Worldwide cesarean section use has nearly doubled in two decades and has reached “epidemic” proportions in some countries, doctors warned Friday, highlighting a huge gap in childbirth care between rich and poor mothers.

They said millions of women each year may be putting themselves and their babies at unnecessary risk by undergoing C-sections at rates “that have virtually nothing to do with evidence-based medicine.”

In 2015, the most recent year for which complete data is available, doctors performed 29.7 million C-sections worldwide, or 21 percent of all births. This was up from 16 million in 2000, or 12 percent of all births, according to research published in The Lancet.

It is estimated that the operation, a vital surgical procedure when complications occur during birth, is necessary 10-15 percent of the time.

Varying country rates

But the research found wildly varying country rates of C-section use, often according to economic status: In at least 15 countries, more than 40 percent births are performed using the practice, often on wealthier women in private facilities.

In Brazil, Egypt and Turkey, more than half of all births are done via C-section.

The Dominican Republic has the highest rate of any nation, with 58.1 percent of all babies delivered using the procedure.

But in close to a quarter of nations surveyed, C-section use is significantly lower than average.

Reasons to opt for surgery

Authors pointed out that while the procedure is generally overused in many middle- and high-income settings, women in low-income situations often lack necessary access to what can be a life-saving procedure.

“We would not expect such differences between countries, between women by socioeconomic status or between provinces/states within countries based on obstetric need,” Ties Boerma, professor of public health at the University of Manitoba, Winnipeg, and a lead author on the study, told AFP.

Jane Sandall, professor of social science and women’s health at King’s College London and a study author, told AFP that there were a variety of reasons women were increasingly opting for surgery.

These include “a lack of midwives to prevent and detect problems, loss of medical skills to confidently and competently attend a vaginal delivery, as well as medico-legal issues.”

Doctors are often tempted to organize C-sections to ease the flow of patients through a maternity clinic, and medical professionals are generally less vulnerable to legal action if they choose an operation over a natural birth.

Sandall also said there were often “financial incentives for both doctor and hospital” to perform the procedure.

The study warned that in many settings young doctors were becoming “experts” in C-section while losing confidence in their abilities when it comes to natural birth.

Income a factor

It also identified an emerging gap between wealthy and poorer regions within the same country. In China, C-section rates diverged from 4 percent to 62 percent; in India the range was 7-49 percent.

While the U.S. saw more than a quarter of all births performed by C-section, some states used the procedure more than twice as often as others.

“It is clear that poor countries have low C-section use because access to services is a problem,” Sandall said. “In many of those countries, however, richer women who live in urban areas, have access to private facilities have much higher C-section use.”

Risks to mother, child

C-sections may be marketed by clinics as the “easy” way to give birth, but they are not without risks.

Maternal death and disability rates are higher after C-section than vaginal birth. The procedure scars the womb, which can lead to bleeding, ectopic pregnancies (where the embryo is stuck in the ovaries), as well as still- and premature future births.

The authors suggested better education, more midwifery-led care and improved labor planning as ways of ensuring C-sections are only performed when medically necessary, as well as ensuring women properly understand the risks involved with the procedure.

“C-section is a type of major surgery, which carries risks that require careful consideration,” Sandall said.

In a comment accompanying the study, Gerard Visser of the University Medical Centre in the Netherlands, called the rise in C-sections “alarming.”

“The medical profession on its own cannot reverse this trend,” he said. “Joint actions are urgently needed to stop unnecessary C-sections and enable women and families to be confident of receiving the most appropriate care for their circumstances.”
…

From: MeNeedIt

Worldwide cesarean section use has nearly doubled in two decades and has reached “epidemic” proportions in some countries, doctors warned Friday, highlighting a huge gap in childbirth care between rich and poor mothers.

They said millions of women each year may be putting themselves and their babies at unnecessary risk by undergoing C-sections at rates “that have virtually nothing to do with evidence-based medicine.”

In 2015, the most recent year for which complete data is available, doctors performed 29.7 million C-sections worldwide, or 21 percent of all births. This was up from 16 million in 2000, or 12 percent of all births, according to research published in The Lancet.

