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Association Of Breastfeeding And The Federal Poverty Level: National Survey Of Family Growth, 2011–2013, R Constance Wiener Jan 2016

Association Of Breastfeeding And The Federal Poverty Level: National Survey Of Family Growth, 2011–2013, R Constance Wiener

Faculty & Staff Scholarship

Breastfeeding is strongly endorsed in the Healthy People 2020 goals; however, there remain many disparities in breastfeeding prevalence. The purpose of this study was to examine the association between breastfeeding and the Federal Poverty Level in the United States. Data from 5,397 women in the National Survey of Family Growth 2011–2013 survey were included in this study. The data were analyzed for descriptive features and logistic regressions of the Federal Poverty Level on breastfeeding. There were 64.1% of women who reported breastfeeding. Over one-third (35.2%) of women reported having a household income of 0–99% of the Federal Poverty Level. There …


Association Of Blood Lead Levels In Children 0–72 Months With Living In Mid-Appalachia: A Semiecologic Study, R Constance Wiener Jan 2016

Association Of Blood Lead Levels In Children 0–72 Months With Living In Mid-Appalachia: A Semiecologic Study, R Constance Wiener

Faculty & Staff Scholarship

Introduction: Lead exposure in children remains a significant public health issue, although many advances have been made. The Mid-Appalachia area (Kentucky, New York, Ohio, Pennsylvania, and West Virginia) is 89-91% rural with a population density of 16-21 people/km2 (41-54 people/mi2). Mid-Appalachia has significant health disparities including concerns for the consequences of greater lead exposure to children due to mining and industrial footprints, and existing older housing. The purpose of this study is to compare the reported blood lead levels of screened children, aged 0-72 months in Mid-Appalachia, to the children in the USA in general.
Methods: Data from the Centers …


Conservation Biology Of The Endangered Swamp Metalmark Butterfly (Calephelis Muticum), Alison Gordon Jan 2016

Conservation Biology Of The Endangered Swamp Metalmark Butterfly (Calephelis Muticum), Alison Gordon

Theses & ETDs

The Swamp Metalmark (Calephelis muticum) is a small North American butterfly (Riodinidae: Lepidoptera). It resides solely in calciferous fens, a wetland found only in the glaciated Midwest. Environmental processes, like succession, coupled with nearby anthropogenic change have fragmented these fens into small, isolated patches. This habitat loss has resulted in small, isolated populations throughout the range. These small populations are much more vulnerable to disease and are less likely to recover after a significant population decline. In this thesis, I evaluated two populations of C. muticum;one at the Riveredge Nature Center (Saukville, WI) and one along Boone Creek Road (Boone …


Association Of Blood Lead Levels In Children 0-72 Months With Living In Mid-Appalachia: A Semiecologic Study, R. Constance Wiener, R. J. Jurevic Jan 2016

Association Of Blood Lead Levels In Children 0-72 Months With Living In Mid-Appalachia: A Semiecologic Study, R. Constance Wiener, R. J. Jurevic

Faculty & Staff Scholarship

Introduction—Lead exposure in children remains a significant public health issue, although many advances have been made. The Mid-Appalachia area (Kentucky, New York, Ohio, Pennsylvania, and West Virginia) is 89–91% rural with a population density of 16–21 people/km2 (41–54 people/mi2 ). Mid-Appalachia has significant health disparities including concerns for the consequences of greater lead exposure to children due to mining and industrial footprints, and existing older housing. The purpose of this study is to compare the reported blood lead levels of screened children, aged 0–72 months in Mid-Appalachia, to the children in the USA in general.

Methods—Data from the Centers for …


Arsenic In Drinking Water And Lung Cancer Mortality In The United States: An Analysis Based On Us Counties And 30 Years Of Observation (1950-1979)., Hamid Ferdosi, Elisabeth K Dissen, Nana Ama Afari-Dwamena, Ji Li, Rusan Chen, Manning Feinleib, Steven H Lamm Jan 2016

Arsenic In Drinking Water And Lung Cancer Mortality In The United States: An Analysis Based On Us Counties And 30 Years Of Observation (1950-1979)., Hamid Ferdosi, Elisabeth K Dissen, Nana Ama Afari-Dwamena, Ji Li, Rusan Chen, Manning Feinleib, Steven H Lamm

