Browsing by Author "Jr"

Now showing 1 - 7 of 7
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    Association between Nutritional Status and Positive Childhood Disability Screening Using the Ten Questions Plus Tool in Sarlahi, Nepal.
    (2010-12) Wu, L; Katz, J; Mullany, L C; Haytmanek, E; Khatry, S K; Darmstadt, G L; West, K P; Jr; LeClerq, S C; Tielsch, J M
    The study was conducted to examine the association between the indicators of malnutrition and disability of children as reported by caregivers. The Ten Questions Plus questionnaire was administered to caregivers of 1,902 children aged 1-9 years, during August 2007–March 2008, in rural Nepal. Height and weight of chil- dren were also measured. The main outcome was a positive response to one or more questions. In total, 514 (27%) children had a positive response to at least one question. Moderate stunting [odds ratio (OR)=1.47, 95% confidence interval (CI) 1.02-2.12) and severe (OR=2.39, 95% CI 1.60-3.57) stunting were independently associated with reported delay in sitting, standing, or walking. Severe stunting was also associated with report of delayed learning compared to other children of similar age (OR=2.01, 95% CI 1.27-3.20). Parental report of disability was quite prevalent in this setting, with over a quarter of the sample screening positive. Chronic malnutrition may be associated with delayed motor and mental development.
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    Constructing Indices of Rural Living Standards in Northwestern Bangladesh.
    (2010-10) Gunnsteinsson, Snaebjorn; Labrique, Alain B; West, Keith P; Jr; Christian, Parul; Mehra, Sucheta; Shamim, Abu Ahmed; Rashid, Mahbubur; Katz, Joanne; Klemm, Rolf D W
    This study aimed to construct indices of living standards in rural Bangladesh that could be useful to study health outcomes or identify target populations for poverty-alleviation programmes. The indices were constructed using principal component analysis of data on household assets and house construction materials. Their robustness and use was tested and found to be internally consistent and correlated with maternal and infant health, nutritional and demographic indicators, and infant mortality. Indices derived from 9 or 10 household asset variables performed well; little was gained by adding more variables but problems emerged if fewer variables were used. A ranking of the most informative assets from this rural, South Asian context is provided. Living standards consistently and significantly improved over the six-year study period. It is concluded that simple household socioeconomic data, collected under field conditions, can be used for constructing reliable and useful indices of living standards in rural South Asian communities that can assist in the assessment of health, quality of life, and capabilities of households and their members.
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    In which wretched part of the world? A glimpse into western drug- and device-makers (and others) behaving badly.
    (2013-07) Gillon, John J; Jr
    A bioethics colleague wrote of the efforts of those in India “who struggle each and every day in this wretched part of the world” to eliminate corruption from the clinical and research practice of medicine, and from medical education.
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    Protein secondary structure from circular dichroism spectra.
    (1985-08) Manavalan, Parthasarathy; Johnson, W Curtis; Jr
    Circular dichroism spectra of proteins are extremely sensitive to secondary structure. Nevertheless, circular dichroism spectra should not be analyzed for protein secondary structure unless they are measured to at least 184 nm. Even if all the various types of β-turns are lumped together, there are at least 5 different types of secondary structure in a protein (α-helix, antiparallel β-sheet, parallel β-sheet, β-turn, and other structures not included in the first 4 categories). It is not possible to solve for these 5 parameters unless there are 5 equations. Singular value decomposition can be used to show that circular dichroism spectra of proteins measured to 200 nm contain only 2 pieces of information, while spectra measured to 190 nm contain about 4. Adding the constraint that the sum of secondary structures must equal 1 provides another piece of information, but even with this constraint, spectra measured to 190 nm simply do not analyze well for the 5 unknowns in secondary structure. Spectra measured to 184 nm do contain 5 pieces of information and we have used such spectra successfully to analyze a variety of proteins for their component secondary structures.
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    Reporting Diarrhoea through a Vernacular Term in Quechua-speaking Settings of Rural Bolivia.
