bluuebunny/crossref_metadata_2025_split huggingface dataset:
PS21 Evaluation of Maternity Care Intervention in Rural Nepal: Can a Health Promotion Exercise Improve Maternal Health and Service uptake in Rural Nepal?
Authors: Sharma S , Sicuri E , Belizan J , Teijlingen E van , Simkhada P , Stephens J 
Published: September 2012

BackgroundIn developing countries, where the majority of the world’s maternal deaths occur it is recognised that to target maternal mortality within limited resources, safe motherhood strategies need to be targeted to rural areas and to the poor in order to increase access to antenatal care and delivery care. In these populations, a lack of understanding of local beliefs and practices, and the reasons for them, can hinder the development of appropriate interventions.The Green Tara Nepal intervention, Pharping, Nepal, aims to improve the uptake of maternal care practices in rural Nepal via health promotion activities in the community. The expectation is that the measured aspect of health-seeking behaviour should improve in the intervention area relative to the control.MethodsIn 2008, Green Tara Nepal (GTN), a Nepalese Non-Governmental Organisation implemented a 5 year health promotion intervention to improve maternal and neonatal health in 2 rural village development communities (VDC) in Pharping, Nepal. The GTN programme works with midwives and community health workers to target fertile women, in health promotion groups and on a one-to-one basis. During this interaction, women receive advice on health behaviours and care-seeking practice.Two surveys were conducted a baseline (2008) and a midline (2010) on the intervention communities and in 2 control communities.; 833 women of childbearing age with their last child of less than 2 years old, were interviewed in this controlled before and after, cross-sectional study.ResultsAfter the intervention the proportion of women, during their last pregnancy, attending antenatal care, at least once, increased by from 84.6% to 96.8% (p=0.00). The proportion of women who had their first prenatal visit in the first trimester was increased from 39.9% to 58.1% (p=0.00). Women attending more than 4 visits increased from 37.1% to 42.6% (p=0.28).ConclusionThis ongoing community intervention providing health promotion shows an improvement on women’s attendance of antenatal care.
PS22 Life Course Socio-Economic Position and Quality of Life in Adulthood: A Systematic Review of Life Course Models
Authors: Niedzwiedz C , Katikireddi SV , Pell J , Mitchell R 
Published: September 2012

BackgroundMeasurement and determinants of quality of life are of increasing interest to researchers and policymakers. A relationship between current socio-economic position and subjective quality of life has been demonstrated, using wellbeing, life and needs satisfaction approaches. Less is known regarding the influence of different socio-economic trajectories across the life course and their subsequent effect on quality of life. Several conceptual models have been proposed to help explain potential life course effects on health, including accumulation, latent, pathway and social mobility models. This systematic review aimed to apply these models to studies investigating life course socio-economic effects on quality of life, in order to assess which model(s) best described any relationship.MethodsA review protocol was developed detailing explicit inclusion and exclusion criteria, search terms, data extraction items and quality appraisal procedures. Literature searches were performed in 12 electronic databases during January 2012 and the references and citations of included articles were checked for additional relevant articles. Narrative synthesis was used to analyse the results and studies were categorised into groups based on the life course design implemented.ResultsAfter screening 7,566 records, 12 studies met the eligibility criteria. The included articles used data from 10 different datasets and five countries. Study quality varied and heterogeneity was high. Five studies assessed the latent model, two assessed the pathway model and three tested the accumulation model. Seven studies assessed social mobility models (inter-generational mobility in three, intra-generational mobility in five and one included both types). More evidence was found to support the latent model among women (but results were contradictory) and mixed evidence was found for intra-generational mobility and pathway effects. Associations also tended to vary by gender. Few studies were identified for accumulation and inter-generational mobility effects and heterogeneity of these studies resulted in limited synthesis.ConclusionA lack of available and comparable evidence prevented the identification of the optimal life course model(s). Different target populations, outcomes and methodologies used between studies likely contributed to the mix of results. To improve the potential for synthesis in this area, future studies should aim to increase study comparability. Recommendations include testing all life course models within studies and the use of multiple measures of socio-economic position and quality of life. To enable investigation of between-country differences, the increased collection, harmonisation and utilisation of comparable cross-national data would be beneficial.
PS24 Nutritional Status in Relation to Caries Experience Among Primary School Iraqi Children in the Middle Region of Iraq
Authors: Diab Ban S , Samarrai SK El , Al-Alousi WS , Al-Radha ASD 
Published: September 2012

