Impact of feed supplement with alfa-amylase and beta-glucanase on ingestive-related biomarkers registered with real-time sensors.

The aim of this study was to investigate the impact of feed supplements with alfa-amylase and beta-glucanase (Optipartum C+ 200) on ingestive-related behaviour biomarkers registered with real-time sensors: rumination behaviours and reticulorumen parameters (pH and temperature). Cows (n=20) in the treatment group (TG) were fed with Optipartum C+ 200 (Enzymes feed supplement: Alfa-Amylase 57 Units; Beta-Glucanase 107 Units) from 21 days before calving until 30 days after calving with a feeding rate of 200 g/cow/day. Cows (n=22) in the control group (CG) were fed a feed ration without feed supplement. Measurements started from 6 days before calving and continued until 21 days after calving. The following indicators were registered: with the RumiWatch System: Rumination time; Eating time; Drinking time; Rumination chews; Eating chews; Drinking gulps; Bolus; Chews per minute; Chews per bolus. With the SmaXtec system: the temperature, pH of the contents of the cows' reticulorumens, and cows' walking activity. According to our results, feed supplementation with alfa-amylase and beta-glucanase (Optipartum C+ 200) in the TG group resulted in increases in the following parameters: 9% rumination time and eating time, 19% drinking time, 11% rumination chews, 16% eating chews, 13% number of boluses per rumination, 5% chews per minute and 16% chews per bolus. The rumination time showed a strong, positive relation with rumination chews and bolus indicators in both groups (TG and CG) (p⟨0.001); while the rumination time in both groups of cows showed an opposite direction and was negatively related to eating time and eating chews (p⟨0.05). We found a 1.28 % lower reticulorumen pH and a 0.64 % lower reticulorumen temperature in cows fed with the supplement compared with cows in the control group. Cows in TG were 8.80% more active than those in the CG group. For improvement of ingestive-related behaviour we suggest adding a feed supplement with alfa-amylase and beta-glucanase (Optipartum C+ 200).

Is breast-feeding a substitute for contraception in family planning?

Using data from the Cebu Longitudinal Health and Nutrition Survey, I disentangle the complex interrelationship between breast-feeding, postpartum amenorrhea, and choice of contraceptive method. I find evidence that women substitute breast-feeding for contraception. Further, endogeneity bias, if not controlled, would cause the relationship to be slightly overstated. In addition, the results suggest that although increased education and income result in decreased breast-feeding, any effect on fertility will be offset by changes in contraceptive use.

The effects of maternal-child health service utilization on subsequent contraceptive use in Morocco.

There are a number of reasons for anticipating that contact by women in developing country settings with modern maternal-child health (MCH) services will lead to increased use of family planning services. Indeed, the expectation of such a relationship underlies the integrated service delivery strategy that has been adopted on a more or less global basis. However, the available empirical evidence in support of this proposition is inconclusive. This study re-examines this issue in Morocco. Household survey data and data on the supply environment for health and family planning services gathered in 1992 are analysed in the study. A full-information maximum likelihood estimator is used to control for the possible endogeneity of health care and contraceptive choices. The findings indicate a substantial and apparently causal relationship between the intensity of MCH service use and subsequent contraceptive use. Policy simulations indicate that sizeable increases in contraceptive prevalence might be realized by increasing the coverage and intensity of use of MCH services.

PIP: This study examined the association between frequency of use of maternal and child health (MCH) services and subsequent contraceptive use (CU) in Morocco. Data were obtained from a 1992 Moroccan Health Survey among 3267 married women with at least 1 live birth and the 1992 Service Availability Module. Analysis was based on full information maximum likelihood estimates and nonparametric, discrete factor strategies. The analysis ignored the possibility that CU can lead to increase MCH use, because few women use contraception before a first birth. Findings indicate that intensity of MCH service use was a statistically significant determinant of subsequent CU. The magnitude of the effect was large. For example, an increase in MCH service use from 2 to 4 would result in an increase of over 71% in contraceptive prevalence, from 32% to 55%. Modern CU would increase from 55% to 65%. Traditional CU would increase from 7% to 19%. Increases were more likely despite controls for individual and household characteristics. Findings do not explain the role of integrated services. Since there are numerous sources of supply, it is likely that counseling and promotion by health facility staff were significant factors. Evidence supports the need to include community-level factors in the analysis, but key community factors remain unmeasured.

