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Background: Antenatal Care (ANC) during pregnancy can play an important role in the uptake of evidence-based services vital to the health of women and their infants. Studies report positive effects of ANC on use of facility-based delivery and perinatal mortality. However, most existing studies are limited to cross-sectional surveys with long

Background: Antenatal Care (ANC) during pregnancy can play an important role in the uptake of evidence-based services vital to the health of women and their infants. Studies report positive effects of ANC on use of facility-based delivery and perinatal mortality. However, most existing studies are limited to cross-sectional surveys with long recall periods, and generally do not include population-based samples.

Methods: This study was conducted within the Health and Demographic Surveillance System (HDSS) of the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b) in Matlab, Bangladesh. The HDSS area is divided into an icddr,b service area (SA) where women and children receive care from icddr,b health facilities, and a government SA where people receive care from government facilities. In 2007, a new Maternal, Neonatal, and Child Health (MNCH) program was initiated in the icddr,b SA that strengthened the ongoing maternal and child health services including ANC. We estimated the association of ANC with facility delivery and perinatal mortality using prospectively collected data from 2005 to 2009. Using a before-after study design, we also determined the role of ANC services on reduction of perinatal mortality between the periods before (2005 – 2006) and after (2008–2009) implementation of the MNCH program.

Results: Antenatal care visits were associated with increased facility-based delivery in the icddr,b and government SAs. In the icddr,b SA, the adjusted odds of perinatal mortality was about 2-times higher (odds ratio (OR) 1.91; 95% confidence intervals (CI): 1.50, 2.42) among women who received ≤1 ANC compared to women who received ≥3 ANC visits. No such association was observed in the government SA. Controlling for ANC visits substantially reduced the observed effect of the intervention on perinatal mortality (OR 0.64; 95% CI: 0.52, 0.78) to non-significance (OR 0.81; 95% CI: 0.65, 1.01), when comparing cohorts before and after the MNCH program initiation (Sobel test of mediation P < 0.001).

Conclusions: ANC visits are associated with increased uptake of facility-based delivery and improved perinatal survival in the icddr,b SA. Further testing of the icddr,b approach to simultaneously improving quality of ANC and facility delivery care is needed in the existing health system in Bangladesh and in other low-income countries to maximize health benefits to mothers and newborns.

ContributorsPervin, Jasmine (Author) / Moran, Allisyn (Author) / Rahman, Monjur (Author) / Razzaque, Abdur (Author) / Sibley, Lynn (Author) / Streatfield, Peter K. (Author) / Reichenbach, Laura J. (Author) / Koblinsky, Marge (Author) / Hruschka, Daniel (Author) / Rahman, Anisur (Author) / College of Liberal Arts and Sciences (Contributor)
Created2012-10-16
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Background: Chemistry and particularly enzymology at surfaces is a topic of rapidly growing interest, both in terms of its role in biological systems and its application in biocatalysis. Existing protein immobilization approaches, including noncovalent or covalent attachments to solid supports, have difficulties in controlling protein orientation, reducing nonspecific absorption and preventing

Background: Chemistry and particularly enzymology at surfaces is a topic of rapidly growing interest, both in terms of its role in biological systems and its application in biocatalysis. Existing protein immobilization approaches, including noncovalent or covalent attachments to solid supports, have difficulties in controlling protein orientation, reducing nonspecific absorption and preventing protein denaturation. New strategies for enzyme immobilization are needed that allow the precise control over orientation and position and thereby provide optimized activity.

Methodology/Principal Findings: A method is presented for utilizing peptide ligands to immobilize enzymes on surfaces with improved enzyme activity and stability. The appropriate peptide ligands have been rapidly selected from high-density arrays and when desirable, the peptide sequences were further optimized by single-point variant screening to enhance both the affinity and activity of the bound enzyme. For proof of concept, the peptides that bound to β-galactosidase and optimized its activity were covalently attached to surfaces for the purpose of capturing target enzymes. Compared to conventional methods, enzymes immobilized on peptide-modified surfaces exhibited higher specific activity and stability, as well as controlled protein orientation.

Conclusions/Significance: A simple method for immobilizing enzymes through specific interactions with peptides anchored on surfaces has been developed. This approach will be applicable to the immobilization of a wide variety of enzymes on surfaces with optimized orientation, location and performance, and provides a potential mechanism for the patterned self-assembly of multiple enzymes on surfaces.