BackgroundMalnutrition when occurs during development period may cause irreversible effect on developing dental tissues leading to dental caries. The aims of the present study were to evaluate the nutritional status of primary school children and its influence on dental caries.MethodsThis study was conducted among primary school children (6–10 years old) in the middle region of Iraq (five governorates). The total sample composed of 4,089 children randomly selected. The assessment of nutritional status was performed using height for age indicator for chronic malnutrition (stunted), the values were compared with the international reference values defined by the National Center for Health Statistics (NCHS) and classify them into mild, moderate, and sever stunted. The nutrient analysis was done through the dietary assessment using semi-quantitative food frequency questionnaires the assessment was converted to nutrient data (according to nutrient composition of Iraqi food) which was performed using software program especially designed for this study. Diagnosis and recording of dental caries was conducted according to World Health Organization criteria in 1997 using dmfs and DMFs indices for primary and permanent teeth respectively. Statistical analyses were performed using Analysis of Variance and Least Significant Different tests.ResultsThe prevalence of stunted, was found to be 49%, where the mild grade was the most prevalent (29%). The data presented in the study showed that there is a significant difference in mean of caries experience between different grades of nutritional status (P<0.01). The well-nourished children had significantly lower dmfs values (11.76±0.95) than mild (10.44±0.61) and sever stunted (16.32±1.07). Concerning caries experience of permanent dentition, apposite figure were found, well-nourished children had higher DMFS values (2.11±0.93) than mild (1.39±0.07), moderate (1.56±0.10), and sever stunted (1.14±0.18). However all these differences were statistically not significant (P>0.05).The daily nutrients intake for the well-nourished children were recorded to be for protein 52.0±0.62grams, calcium 0.63±0.01 grams, phosphorus 1.01±0.01grams, calcium/phosphate ratio 0.61±0.004, iron 0.01±0.0002 milligrams, vitamin A 6981±84.04 I.U and vitamin C 0.10±0.002 milligrams. These amounts tended to be decreased significantly with increased severity of malnutrition. Multiple linear regressions showed correlation between nutrients and dmfs, DMFs with R² value 0.7%, 0.5% respectively.ConclusionThe oral cavity is considered a mirror of nutritional status of the body. Stunted children with inadequate nutrients intake during growth and development had a significant effect on tooth development and subsequent caries initiation and progression.
PS33 Health-Seeking Behaviour in the Era of Free Healthcare in Urban Slums in Sierra Leone
Authors: Nathaniel-Wurie L , Martin G , Cooper G , Bernier G-L De , Ajayi T , Martineau F , Cridford B , Lako S 
Published: September 2012

