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  • 1
    Electronic Resource
    Electronic Resource
    Strategies to Address Global Cesarean Section Rates: A Review of the Evidence (2002)
    Malden, USA : Blackwell Publishing, Inc.
    Birth 29 (2002), S. 0 
    Details
    ISSN: 1523-536X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background: The steadily increasing global rates of cesarean section has become one of the most debated topics in maternity care. This paper reviews and reports on the success of strategies that have been developed in response to this continuing challenge. Methods: A literature search identified studies conducted between 1985 and 2001 from the Cochrane Database of Systematic Reviews, Medline, Sociofile, Current Contents, Psyclit, Cinahl, and EconLit databases. An additional search of electronic databases for Level 1 evidence (systematic reviews), Level 2 (randomized controlled trials), Level 3 (quasi-experimental studies), or Level 4 (observational studies) was performed. Selection criteria used to identify studies for review included types of study participant, intervention, outcome measure, and study. Results: Interventions that have been used in an attempt to reduce cesarean section rates were identified; they are categorized as psychosocial, clinical, and structural strategies. Two clinical interventions, (external cephalic version, vaginal birth after a previous cesarean) and one psychosocial intervention (one-to-one trained support during labor) demonstrated Level 1 evidence for reducing cesarean section rates. Conclusions: Although the evidence for one-to-one care and external cephalic version came from both developed and developing settings, the systematic review for vaginal birth after a cesarean was restricted to studies conducted in the United States. The effective implementation of the preceding strategies to reduce cesarean rates may depend on the social and cultural milieu and on associated beliefs and practices. (BIRTH 29:1 March 2002)
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1523-536X.2002.00153.x
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  • 2
    Electronic Resource
    Electronic Resource
    Increasing Cesarean Section Rates: Exploring the Role of Culture in an Australian Community (2004)
    Oxford, UK; Malden, USA : Blackwell Science Inc
    Birth 31 (2004), S. 0 
    Details
    ISSN: 1523-536X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract:  Background: The proportion of births by cesarean section in Australia has recently increased by 35 percent, rising from 17 percent in 1990 to 23 percent in 2000. Unlike previous research, which has focused on women's role in increasing rates of cesarean section, this study aimed to explore the existence of wider cultural norms of acceptance of cesarean section in the Australian community, and the implications these might have for rising rates. Methods: A postal self-completion questionnaire was sent to a consecutive sample of 148 women who delivered 7 weeks earlier at the Women's and Children's Hospital, a tertiary-referral public maternity hospital in metropolitan Adelaide, South Australia. These women were recruited at 18 weeks’ gestation, and had been involved in a wider study. The questionnaire included three sections, one section on agreement with statements pertaining to cultural acceptance of cesarean section, a second on personal consideration of cesarean section in early pregnancy, and a third including sociodemographic questions. Results: Of the total sample, 92 women responded to the questionnaire (response rate 62%). Of 6 items relating to community acceptance of cesarean section, responses ranged from 71.4 percent agreement (“common for people to think that cesarean section offers an easier way of giving birth”) to 23.1 percent agreement (“the media seems to portray cesarean section as a better option than vaginal delivery”). The option of having a cesarean section was considered by almost 15 percent (10/68) of women early in their pregnancy. For the vast majority (8/10) this consideration was clinically based. Conclusions: This investigation demonstrated that these Australian women, independent of sociodemographic variables such as age and education level, agreed that cesarean section was perceived as an easy, convenient way of giving birth.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.0730-7659.2004.00289.x
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  • 3
    Electronic Resource
    Electronic Resource
    Knee-Chest Postural Management for Breech at Term: A Randomized Controlled Trial (1999)
    Oxford, UK : Blackwell Science Inc
    Birth 26 (1999), S. 0 
    Details