Household health expenditures in Nepal: implications for health care financing reform.

His Majesty's Government of Nepal has embarked on an ambitious social welfare programme of increasing the accessibility of primary education and health care services in rural communities. The implications on the financing of health care services are substantial, as the number of health posts has increased twelve-fold from 1992 to 1996, from 200 to 2597. To strengthen health care financing, government policy-makers are considering a number of financing strategies that are likely to have a substantial impact on household health care expenditures. However, more needs to be known about the role of households in the current structure of the health economy before the government designs and implements policies that affect household welfare. This paper uses the Nepal Living Standards Survey, a rich, nationally-representative sample of households from 1996, to investigate level and distribution of household out-of-pocket health expenditures. Utilization and expenditures for different types of providers are presented by urban/rural status and by socioeconomic status. In addition, the sources of health sector funds are analyzed by contrasting household out-of-pocket expenditures with expenditures by the government and donors. The results indicate that households spend about 5.5% of total household expenditures on health care and that households account for 74% of the total level of funds used to finance the health economy. In addition, rural households are found to spend more on health care than urban households, after controlling for income status. Distributing health care expenditures by type of care utilized indicates that the wealthy, as well as the poor, rely heavily on services provided by the public sector. The results of this analysis are used to discuss the feasibility of implementing alternative health care financing policies.

Effect of provider characteristics on choice of contraceptive provider: a two-equation full-information maximum-likelihood estimation.

We use surveys of households and health-care facilities conducted in the same area at the same time to determine which characteristics of providers attract users of contraceptives. By using the full-information maximum-likelihood technique to jointly estimate choice of contraceptive method and choice of provider, we avoid self-selection bias. Results support the need for modeling quality and for jointly estimating the choice of contraceptive method and the choice of provider to avoid biased estimates of coefficients. The results suggest that for the Cebu, Philippines region, small local clinics that focus on family planning tend to be most favored by clients.

[Dynamic pulmonary densitography in the diagnosis of radiographically non-contrasting foreign bodies in the lower respiratory tract in children]. / Prínos dynamické plicní denzitografie k diagnostice rtg nekontrastních cizích teles v dolních cestách dýchacích u detí.

Densitographic examination of the regional pulmonary ventilation is a non-pretentious and non-invasive method which can be used even in very young children, which when aspiration of a non-contrasting foreign body is suspected can confirm by revealing localized bronchial obstruction the presence of a foreign body and determine its localization in the tracheobronchial tree. By repeated records of adequate ventilation at rest in all pulmonary fields it is possible with a minimal radiation load to rule out the suspicion and the child need not be subjected to an endoscopic examination. In five children aged 19 months to 13 years the usefulness of this procedure for the diagnosis of aspiration of a non-contrasting foreign body was proved, as the physical and skiagraphic finding was not convincing, there was discrepancy of anamnestic data and results of repeated skiagraphic examinations, negative auscultation and negative X-ray examination after an anamnestically obvious cse of aspiration, it ws used, for a more accurate localization of the aspired object, and to confirm localized obstruction of pulmonary ventilation in a chronic foreign body of plant origin in the airways. Foreign bodies of plant origin, most frequently aspired by children, are dangerous because they are fragile, swell and exert toxic action on the bronchial mucosa and there is also the danger of rapid development of serious bronchopulmonary complications. Therefore early diagnosis of aspiration is essential in these frequently obscure situations. When the direct skiagraphic signs of their presence in the lower airways are lacking dynamic pulmonary densitography contributes greatly to the diagnosis.