ContributorsFu, Jinglin (Author) / Reinhold, Jeremy (Author) / Woodbury, Neal (Author) / Biodesign Institute (Contributor)
Created2011-04-08
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Contemporary human populations conform to ecogeographic predictions that animals will become more compact in cooler climates and less compact in warmer ones. However, it remains unclear to what extent this pattern reflects plastic responses to current environments or genetic differences among populations. Analyzing anthropometric surveys of 232,684 children and adults

Contemporary human populations conform to ecogeographic predictions that animals will become more compact in cooler climates and less compact in warmer ones. However, it remains unclear to what extent this pattern reflects plastic responses to current environments or genetic differences among populations. Analyzing anthropometric surveys of 232,684 children and adults from across 80 ethnolinguistic groups in sub-Saharan Africa, Asia and the Americas, we confirm that body surface-to-volume correlates with contemporary temperature at magnitudes found in more latitudinally diverse samples (Adj. R2 = 0.14-0.28). However, far more variation in body surface-to-volume is attributable to genetic population structure (Adj. R2 = 0.50-0.74). Moreover, genetic population structure accounts for nearly all of the observed relationship between contemporary temperature and body surface-to-volume among children and adults. Indeed, after controlling for population structure, contemporary temperature accounts for no more than 4% of the variance in body form in these groups. This effect of genetic affinity on body form is also independent of other ecological variables, such as dominant mode of subsistence and household wealth per capita. These findings suggest that the observed fit of human body surface-to-volume with current climate in this sample reflects relatively large effects of existing genetic population structure of contemporary humans compared to plastic response to current environments.

ContributorsHruschka, Daniel (Author) / Hadley, Craig (Author) / Brewis, Alexandra (Author) / Stojanowski, Christopher (Author) / College of Liberal Arts and Sciences (Contributor)
Created2015-03-27
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Background: The transition from the home to college is a phase in which emerging adults shift toward more unhealthy eating and physical activity patterns, higher body mass indices, thus increasing risk of overweight/obesity. Currently, little is understood about how changing friendship networks shape weight gain behaviors. This paper describes the recruitment,

Background: The transition from the home to college is a phase in which emerging adults shift toward more unhealthy eating and physical activity patterns, higher body mass indices, thus increasing risk of overweight/obesity. Currently, little is understood about how changing friendship networks shape weight gain behaviors. This paper describes the recruitment, data collection, and data analytic protocols for the SPARC (Social impact of Physical Activity and nutRition in College) study, a longitudinal examination of the mechanisms by which friends and friendship networks influence nutrition and physical activity behaviors and weight gain in the transition to college life.

Methods: The SPARC study aims to follow 1450 university freshmen from a large university over an academic year, collecting data on multiple aspects of friends and friendship networks. Integrating multiple types of data related to student lives, ecological momentary assessments (EMAs) are administered via a cell phone application, devilSPARC. EMAs collected in four 1-week periods (a total of 4 EMA waves) are integrated with linked data from web-based surveys and anthropometric measurements conducted at four times points (for a total of eight data collection periods including EMAs, separated by ~1 month). University databases will provide student card data, allowing integration of both time-dated data on food purchasing, use of physical activity venues, and geographical information system (GIS) locations of these activities relative to other students in their social networks.

Discussion: Findings are intended to guide the development of more effective interventions to enhance behaviors among college students that protect against weight gain during college.

ContributorsBruening, Meg (Author) / Ohri-Vachaspati, Punam (Author) / Brewis, Alexandra (Author) / Laska, Melissa (Author) / Todd, Michael (Author) / Hruschka, Daniel (Author) / Schaefer, David (Author) / Whisner, Corrie (Author) / Dunton, Genevieve (Author) / College of Health Solutions (Contributor)
Created2016-08-30
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Ethnic groups experience different societal and economic circumstances that contribute to their well-being. Life satisfaction and happiness are commonly used as a measure of well-being; but they are not often used to evaluate well-being in lower income countries. This study focuses on the self-reported life satisfaction and happiness of members