BackgroundSierra Leone has child health statistics which are amongst the worst in the world. In April 2010, the Government of Sierra Leone launched a Free Health Care Initiative (FHCI), eliminating user fees in government facilities for children under the age of five, as well as pregnant and lactating women. Data from Ola During Children’s Hospital (ODCH), the country’s only government-run tertiary paediatric hospital, suggests that the FHCI has increased service utilisation. However, mortality rates remain high and delayed presentation is a major factor contributing to poor outcomes. This study sought to understand health-seeking behaviour in the era of Free Health Care, as a means of addressing barriers to the delivery of timely paediatric care for the urban poor.MethodsData was collected via focus group discussions and key informant interviews in Freetown. Men and women with at least one child below the age of five under their care were included. Participants were selected from neighbourhoods in Freetown where Ola During Children’s Hospital (ODCH) represented the nearest secondary care facility to their usual place of residence. Focus groups were facilitated in Krio, the national language, guided by a pre-designed survey tool. Discussions were audio-recoded, transcribed and translated into English. Data analysis was conducted by the research team using a thematic framework.ResultsPreliminary analysis reveals several factors contributing to delays in accessing appropriate care for sick children:Indirect costs: Transportation, child-minding, lost income, cost of prescribed medicines and unsanctioned charges for care that continue to be levied.The negative perceptions of ODCH staff and facilities: Perceived disrespectful, discriminatory or unfair treatment within the health facility.Numerous healthcare options more easily accessible: Private pharmacies, self-treatment at home using traditional (herbal) or allopathic remedies.Poor insight into disease: Deficiencies in caregivers’ ability to recognise at what time during illness progression seeking healthcare would result in the highest cost benefit ratio.Non caregiver factors: Long queues, perceived complicated referral process between FHC facilities, and reduced opening hours.ConclusionUser fees represent a major barrier to accessing timely and appropriate care for poor children. However, the elimination of official charges for paediatric care in Sierra Leone has brought to the surface several critical factors, beyond direct costs, which also impact upon healthcare utilisation. Understanding the processes and determinants which modulate health seeking behaviour is fundamental to efforts to improve health outcomes for the most vulnerable children.
PS44 What is the Nature and Extent of Alcohol Advertising on Facebook?
Authors: Page B , Cole K 
Published: September 2012

BackgroundThere is a growing evidence base that alcohol advertising increases consumption, particularly amongst young people. Alcohol companies are increasingly using social media, such as Facebook, as a critical part of their marketing campaigns. The Advertising Standards Agency (ASA) states that alcohol advertising must not link alcohol with social success. However, by using a platform which is inherently social, alcohol companies can implicitly link their brand with these concepts. This study aimed to describe the nature and extent of alcohol advertising on Facebook.MethodsA quantitative descriptive analysis of UK Facebook brand pages of the highest volume sales brand for spirits, beer and cider (Smirnoff GB, Carling and Strongbow respectively) amongst the key Facebook user demographics (18–25 year olds). We collected all status updates for each brand page over a month. These appeared on the Newsfeed of those who Like the brand. The status updates were coded using concepts expressed in the ASA standards, the Committee of Advertising Practice (CAP) Code and the alcohol marketing literature. The frequencies of the identified categories were then calculated for each brand and for all three brands. The numbers of likes and comments of each status was also recorded.Results85 status updates were collected. The average number of status updates each day was 0.94 overall. The number of people receiving these updates at the time of writing is in total 881,398. The total number of likes and comments is 12,984 and 4,780 respectively. The most frequently occurring code was a reference to the Carling Cup. The codes used that refer to enhanced social or sexual success (which is in contravention of the ASA rules) were references to ‘dating’ and ‘partying’. These occurred less often. All the brands encouraged user interaction by asking users a question (32 updates, 37.6% of all posts) and ‘fill in the gap’ statuses.ConclusionThis initial research suggests that the alcohol industry is using Facebook to engage with a large number of young consumers through frequent status updates. There is some evidence that the content on the pages is in contravention of ASA regulations. Further research needs to be conducted in this area in order to determine the effect that alcohol marketing via social media is having on levels of consumption of alcohol and initiation of consumption by young people in order to provide strong evidence for tightening ASA standards that reflect the advancement of alcohol advertising using Facebook.
PS46 The Complex Association Between Blood Glucose Concentration and Birth Weight in Women with Pre-Gestational Diabetes
Authors: Tennant PWG , Glinianaia SV , Bilous RW , Rankin J , Bell R 
Published: September 2012

