NobleBlocks

Concern Worldwide US

nonprofitNew York, New York, United States

Research output, citation impact, and the most-cited recent papers from Concern Worldwide US (United States). Aggregated across the NobleBlocks index of 300M+ scholarly works.

Total works
23.8K
Citations
20.8K
h-index
70
i10-index
372
Also known as
ConcernConcern Worldwide US

Top-cited papers from Concern Worldwide US

Sexual orientation and gender as factors in socioculturally acquired vulnerability to body dissatisfaction and eating disorders.
Michael D. Siever
1994· Journal of Consulting and Clinical Psychology378doi:10.1037//0022-006x.62.2.252

This study investigated the hypothesis that gay men and heterosexual women are dissatisfied with their bodies and vulnerable to eating disorders because of a shared emphasis on physical attractiveness and thinness that is based on a desire to attract and please men. Although men place priority on physical attractiveness in evaluating potential partners, women place greater emphasis on other factors, such as personality, status, power, and income. Therefore, lesbians and heterosexual men are less concerned with their own physical attractiveness and, consequently, less dissatisfied with their bodies and less vulnerable to eating disorders. Several instruments measuring body satisfaction, the importance of physical attractiveness, and symptoms of eating disorders were administered to 250 college students. The sample included 53 lesbians, 59 gay men, 62 heterosexual women, and 63 heterosexual men. Multivariate and univariate analyses of variance were used to examine the differences among the scores of lesbians, gay men, heterosexual women, and heterosexual men on these various constructs. The results generally confirmed the research hypothesis. The implications and ramifications these findings have for the understanding of both the psychology of lesbians and gay men and the prevention and treatment of eating disorders are discussed.

Proliferation and fragmentation: Transactions costs and the value of aid
Arnab Acharya, Ana Teresa Fuzzo de Lima, Mick Moore
2006· The Journal of Development Studies310doi:10.1080/00220380500356225

Abstract The problem of the proliferation of the number of aid donors and aid channels continues to worsen. It is widely and plausibly believed that this significantly reduces the value of aid by increasing direct and indirect transactions costs. We contribute to the existing literature by: (a) categorising the apparent adverse effects of proliferation; (b) producing a reliable and fair indicator of the relative degree to which the main bilateral donors proliferate or concentrate their aid; (c) giving some explanation of why some donors proliferate more than others; (d) constructing a reliable measure of the extent to which recipients suffer from the problem of fragmentation in the sources of their aid; and (e) demonstrating that the worst proliferators among the aid donors are especially likely to be suppliers of aid to recipients suffering most from fragmentation. There are significant implications for aid policy.

Analysis of LGBT identity development models and implications for practice
Brent Bilodeau, Kristen A. Renn
2005· New Directions for Student Services304doi:10.1002/ss.171

Abstract A review of LGBT identity development models reveals fluidity, complexity, and contradictions.

Metabonomics: Evaluation of Nuclear Magnetic Resonance (NMR) and Pattern Recognition Technology for Rapid in Vivo Screening of Liver and Kidney Toxicants
Donald G. Robertson
2000· Toxicological Sciences255doi:10.1093/toxsci/57.2.326

The purpose of this study was to evaluate the feasibility of metabonomics technology for developing a rapid-throughput toxicity screen using 2 known hepatotoxicants: carbon tetrachloride (CCl(4)) and alpha-naphthylisothiocyanate (ANIT) and 2 known nephrotoxicants: 2-bromoethylamine (BEA) and 4-aminophenol (PAP). In addition, the diuretic furosemide (FURO) was also studied. Single doses of CCl(4) (0.1 and 0.5 ml/kg), ANIT (10 and 100 mg/kg), BEA (15 and 150 mg/kg), PAP (15 and 150 mg/kg) and FURO (1 and 5 mg) were administered as single IP or oral doses to groups of 4 male Wistar rats/dose. Twenty-four-h urine samples were collected pretest, daily through Day 4, and on Day 10 (high dose CCl(4) and BEA only). Blood samples were taken on Days 1, 2, and 4 or 1, 4, and 10 for clinical chemistry assessment, and the appropriate target organ was examined microscopically. NMR spectra of urine were acquired and the data processed and subjected to principal component analyses (PCA). The results demonstrated that the metabonomic approach could readily distinguish the onset and reversal of toxicity with good agreement between clinical chemistry and PCA data. In at least 2 instances (ANIT and BEA), PCA analysis suggested effects at low doses, which were not as evident by clinical chemistry or microscopic analysis. Furosemide, which had no effect at the doses employed, did not produce any changes in PCA patterns. These data support the contention that the metabonomic approach represents a promising new technology for the development of a rapid throughput in vivo toxicity screen.