[An unusual early complication of tonsillectomy]. / Neobvyklá casná komplikace tonzilektomie.

The authors describe the observation of a localized tissue emphysema of the right cheek, which developed in an eight-year-old child as the early complication of tonsillectomy performed under local anaesthesia. In addition to reflections on the possible pathways of the gas from the tonsillar bed into interstitial spaces of the cheek, the authors draw attention also to possible concurrent penetration into the soft tissues of the neck and mediastinum.

[Regional lung ventilation in the differential diagnosis of aspiration of roentgenologically non-detectable foreign bodies]. / Die regionale Lungenventilation in der Differentialdiagnostik einer Aspiration von röntgenologisch nicht erfassbaren Fremdkörpern.

A densitographic evaluation of regional lung ventilation represents a positive contribution also for the diagnosis of x-ray non-contrast foreign bodies aspiration, especially when both physical and skiagraphic findings are unconvincing. Dynamic lung densitography is a convenient undemanding method, that can be used even in the youngest children. In 5 adults and 4 children proven localized bronchial obstruction confirmed the suspicion of aspiration of non-contrast foreign body. In one patient with negative densitographic finding a following bronchoscopy excluded the presence of a foreign body in lower airways, too. Therefore no endoscopy was performed in another adult, as well as in one 19-month old child, who had no densitographic disturbance of regional ventilation. Densitographic examination of regional lung ventilation substantially attributes to early diagnosis of non-contrast foreign body aspiration. Such early diagnosis represents important prevention of the development of serious bronchopulmonary complications. Exclusion of the regional lung obstruction allows to avoid the otherwise indicated bronchoscopy, that does not represent, especially in elderly persons and youngest children, a simple and non risk examination.

[Disorders of pulmonary ventilation in children with adenoid vegetations]. / Poruchy plicní ventilace u detí s adenoidními vegetacemi.

In a group of children aged 4 to 13 years with hypertrophic adenoid vegetation the pulmonary ventilation and mechanics of respiration were examined by global and regional spirography, incl. evaluation of VC, FEV1%, RV, IGV and V-V loops and in six children by whole-body plethysmography. While during global spirography a pathological finding was recorded in 31%, during regional spirographic examination pathological changes of the mentioned functional values were recorded in 86% of the children, which provides evidence that regional spirography combined with the densitographic method can reveal local disorders of pulmonary ventilation which cannot be detected by global spirography. In children under 10 years of age as compared with older children, more marked and more frequent changes of the investigated parameters were observed. Dispensarization of children where a pathological functional funding was present is essential as part of prevention of possible future development of chronic organic lesions of the lower respiratory pathways.

[Personal experience with the sleep apnea syndrome]. / Nase zkusenosti se syndromem spánkové apnoe.

In three children aged 3, 9 and 10 years the syndrome of sleep apnea with typical manifestations of obstructive apnoeic episodes during sleep is described. In two instances the nocturnal periodic apnoeic spells were associated with marked varying hypoxemia, objectively recorded by continuous monitoring of the transcutaneous oxygen tension using a skin oximeter. In one child the cause of airway obstruction during sleep were hypertrophic tonsils and adenoid vegetation, in the other two children in the nocturnal apnoeic spells above all the functional component participated, expressed by increased relaxation of the oropharyngeal musculature during sleep. In the first child adenotonsillectomy was followed by immediate regression of all original symptoms, in the remaining two children therapeutic results were achieved only by removal of the slightly enlarged tonsils, while previous adenotomy did not have a favourable effect on the course of their disturbed sleep. Permanent regression of the apnoeic episodes after tonsillectomy was confirmed by records of a smooth level of the skin oxygen tension during sleep. This syndrome is more frequent than generally assumed and late establishment of the diagnosis may lead to the development of serious cardiopulmonary complications, irreversible neurogenic dysfunctions and psychosomatic retardation of the affected children.