    ISSN: 1523-536X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background: In 3 to 4 percent of all term births, the fetus presents as a breech. The objectives of this trial were to assess if assuming the knee-chest position reduced the frequency of breech presentation at delivery, increased the success of the subsequent external cephalic version, or both, and to determine if this management plan reduced the need for cesarean delivery. Methods: A randomized clinical trial recruited 100 women from two hospitals in Adelaide, South Australia, with a singleton breech presentation and a gestational age equal to or more than 36 weeks. Women in the treatment group were advised to assume the knee-chest position for 15 minutes three times a day for one week. Women in the control group did not perform postural management. All participants were reviewed one week later, and women whose baby remained as a breech presentation were offered an external cephalic version. Results: Postural management did not increase the success of the external cephalic version, reduce the frequency of breech presentation at delivery, or reduce the need for cesarean delivery in women with a breech presentation at term. Conclusions: Findings from this trial included in a meta-analysis of postural management for breech presentation at term suggested that this is not an effective form of care to be offered routinely to women with a breech presentation at term.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1523-536x.1999.00071.x
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  • 4
    Electronic Resource
    Electronic Resource
    Is a rising caesarean section rate inevitable? (1998)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 105 (1998), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objective To determine the indications for singleton caesarean sections in Scotland in 1994.Design Prospective survey of singleton caesarean sections using information provided by clinicians entering data onto a computer in labour wards.Setting Twenty-three consultant-led obstetric units in Scotland.Population Women undergoing caesarean section in participating Scottish maternity units during 1994.Results Using routinely collected data it was found that the caesarean section rate varied by maternal age, parity, gestation, history of previous section and hospital of delivery, but there was no difference by area of deprivation. 87.4% (8369/9573) of Scottish caesarean sections were included in the survey of which 8098 were in women with singleton pregnancies. Most singleton caesarean sections were undertaken in primiparae (50.5%), 31.2% were in women with a history of previous section and 18.3% were in multiparous women who had not had a previous section; 38.9% of the operations were elective, 13.9% were emergencies before labour and 47.2% were emergencies during labour. Four main indications—elective section for breech presentation (10.7% of all sections); emergency Caesarean section before labour because of fetal problems (2.8%); emergency caesarean section during labour for fetal distress and/or failure to progress (30.3%); repeat section for reasons other than above (16.2%) accounted for 60% of all Caesarean sections in women with no other recorded complications. 7.7% of all singleton caesarean sections (19.8% of elective operations) were associated with maternal request for the operation.Discussion The survey has identified why caesarean sections are performed by Scottish obstetricians and highlighted some areas where there would be scope to increase the vaginal delivery rate. Before this can be attempted, agreement must be reached by clinicians about effective management of particular problems. Women also need to have ready access to evidenced-based information about caesarean section.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.1998.tb09349.x
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  • 5
    Electronic Resource
    Electronic Resource
    The development and process evaluation of an information-based intervention for pregnant women aimed at addressing rates of caesarean section (2005)
    Oxford, UK and Malden, USA : Blackwell Science Ltd
    BJOG 112 (2005), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objective  Few strategies aimed at addressing rising rates of caesarean section have explicitly involved information-based approaches for pregnant women. This study describes the development and evaluation of such an intervention for pregnant women, encompassing pamphlets and a peer support network (PSN).Design  Process evaluation.Setting  The study was undertaken at a metropolitan teaching hospital in Adelaide, South Australia.Population  A consecutive sample of pregnant women attending the ultrasound clinic over a two-month period, recruited at 18 weeks of gestation.Methods  Participants received two pamphlets at 18 weeks of gestation and information on a PSN at around 28 weeks of gestation. A questionnaire was sent to women at seven weeks postnatal, asking them to evaluate the intervention.Main outcome measures  The extent to which the intervention resources were used and participants were satisfied with the resources they received.Results  Ninety-two women returned questionnaires (response rate of 62%). Women generally resisted engaging with the informational resources, citing irrelevance to their situation, for example, 53% (49/92) read all of the pamphlets. None of the women used the PSN. Women who had experienced childbirth previously and those of higher education were significantly more likely to read the pamphlets. While generally satisfied with pamphlet content, one in five women reported feeling distressed by some of the information.Conclusions  This exploratory study casts doubt on the notion of information provision for pregnant women as a panacea for addressing rising rates of caesarean section.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.2005.00753.x