    (2011-12) Pacheco, Gonzalo Durán; Christen, Andri; Arnold, Ben; Hattendorf, Jan; Colford, John M; Jr; Smith, Thomas A; Mäusezahl, Daniel
    Field studies often use caregiver-reported diarrhoea and related symptoms to measure child morbidity. There are various vernacular terms to define diarrhoea that vary across the local cultural contexts. The relationship between vernacular definitions of diarrhoea and symptoms-based definitions is not well-documented. This paper describes the association of the vernacular Quechua term k’echalera with the symptoms-based standard definition of diarrhoea in rural Bolivian settings. During a cluster randomized trial in rural Bolivia, both signs and symptoms of diarrhoea and reports of k’echalera were collected for children aged less than five years. Reported k’echalera were found to be associated with important changes in stool frequency, consistency, and presence of blood and mucus. Reported k’echalera were highly related to three of four recorded categories of watery stool. The intermediate (milk-rice) stool consistency, which fits into the definition of watery stool, was not strongly related to k’echalera. Mucus in the stool was also associated with k’echalera; however, its presence in k’echalera-free days accounted for at least 50% of the possible false negatives. The sensitivity and specificity of the term k’echalera were estimated by Bayesian methods, allowing for both symptoms of diarrhoea and reports of k’echalera to be subject to diagnosis error. An average specificity of at least 97% and the sensitivity of at least 50% were obtained. The findings suggest that the use of k’echalera would identify fewer cases of diarrhoea than a symptom-based definition in rural Bolivia.
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    Seasonal Dietary Intakes and Socioeconomic Status among Women in the Terai of Nepal.
    (2014-06) Campbell, Rebecca K; Talegawkar, Sameera A; Christian, Parul; LeClerq, Steven C; Khatry, Subarna K; Wu, Lee S.F; West, Keith P; Jr
    Despite widespread nutritional deficiencies, investigations of usual diet in rural South Asia remain sparse. The present study characterizes year-round and seasonal dietary patterns of women in the Terai of Nepal by sociodemographic status, using a novel, weekly single-visit and usual food frequency questionnaire that links recall to the agricultural season. The study was conducted across seasons in 2006-2008 among 15,899 women of reproductive age in Sarlahi district. Intakes were tabulated for all foods, overall and by socioeconomic status (SES), and in and out of season, as appropriate. Foods consumed regularly [median (interquartile range) weekly frequency] were rice [13 (7-13)], potatoes [10 (5-13)], legumes [6 (2-9)], and vegetable oil [13 (13-13)]. Animal products were infrequently consumed [1 (0-2) time per week] as were fruits and vegetables, most with a median weekly intake frequency of 0. Higher SES was associated with more frequent consumption of most food-groups, including in-season fruits and vegetables. Diets of women in the Terai of Nepal lack diversity and, likely, nutrient adequacy, which may pose health risks.
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    Validation of Two Portable Instruments to Measure Iron Concentration in Groundwater in Rural Bangladesh.
    (2009-06) Merrill, Rebecca D; Shamim, Abu Ahmed; Labrique, Alain B; Ali, Hasmot; Schulze, Kerry; Rashid, Mahbubur; Christian, Parul; West, Keith P; Jr
    Iron is ubiquitous in natural water sources used around the world for drinking and cooking. The health impact of chronic exposure to iron through water, which in groundwater sources can reach well above the World Health Organization’s defined aesthetic limit of 0.3 mg/L, is not currently understood. To quantify the impact of consumption of iron in groundwater on nutritional status, it is important to accurately assess naturally-occurring exposure levels among populations. In this study, the validity of iron quantification in water was evaluated using two portable instruments: the HACH DR/890 portable colorimeter (colorimeter) and HACH Iron test-kit, Model IR-18B (test-kit), by comparing field-based iron estimates for 25 tubewells located in northwestern Bangladesh with gold standard atomic absorption spectrophotometry analysis. Results of the study suggest that the HACH test-kit delivers more accurate point-of-use results across a wide range of iron concentrations under challenging field conditions.