It is estimated that the operation, a vital surgical procedure when complications occur during birth, is necessary 10-15 percent of the time.

Varying country rates

But the research found wildly varying country rates of C-section use, often according to economic status: In at least 15 countries, more than 40 percent births are performed using the practice, often on wealthier women in private facilities.

In Brazil, Egypt and Turkey, more than half of all births are done via C-section.

The Dominican Republic has the highest rate of any nation, with 58.1 percent of all babies delivered using the procedure.

But in close to a quarter of nations surveyed, C-section use is significantly lower than average.

Reasons to opt for surgery

Authors pointed out that while the procedure is generally overused in many middle- and high-income settings, women in low-income situations often lack necessary access to what can be a life-saving procedure.

“We would not expect such differences between countries, between women by socioeconomic status or between provinces/states within countries based on obstetric need,” Ties Boerma, professor of public health at the University of Manitoba, Winnipeg, and a lead author on the study, told AFP.

Jane Sandall, professor of social science and women’s health at King’s College London and a study author, told AFP that there were a variety of reasons women were increasingly opting for surgery.

These include “a lack of midwives to prevent and detect problems, loss of medical skills to confidently and competently attend a vaginal delivery, as well as medico-legal issues.”

Doctors are often tempted to organize C-sections to ease the flow of patients through a maternity clinic, and medical professionals are generally less vulnerable to legal action if they choose an operation over a natural birth.

Sandall also said there were often “financial incentives for both doctor and hospital” to perform the procedure.

The study warned that in many settings young doctors were becoming “experts” in C-section while losing confidence in their abilities when it comes to natural birth.

Income a factor

It also identified an emerging gap between wealthy and poorer regions within the same country. In China, C-section rates diverged from 4 percent to 62 percent; in India the range was 7-49 percent.

While the U.S. saw more than a quarter of all births performed by C-section, some states used the procedure more than twice as often as others.

“It is clear that poor countries have low C-section use because access to services is a problem,” Sandall said. “In many of those countries, however, richer women who live in urban areas, have access to private facilities have much higher C-section use.”

Risks to mother, child

C-sections may be marketed by clinics as the “easy” way to give birth, but they are not without risks.

Maternal death and disability rates are higher after C-section than vaginal birth. The procedure scars the womb, which can lead to bleeding, ectopic pregnancies (where the embryo is stuck in the ovaries), as well as still- and premature future births.

The authors suggested better education, more midwifery-led care and improved labor planning as ways of ensuring C-sections are only performed when medically necessary, as well as ensuring women properly understand the risks involved with the procedure.

“C-section is a type of major surgery, which carries risks that require careful consideration,” Sandall said.

In a comment accompanying the study, Gerard Visser of the University Medical Centre in the Netherlands, called the rise in C-sections “alarming.”

“The medical profession on its own cannot reverse this trend,” he said. “Joint actions are urgently needed to stop unnecessary C-sections and enable women and families to be confident of receiving the most appropriate care for their circumstances.”
…

From: MeNeedIt

A U.S. astronaut and a Russian cosmonaut made an emergency return to earth Thursday shortly after launching on what was supposed to be a mission to the International Space Station. Rescuers reached American Nick Hague and Russian Alexei Ovchinin after their emergency landing in Kazakhstan. VOA Pentagon correspondent Carla Babb recently sat down with Hague to talk about his future in space, a future now up in the air after his unexpected fall to Earth.
…

From: MeNeedIt

A U.S. astronaut and a Russian cosmonaut made an emergency return to earth Thursday shortly after launching on what was supposed to be a mission to the International Space Station. Rescuers reached American Nick Hague and Russian Alexei Ovchinin after their emergency landing in Kazakhstan. VOA Pentagon correspondent Carla Babb recently sat down with Hague to talk about his future in space, a future now up in the air after his unexpected fall to Earth.
…

From: MeNeedIt

Facebook announced Thursday that it had deleted over 800 mostly U.S.-based pages and accounts that were posting politically oriented spam and engaging in “inauthentic behavior.” 

The social media giant declined a request from VOA News to name the 559 pages and 251 accounts. Nation in Distress, a pro-President Donald Trump page identified by The Washington Post as being among the banned, had over 3 million followers.

