatment and the 5-year survival rate depending on pTNM stage, treatment approach remains challenging for oncologists. Several treatment modalities including systemic chemotherapy have been evaluated to prevent recurrences and improve overall survival. The UK-MAGIC and FNCLCCFFCD trials showed survival benefit with preoperative chemotherapy in operable gastric and lower oesophageal cancers, and those results had impact on clinical practice in Europe. Novel strategies such as the induction chemotherapy followed by preop-CRT, targeted therapies added to perioperative chemotherapy or the use of new cytotoxic regimens are being assessed to improve current standards and facilitate the delivery of more tailored therapeutic interventions. © 2013 Springer-Verlag France.
Simarro G.,ICM |
Orfila A.,CSIC - Mediterranean Institute for Advanced Studies |
Coastal Engineering | Year: 2013
This work focuses on linear shoaling performance of low order Boussinesq-type equations. It is shown that the linear shoaling errors can be important in well known equations in the literature. New sets of coefficients are presented for three well known sets of equations. The sets are found so as to minimize a global linear error that includes celerity and shoaling errors. Finally, a new set of enhanced bilayer low order equations is presented, with much improved linear behavior (errors in wave celerity and wave amplitude below 1% up to kh=. 20). For completeness, the equations are written in their fully nonlinear version, and the nonlinear coefficients are also given. © 2013.