Vulnerability to Food Insecurity in Urban Slums: Experiences from Nairobi, Kenya
Elizabeth Kimani‐Murage, Lilly Schofield, Frederick Murunga Wekesah, Shukri F. Mohamed +4 more
2014· Journal of Urban Health204doi:10.1007/s11524-014-9894-3

Food and nutrition security is critical for economic development due to the role of nutrition in healthy growth and human capital development. Slum residents, already grossly affected by chronic poverty, are highly vulnerable to different forms of shocks, including those arising from political instability. This study describes the food security situation among slum residents in Nairobi, with specific focus on vulnerability associated with the 2007/2008 postelection crisis in Kenya. The study from which the data is drawn was nested within the Nairobi Urban Health and Demographic Surveillance System (NUHDSS), which follows about 70,000 individuals from close to 30,000 households in two slums in Nairobi, Kenya. The study triangulates data from qualitative and quantitative sources. It uses qualitative data from 10 focus group discussions with community members and 12 key-informant interviews with community opinion leaders conducted in November 2010, and quantitative data involving about 3,000 households randomly sampled from the NUHDSS database in three rounds of data collection between March 2011 and January 2012. Food security was defined using the Household Food Insecurity Access Scale (HFIAS) criteria. The study found high prevalence of food insecurity; 85% of the households were food insecure, with 50% being severely food insecure. Factors associated with food security include level of income, source of livelihood, household size, dependence ratio; illness, perceived insecurity and slum of residence. The qualitative narratives highlighted household vulnerability to food insecurity as commonplace but critical during times of crisis. Respondents indicated that residents in the slums generally eat for bare survival, with little concern for quality. The narratives described heightened vulnerability during the 2007/2008 postelection violence in Kenya in the perception of slum residents. Prices of staple foods like maize flour doubled and simultaneously household purchasing power was eroded due to worsened unemployment situation. The use of negative coping strategies to address food insecurity such as reducing the number of meals, reducing food variety and quality, scavenging, and eating street foods was prevalent. In conclusion, this study describes the deeply intertwined nature of chronic poverty and acute crisis, and the subsequent high levels of food insecurity in urban slum settings. Households are extremely vulnerable to food insecurity; the situation worsening during periods of crisis in the perception of slum residents, engendering frequent use of negative coping strategies. Effective response to addressing vulnerability to household food insecurity among the urban poor should focus on both the underlying vulnerabilities of households due to chronic poverty and added impacts of acute crises.

Cigarette smoking during pregnancy
Alison K. Shea, Meir Steiner
2008· Nicotine & Tobacco Research200doi:10.1080/14622200701825908

Maternal smoking during pregnancy is associated with several adverse developmental outcomes in the offspring. These include preterm delivery, spontaneous abortion, growth restriction, increased risk of sudden infant death syndrome (SIDS), as well as long-term behavioral and psychiatric disorders. However, the underlying physiological mechanisms for these ill-effects are not fully understood. The aim of this paper is to review the animal and human data to date, linking in utero smoke exposure to negative neurodevelopmental outcomes. It is known that nicotine from cigarette smoke exerts its effects by affecting placental vasculature, and also by nicotinic acetylcholine receptor binding in fetal membranes. Thus, subsequent consequences involve a cascade of events causing not only dysregulation of the nicotinic and muscarinic, but also catecholaminergic and serotonergic neurotransmitter systems. These observations provide some insight into how smoking can impair neurodevelopment, but the long-term neurotransmitter involvement in dysregulation of emotion and attention awaits further elucidation. It is important that pregnant women are warned of the detrimental effects of smoking, and encouraged to abstain for healthy fetal development.

