1,721,196 research outputs found

    Lifecourse determinants of bone mass accrual in a transitional rural community in South India: the Andhra Pradesh Children and Parents Study (APCAPS)

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    Abstract In urbanizing rural communities in India, bone development in children and adolescents may be affected by nutrition transition. This thesis work used a lifecourse approach to investigate the combined effects of early life undernutrition and urbanized lifestyles in late adolescence on bone mass accrual in a rural area in southern India that has been undergoing socioeconomic development over the past decade. The analyses used data from a prospective cohort study near Hyderabad city in India, the Andhra Pradesh Children and Parents Study (APCAPS). Research Paper 1 The first study examined bone mass in the population of APCAPS. Over 50% of female and 30% of male participants aged 50 years and above had osteopenia or osteoporosis. Peak bone mass was low in this lean rural population (hip BMD in 2029 year old female: 0.84±0.1; male: 0.95±0.11 g/cm2) in comparison to the reference values from a healthy Indian population in the same age group (female: 0.90±0.11; male: 0.99±0.13). There was clearer evidence of positive association between hip BMD and lean mass than fat mass in this population. Research Paper 2: The second study examined longitudinal effects of early life proteinenergy supplementation on bone mass in young adulthood, adjusting for current body size and lifestyles. There was no clear evidence for a longterm positive effect of prenatal and infant exposure to modest proteinenergy supplementation on bone mass accrual in this rural community. Greater lean mass in young adulthood was associated with higher hip and lumbar spine BMD. Weightbearing physical activity was positively associated with hip, LS, and wholebody BMD in males. Research Paper 3: The third study assessed longitudinal effects of low body mass index (BMI) during adolescence on bone mass in young adulthood. When adjusted for current BMI, there was no clear evidence for association of hip and LS BMD in young adulthood with adolescent BMI. Controlling for adolescent BMI, greater increase in BMI during adolescence was associated with higher BMD in young adulthood, although it was 3 still suboptimal in comparison to a healthy young Indian population. Concluding remarks In this transitional rural community from south India, the prevalence of osteopenia and osteoporosis was high, especially among females. Although neither modest early life supplementation nor weight gain in late adolescence was sufficient to achieve optimal peak bone mass, increase in body size in late adolescence and young adulthood was beneficial for bone mass accrual in this young population. There is a need to develop strategies to take advantage of, and also prevent any detrimental effects of, nutrition transition to improve peak bone mass in transitional rural communities in India

    Development of a Smartphone-enabled hypertension and diabetes management package to facilitate evidence-based care delivery in primary healthcare facilities in India: A formative research to inform intervention design

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    Background. Hypertension and diabetes have become a major public health challenge in India. This research work aims to develop a feasible and scalable intervention for hypertension and diabetes, tailored to primary care settings in India. Objectives. To conduct a healthcare facility assessment to inform the development of a Smartphone-enabled intervention package for hypertension and diabetes at primary healthcare facilities in India. To pilot the Smartphone-enabled hypertension and diabetes intervention package at primary healthcare facilities in India in order to identify the barriers, synergies and health system strengthening requirements for the feasibility and scalability of such an intervention. Methodology. This research work was carried out in five Community Health Centres (CHCs) in Solan, Himachal Pradesh. The implementation and evaluation of the piloting, guided by a conceptual framework1, was carried out using mixed methods, following implementation science principles. Results. In this research work, a six component intervention was developed comprising a Nurse Care Coordinator (NCC), a structured training programme, clinical management guidelines, a Smartphone-based clinical decision-support system, counselling services and follow-up plan for patients. During piloting, NCCs detected that 37% of the out-patient clinic attendees had hypertension/diabetes. At three months of follow-up, systolic blood pressure had a mean reduction of 10.9+/-13.1 mmHg (p<0.001) in 2974 participants while fasting glucose level had a mean reduction of 26.4+/-49.0 mg/dl (p<0.001) in 717 subjects. Discussion. This research work demonstrated that a six component intervention for hypertension and diabetes care is feasible. However, barriers such as inadequate manpower, insufficient drug supply and inadequate lab facilities need to be addressed for optimal intervention delivery. Conclusion. A Smartphone decision-support-enabled, NCC-facilitated intervention for hypertension and diabetes is feasible for primary care settings in India

    Going Beyond Counting First Authors in Author Co-citation Analysis

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    The present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed

    Variations on the Author

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    “Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship

    Appropriate Similarity Measures for Author Cocitation Analysis

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    We provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis

    Dispelling the Myths Behind First-author Citation Counts

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    We conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more sophisticated methods

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    Commentary: Can conventional migration studies really identify critical age-period effects?

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    In summary, this study provides useful estimation of the risk of cardiovascular disease associated with migration to a more advantaged environment in childhood. Whether this represents a longer duration of adult life exposure to the new environment or some critical period in childhood remains to be established. © International Epidemiological Association 2004; all rights reserved
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