BackgroundLarge fetal size (macrosomia) is a frequent pregnancy complication in women with diabetes. High blood glucose during pregnancy is hypothesised to explain much of the association, but previous investigations have presented equivocal results. This could be due to inadequate adjustment for confounding factors or a non-uniform association between blood glucose concentration and birth weight.This study investigated the association between blood glucose concentrations during early and late pregnancy and birth weight in women with pre-gestational diabetes, whilst accounting for a range of potentially relevant clinical and socio-demographic factors.MethodsAll singleton births in women with pre-gestational diabetes delivered during 1996–2008 were identified from the Northern Diabetes in Pregnancy, a population-based survey of all pregnancies occurring in women with pre-gestational diabetes in the North of England. Cases of congenital anomaly (identified from the Northern Congenital Abnormality Survey) were excluded.Three measures of glycated haemoglobin concentration (HbA1c) were obtained, to estimate the blood glucose concentration around conception, and during the second and third trimesters. The associations between HbA1c at these time points, a range of other clinical and socio-demographic variables, and birth weight were examined by multiple linear regression. The total and indirect associations were further examined by path-analysis. Gestational age was modelled as a three-order polynomial.ResultsIncreasing peri-conceptional HbA1c was associated with reduction in birth weight (adjusted regression coefficient, b=-50.4 grams per 1%, 95% CI: -71.1 to -29.6), while increasing third-trimester HbA1c was associated with increase in birth weight (b=171.9 grams per 1%, 95% CI: 132.1–211.7). There was no association between birth weight and second-trimester HbA1c.Of the other variables in the adjusted model; male sex, increasing maternal height, increasing maternal BMI, multiparity, and later gestational age at delivery were all significantly associated with larger birth weight, while increasing maternal age, later gestational age at booking, maternal smoking, history of pre-pregnancy nephropathy or retinopathy were all significantly associated with smaller birth weight.Maternal socio-economic status (estimated from maternal postcode at birth) was associated with a range of birth weight modifiers (maternal height, BMI, age, parity, smoking status, and periconceptional HbA1c), but as these acted in opposite directions, the overall effect on birth weight was negligible.ConclusionMaternal blood glucose concentrations are associated with birth weight, but the association is complex, reversing as pregnancy progresses. For women with pre-gestational diabetes, maintaining good glucose control throughout pregnancy is likely to be associated with the lowest risk of pathological fetal size.
PS50 The Development Of Minimum Unit Pricing Of Alcohol In Scotland: A Policy Case Study
Authors: Katikireddi SV , Hilton S , Bond L 
Published: September 2012

BackgroundAwareness of alcohol as a public health issue has increased in the UK and elsewhere over recent years. Evidence exists to support the use of price mechanisms to address alcohol harms. While various Canadian provinces have used reference pricing to control off-license alcohol prices in state-run monopolies, no country has implemented a uniform minimum unit price (MUP) that applies to all alcohol sales. This policy is being actively considered in Scotland, with legislation likely to be passed this year. Studying developments in Scotland may therefore help those working in public health to improve their engagement with policymakers as well as being of use to other countries seeking to introduce MUP in the future.MethodsPolitical science theories can be used to identify potential explanations for the development of policy. We draw on a number of theories to allow a range of explanations to be identified (a ‘multiple-lenses’ approach). Punctuated-Equilibrium Theory (PET) suggests policymakers use their limited time to address a few issues in detail (which can experience major policy change), while paying little attention to most other policy areas. Alternatively, multi-level governance highlights the diversity of actors seeking to influence policy within different governmental levels (venues). The same policy issue can therefore be considered at European Union, Westminster Parliament or Scottish Parliament, for example. We utilise political science theories to provide explanations for the development of minimum unit pricing for alcohol as a public health policy in Scotland.ResultsPET highlights the importance of redefining the policy problem so that it becomes a focus for policymaking. This therefore suggests reframing of alcohol as a public health problem amenable to a population-based solution has been instrumental in bringing about consideration of MUP. A multi-level governance framework suggests that the devolution of health (but not trade or taxation policy) to Scottish Parliament illustrates how public health advocates were able to ‘venue shop’ from Westminster to the Scottish Parliament. We also provide a necessary description of the process through which MUP has emerged.ConclusionPolitical science theories are useful for understanding public health policy developments and could be more widely used by the public health community to inform advocacy or engagement with policymakers. This case study illustrates their value as well as providing more generalisable lessons for public health advocates (such as to seek opportunities for ‘venue shopping’ and an appreciation of the importance of framing of policy issues).
PS55 The Use Of A Wealth Index Within An Impoverished Community: A Cohort Study In Kwazulu-Natal, South Africa
Authors: Davidson LL , Kauchali S , Chhagan MK , Bah F , Uwemedimo OOT , Craib MH , McKeague I 
Published: September 2012

