39 research outputs found
APPJ
No full textA Strategic Approach to Reproductive Health Programme Development - By Jay Satia, Peter Fajans, Christopher Elias and Maxine Whittaker ... 5
Strategic Assessment of Reproductive Health in the Lao People’s Democratic Republic - By Pany Sananikhom, letje Reerink, Peter Fajans, Christopher Elias and Jay Satia ... 21
A Strategy for Advancing Reproductive Health in Myanmar - By Thein Thein Htay, Katherine Ba-Thike, Michelle Gardner, Christopher Elias and Peter Fajans ... 39
The Strategic Approach to the Introduction of DMPA as an Opportunity to Improve Quality of Care for All Contraceptive Methods in Viet Nam - Nguyen Thi Thorn, Do Trong Hieu, Vu Quy Nhan, Do Thanh Nhan, Maxine Whittaker Peter Fajans and Jay Satia ... 6
Strategic choices in scaling up: Introducing injectable contraception and improving quality of care in Vietnam
No full textStrategic choices in scaling up: introducing injectable contraception and improving quality of care In Viet Nam
No full textThis chapter analyses the process of scaling up introduction of the injectable contraceptive depot-medroxyprogesterone acetate (DMPA) as part of a package of interventions to improve quality of care in the provision of all contraceptives in the Vietnamese family planning programme. After a strategic assessment of the need for contraceptive introduction and pilot testing of the interventions in three provinces, these interventions were scaled up to 21 of Viet Nam's 64 provinces. Although DMPA was widely introduced, going to scale did not fully achieve the gains in quality of care for all methods found in the pilot phase. Three interrelated variables affected this outcome: the degree of change required in the service delivery system, the pace of expansion, and available resources to support expansion. In this case, scaling up proceeded faster than was desirable, given the extensive changes entailed by the interventions and the limitations in resources. Before embarking on rapid expansion involving complex programmatic changes, planners of scaling-up strategies should carefully assess the balance between these three variables
Development of a growth reference for the mid-upper arm circumference (MUAC) as an anthropometric indicator of protein status in marginally nourished populations.
No full textThis dissertation focuses on the development of a marker of protein status to identify children with severe negative energy balance and protein deficiency. Such a tool would have considerable value in epidemiological studies since muscle mass is an important indicator of protein-energy malnutrition (PEM). While biochemical measures are available to precisely measure muscle protein status, anthropometry provides an inexpensive practical means for the assessment of muscle mass in developing countries where severe PEM is prevalent. This dissertation addresses the utility of the anthropometric measurement of the mid-upper arm circumference (MUAC) as an indicator of muscle mass for the evaluation of protein status in marginally nourished populations. A standardized reference for MUAC has been developed which takes into account the observed variations in MUAC by age and gender to obtain a biologically meaningful assessment of protein status. Using data from the Second National Health and Nutrition Examination Survey (NHANES II), several polynomial regression models were constructed to compute MUAC z-scores. Poor correspondence between the MUAC z-scores and other anthropometric indices, e.g., WFA, HFA and WFH, was noted which suggests that distinct biological processes and manifestations of malnutrition may be detected by different anthropometric measures. In addition, both age and gender are important covariates in the classification of malnutrition. The association of clinical vitamin A deficiency (VAD) with standardized MUAC as an index of protein deficiency among children was assessed. The MUAC z-score was found to be a more discriminating correlate of clinical VAD (conjunctival xerophthalmia) than other anthropometric indicators in both bivariate and multivariate analyses. Where VAD is endemic, the use of the standardized MUAC may allow for targeting of resources to children with marginal muscle mass. This may ensure the greatest reduction in VAD, along with it's associated morbidity and mortality. Additional studies are proposed to confirm the usefulness and validity of the MUAC z-scores as an independent, and absolute indicator of protein status, and to serve as a screening tool to identify children at risk for protein deficiency.PhDInternational HealthUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/104115/1/9500930.pdfDescription of 9500930.pdf : Restricted to UM users only
Maternal education and infant survival in the Dominican Republic, 1984-1986.
No full textThis study investigates the determinants of infant mortality in the Dominican Republic using data from the 1986 Dominican Republic Demographic and Health Survey (DHS). The sample consisted of all children (1899) born alive during the two years prior to the date of the survey. We studied the relationship between maternal education and child survival in three ways. First, we have developed an analytical causal framework of the determinants of child survival as an extension of the Mosley-Chen model of proximate determinants in order to identify possible intervening mechanisms between maternal education and child survival. Second, we estimated the determinants of both neonatal and post-neonatal infant mortality using a proportional hazards logistic regression approach, in which maternal education and possible confounding variables were included both with and without hypothesized intervening variables. Third, we estimated the determinants of breast-feeding, utilization of maternal health care services, practice of family planning, and maternal employment away from home. Post-primary maternal education was found to have a sizable protective effect during the post-neonatal period, with odds ratios for secondary and higher education of 1.94 and 3.22 respectively without, and 2.23 and 3.73 with the intervening variables included. Contrary to expectations, including the intervening variables in the model increased rather than decreased the effect attributable to maternal education. This was because non-breast-feeding and working away from home significantly increased the risk of infant death and both were more commonly practiced by more educated women. Mother's used of family planning, parity less than six, and receipt of tetanus toxoid injection during pregnancy (an indicator of health services utilization) all were found to be associated both with less risk of infant death and with more education. Maternal education did not act as a proxy for socioeconomic status in influencing child survival. The inclusion of household SES and area of residence reduced the effects of maternal education by about one tenth. However, we were not able to control for the association of education with social class of origin. Finally, policy and research recommendations are made based on the results of the study.PhDDemographyEducationHealth and Environmental SciencesHealth educationPublic healthSocial SciencesUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/128941/2/9303793.pd
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Cyclotron-Cavity Mode Resonant Cooling in Single Component Electron Plasmas
No full textGenerating cold single component electron plasmas, below 20K, is of interest to many experiments that require low temperatures for optimizing recombination rates or producing monoenergetic beams. Here, we report on the demonstration of a technique that allows for rapid cooling of a single-component electron plasma confined in a Penning trap. Electrons are confined in an electromagnetic cavity, allowing use of the Purcell effect to enhance spontaneous emission of cyclotron radiation in the cavity. This allows for faster passive thermalization of the confined plasma to the temperature of electrodes that constitute the cavity
The impact of vitamin A supplementation on the incidence of severe diarrhea and ARI in children in Nepal.