Kangaroo mother care: a multi-country analysis of health system bottlenecks and potential solutions
Linda Vesel, Anne‐Marie Bergh, Kate Kerber, Bina Valsangkar +4 more
2015· BMC Pregnancy and Childbirth193doi:10.1186/1471-2393-15-s2-s5

BACKGROUND: Preterm birth is now the leading cause of under-five child deaths worldwide with one million direct deaths plus approximately another million where preterm is a risk factor for neonatal deaths due to other causes. There is strong evidence that kangaroo mother care (KMC) reduces mortality among babies with birth weight <2000 g (mostly preterm). KMC involves continuous skin-to-skin contact, breastfeeding support, and promotion of early hospital discharge with follow-up. The World Health Organization has endorsed KMC for stabilised newborns in health facilities in both high-income and low-resource settings. The objectives of this paper are to: (1) use a 12-country analysis to explore health system bottlenecks affecting the scale-up of KMC; (2) propose solutions to the most significant bottlenecks; and (3) outline priority actions for scale-up. METHODS: The bottleneck analysis tool was applied in 12 countries in Africa and Asia as part of the Every Newborn Action Plan process. Country workshops involved technical experts to complete the survey tool, which is designed to synthesise and grade health system "bottlenecks", factors that hinder the scale-up, of maternal-newborn intervention packages. We used quantitative and qualitative methods to analyse the bottleneck data, combined with literature review, to present priority bottlenecks and actions relevant to different health system building blocks for KMC. RESULTS: Marked differences were found in the perceived severity of health system bottlenecks between Asian and African countries, with the former reporting more significant or very major bottlenecks for KMC with respect to all the health system building blocks. Community ownership and health financing bottlenecks were significant or very major bottlenecks for KMC in both low and high mortality contexts, particularly in South Asia. Significant bottlenecks were also reported for leadership and governance and health workforce building blocks. CONCLUSIONS: There are at least a dozen countries worldwide with national KMC programmes, and we identify three pathways to scale: (1) champion-led; (2) project-initiated; and (3) health systems designed. The combination of all three pathways may lead to more rapid scale-up. KMC has the potential to save lives, and change the face of facility-based newborn care, whilst empowering women to care for their preterm newborns.

Environmental injustice in North Carolina's hog industry.
S Wing, Donald C. Cole, G. Grant
2000· Environmental Health Perspectives188doi:10.1289/ehp.00108225

Rapid growth and the concentration of hog production in North Carolina have raised concerns of a disproportionate impact of pollution and offensive odors on poor and nonwhite communities. We analyzed the location and characteristics of 2,514 intensive hog operations in relation to racial, economic, and water source characteristics of census block groups, neighborhoods with an average of approximately 500 households each. We used Poisson regression to evaluate the extent to which relationships between environmental justice variables and the number of hog operations persisted after consideration of population density. There are 18.9 times as many hog operations in the highest quintile of poverty as compared to the lowest; however, adjustment for population density reduces the excess to 7.2. Hog operations are approximately 5 times as common in the highest three quintiles of the percentage nonwhite population as compared to the lowest, adjusted for population density. The excess of hog operations is greatest in areas with both high poverty and high percentage nonwhites. Operations run by corporate integrators are more concentrated in poor and nonwhite areas than are operations run by independent growers. Most hog operations, which use waste pits that can contaminate groundwater, are located in areas with high dependence on well water for drinking. Disproportionate impacts of intensive hog production on people of color and on the poor may impede improvements in economic and environmental conditions that are needed to address public health in areas which have high disease rates and low access to medical care as compared to other areas of the state.

