Coalition for a Healthier Community: Lessons learned and implications for future work

The Coalition for a Healthier Community (CHC) initiative was implemented to improve the health and well-being of women and girls. Underpinning CHC is a gender-based focus that uses a network of community partners working collaboratively to generate relevant behavior change and improved health outcomes. Ten programs are trying to determine whether gender-focused system approaches are cost-effective ways to address health disparities in women and girls. Programs implemented through coalitions made up of academic institutions, public health departments, community-based organizations, and local, regional, and national organizations, are addressing health issues such as domestic violence, cardiovascular disease prevention, physical activity, and healthy eating. Although these programs are ongoing, they have made significant progress. Key factors contributing to their early success include a comprehensive needs assessment, robust coalitions, the diversity of populations targeted, programs based on findings of the needs assessments, evaluations taking into consideration the effect of gender, and strong academic–community partnerships. A noteworthy impact of these programs has been their ability to shape and impact public, social, and health policies at the state and local levels. However, there have been challenges associated with the implementation of such a complex program. Lessons learned are discussed in this paper.     

An approximation of logarithmic functions in the regression setting

We consider a method of moments approach for dealing with censoring at zero for data expressed in levels when researchers would like to take logarithms. A Box–Cox transformation is employed. We explore this approach in the context of linear regression where both dependent and independent variables are censored. We contrast this method to two others, (1) dropping records of data containing censored values and (2) assuming normality for censored observations and the residuals in the model. Across the methods considered, where researchers are interested primarily in the slope parameter, estimation bias is consistently reduced using the method of moments approach.     

Evaluation of an intervention supporting breastfeeding among late-preterm infants during in-hospital stay

BackgroundLate-preterm infants show lower breastfeeding rates when compared with term infants. Current practice is to keep them in low-risk wards where clinical guidelines to support breastfeeding are well established for term infants but can be insufficient for late-preterm.ObjectiveThe aim of this study was to evaluate an intervention supporting breastfeeding among late-preterm infants in a maternity service in the Basque Country, Spain.MethodsThe intervention was designed to promote parents’ education and involvement, provide a multidisciplinary approach and decision-making, and avoid separation of the mother-infant dyad. A quasi-experimental study was conducted with a control (n = 212) and an intervention group (n = 161). Data was collected from clinical records from November 2012 to January 2015. Feeding rate at discharge, breast-pump use, incidence of morbidities, infant weight loss and hospital stay length were compared between the two groups.ResultsInfants in the control group were 50.7% exclusive breastfeeding, 37.8% breastfeeding, and, 11.5% formula feeding at discharge, whereas in the intervention group, frequencies were 68.4%, 25.9%, and 5.7%, respectively (p = 0.002). Mothers in the intervention group were 2.66 times more likely to use the breast-pump after almost all or all feeds and 2.09 times more likely to exclusively breastfeed at discharge. There were no significant differences in morbidities and infant weight loss between groups. Hospital stay was longer for infants who required phototherapy in the intervention group (p = 0.009).ConclusionThe intervention resulted in a higher breastfeeding rate at discharge. Interventions aimed to provide specific support among late-pretem infants in maternity services are effective.     

Stigma, HIV/AIDS and prevention of mother-to-child transmission in Zambia

This report evaluates the extent of perceived and enacted HIV/AIDS-related stigma in a rural setting in Zambia. Stigmatisation is abundant, ranging from subtle actions to the most extreme degradation, rejection and abandonment. Women with HIV and pregnant women assumed to be HIV positive are repeatedly subjected to extensive forms of stigma, particularly once they become sick or if their child dies. Despite increasing access to prevention of mother to child transmission initiatives, including anti-retroviral drugs, the perceived disincentives of HIV testing, particularly for women, largely outweigh the potential gains from available treatments. HIV/AIDS related stigma drives the epidemic underground and is one of the main reasons that people do not wish to know their HIV status. Unless efforts to reduce stigma are, as one peer educator put it, “written in large letters in any HIV/AIDS campaign rather than small”, stigma will remain a major barrier to curbing the HIV/AIDS pandemic.     

武术套路训练对幼儿类比推理能力影响的实验研究

采用实验对比的方法 ,研究武术套路训练对幼儿类比推理能力的影响 .其实验结果经统计分析证实 ,武术套路训练对于提高幼儿类比推理能力有显著性的影响 ,对今后提高幼儿的观察和思考问题的敏捷能力起着一定的效果     

Child‐Care Usage and Mother‐Infant “Quality Time”

Mothers' time‐use patterns were compared in families in which infants spent more than 30 hours per week in child care (In‐Care group; n= 143) versus 0 hours per week (At‐Home group; n= 183) from birth to 6 months of age. In‐Care group mothers spent about 12 fewer hours per week interacting with their infants, for about 32% less time; fathers of these infants were more involved in caregiving. The groups did not differ in the quality of mother‐infant interaction. In the In‐Care group, quantity of interaction was related to greater separation anxiety and concerns about effects of maternal employment. Time‐use data were not related to child outcomes at 15 months of age. Results suggest that the effect of extensive time spent apart on the quantity and quality of mother‐infant interaction may be smaller than anticipated.     

BATHTUB-TYPE CURVES IN RELIABILITY AND BEYOND

Finding optimal, or at least good, maintenance and repair policies is crucial in reliability engineering. Likewise, describing life phases of human mortality is important when determining social policy or insurance premiums. In these tasks, one searches for distributions to fit data and then makes inferences about the population(s). In the present paper, we focus on bathtub‐type distributions and provide a view of certain problems, methods and solutions, and a few challenges, that can be encountered in reliability engineering, survival analysis, demography and actuarial science.     

Predicting body fat using weight–height indices

While body fat is the most accurate measure of obesity, its measurement requires special equipment that can be costly and time consuming to operate. Attention has thus typically focused on the easier to calculate body mass index (BMI). However, the ability of BMI to accurately identify obesity has been increasingly questioned. This paper focuses attention on whether more general body mass indices are appropriate measures of body fat. Using a data set of body fat, height, and weight measurements, general models are estimated which nest a wide variety of weight–height indices as special cases. In the absence of a race and gender categorisation, the conventional BMI was found to be the appropriate index with which to predict body fat. When such a categorisation was made, however, the BMI was never selected as the appropriate index. In general, predicted female body fat was some 10 kg higher than that of a male of identical build and predicted % body fat was over 11 percentage points higher, but age effects were smaller for females. Considerable racial differences in predicted body fat were found for males, but such differences were less marked for females. The implications of this finding for interpreting recent research on the effect of obesity on health, society, and economic factors are considered.