BackgroundAn index of wealth is widely used in national surveys to create economic profiles. We constructed such an index within a population-based cohort study of 1,788 preschool children and their primary caregivers living in five isiZulu tribal areas of KwaZulu-Natal, South Africa, an extremely poor area which remains at the epi-center of the South African HIV/AIDS epidemic.MethodsStudy Design: Information on household assets, employment, household structure was obtained by door-to-door survey alongside a screen for child disability in developing countries. All children were invited to a structured medical and psychological assessment for disability and HIV status of child and primary caregiver. Wealth Index: A household asset index developed within our study population used many items identical to those in WHO DHS surveys, employing a principal components approach. Asset indicators were grouped into 3 categories: land ownership, ownership of consumer goods, and characteristics of household dwelling (building material, water sources, toilet facility, energy source, etc.). Factor analysis was performed: variables with zero variances and all variables with prevalence less than 2% were removed. The first component explained 16% of the variance and a KMO of 0.532. We ranked the factor scores on the first component in ascending order, standardized to a range of 0 to 4, and grouped into tertiles (1=lowest third, 2=middle third, 3=top third).ResultsThe wealth index gave information about study participation: Of 1788 children screened, children from households in the poorest third were significantly more likely to be brought to the assessment: 91% compared to 83 and 89 % in the middle and top third respectively. Significant differences in the wealth index were found between the five areas in the sample. With regard to caregiver responses about child disability, those in the poorest third were most likely to report that their child had a disability (43% compared to 46 and 49% - significant on test for trend). Though doctors found a lower rate of disability than reported by parents, there was no difference in disability or false positives rate by wealth index tertile. HIV seropositivity of caregiver varied by tertile (30.3%, 28.5% and 21.8 % in poorest, middle and least poor) but not that of children.ConclusionEven within extremely deprived areas in a low or middle income country, a wealth index can assess comparative risk among groups suffering more or less material disadvantage and also provide important information in assessing possibility of selection bias in the findings.
Automated Invariant Alignment to Improve Canonical Variates in Image Fusion of Satellite and Weather Radar Data
Authors: Vestergaard Jacob S. , Nielsen Allan A. 
Published: September 2012

AbstractCanonical correlation analysis (CCA) maximizes the correlation between two sets of multivariate data. CCA is applied to multivariate satellite data and univariate radar data to produce a subspace descriptive of heavily precipitating clouds. A misalignment, inherent to the nature of the two datasets, was observed, corrupting the subspace. A method for aligning the two datasets is proposed to overcome this issue and render a useful subspace projection. The observed corruption of the subspace gives rise to the hypothesis that the optimal correspondence between a heavily precipitating cloud in the radar data and the associated cloud top registered in the satellite data is found by a scale, rotation, and translation invariant transformation together with a temporal displacement. The method starts by determining a conformal transformation of the radar data at the time of maximum precipitation for optimal correspondence with the satellite data at the same time. This optimization is repeated for an increasing temporal lag until no further improvement can be found. The method is applied to three meteorological events that caused heavy precipitation in Denmark. The three cases are analyzed with and without using the proposed method. In all cases, the use of prealignment shows significant improvements in the descriptive capabilities of the subspaces, thus supporting the posed hypothesis.