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  • 6
    Electronic Resource
    Electronic Resource
    Nanometre Scale Reactive Ion Etching of GaN Epilayers (1998)
    s.l. ; Stafa-Zurich, Switzerland
    Materials science forum Vol. 264-268 (Feb. 1998), p. 1403-1406 
    Details
    ISSN: 1662-9752
    Source: Scientific.Net: Materials Science & Technology / Trans Tech Publications Archiv 1984-2008
    Topics: Mechanical Engineering, Materials Science, Production Engineering, Mining and Metallurgy, Traffic Engineering, Precision Mechanics
    Type of Medium: Electronic Resource
    URL: http://www.tib-hannover.de/fulltexts/2011/0528/02/03/transtech_doi~10.4028%252Fwww.scientific.net%252FMSF.264-268.1403.pdf
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  • 7
    Electronic Resource
    Electronic Resource
    Nano Patterned Surfaces for Biomaterial Applications (2006)
    s.l. ; Stafa-Zurich, Switzerland
    Advances in science and technology Vol. 53 (Oct. 2006), p. 107-115 
    Details
    ISSN: 1662-0356
    Source: Scientific.Net: Materials Science & Technology / Trans Tech Publications Archiv 1984-2008
    Topics: Natural Sciences in General , Technology
    Notes: Bionanotechnology has seen much interest in the past few years. The development innew nanotechnologies and the transfer of such to biomedical applications has been received withlarge expectations. Here we will describe some of the most common techniques to prepare surfaceswith nanometric sized features and how they have been applied to control cell behavior. The focus,however, will be on electron beam lithography and its use in biological applications. We will showthat such highly ordered surfaces exhibit low adhesive properties for cells. Also, such topographieschange the wetting properties to be either more hydrophilic or hydrophobic depending on thesurface energy of the flat surface. Today, little research has found its way to the commercial market.This is mainly down to the ability to make large areas or large quantities of nano patternedmaterials. We will describe a few methods by which we think it would be possible to mass producenano topographically patterned surfaces
    Type of Medium: Electronic Resource
    URL: http://www.tib-hannover.de/fulltexts/2011/0528/01/42/transtech_doi~10.4028%252Fwww.scientific.net%252FAST.53.107.pdf
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  • 8
    Electronic Resource
    Electronic Resource
    Morphogenetic guidance cues can interact synergistically and hierarchically in steering nerve cell growth (1997)
    Springer
    Experimental biology online 1 (1997), S. 1-15 
    Details
    ISSN: 1430-3418
    Keywords: Nerve cell ; Microelectronics ; Development ; Regeneration
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology
    Notes: Abstract Nerve cell growth is influenced by guiding properties of its substratum. Microfabricated cell culture substrata were used to determine whether rat dorsal root ganglia (DRG) nerve cells could detect and integrate simultaneous model adhesive and topographic guidance cues. Interference reflection microscopy demonstrated strips of surface contact under the marginal zone of growth cones on planar surfaces which were coincident with actin immunostaining at the periphery of the C-domain. Clusters of focal contacts below the growth cone C-domain delineated the track edges on adhesive gratings. Neurite extension was guided most effectively by adhesive gratings of 25-μm period where highly aligned cells were typically bipolar. Nanometric steps and differences in surface texture between the adhesive tracks was detected using atomic force microscopy (AFM). Neurites did not align to 12- to 100-μm pitch grooves which were less than 1 μm deep. The proportion of aligned neurites increased with groove depth. Maximum neurite alignment was seen when 6-μm-deep, 25-μm-wide grooves contained superimposed parallel adhesive tracks of matched pitch. Neurites aligned preferentially to adhesive tracks superimposed orthogonally over shallow grooves (1 μm deep). Primary neurites aligned increasingly to grooves with orthogonal adhesive tracks as their depth increased. These neurites frequently had highly branched terminal arbours aligned to the orthogonal adhesive tracks. We conclude that morphogenetic guidance cues can interact synergistically and hierarchically to steer nerve cell growth.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s00898-996-0002-3
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