The culture, mental health and psychosocial wellbeing of Rohingya refugees: a systematic review
Alvin Kuowei Tay, Andrew Riley, Md. Rafiqul Islam, Courtney Welton‐Mitchell +4 more
2019· Epidemiology and Psychiatric Sciences186doi:10.1017/s2045796019000192

AIMS: Despite the magnitude and protracted nature of the Rohingya refugee situation, there is limited information on the culture, mental health and psychosocial wellbeing of this group. This paper, drawing on a report commissioned by the United Nations High Commissioner for Refugees (UNHCR), aims to provide a comprehensive synthesis of the literature on mental health and psychosocial wellbeing of Rohingya refugees, including an examination of associated cultural factors. The ultimate objective is to assist humanitarian actors and agencies in providing culturally relevant Mental Health and Psychosocial Support (MHPSS) for Rohingya refugees displaced to Bangladesh and other neighbouring countries. METHODS: We conducted a systematic search across multiple sources of information with reference to the contextual, social, economic, cultural, mental health and health-related factors amongst Rohingya refugees living in the Asia-Pacific and other regions. The search covered online databases of diverse disciplines (e.g. medicine, psychology, anthropology), grey literature, as well as unpublished reports from non-profit organisations and United Nations agencies published until 2018. RESULTS: The legacy of prolonged exposure to conflict and persecution compounded by protracted conditions of deprivations and displacement is likely to increase the refugees' vulnerability to wide array of mental health problems including posttraumatic stress disorder, anxiety, depression and suicidal ideation. High rates of sexual and gender-based violence, lack of privacy and safe spaces and limited access to integrated psychosocial and mental health support remain issues of concern within the emergency operation in Bangladesh. Another challenge is the limited understanding amongst the MHPSS personnel in Bangladesh and elsewhere of the language, culture and help-seeking behaviour of Rohingya refugees. While the Rohingya language has a considerable vocabulary for emotional and behavioural problems, there is limited correspondence between these Rohingya terms and western concepts of mental disorders. This hampers the provision of culturally sensitive and contextually relevant MHPSS services to these refugees. CONCLUSIONS: The knowledge about the culture, context, migration history, idioms of distress, help-seeking behaviour and traditional healing methods, obtained from diverse sources can be applied in the design and delivery of culturally appropriate interventions. Attention to past exposure to traumatic events and losses need to be paired with attention for ongoing stressors and issues related to worries about the future. It is important to design MHPSS interventions in ways that mobilise the individual and collective strengths of Rohingya refugees and build on their resilience.

Repetitive Regret, Depression, and Anxiety: Findings from a Nationally Representative Survey
Neal J. Roese, Kai Epstude, Florian Fessel, Mike Morrison +4 more
2009· Journal of Social and Clinical Psychology155doi:10.1521/jscp.2009.28.6.671

Past research has established a connection between regret (negative emotions connected to cognitions about how past actions might have achieved better outcomes) and both depression and anxiety. In the present research, the relations between regret, repetitive thought, depression, and anxiety were examined in a nationally representative telephone survey. Although both regret and repetitive thought were associated with general distress, only regret was associated with anhedonic depression and anxious arousal. Further, the interaction between regret and repetitive thought (i.e., repetitive regret) was highly predictive of general distress but not of anhedonic depression nor anxious arousal. These relations were strikingly consistent across demographic variables such as sex, race/ethnicity, age, education, and income.

Resting-state functional connectivity in individuals with bipolar disorder during clinical remission: a systematic review
Sabrina K. Syan, Mara Smith, Benício N. Frey, Raheem Remtulla +3 more
2018· Journal of Psychiatry and Neuroscience148doi:10.1503/jpn.170175