No full textThere is a growing body of knowledge on the relationship between vitamin A supplementation interventions and mortality reduction. However, the mechanism of mortality reduction is not fully understood. Several studies have failed to demonstrate mortality reduction. Vitamin A deficiency has been known to be associated with a high risk of morbidity and mortality, and vitamin A supplementation has been associated with a reduction in child mortality. Paradoxically, vitamin A supplementation has not reduced the prevalence of diarrhea and respiratory diseases. Many researchers have postulated that vitamin A reduced mortality not by reducing the incidence of these two conditions, but through reducing the severity of infection. This study aims to evaluate the impact of vitamin A supplementation on the severity of diarrhea and acute respiratory infection (ARI). Data used in this study were part of the data set of the second year evaluation of the Vitamin A Child Survival Project in Nepal. The analysis focused on those who suffered from diarrhea or ARI during the health examination by the study team in the second year of a three year study. While the project had three vitamin A interventions, only the vitamin A capsule and control groups were used in the analysis (a total of 889 children, of whom 695 suffered from diarrhea and 256 from ARI). The study found that supplementation with one capsule of vitamin A in a year was not associated with a reduction in the risk of severe diarrhea. However, children who received two capsules enjoyed a 56% reduction in the risk of diarrhea with dehydration and a 64% reduction on the risk of having diarrhea of duration of 5 days or more. Xerophthalmia was associated with a higher risk of having diarrhea with dehydration for 5 days or more. Stunting and wasting was associated with a higher risk of diarrhea with dehydration but not with having diarrhea for 5 days or more. The premonsoon period was associated with much higher risk for diarrhea of both types, compared to the period from August to November. The presence of a market in the ward was associated with a lower risk of diarrhea with dehydration as well as for diarrhea for 5 days and more. There was an indication that vitamin A supplementation was associated with a lower risk of severe ARI; however, the model was not sensitive. Further study is needed on the impact of vitamin A supplementation on persistent diarrhea and severe ARI in different nutritional and socieconomic conditions.PhDInternational HealthUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/105061/1/9629606.pdfDescription of 9629606.pdf : Restricted to UM users only
A multivariate analysis of the impact of vitamin A supplementation on mortality of children in Nepal.
No full textABSTRACT HAS BEEN ARCHIVED 10/29/96.Doctor of Public Health (DPH)International HealthUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/104242/1/9512231.pdfDescription of 9512231.pdf : Restricted to UM users only
Album Kaliskie Edwarda Staweckiego - nietypowy album malowniczy
No full textAlbum Kaliskie was published in 1858 in Warsaw. Edward Stawecki – a teacher, official and amateur historian who took part in the January Uprising – was both the author of texts and the originator of the edition. Illustrations included in the work were prepared by Stanisław Barcikowski, a teacher in Wyższa Szkoła Realna in Kalisz and a graduate of Szkoła Sztuk Pięknych in Warsaw. Lithographs based on the illustrations were created by Maksymilian Fajans, a well-known lithographer from Warsaw. Album Kaliskie was the first comprehensive publication presenting the history of Kalisz. The author combined the conventions of historical compilation and album of illustrations. All selected pictures presented important buildings existing in Kalisz and the most valuable museum pieces such as Peter Paul Rubens’s paintings, Kazimierz Wielki’s goblet or Stanisław Karnowski’s headstone. The illustrations were produced in the style typical of drawings from the Romantic era or the Biedermeier period, when it was important to create picturesque works filled with the aura of sentimentality and to emphasize their painterly values.Album Kaliskie Edwarda Staweckiego zostało opublikowane w 1858 roku w Warszawie. Autorem tekstów i pomysłodawcą tego wydawnictwa był Edward Stawecki – nauczyciel, urzędnik, historyk – amator, uczestnik powstania styczniowego, który zmarł w radomskim więzieniu. Rysunki wykonał Stanisław Barcikowski – nauczyciel kaliskiej Wyższej Szkoły Realnej, absolwent warszawskiej Szkoły Sztuk Pięknych. Litografie według tych rysunków wykonał Maksymilian Fajans, znany warszawski litograf – zostały one odbite w jego zakładzie litograficznym. Album było pierwszym historycznym opracowaniem dziejów miasta w tak obszernej publikacji. Autor połączył w nim konwencję naukowego opracowania historycznego i albumu malowniczego. Wybrane ilustracje prezentują najważniejsze kaliskie budowle – zarówno zabytkowe, jak i te powstałe całkiem niedawno – oraz najcenniejsze kaliskie zabytki ruchome: obraz Rubensa, kielich Kazimierza Wielkiego czy nagrobek prymasa Karnkowskiego. Rysunki utrzymane są w charakterystycznym dla epoki stylu romantycznej, biedermeierowskiej, malowniczej ilustracji, w której celem nadrzędnym jest kreacja malowniczego widoku utrzymanego w sentymentalnej aurze, z podkreśleniem malarskich wartości kompozycji
