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The Tale of Greater Bengal: People, Polity and Progress



Eastern India is a historically significant centre of India, the birthplace of numerous religions and a locus of influence that has shaped the history of the entire region of Asia. It is unique in its identity due to the multiplicity of faiths and ethos which have been interacting and creating different cultural realms within a single landmass. This region, due to its connectivity with west and east along with its natural and intellectual wealth, has continually witnessed colonization, trade-based development and diverse political climate.
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Those people who live in rural areas more likely face a higher risk of poverty and lower incomes compared with urban areas. That why, a large number of rural people including those from West Bengal are migrating from these areas for their sustenance. In India as well as in West Bengal, most of the people live in rural areas and most of the rural workers only depend on agriculture activities. Majority of the rural people are is agricultural labourers. In terms of outmigration, the most important measure is that of male outmigration as much of female outmigration is due to marriage. Generally, most of the males migrate for work. The main reason for outmigration in rural villages for male is shortage of work opportunities. Short distance movement are likely to be marriage related, while long-distance movement are probably work related. The paper, using data available in successive census counts, unravels the pattern of male out-migrants in the state. This study mainly deals to recognize the spatial variation of male out-migration and determinants.
STUDY QUESTION What were the utilization, effectiveness and safety of practices in assisted reproductive technologies (ART) globally in 2014 and what global trends could be observed? SUMMARY ANSWER The estimated total number of ART cycles conducted in 76 participating countries in 2014 was 1.93 million representing ∼66% of global activity, with 5-year trends including an increase in success rates and proportion of frozen embryo transfer (FET) cycles, improvement in cumulative live birth rates per aspiration, a continued increase in single embryo transfer (SET) and thus a reduction in multiple birth rates, an increase in preimplantation genetic testing and stabilization in the use of intracytoplasmic sperm injection (ICSI). WHAT IS KNOWN ALREADY ART is widely practiced throughout the world but continues to be characterized by significant disparities in utilization, practice, effectiveness and safety. The International Committee for Monitoring Assisted Reproductive Technologies (ICMART) annual world report series provides an important instrument for tracking trends in ART treatment and for providing clinical and public health data to ART professionals, health authorities, patients and the general public. STUDY DESIGN, SIZE, DURATION A retrospective, cross-sectional survey on ART procedures performed globally during 2014 was carried out. A new method for calculating ART utilization rates and number of babies born was introduced in this latest ICMART world report. PARTICIPANTS/MATERIALS, SETTING, METHODS Overall, 76 countries and 2 746 ART centres submitted data through national and regional ART registries on ART cycles performed during 2014 and their treatment and pregnancy outcomes. ART cycles and outcomes are described at a country level, regionally and globally. Aggregate country data are processed and analyzed based on methods developed by ICMART. MAIN RESULTS AND THE ROLE OF CHANCE A total of 1 629 179 ART cycles were reported for the treatment year 2014. After imputing data for missing values and non-reporting centres in reporting countries, an estimated 1 929 905 cycles resulted in >439 039 babies in reporting countries. From 2010 to 2014, the number of reported non-donor aspirations and FET cycles increased by 37.3% and 67.5%, respectively. The proportion of women aged ≥40 years undergoing non-donor ART increased from 23.2% in 2010 to 27.0% in 2014. ICSI, as a percentage of non-donor aspiration cycles, remained relatively stable at 64.8%. The IVF/ICSI combined delivery rates per fresh aspiration and FET cycle were 19.9% and 24.3%, respectively. In fresh non-donor cycles, SET increased from 30.0% in 2010 to 40.0% in 2014, while the average number of transferred embryos decreased from 1.95 to 1.73—but with wide country variation. The rate of twin deliveries following fresh non-donor transfers continued to decrease, from 20.4% in 2010 to 16.2% in 2014, and the triplet rate decreased from 1.1% to 0.5%. In FET non-donor cycles in 2014, the SET rate was 61.6%, with an average of 1.43 embryos transferred, resulting in twin and triplet rates of 10.1% and 0.2%, respectively. The cumulative delivery rate per aspiration increased from 27.1% in 2010 to 32.1% in 2014. The overall perinatal mortality rate per 1 000 births was 19.4 following fresh IVF/ICSI cycles and 9.5 following FET cycles. Among reporting countries, oocyte donation cycles represented 7.3% of all embryo transfers (89 751 transfer cycles) and resulted in 39 278 babies. LIMITATIONS, REASONS FOR CAUTION The data presented are dependent on the quality and completeness of data submitted by individual countries to ICMART directly or through regional registries. This report covers approximately two-thirds of world ART activity. China is a major contributor of global cycles missing from this report. Continued efforts to improve the quality and consistency of ART data reported by registries are still needed, including the use of internationally agreed standard definitions (The International Glossary of Infertility and Fertility Care). A new method was introduced in this report to calculate ART utilization and number of babies born following ART; therefore, these results are not directly comparable with previous reports. WIDER IMPLICATIONS OF THE FINDINGS The ICMART world reports provide the most comprehensive global statistical census and review of ART utilization, effectiveness, safety and quality. While ART treatment effectiveness and safety continue to increase globally, the wide disparities in access to treatment, procedures performed and embryo transfer practices warrant attention by clinicians and policymakers. The new method for estimating ART utilization and number of babies born provided more conservative estimates compared to the previuos method. STUDY FUNDING/COMPETING INTEREST(S) ICMART receives unrestricted grants from Abbott and Ferring Pharmaceuticals. ICMART also acknowledges financial support from the following organizations: American Society for Reproductive Medicine; Asia Pacific Initiative on Reproduction; European Society of Human Reproduction and Embryology; Fertility Society of Australia and New Zealand; Japan Society for Reproductive Medicine; Japan Society of Fertilization and Implantation; Red Latinoamericana de Reproducción Asistida; and the Society for Assisted Reproductive Technology. S.D. reports industry sponsorship for attendance of conference from Ferring, and research grants to support African Network and Registry of ART from Ferring and Merck outside the submitted work. F.Z.-H. reports lectures at organized webinars for Ferring and Merck. O.I. reports honoraria for consulting from Ferring, Merck and ObsEva, as well as honoraria for lectures from Ferring and Merck. G.M.C., J.d.M., M.B., M.S.K. and G.D.A. have nothing to disclose. TRIAL REGISTRATION NUMBER N/A.