BACKGROUND: Bipolar disorder is chronic and debilitating. Studies investigating resting-state functional connectivity in individuals with bipolar disorder may help to inform neurobiological models of illness. METHODS: We conducted a systematic review with the following goals: to summarize the literature on resting-state functional connectivity in bipolar disorder during clinical remission (euthymia) compared with healthy controls; to critically appraise the literature and research gaps; and to propose directions for future research. We searched PubMed/MEDLINE, Embase, PsycINFO, CINAHL and grey literature up to April 2017. RESULTS: Twenty-three studies were included. The most consistent finding was the absence of differences in resting-state functional connectivity of the default mode network (DMN), frontoparietal network (FPN) and salience network (SN) between people with bipolar disorder and controls, using independent component analysis. However, 2 studies in people with bipolar disorder who were positive for psychosis history reported DMN hypoconnectivity. Studies using seed-based analysis largely reported aberrant resting-state functional connectivity with the amygdala, ventrolateral prefrontal cortex, cingulate cortex and medial prefrontal cortex in people with bipolar disorder compared with controls. Few studies used regional homogeneity or amplitude of low-frequency fluctuations. LIMITATIONS: We found heterogeneity in the analysis methods used. CONCLUSION: Stability of the DMN, FPN and SN may reflect a state of remission. Further, DMN hypoconnectivity may reflect a positive history of psychosis in patients with bipolar disorder compared with controls, highlighting a potentially different neural phenotype of psychosis in people with bipolar disorder. Resting-state functional connectivity changes between the amygdala, prefrontal cortex and cingulate cortex may reflect a neural correlate of subthreshold symptoms experienced in bipolar disorder euthymia, the trait-based pathophysiology of bipolar disorder and/or a compensatory mechanism to maintain a state of euthymia.

Shifting management of a community volunteer system for improved child health outcomes: results from an operations research study in Burundi
Jennifer Weiss, Raphael Makonnen, Delphin Sula
2015· BMC Health Services Research141doi:10.1186/1472-6963-15-s1-s2

BACKGROUND: Community-based strategies that foster frequent contact between caregivers of children under five and provide credible sources of health information are essential to improve child survival. Care Groups are a community-based implementation strategy for the delivery of social and behavior change interventions. This study assessed if supervision of Care Group activities by Ministry of Health (MOH) personnel could achieve the same child health outcomes as supervision provided by specialized non-governmental organization (NGO) staff. METHODS: The study was a pretest-posttest quasi-experimental design implemented in Burundi. A total of 45 MOH-led Care Groups with 478 Care Group Volunteers (CGVs) were established in the intervention area; and 50 NGO-led Care Groups with 509 CGVs were formed in the comparison area. Data were collected from 593 and 700 mothers of children 0-23 months at baseline and endline, respectively. Pearson's chi-squared test and difference-in-difference analysis assessed changes in 40 child health and nutrition outcomes. A qualitative process evaluation was also conducted midway through the study. RESULTS: The MOH-led Care Group model performed at least as well as the NGO-led model in achieving specific child health and nutrition outcomes. Mothers of children 0-23 months in the intervention and comparison sites reported similar levels of knowledge and practices for 38 of 40 dependent variables measured in the study, and these results remained unchanged after accounting for differences in the indicator values at baseline. Process monitoring data confirmed that the MOH-led Care Group model and the NGO-led Care Group model were implemented with similar intervention strength. CONCLUSIONS: The study demonstrated that behavior change interventions traditionally led by NGOs can be implemented through the existing MOH systems and achieve similar results, thereby increasing the potential for sustainable child health outcomes. Future research on the MOH-led Care Group model is required to systematically document all inputs and monetary costs borne by the MOH to implement the model.

Tailored Telemonitoring in Patients with Heart Failure: Results of a Multicentre Randomized Controlled Trial
Josiane Boyne, Hubertus JM Vrijhoef, Harry J.G.M. Crijns, Gerjan De Weerd +2 more
2012· European Journal of Heart Failure128doi:10.1093/eurjhf/hfs058