Facebook said that many of the pages and accounts had posted political clickbait across multiple fake accounts to drive users to their websites, where they were often targeted with ads. 

“Many used the same techniques to make their content appear more popular on Facebook than it really was,” Facebook said on its news blog. “Others were ad farms using Facebook to mislead people into thinking that they were forums for legitimate political debate.”

Facebook said “the ‘news’ stories or opinions these accounts and pages share are often indistinguishable from legitimate political debate,” noting the proximity of the 2018 midterm elections.

In the past, Facebook has purged dozens of pages spreading fake news originating from Iran and Russia, countries that have antagonistic relations with the U.S. The company says most of the pages and accounts banned this time were from the U.S.
…

From: MeNeedIt

Australia is rejecting the latest U.N. report on climate change, insisting coal remains critical to energy security and lowering household power bills.

The United Nations’ Intergovernmental Panel on Climate Change (IPCC) said in its report released Monday that global greenhouse gas emissions must reach zero by the middle of the century to stop global warming exceeding 1.5 degrees Celsius.

The authors warned that if warming was allowed to reach two degrees, the world would be on course toward uncontrollable temperatures.

They made special mention of coal, insisting that its use for power generation would have to fall to between zero and two percent of current usage.

The report has received a lukewarm response by Australia’s center-right government. It has said it has no intention of scaling back fossil fuel production because without coal, household power bills would soar.

Canberra also insists it is on target to meet its commitments under the Paris agreement, which attempts to unite every nation under a single accord to tackle climate change for the first time ever.

Australia earns billions of dollars exporting coal to China and other parts of Asia, while it generates more than 60 percent of domestic electricity.

Australia’s Environment Minister Melissa Price believes the IPCC report exaggerates the threat posed by fossil fuel.

“Coal does form a very important part of the Australian energy mixer and we make no apology for the fact that our focus at the moment is on getting electricity prices down,” Price said. “Every year, there is new technology with respect to coal and what its contribution is to emissions. So, you know, to say that it has got to be phased out by 2050 is drawing a very long bow.”

Australia has some of the world’s highest per capita rates of greenhouse gas pollution. A recent government report showed a failure to reduce levels of greenhouse gas pollution. The survey said that between January and March this year, Australia had its most elevated levels of carbon pollution since 2011.

Conservationists argue Australia is doing too little to protect itself from the predicted ravages of a shifting climate.

Australia is the world’s driest inhabited continent. Scientists warn that droughts, floods, heat waves, brush fires and storms will become more intense as temperatures rise, with potentially disastrous consequences for human health and the environment, including the Great Barrier Reef.
…

From: MeNeedIt

Australia is rejecting the latest U.N. report on climate change, insisting coal remains critical to energy security and lowering household power bills.

The United Nations’ Intergovernmental Panel on Climate Change (IPCC) said in its report released Monday that global greenhouse gas emissions must reach zero by the middle of the century to stop global warming exceeding 1.5 degrees Celsius.

The authors warned that if warming was allowed to reach two degrees, the world would be on course toward uncontrollable temperatures.

They made special mention of coal, insisting that its use for power generation would have to fall to between zero and two percent of current usage.

The report has received a lukewarm response by Australia’s center-right government. It has said it has no intention of scaling back fossil fuel production because without coal, household power bills would soar.

Canberra also insists it is on target to meet its commitments under the Paris agreement, which attempts to unite every nation under a single accord to tackle climate change for the first time ever.

Australia earns billions of dollars exporting coal to China and other parts of Asia, while it generates more than 60 percent of domestic electricity.

Australia’s Environment Minister Melissa Price believes the IPCC report exaggerates the threat posed by fossil fuel.

“Coal does form a very important part of the Australian energy mixer and we make no apology for the fact that our focus at the moment is on getting electricity prices down,” Price said. “Every year, there is new technology with respect to coal and what its contribution is to emissions. So, you know, to say that it has got to be phased out by 2050 is drawing a very long bow.”