Japan has been experiencing a continuing decline in fertility and an increase in premarital conceptions and abortions among young people. Child rearing is often viewed as a burden. In response, Japan is now seeking ways to improve the child-rearing environment for parents. In this context, we conducted a prospective study among 206 pregnant women in Sukagawa City, Fukushima, to explore the influences of pregnancy intention on child rearing. We found that unintended pregnancy was associated with a higher risk of negative child-rearing outcomes, including lower mother-to-child attachment, increased negative feelings of mothers and a lower level of participation of fathers in child rearing. Unintended pregnancy exacerbates the real and perceived burdens of child rearing. Japan is currently facing a conflict between wanting to reduce unintended pregnancies and increase the national fertility rate. We believe the government needs to address the social challenges affecting people's family lives, which underpin low fertility, rather than focus on fertility decline per se. We suggest Japan seeks to reduce unintended pregnancies and provide support to parents at high risk of child-rearing difficulties. We also suggest adopting a comprehensive approach to improving the lives of young couples, with a focus on adolescents, including life-skills education to prepare for adulthood, marriage and parenthood. Résumé Le Japon a enregistré une baisse suivie de la fécondité et une augmentation des conceptions prémaritales et des avortements chez les jeunes. L'éducation des enfants est souvent considérée comme un fardeau. Par conséquent, le Japon cherche maintenant à améliorer les conditions dans lesquelles les parents élèvent leurs enfants. Dans ce contexte, nous avons réalisé une étude prospective auprès de 206 femmes enceintes à Sukagawa, Fukushima, pour analyser les influences de l'intention de grossesse sur l'éducation des enfants. Une grossesse non désirée était associée avec un risque supérieur de conséquences négatives sur l'éducation de l'enfant, avec notamment un lien moins étroit entre la mère et l'enfant, des sentiments négatifs accrus chez les mères et moins de participation des pères à l'éducation de l'enfant. Une grossesse non désirée exacerbe les fardeaux réels et perçus du rôle de parent. Le Japon connaît actuellement un conflit entre la volonté de réduire les grossesses non désirées et celle d'accroître le taux national de fécondité. Nous pensons que le Gouvernement doit aborder les problèmes sociaux touchant la vie familiale, qui motivent la faible fécondité, plutôt que de se centrer sur la baisse de la fécondité en tant que telle. Il doit s'efforcer de réduire les grossesses non désirées et soutenir les parents à haut risque de difficultés dans l'éducation des enfants. Nous préconisons également une approche globale pour améliorer la vie des jeunes couples, axée sur les adolescents, avec une éducation aux compétences essentielles pour les préparer à l'âge adulte, au mariage et au rôle de parents. Resumen En Japón, la juventud ha experimentado un descenso continuo en fertilidad y un aumento en concepciones y abortos premaritales. A menudo se percibe la crianza de los hijos como una carga. Por ello, se están investigando formas de ayudar a los padres al respecto. En este contexto, se realizó un estudio prospectivo entre 206 mujeres embarazadas en Ciudad de Sukagawa, Fukushima, a fin de explorar las influencias de la intención relacionada con el embarazo en la crianza de los hijos. Se encontró que el embarazo no intencional estaba asociado con mayor riesgo de resultados negativos: por ejemplo, menos apego de madre a hijo, aumento en los sentimientos negativos de las madres y menos participación de los padres en la crianza de los hijos. El embarazo no intencional exacerba las cargas reales y percibidas de la crianza de los hijos. Actualmente, Japón afronta un conflicto entre su deseo de disminuir la tasa de embarazos no intencionales y aumentar la tasa nacional de fertilidad. Estimamos que el gobierno necesita abordar los retos sociales que afectan la vida en familia, los cuales sustentan una baja tasa de fertilidad, y no centrarse en el descenso de la fertilidad en sí. Sugerimos que Japón se proponga disminuir la tasa de embarazos no intencionales y brindar apoyo a los padres que corren alto riesgo de tener dificultades con la crianza de los hijos, así como adoptar una estrategia integral para mejorar la vida de las parejas adolescentes, que incluya preparación para la adultez, el matrimonio y la paternidad/maternidad.