Pakistan: innovative population planning

In Pakistan the population planning program has been "federalized." As part of the new plan, the Population Planning Division will be responsible for policy formation, preparation of plans, and program implementation. With this new organization, the program will promote close coordination with provincial governments. An effective information program has been planned to promote pro-family planning attitudes. In order to develop these attitudes among the young, population education is being integrated into the curricula of the schools and colleges. At the policy making level, development projects of the Ministries of Education, Local Government, Rural Development, Health, Labor and Manpower Production, and Agriculture will in future be prepared so as to contain a component of the population planning program. The operational structure of the program was strengthened during 1976-1977 in order to reduce the crude birthrate from an estimated level of 45 per 1000 in mid-1976 to 43.6 per 1000 in mid-1977.     

Narrating Sustainability in Canadian Health Care Reform Discourse

In Canada, as in other industrialized welfare states, definitions of health system sustainability reflect different goals and correspondingly diverse ways of understanding exactly what is to be sustained and how. In this article, we report on results from a survey of documents and groups involved in and/or concerned about sustainability of the healthcare system. We identify four broad narratives of sustainability in Canadian healthcare reform discourse, and explore what these different sustainability narratives tell us about the character and contours of these often‐fractious debates. We argue that sustainability itself may not be a paradigm shift, as has been suggested, but a plot device that helps to steer the story in a particular direction, ‘black‐boxing’ certain aspects of context and emphasizing others.     

‘America’ in Indian Advertising: Change and Impact

The aims of this article are threefold: One, to focus on the advertising and marketing communications situating the presence of the USA in India. Two, to address three issues concerning the where, how, and impact dimensions of marking the US presence in Indian advertising. In that process an attempt will be made to integrate three aspects of advertising, namely: marketing, media, and linguistics. Three, to account for US corporate culture as it manifests itself in advertising. Central to our discussion are two product types: consumer products (e.g. Coke, Pepsi, Kellogg’s cereals, or Cadbury’s chocolates) and socially-sensitive, or ‘taboo’, products (e.g. condoms, alcohol, and breath fresheners).     

Facility Location with Dynamic Distance Functions

Facility location problems have always been studied with theassumption that the edge lengths in the network are static anddo not change over time. The underlying network could be used to model a city street networkfor emergency facility location/hospitals, or an electronic network for locating information centers. In any case, it is clear that due to trafficcongestion the traversal time on links changes with time. Very often, we have estimates as to how the edge lengths change over time, and our objective is to choose a set of locations (vertices) ascenters, such that at every time instant each vertex has a center close to it (clearly, the center close to a vertex may change over time). We also provide approximation algorithms as well as hardness results forthe K-center problem under this model. This is the first comprehensive study regarding approximation algorithmsfor facility location for good time-invariant solutions.     

Hypogonadotrophic hypogonadism in type 2 diabetes

Recent work shows a high prevalence of low testosterone and inappropriately low luteinizing hormone (LH) and follicle stimulating hormone (FSH) concentrations in type 2 diabetes. This syndrome of hypogonadotrophic hypogonadism (HH) is associated with obesity in patients with type 2 diabetes. However, the duration of diabetes or HbA1c are not related to HH. Furthermore, recent data show that HH is not associated with type 1 diabetes. C-reactive protein concentrations have been shown to be elevated in patients with HH and are inversely related to plasma testosterone concentrations. This inverse relationship between plasma free testosterone and C- reactive protein concentrations in patients with type 2 diabetes suggests that inflammation may play an important role in the pathogenesis of this syndrome. This is of interest since inflammatory mechanisms may have a cardinal role in the pathogenesis of insulin resistance. It is also relevant that in the mouse, deletion of the insulin receptor in neurons leads to HH in addition to a state of systemic insulin resistance. It has also been shown that insulin facilitates the secretion of gonadotrophin releasing hormone (GnRH) from neuronal cell cultures. Thus, HH may be the result of insulin resistance at the level of the GnRH secreting neuron. Low testosterone concentrations are also related to an increase in total and regional adiposity. This review discusses these issues and attempts to make the syndrome relevant as a clinical entity. Clinical trials are required to determine whether testosterone replacement alleviates insulin resistance and inflammation. In addition, low testosterone levels are associated with an increase in cardiovascular events. Testosterone therapy may therefore, reduce cardiovascular risk. This important aspect requires further investigation.     

Non-parametric MANOVA approaches for non-normal multivariate outcomes with missing values

Between-group comparisons often entail many correlated response variables. The multivariate linear model, with its assumption of multivariate normality, is the accepted standard tool for these tests. When this assumption is violated, the non-parametric multivariate Kruskal–Wallis (MKW) test is frequently used. However, this test requires complete cases with no missing values in response variables. Deletion of cases with missing values likely leads to inefficient statistical inference. Here we extend the MKW test to retain information from partially observed cases. Results of simulated studies and analysis of real data show that the proposed method provides adequate coverage and superior power to complete case analyses.     

Operations research in the management of the airlines

This paper is intended to present an introduction to the use of operations research in the international airline industry, and to demonstrate the scope and significance of the airline OR activities. First, the special reasons for the viability and spread of airline OR are discussed. Then a functional framework for an airline is outlined, to be used in analyzing the problems of an airline and relating the OR work to it. Four major applications are described, corresponding to four major components of the framework. These applications are: schedule development, overbooking control, crew scheduling and engine management, respectively. In each case we describe the problem and its significance, indicate the types of solution techniques which have been developed, and assess the implemented solutions. The paper concludes with comments on the current state-of-the-art and the future of airline OR. A detailed bibliography is given.Both of the authors have been operations research directors in major airlines and more recently have focused their attention upon the industry as academic researchers. This background has provided us with an unusual opportunity to analyze the role of OR in the airlines, and our paper seeks to share with the reader some of the insights we have gained thereby.     

A study in family planning communication—Direct mailing

It is sometimes stated that direct mailing to individuals in developing countries like India may be wasteful due to the low literacy rate among village people. Direct mailing is a relatively new development in India and comparatively a newer channel of communication. An exploratory study was carried out by the Central Family Planning Institute to test this hypothesis. The observations made showed that direct mailing is practical, controllable, inexpensive, and useful.The information provided by direct mailing seems to cross the barriers of illiteracy. Based on this experience, the Central Family Planning Institute has initiated a large-scale communication action research project in Meerut district in North India where the impact of direct mailing on specific groups is being studied further. It is hoped that such studies would help in developing prototype information material and would provide a methodology to supplement the available channels of communication in a nation-wide family planning program.