Epidemiology Faculty Publications

Background. To examine whether the US EPA (2010) lung cancer risk estimate derived from the high arsenic exposures (10-934 µg/L) in southwest Taiwan accurately predicts the US experience from low arsenic exposures (3-59 µg/L). Methods. Analyses have been limited to US counties solely dependent on underground sources for their drinking water supply with median arsenic levels of ≥3 µg/L. Results. Cancer risks (slopes) were found to be indistinguishable from zero for males and females. The addition of arsenic level did not significantly increase the explanatory power of the models. Stratified, or categorical, analysis yielded relative risks that hover about 1.00. …


A New Look At Care In Pregnancy: Simple, Effective Interventions For Neglected Populations, Stephen Hodgins, James M. Tielsch, Kristen Rankin, Amber Robinson, Annie Kearns, Jacquelyn Caglia Jan 2016

A New Look At Care In Pregnancy: Simple, Effective Interventions For Neglected Populations, Stephen Hodgins, James M. Tielsch, Kristen Rankin, Amber Robinson, Annie Kearns, Jacquelyn Caglia

Global Health Faculty Publications

Background

Although this is beginning to change, the content of antenatal care has been relatively neglected in safe-motherhood program efforts. This appears in part to be due to an unwarranted belief that interventions over this period have far less impact than those provided around the time of birth. In this par, we review available evidence for 21 interventions potentially deliverable during pregnancy at high coverage to neglected populations in low income countries, with regard to effectiveness in reducing risk of: maternal mortality, newborn mortality, stillbirth, prematurity and intrauterine growth restriction. Selection was restricted to interventions that can be provided by …


Assessing Future Vegetation Trends And Restoration Prospects In The Karst Regions Of Southwest China, Xiaowei Tong, Kelin Wang, Martin Brandt Jan 2016

Assessing Future Vegetation Trends And Restoration Prospects In The Karst Regions Of Southwest China, Xiaowei Tong, Kelin Wang, Martin Brandt

KIP Articles

To alleviate the severe rocky desertification and improve the ecological conditions in Southwest China, the national and local Chinese governments have implemented a series of Ecological Restoration Projects since the late 1990s. In this context, remote sensing can be a valuable tool for conservation management by monitoring vegetation dynamics, projecting the persistence of vegetation trends and identifying areas of interest for upcoming restoration measures. In this study, we use MODIS satellite time series (2001–2013) and the Hurst exponent to classify the study area (Guizhou and Guangxi Provinces) according to the persistence of future vegetation trends (positive, anti-persistent positive, negative, anti-persistent …


Social Disparities In Exposure To Point-Of-Sale Cigarette Marketing, Mohammad Siahpush, Evi A. Farazi, Jungyoon Kim, Tzeyu L. Michaud, Aaron Yoder, Ghada Soliman, Melissa Tibbits, Minh N. Nguyen, Raees A. Shaikh Jan 2016

Social Disparities In Exposure To Point-Of-Sale Cigarette Marketing, Mohammad Siahpush, Evi A. Farazi, Jungyoon Kim, Tzeyu L. Michaud, Aaron Yoder, Ghada Soliman, Melissa Tibbits, Minh N. Nguyen, Raees A. Shaikh

Journal Articles: Epidemiology

While most ecological studies have shown that higher levels of point-of-sale (POS) cigarette marketing are associated with larger proportions of residents from lower socioeconomic and minority backgrounds in neighborhoods, there are no studies that examine individual-level social disparities in exposure to POS cigarette marketing among smokers in the United States. Our aim was to examine these disparities in a Midwestern metropolitan area in the United States. We conducted a telephone survey to collect data on 999 smokers. Cigarette marketing was measured by asking respondents three questions about noticing advertisements, promotions, and displays of cigarettes within their respective neighborhoods. The questions …


Characterization Of Mechanisms That Mediate Cancer Metastatic Colonization, Alexander Huan Nguyen Jan 2016

Characterization Of Mechanisms That Mediate Cancer Metastatic Colonization, Alexander Huan Nguyen

Student Theses and Dissertations

Metastatic disease is the major cause of death in all solid tumor cancers. Current therapeutic strategies fail to target metastasis as the genes and mechanisms that regulate this process remain poorly understood. Metastatic colonization is the final step of the metastatic cascade whereby cancer cells form a tumor at a distant site. This final step is the culmination of clonal evolution of cancer populations that results in a highly aggressive population with enhanced metastatic capacity and often presents clinically as numerous inoperable tumor nodules that lead to mortality. Characterization of the mechanisms that govern metastatic colonization at cellular and molecular …