Australia has some of the world’s highest per capita rates of greenhouse gas pollution. A recent government report showed a failure to reduce levels of greenhouse gas pollution. The survey said that between January and March this year, Australia had its most elevated levels of carbon pollution since 2011.

Conservationists argue Australia is doing too little to protect itself from the predicted ravages of a shifting climate.

Australia is the world’s driest inhabited continent. Scientists warn that droughts, floods, heat waves, brush fires and storms will become more intense as temperatures rise, with potentially disastrous consequences for human health and the environment, including the Great Barrier Reef.
…

From: MeNeedIt

Australia is rejecting the latest U.N. report on climate change, insisting coal remains critical to energy security and lowering household power bills.

The United Nations’ Intergovernmental Panel on Climate Change (IPCC) said in its report released Monday that global greenhouse gas emissions must reach zero by the middle of the century to stop global warming exceeding 1.5 degrees Celsius.

The authors warned that if warming was allowed to reach two degrees, the world would be on course toward uncontrollable temperatures.

They made special mention of coal, insisting that its use for power generation would have to fall to between zero and two percent of current usage.

The report has received a lukewarm response by Australia’s center-right government. It has said it has no intention of scaling back fossil fuel production because without coal, household power bills would soar.

Canberra also insists it is on target to meet its commitments under the Paris agreement, which attempts to unite every nation under a single accord to tackle climate change for the first time ever.

Australia earns billions of dollars exporting coal to China and other parts of Asia, while it generates more than 60 percent of domestic electricity.

Australia’s Environment Minister Melissa Price believes the IPCC report exaggerates the threat posed by fossil fuel.

“Coal does form a very important part of the Australian energy mixer and we make no apology for the fact that our focus at the moment is on getting electricity prices down,” Price said. “Every year, there is new technology with respect to coal and what its contribution is to emissions. So, you know, to say that it has got to be phased out by 2050 is drawing a very long bow.”

Australia has some of the world’s highest per capita rates of greenhouse gas pollution. A recent government report showed a failure to reduce levels of greenhouse gas pollution. The survey said that between January and March this year, Australia had its most elevated levels of carbon pollution since 2011.

Conservationists argue Australia is doing too little to protect itself from the predicted ravages of a shifting climate.

Australia is the world’s driest inhabited continent. Scientists warn that droughts, floods, heat waves, brush fires and storms will become more intense as temperatures rise, with potentially disastrous consequences for human health and the environment, including the Great Barrier Reef.
…

From: MeNeedIt

Australia is rejecting the latest U.N. report on climate change, insisting coal remains critical to energy security and lowering household power bills.

The United Nations’ Intergovernmental Panel on Climate Change (IPCC) said in its report released Monday that global greenhouse gas emissions must reach zero by the middle of the century to stop global warming exceeding 1.5 degrees Celsius.

The authors warned that if warming was allowed to reach two degrees, the world would be on course toward uncontrollable temperatures.

They made special mention of coal, insisting that its use for power generation would have to fall to between zero and two percent of current usage.

The report has received a lukewarm response by Australia’s center-right government. It has said it has no intention of scaling back fossil fuel production because without coal, household power bills would soar.

Canberra also insists it is on target to meet its commitments under the Paris agreement, which attempts to unite every nation under a single accord to tackle climate change for the first time ever.

Australia earns billions of dollars exporting coal to China and other parts of Asia, while it generates more than 60 percent of domestic electricity.

Australia’s Environment Minister Melissa Price believes the IPCC report exaggerates the threat posed by fossil fuel.

“Coal does form a very important part of the Australian energy mixer and we make no apology for the fact that our focus at the moment is on getting electricity prices down,” Price said. “Every year, there is new technology with respect to coal and what its contribution is to emissions. So, you know, to say that it has got to be phased out by 2050 is drawing a very long bow.”

Australia has some of the world’s highest per capita rates of greenhouse gas pollution. A recent government report showed a failure to reduce levels of greenhouse gas pollution. The survey said that between January and March this year, Australia had its most elevated levels of carbon pollution since 2011.

Conservationists argue Australia is doing too little to protect itself from the predicted ravages of a shifting climate.