Ethnic groups experience different societal and economic circumstances that contribute to their well-being. Life satisfaction and happiness are commonly used as a measure of well-being; but they are not often used to evaluate well-being in lower income countries. This study focuses on the self-reported life satisfaction and happiness of members of ethnic groups from low- and middle-income countries and its correlation with ethnic privilege, gender opportunity, and income. Using two self-reported measures of well-being—life satisfaction and happiness—among 110,391 women in 27 countries (ages 15-49) surveyed in Multiple Indicator Cluster Surveys, this study examines how country-level indicators of gender opportunity, ethnic-level indicators of privilege and household-level measures of wealth are associated with well-being. Our findings indicate a significant relationship between ethnic privilege, gender opportunity and income on life satisfaction. The results from this study provide valuable data and implications for lower income countries to identify and reduce modifiable risk factors that affect a population’s well-being.
ContributorsChavez Lopez, Giselle (Co-author, Co-author) / Hruschka, Daniel (Thesis director) / Gonzales, Angela (Committee member) / School of Molecular Sciences (Contributor) / School of Human Evolution & Social Change (Contributor) / Barrett, The Honors College (Contributor)
Created2020-05
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The lonely, empty face panhandling on the street corner has a story to tell. At first glance, most people write the homeless off as less than worthy. However, there is a deeper connection and understanding of relationships and a sense of community unseen by the majority of passer-byers. Amidst the

The lonely, empty face panhandling on the street corner has a story to tell. At first glance, most people write the homeless off as less than worthy. However, there is a deeper connection and understanding of relationships and a sense of community unseen by the majority of passer-byers. Amidst the humdrum beat of every day life, there is toil to find basic necessities such as food, water, sanitation, and a place to rest. At the same time, there is laughter and friendship as they help one another through the hostilities of their circumstances. Combining the creative elements of photojournalism and qualitative interviewing, the basic daily needs and struggles of the homeless will be delved into to answer how friendship is pertinent to survival on the streets.
ContributorsFisher, Meghan (Author) / Hruschka, Daniel (Thesis director) / Hita, Liza (Committee member) / Newland, Judy (Committee member) / Barrett, The Honors College (Contributor) / College of Liberal Arts and Sciences (Contributor)
Created2012-12
Description
Examining the effect of various factors such as class, gender, and status on health inequalities in India is crucial for improving access to health services. However, most research on castes in India is done using broad, government-defined categories, including “Scheduled Castes,” “Scheduled Tribes,” “Forward Classes,” and “Other Backwards Classes.” These

Examining the effect of various factors such as class, gender, and status on health inequalities in India is crucial for improving access to health services. However, most research on castes in India is done using broad, government-defined categories, including “Scheduled Castes,” “Scheduled Tribes,” “Forward Classes,” and “Other Backwards Classes.” These general categories erase the experiences that more specific caste groups have in their health and their livelihood. Using the 2015-2016 Demographic and Health Survey of India, this study analyzes data on 699,686 women aged 15-49 to investigate the association of socioeconomic status, assessed by wealth, education, and community status on two types of contraceptive use–sterilization and other modern methods. Those with secondary education or higher were much less likely to be sterilized and more likely to use non-sterilization forms of modern contraception. Interestingly, those with greater household wealth were more likely to be sterilized but had no different chance of using non-sterilization forms of modern contraception. After controlling for other socioeconomic factors, members of Scheduled Castes and Backward Classes are more likely to be sterilized. However, there was additional heterogeneity between groups, with Muslim groups and Northeastern tribes much less likely to be sterilized, and Southern tribes more likely to be sterilized. Moreover, Muslim groups as well as Northern and Northeastern tribes were more likely to use non-sterilizations forms of contraception, whereas Southern tribes were less likely to use non-sterilization forms of contraception. These findings illustrate that in addition to differences by major caste categories, there is still religious and regional variation in the likelihood of using different forms of contraception. Future research should examine how unique community factors erased within the already present government caste system can affect health. In addition, more research should be done on the various effects of discrimination faced by these communities and how this discrimination affects their health education, access, and autonomy.
ContributorsChandra, Natasha (Author) / Hruschka, Daniel (Thesis director) / Drake, Alexandria (Committee member) / Barrett, The Honors College (Contributor) / School of Human Evolution & Social Change (Contributor) / School of International Letters and Cultures (Contributor) / Dean, W.P. Carey School of Business (Contributor)
Created2024-05