Tweedie's Compound Poisson Model With Grouped Elastic Net, Wei Qian, Yi Yang, Hui Zou Jan 2016

Tweedie's Compound Poisson Model With Grouped Elastic Net, Wei Qian, Yi Yang, Hui Zou

Articles

Tweedie's Compound Poisson model is a popular method to model data with probability mass at zero and non-negative, highly right-skewed distribution. Motivated by wide applications of the Tweedie model in various fields such as actuarial science, we investigate the grouped elastic net method for the Tweedie model in the context of the generalized linear model. To efficiently compute the estimation coefficients, we devise a two-layer algorithm that embeds the blockwise majorization descent method into an iteratively re-weighted least square strategy. In together with the strong rule, the proposed algorithm is implemented in an easy-to-use R package HDtweedie, and is shown …


Channeled Whelk (Busycotypus Canaliculatus) Ecology In Relation To The Fishery In Vineyard And Nantucket Sounds, Massachusetts, Shelley Ann Edmundson Jan 2016

Channeled Whelk (Busycotypus Canaliculatus) Ecology In Relation To The Fishery In Vineyard And Nantucket Sounds, Massachusetts, Shelley Ann Edmundson

Doctoral Dissertations

Channeled whelks (Busycotypus canaliculatus) are predatory marine gastropods that support lucrative commercial fisheries along the east coast of the United States, with areas around Massachusetts supplying the largest landings. In the absence of a more thorough and comprehensive understanding of channeled whelk biology, it is unclear how to sustainably manage their fisheries. Within this dissertation, various aspects of whelk ecology were investigated to determine how to protect this species, while effectively managing the local fishery.

Early life history experiments revealed channeled whelk egg strings may incubate for 8 to 9 months in MA water temperatures. Incubation period decreased with increasing …


Bibliographia Phytosociologica Et Floristica Mongolia: Pars Iv, Werner Hilbig Jan 2016

Bibliographia Phytosociologica Et Floristica Mongolia: Pars Iv, Werner Hilbig

Erforschung biologischer Ressourcen der Mongolei / Exploration into the Biological Resources of Mongolia, ISSN 0440-1298

In Ergänzung zu den bisherigen drei Teilen der Bibliographie vegetationskundlicher, vegetationsökologischer, floristischer und pflanzengeographischer Arbeiten über die Mongolei wird in dieser Arbeit Teil IV der Bibliographie vorgelegt. Er umfasst im Wesentlichen den Zeitraum 2007 bis 2014. Auch Publikationen zur Vegetationsgeschichte und zum botanischen Naturschutz werden berücksichtigt.

English summary:

In addition to the hitherto existing three parts of the bibliography of geobotanical, ecological, floristic and plant-geographical papers on Mongolia the part IV of the bibliography is given. It comprises in the main point the period from 2007 until 2014. In addition, publications on vegetation history and botanical nature protection are considered.


Late Holocene Expansion Of Ponderosa Pine (Pinus Ponderosa) In The Central Rocky Mountains, Usa, Jodi R. Norris, Julio L. Betancourt, Stephen T. Jackson Jan 2016

Late Holocene Expansion Of Ponderosa Pine (Pinus Ponderosa) In The Central Rocky Mountains, Usa, Jodi R. Norris, Julio L. Betancourt, Stephen T. Jackson

United States National Park Service: Publications

Aim: Ponderosa pine (Pinus ponderosa) experienced one of the most extensive and rapid post-glacial plant migrations in western North America. We used plant macrofossils from woodrat (Neotoma) middens to reconstruct its spread in the Central Rocky Mountains, identify other vegetation changes coinciding with P. ponderosa expansion at the same sites, and relate P. ponderosa migrational history to both its modern phylogeography and to a parallel expansion by Utah juniper (Juniperus osteosperma).

Location: Central Rocky Mountains, Wyoming and Montana, and Black Hills, Wyoming and South Dakota, USA.