Australia is the world’s driest inhabited continent. Scientists warn that droughts, floods, heat waves, brush fires and storms will become more intense as temperatures rise, with potentially disastrous consequences for human health and the environment, including the Great Barrier Reef.
…

From: MeNeedIt

Google will begin offering its pay-to-carpool service throughout the U.S., an effort to reduce the commute-time congestion that its popular Waze navigation app is designed to avoid.

The expansion announced Wednesday builds upon a carpooling system that Waze began testing two years ago in northern California and Israel before gradually extending it into Brazil and parts of 12 other states.

Now it will be available to anyone in the U.S.

Drivers willing to give someone a ride for a small fee to cover some of their costs for gas and other expenses need only Waze’s app on their phone. Anyone willing to pay a few bucks to hitch a ride will need to install a different Waze app focused on carpooling.

About 1.3 million drivers and passengers have signed up for Waze’s carpooling service, the company says. About 30 million people in the U.S. currently rely on the Waze app for directions; it has 110 million users worldwide.

Waze’s carpooling effort has been viewed as a potential first step for Google to mount a challenge to the two top ride-hailing services, Uber and Lyft.

But Waze founder and CEO Noam Bardin rejected that notion in an interview with The Associated Press, insisting that the carpooling service is purely an attempt to ease traffic congestion.

“We don’t want to be a professional driving network,” Bardin said. “We see ride sharing as something that needs to become part of the daily commute. If we can’t get people out of their cars, it won’t be solving anything.”

Gartner analyst Mike Ramsey also sees Waze’s service as a bigger threat to other carpooling apps such as Scoop and Carpool Buddy than to Uber and Lyft. “Carpooling is a much different animal,” he said.

It’s a form of transportation that Bardin said Waze had difficulty figuring out. Early on, Waze tried to get more drivers to sign up by emphasizing the economic benefits of having someone help cover gas costs for a trip that they were going to make anyway.

But earlier this year, Waze realized it needed a better formula for connecting strangers willing to ride together in a car. Many women, for instance, only want to ride with other women, Bardin said, while other people enjoy commuting with others who work for the same employer or live in the same neighborhood.

“Carpooling is a more social experience,” Bardin said. “A lot of time those of us working in the digital world forget that social connections are often the most important thing in the real world.”

Waze’s app still sets a price for each carpooling trip and transfers payments without charging a commission. That’s something Waze can afford to do because Google makes so much money from selling digital ads on Waze and its many other services.

The carpooling fees are supposed to be similar to what it would cost to take a train or type of public transportation to work, Bardin said. Drivers and riders can agree to adjust the price upward or downward, but the fees can never exceed the rate the Internal Revenue Service allows for business-related mileage — currently 54.5 cents per mile.

Even though Waze’s carpooling service doesn’t appear to be driven by profit motive, Ramsey isn’t convinced that will always be the case. “I do think Google is realizing that it can’t just keep making all its money from selling ads,” he said.
…

From: MeNeedIt

Google will begin offering its pay-to-carpool service throughout the U.S., an effort to reduce the commute-time congestion that its popular Waze navigation app is designed to avoid.

The expansion announced Wednesday builds upon a carpooling system that Waze began testing two years ago in northern California and Israel before gradually extending it into Brazil and parts of 12 other states.

Now it will be available to anyone in the U.S.

Drivers willing to give someone a ride for a small fee to cover some of their costs for gas and other expenses need only Waze’s app on their phone. Anyone willing to pay a few bucks to hitch a ride will need to install a different Waze app focused on carpooling.

About 1.3 million drivers and passengers have signed up for Waze’s carpooling service, the company says. About 30 million people in the U.S. currently rely on the Waze app for directions; it has 110 million users worldwide.

Waze’s carpooling effort has been viewed as a potential first step for Google to mount a challenge to the two top ride-hailing services, Uber and Lyft.

But Waze founder and CEO Noam Bardin rejected that notion in an interview with The Associated Press, insisting that the carpooling service is purely an attempt to ease traffic congestion.

“We don’t want to be a professional driving network,” Bardin said. “We see ride sharing as something that needs to become part of the daily commute. If we can’t get people out of their cars, it won’t be solving anything.”

