A Review on Biomaterial Design for Vascular Tissue Engineering Applications.

Biomaterials play a critical role in the success of tissue engineering approaches as they guide theshape and structure of developing tissues, provide mechanical stability, and present opportunities to deliver inductive molecules to transplanted or migrating cells. Therefore, the selection of theappropriate biomaterial can have a profound impact on the quality of newly formed tissue. A major challenge facing the field of tissue engineering is the development or identification of materialscapable of promoting the desired cellular and tissue behaviour. Given that few biomaterials possess all the necessary characteristics to perform ideally, engineers and clinicians alike have pursued thedevelopment of hybrid or composite biomaterials to synergize the beneficial properties of multiplematerials into a superior matrix.The combination of natural and synthetic polymers with variousother materials has demonstrated the ability to enhance various properties required for tissue engineering. In this review, we have made an attempt to review artificial components such as polymers, and strategies to design a composite which offer the desired physical properties. We also discuss synthesis methods for designer biomaterialsand its applications in vascular tissue engineering. The continued development andimplementation of hybrid biomaterials will lead to further successes in tissue engineering andregenerative medicine.The articles written with this goal in mind are by no meansexhaustive and are only intended to stimulate the community tothink more broadly about biomaterial composites and their designing.

Nutritional Disparities among Women in Urban India.

The paper presents a wealth quartile analysis of the urban subset of the third round of Demographic Health Survey of India to unmask intra-urban nutrition disparities in women. Maternal thinness and moderate/ severe anaemia among women of the poorest urban quartile was 38.5% and 20% respectively and 1.5-1.8 times higher than the rest of urban population. Receipt of pre- and postnatal nutrition and health education and compliance to iron folic acid tablets during pregnancy was low across all quartiles. One-fourth (24.5%) of households in the lowest urban quartile consumed salt with no iodine content, which was 2.8 times higher than rest of the urban population (8.7%). The study highlights the need to use poor-specific urban data for planning and suggests (i) routine field assessment of maternal nutritional status in outreach programmes, (ii) improving access to food subsidies, subsidized adequately-iodized salt and food supplementation programmes, (iii) identifying alternative iron supplementation methods, and (iv) institutionalizing counselling days.

Birth Preparedness and Complication Readiness among Slum Women in Indore City, India.

Three hundred twelve mothers of infants aged 2-4 months in 11 slums of Indore, India, were interviewed to assess birth preparedness and complication readiness (BPACR) among them. The mothers were asked whether they followed the desired four steps while pregnant: identified a trained birth attendant, identified a health facility, arranged for transport, and saved money for emergency. Taking at least three steps was considered being well-prepared. Taking two or less steps was considered being less-prepared. One hundred forty-nine mothers (47.8%) were well-prepared. Factors associated with well-preparedness were assessed using adjusted multivariate models. Factors associated with well-preparedness were maternal literacy [odds ratio (OR)=1.9, (95%) confidence interval (CI) 1.1-3.4] and availing of antenatal services (OR=1.7, CI 1.05- 2.8). Deliveries in the slum-home were high (56.4%). Among these, skilled attendance was low (7.4%); 77.3% of them were assisted by traditional birth attendants. Skilled attendance during delivery was three times higher in well-prepared mothers compared to less-prepared mothers (OR: 3.0, CI 1.6-5.4) Antenatal outreach sessions can be used for promoting BPACR. It will be important to increase the competency of slum-based traditional birth attendants, along with promoting institutional deliveries.

Human touch to detect hypothermia in neonates in indian slum dwellings.

Objective. To assess the validity of human touch (HT) method to measure hypothermia compared against axillary digital thermometry (ADT) and study association of hypothermia with poor suckle and underweight status in newborns and environmental temperature in 11 slums of Indore city, India. Methods. Field supervisors of slum-based health volunteers measured body temperature of 152 newborns by HT and ADT, observed suckling and weighed newborns. Underweight status was determined using WHO growth standards. Results. Hypothermia prevalence (axillary temperature <36.5oC) was 30.9%. Prevalence varied by season but insignificantly. Hypothermia was insignificantly associated with poor suckle (31% vs 19.7%, p=0.21) and undernutrition (33.3% vs 25.3%, p=0.4). HT had moderate diagnostic accuracy when compared with ADT (kappa: 0.38, sensitivity: 74.5%, specificity: 68.5%). Conclusions. HT emerged simpler and programmatically feasible. There is a need to examine whether trained and supervised community-based health workers and mothers can use HT accurately to identify and manage hypothermia and other simple signs of newborn illness using minimal algorithm at home and more confidently refer such newborns to proximal facilities linked to the program to ensure prompt management of illness.

Understanding and addressing childhood immunization coverage in urban slums.

The National Population Policy (2000) aims at complete protection of all children against vaccine preventable diseases by 2010. Urban poor, many residing in slums, comprise about one fourth of India's 285 million urban population. 60% of the children aged 12-23 months in urban India are fully immunized; coverage among urban poor children is a dismal 43%. The inter state variations of immunization coverage in urban areas, reveals a service coverage gap which calls for a rethink on resource allocation and strengthening processes to improve immunization coverage amongst urban poor. Debilitating environmental conditions and high population density in slums expedite disease transmission. Comparisons of urban rural disease incidence indicate a particular urban risk for vaccine preventable diseases. This paper attempts to understand the current scenario and challenges in improving immunization coverage in urban slums; immunization being one of the most successful public health interventions of the past century. It also discusses possible mechanisms for effectively reaching the often left out urban poor. Coordinated activities by the multitude of providers, accurate information based outreach, effective monitoring and community enablement to demand quality services are critical for improving utilization of immunization services by a heterogeneous urban poor population.

All slums are not equal: child health conditions among the urban poor.

Increasing urbanization has resulted in a faster growth of slum population. Various agencies, especially those in developing countries are finding it difficult to respond to this situation effectively. Disparities among slums exist owing to various factors. This has led to varying degrees of health burden on the slum children. Child health conditions in slums with inadequate services are worse in comparison to relatively better served slums. Identification, mapping and assessment of all slums is important for locating the hitherto missed out slums and focusing on the neediest slums. In view of the differential vulnerabilities across slums, an urban child health program should build context appropriate and community-need-responsive approaches to improve children's health in the slums.

Determinants of childhood mortality and morbidity in urban slums in India.

The large and continuous increase in India's urban population and the concomitant growth of the population residing in slums has resulted in overstraining of infrastructure and deterioration in public health. The link between urbanization, a degraded environment, inaccessibility to healthcare and a deteriorating quality of life is significant and particularly evident in the sharp inequities in IMR if one looks at urban specific studies. It is hence, germane to address the appalling inequalities in the distribution and access to basic amenities and health services with a focus on enhanced service coverage, improved sanitation and water supplies and mobilization of community action for effectively mitigating the childhood death and disease burden in urban slums.