Methods: Plant macrofossils were analysed in …


Prehistoric Human Impact On Tree Island Lifecycles In The Florida Everglades, Traci Ardren, Justin P. Lowry, Melissa Memory, Kelin Flanagan, Alexandra Busot Jan 2016

Prehistoric Human Impact On Tree Island Lifecycles In The Florida Everglades, Traci Ardren, Justin P. Lowry, Melissa Memory, Kelin Flanagan, Alexandra Busot

United States National Park Service: Publications

The current study provides a fine-grained analysis of evidence for sustained pre-Columbian human occupation and socio-ecological interaction within Everglades National Park. Utilizing archaeological data on dietary and cultural patterns recovered from recent excavations at a prehistoric tree island site, we argue the role of ancient human populations in the formation or augmentation of tree islands should be incorporated into environmental models of the tree island lifecycle. High phosphorus levels in human waste, especially the largely organic waste of prehistoric populations, as well as other anthropogenic factors have not been adequately factored into current environmental models of tree island formation or …


Hydrothermal Monitoring In Yellowstone National Park Using Airborne Thermal Infrared Remote Sensing, C. M.U. Neale, C. Jaworowski, H. Heasler, S. Sivarajan, A. Masih Jan 2016

Hydrothermal Monitoring In Yellowstone National Park Using Airborne Thermal Infrared Remote Sensing, C. M.U. Neale, C. Jaworowski, H. Heasler, S. Sivarajan, A. Masih

United States National Park Service: Publications

This paper describes the image acquisition and processing methodology, including surface emissivity and atmospheric corrections, for generating surface temperatures of two active hydrothermal systems in Yellowstone National Park. Airborne thermal infrared (8–12 μm) images were obtained annually from 2007 to 2012 using a FLIR SC640 thermal infrared camera system. Thermal infrared image acquisitions occurred under clear-sky conditions after sunset to meet the objective of providing high-spatial resolution, georectified imagery for hydrothermal monitoring. Comparisons of corrected radiative temperature maps with measured ground and water kinetic temperatures at flight times provided an assessment of temperature accuracy. A repeatable, time-sequence of images for …


Preliminary Taxonomic Survey And Molecular Documentation Of Jellyfish Species (Cnidaria: Scyphozoa And Cubozoa) In Malaysia, I. Mohammed Rizman, A.B. Farah Azwa, V.C. Chong Jan 2016

Preliminary Taxonomic Survey And Molecular Documentation Of Jellyfish Species (Cnidaria: Scyphozoa And Cubozoa) In Malaysia, I. Mohammed Rizman, A.B. Farah Azwa, V.C. Chong

Research Publications (2016 to 2020)

Scientific enqumes into jellyfish blooms and associated problems in Malaysia are often deterred by the lack of taxonomical and ecological studies. To date, only two scyphozoan jellyfish species have been documented from field surveysin Malaysian waters, whereas other four Malaysian scyphozoan and two cubozoan jellyfish species have been mentioned in toxicological studies, all of which their species identity were not verified. Thus,this study aimed to document and to resolve the identification of jellyfish in Malaysia using morphology and molecular DNA sequencing of COl, 16Sand ITS1 regions. Jellyfish specimens were collected from 2008 to 2010 in the Straits of Malacca, South-China …


Special Topic: Wildlife And Wing Energy: Are They Compatible? Introduction, Michael Hutchins, Bruce D. Leopold Jan 2016

Special Topic: Wildlife And Wing Energy: Are They Compatible? Introduction, Michael Hutchins, Bruce D. Leopold

Human–Wildlife Interactions

No abstract provided.


Diet Of The Endangered Big-Headed Turtle Platysternon Megacephalum, Yik-Hei Sung, Billy C.H. Hau, Nancy E. Karraker Jan 2016

Diet Of The Endangered Big-Headed Turtle Platysternon Megacephalum, Yik-Hei Sung, Billy C.H. Hau, Nancy E. Karraker

Natural Resources Science Faculty Publications

Populations of the big-headed turtle Platysternon megacephalum are declining at unprecedented rates across most of its distribution in Southeast Asia owing to unsustainable harvest for pet, food, and Chinese medicine markets. Research on Asian freshwater turtles becomes more challenging as populations decline and basic ecological information is needed to inform conservation efforts. We examined fecal samples collected from P. megacephalum in five streams in Hong Kong to quantify the diet, and we compared the germination success of ingested and uningested seeds. Fruits, primarily of Machilus spp., were most frequently consumed, followed by insects, plant matter, crabs and mollusks. The niche …


Business Meeting Report (Secretary’S And Treasurer’S Report), Academy Editors Jan 2016

Business Meeting Report (Secretary’S And Treasurer’S Report), Academy Editors

Journal of the Arkansas Academy of Science

No abstract provided.