Gartner analyst Mike Ramsey also sees Waze’s service as a bigger threat to other carpooling apps such as Scoop and Carpool Buddy than to Uber and Lyft. “Carpooling is a much different animal,” he said.

It’s a form of transportation that Bardin said Waze had difficulty figuring out. Early on, Waze tried to get more drivers to sign up by emphasizing the economic benefits of having someone help cover gas costs for a trip that they were going to make anyway.

But earlier this year, Waze realized it needed a better formula for connecting strangers willing to ride together in a car. Many women, for instance, only want to ride with other women, Bardin said, while other people enjoy commuting with others who work for the same employer or live in the same neighborhood.

“Carpooling is a more social experience,” Bardin said. “A lot of time those of us working in the digital world forget that social connections are often the most important thing in the real world.”

Waze’s app still sets a price for each carpooling trip and transfers payments without charging a commission. That’s something Waze can afford to do because Google makes so much money from selling digital ads on Waze and its many other services.

The carpooling fees are supposed to be similar to what it would cost to take a train or type of public transportation to work, Bardin said. Drivers and riders can agree to adjust the price upward or downward, but the fees can never exceed the rate the Internal Revenue Service allows for business-related mileage — currently 54.5 cents per mile.

Even though Waze’s carpooling service doesn’t appear to be driven by profit motive, Ramsey isn’t convinced that will always be the case. “I do think Google is realizing that it can’t just keep making all its money from selling ads,” he said.
…

From: MeNeedIt

Google will begin offering its pay-to-carpool service throughout the U.S., an effort to reduce the commute-time congestion that its popular Waze navigation app is designed to avoid.

The expansion announced Wednesday builds upon a carpooling system that Waze began testing two years ago in northern California and Israel before gradually extending it into Brazil and parts of 12 other states.

Now it will be available to anyone in the U.S.

Drivers willing to give someone a ride for a small fee to cover some of their costs for gas and other expenses need only Waze’s app on their phone. Anyone willing to pay a few bucks to hitch a ride will need to install a different Waze app focused on carpooling.

About 1.3 million drivers and passengers have signed up for Waze’s carpooling service, the company says. About 30 million people in the U.S. currently rely on the Waze app for directions; it has 110 million users worldwide.

Waze’s carpooling effort has been viewed as a potential first step for Google to mount a challenge to the two top ride-hailing services, Uber and Lyft.

But Waze founder and CEO Noam Bardin rejected that notion in an interview with The Associated Press, insisting that the carpooling service is purely an attempt to ease traffic congestion.

“We don’t want to be a professional driving network,” Bardin said. “We see ride sharing as something that needs to become part of the daily commute. If we can’t get people out of their cars, it won’t be solving anything.”

Gartner analyst Mike Ramsey also sees Waze’s service as a bigger threat to other carpooling apps such as Scoop and Carpool Buddy than to Uber and Lyft. “Carpooling is a much different animal,” he said.

It’s a form of transportation that Bardin said Waze had difficulty figuring out. Early on, Waze tried to get more drivers to sign up by emphasizing the economic benefits of having someone help cover gas costs for a trip that they were going to make anyway.

But earlier this year, Waze realized it needed a better formula for connecting strangers willing to ride together in a car. Many women, for instance, only want to ride with other women, Bardin said, while other people enjoy commuting with others who work for the same employer or live in the same neighborhood.

“Carpooling is a more social experience,” Bardin said. “A lot of time those of us working in the digital world forget that social connections are often the most important thing in the real world.”

Waze’s app still sets a price for each carpooling trip and transfers payments without charging a commission. That’s something Waze can afford to do because Google makes so much money from selling digital ads on Waze and its many other services.

The carpooling fees are supposed to be similar to what it would cost to take a train or type of public transportation to work, Bardin said. Drivers and riders can agree to adjust the price upward or downward, but the fees can never exceed the rate the Internal Revenue Service allows for business-related mileage — currently 54.5 cents per mile.

Even though Waze’s carpooling service doesn’t appear to be driven by profit motive, Ramsey isn’t convinced that will always be the case. “I do think Google is realizing that it can’t just keep making all its money from selling ads,” he said.
…

From: MeNeedIt