Keynote Address And Meeting Program, Academy Editors Jan 2016

Keynote Address And Meeting Program, Academy Editors

Journal of the Arkansas Academy of Science

No abstract provided.


Celebrating 100 Years Of The National Park System In The Classroom, Kailyn Louise Bettle Jan 2016

Celebrating 100 Years Of The National Park System In The Classroom, Kailyn Louise Bettle

Honors Program Theses

This research evaluates the effects of a curricular tool on students in a social studies and upper elementary classroom. Consisting of a text set, a compilation of varying primary and secondary resources such as letters and maps at varying reading levels, focused around an interesting central topic. The research employs text sets created for fourth and seventh grade on the topic of US national parks and focuses on the history of national parks, curricular materials already available on national parks, creation of the text sets, and the importance of disciplinary literacy and interdisciplinary connections between geography and literacy. The text …


Changes In Wetland Conditions And Wetland Plant Communities In The Prairie Pothole Region After 50 Years, Ryann Cressey Jan 2016

Changes In Wetland Conditions And Wetland Plant Communities In The Prairie Pothole Region After 50 Years, Ryann Cressey

Electronic Theses and Dissertations

Wetlands in Stutsman County, North Dakota were revisited after 50 years to assess changes in wetland conditions and plant communities within wetland zones in the Prairie Pothole Region. In 1961-1966, Robert E. Stewart and Harold A. Kantrud conducted a study to investigate the relationship of wetland plant communities to variations of water permanence and chemistry on three study areas: Crystal Springs, Cottonwood, and Mt. Moriah. Within in this region, a severe drought occurred in 1988- 1992 followed by the longest deluge starting in 1993 with wetlands still impacted today. In 2013 and 2014, I revisited 80 of the original wetlands …


Raptors In Temperate Grasslands: Ecology Of Ferruginous Hawk, Golden Eagle, And Northern Harrier In The Northern Great Plains, Shubham Datta Jan 2016

Raptors In Temperate Grasslands: Ecology Of Ferruginous Hawk, Golden Eagle, And Northern Harrier In The Northern Great Plains, Shubham Datta

Electronic Theses and Dissertations

Ferruginous hawks (Buteo regalis) are a grassland and shrubland obligate nesting raptor and prefer lightly grazed pasture or idle areas for nesting. Their population reportedly declines in number if more than 30% of an area is cultivated and they rarely nest in areas dominated by croplands. Golden eagles (Aquila chrysaetos) are long-lived raptors with high nest-site fidelity and relatively low reproductive success. Population trends of golden eagles in western United States are unclear although long-term monitoring of populations shows declines in occupancy and breeding performance. Northern harriers (Circus cyaneus) prefer relatively open grasslands and …


Performance Measures Of Road Crossing Structures From Relative Movement Rates Of Large Mammals, Adam Andis Jan 2016

Performance Measures Of Road Crossing Structures From Relative Movement Rates Of Large Mammals, Adam Andis

Graduate Student Theses, Dissertations, & Professional Papers

In recent decades, there has been an increase of engineering projects that seek to mitigate the barrier effect roads impose on wildlife by installing wildlife crossing structures that promote permeability of the road corridor. The 41 fish and wildlife crossing structures installed along a 90km stretch of US Highway 93 on the Flathead Indian Reservation in western Montana, represent one of the most extensive of such projects in North America. As mitigation efforts are increasingly considered and implemented in road construction projects, the need to assess these structures’ effectiveness grows. This study is the first to compare observations of animal …


Shifting Baselines Of Iconic Marine Species In The Caribbean, Samantha Lovell Jan 2016

Shifting Baselines Of Iconic Marine Species In The Caribbean, Samantha Lovell

Honors Theses

As the degradation of Caribbean coral reefs occurs, memory of past states is lost so the degraded status is used as a standard in management, a phenomenon known as “shifting baselines.” To set restoration targets, marine historical ecology studies are helpful to document baselines of species and understand the past productivity of ecosystems. In this study, I examine the historical ecology of the islands Barbuda, Curaçao, and Montserrat. I analyzed archival materials, including historical maps and other documents from the islands to identify previously abundant or iconic species and understand historical changes. From the archival resources I identified 30 places …


The Link Between Smoking, Lung Cancer And Socioeconomic Factors In Kentucky, Shreya Berlia Jan 2016

The Link Between Smoking, Lung Cancer And Socioeconomic Factors In Kentucky, Shreya Berlia

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Background and Purpose

Lung cancer is the leading cause of cancer death and the second most diagnosed cancer in both men and women in the United States. An estimated 158,080 deaths from lung cancer are expected to occur in 2016, which will account for approximately 1 in 4 of all cancer deaths. The 1- and 5-year relative survival rates for lung cancer are 44% and 17%, respectively. The incidence rate for lung cancer has been declining since the mid-1980s in men, but only since the mid-2000s in women. Tobacco smoke is the leading cause of preventable disease and death in …


Purpose And Satisfaction Of Activities In Rural Communities Using Ecological Momentary Assessment, Jennifer Lauren Wong Jan 2016

Purpose And Satisfaction Of Activities In Rural Communities Using Ecological Momentary Assessment, Jennifer Lauren Wong

Graduate Student Theses, Dissertations, & Professional Papers

Individuals’ wellbeing have been investigated through one of two primary perspectives, hedonic or eudaimonic. The hedonic perspective has focused on studying happiness and considers individuals’ maximization of their pleasurable moments as the pathway to happiness (Henderson & Knight, 2012). The eudaimonic perspective suggests that people should live a life of virtue and that actualizing their potential is the pathway to wellbeing (Henderson & Knight, 2012). Both perspectives have used retrospective recall to investigate individuals’ wellbeing. This method has given researchers a better understanding of individuals’ overall wellbeing, but is unable to describe their wellbeing as it varies throughout the day. …


Coloration In The Polymorphic Frog Oophaga Pumilio Associates With Level Of Aggressiveness In Intraspecific And Interspecific Behavioral Interactions, Sandra P. Galeano, Kyle E. Harms Jan 2016

Coloration In The Polymorphic Frog Oophaga Pumilio Associates With Level Of Aggressiveness In Intraspecific And Interspecific Behavioral Interactions, Sandra P. Galeano, Kyle E. Harms

Faculty Publications

© 2015, Springer-Verlag Berlin Heidelberg. Intraspecific morphological variation may correspond to behavioral variation that helps determine the nature of species interactions. Color variation among populations of variably toxic organisms has been shown to associate with alternative anti-predator behaviors. However, the effects of these alternative behavioral tendencies on the outcomes of interspecific interactions other than predator–prey remain largely unexplored. We investigated how coloration and body size variation in Oophaga pumilio, one of the most phenotypically diverse amphibians known, associated with territorial aggressiveness and how this association influenced the outcome of agonistic male–male interactions with conspecifics and heterospecifics of two sympatric species …


Current Status Of Falcon Populations In Saudi Arabia, Albara M. Binothman Jan 2016

Current Status Of Falcon Populations In Saudi Arabia, Albara M. Binothman

Electronic Theses and Dissertations

Falcons (Falco spp.) are widely used for falconry in the countries of the Middle East. During the 2015 breeding season, we surveyed historic and active nest sites of Barbary (Falco pelegrinoides pelegrinoides) and Lanner (F. biarmicus) Falcons in Saudi Arabia. Field and questionnaire surveys were conducted and personal contact with falconers was made to document the current distribution and price changes for Lanner Falcons, Barbary Falcons, Saker Falcons (F. cherrug), Peregrine Falcons (F. peregrinus), Gyrfalcons (F. rusticolus), and Hybrid Falcons in Saudi Arabia. We categorized our survey into three geographic groups; southwest (A), northwest (B), and central (C) regions of …


Who Statement On Caesarean Section Rates, A. P. Betran, M. R. Torloni, J. J. Zhang, A. M. Gulmezoglu, Marleen Temmerman, Who Working Group On Caesarean Section Jan 2016

Who Statement On Caesarean Section Rates, A. P. Betran, M. R. Torloni, J. J. Zhang, A. M. Gulmezoglu, Marleen Temmerman, Who Working Group On Caesarean Section

Obstetrics and Gynaecology, East Africa

In 1985 when a group of experts convened by the World Health Organization in Fortaleza, Brazil, met to discuss the appropriate technology for birth, they echoed what at that moment was considered an unjustified and remarkable increase of caesarean section (CS) rates worldwide.1 Based on the evidence available at that time, the experts in Fortaleza concluded: ‘there is no justification for any region to have a caesarean section rate higher than 10–15%’.1 Over the years, this quote has become ubiquitous in scientific literature, being interpreted as the ideal CS rate. Although this reference range was intended for ‘populations’, which are …