AIMS: Recent increases in heart failure tend to overload the healthcare system. Consequently, there is a need for innovative strategies to reduce heart failure hospitalizations. METHODS AND RESULTS: A multicentre randomized controlled trial was carried out to test the hypothesis that telemonitoring reduces heart failure hospitalizations during 1 year follow-up. The mean age of the 382 participating patients was 71.5 (32-93) years; the mean left ventricular ejection fraction was 0.38, and in 61% it was ≤0.45%. Mean time to first heart failure-related hospitalization was 161 days for the intervention group and 139 days for the usual-care group; hospitalizations occurred in 18 (9.1%) compared with 25 (13.5%) patients, with a total number of 24 and 43 hospitalizations, respectively [Kaplan-Meier P = 0.151, hazard ratio (HR) 0.65, 95% confidence interval (CI) 0.35-1.17]. Subgroup analysis of the primary endpoint showed benefits for three subgroups: duration of heart failure, having a pacemaker, and co-habiting. The combined endpoint of heart failure admission and all-cause mortality was similar for both groups (Kaplan-Meier P = 0.641, HR 0.89, 95% CI 0.69-1.83). No differences were found regarding secondary endpoints, except for the reduced number of face to face contacts with the heart failure nurse (Mann-Whitney P < 0.001). Mortality was 18 (9.1%) in the intervention group and 12 (6.5%) in the usual-care group (Mann-Whitney P = 0.34, Cox regression analysis P = 0.82). CONCLUSION: No significant differences were found regarding the primary endpoint, possibly caused by a relative underpowering of the population combined with well-treated study groups. However, telemonitoring tends to reduce heart failure (re)admissions and significantly decreases contacts with specialized nurses. Further research with pre-specified groups, as found in the subgroup analysis, is needed. TRIAL REGISTRATION: NCT00502255.

Trends in childhood mortality in Kenya: The urban advantage has seemingly been wiped out
Elizabeth Kimani‐Murage, Jean‐Christophe Fotso, T. Egondi, Benta Abuya +4 more
2014· Health & Place121doi:10.1016/j.healthplace.2014.06.003

BACKGROUND: We describe trends in childhood mortality in Kenya, paying attention to the urban-rural and intra-urban differentials. METHODS: We use data from the Kenya Demographic and Health Surveys (KDHS) collected between 1993 and 2008 and the Nairobi Urban Health and Demographic Surveillance System (NUHDSS) collected in two Nairobi slums between 2003 and 2010, to estimate infant mortality rate (IMR), child mortality rate (CMR) and under-five mortality rate (U5MR). RESULTS: Between 1993 and 2008, there was a downward trend in IMR, CMR and U5MR in both rural and urban areas. The decline was more rapid and statistically significant in rural areas but not in urban areas, hence the gap in urban-rural differentials narrowed over time. There was also a downward trend in childhood mortality in the slums between 2003 and 2010 from 83 to 57 for IMR, 33 to 24 for CMR, and 113 to 79 for U5MR, although the rates remained higher compared to those for rural and non-slum urban areas in Kenya. CONCLUSIONS: The narrowing gap between urban and rural areas may be attributed to the deplorable living conditions in urban slums. To reduce childhood mortality, extra emphasis is needed on the urban slums.

Modified Blumgart Mattress Suture Versus Conventional Interrupted Suture in Pancreaticojejunostomy During Pancreaticoduodenectomy
Seiko Hirono, Manabu Kawai, Ken‐ichi Okada, Motoki Miyazawa +4 more
2018· Annals of Surgery116doi:10.1097/sla.0000000000002802

OBJECTIVE: This study used a randomized controlled trial (RCT) to evaluate whether mattress suture of pancreatic parenchyma and the seromuscular layer of jejunum (modified Blumgart method) during pancreaticojejunostomy (PJ) decreases the incidence of clinically relevant postoperative pancreatic fistula (POPF) after pancreaticoduodenectomy (PD). BACKGROUND: Several studies reported that mattress suture of Blumgart anastomosis in PJ could reduce POPF rate. This, however, is the first RCT. METHODS: Between June, 2013 and May, 2017, 224 patients scheduled for PD were enrolled in this study in Wakayama Medical University Hospital. Enrolled patients were randomized to either interrupted suture or modified Blumgart mattress suture. The primary endpoint was the incidence of grade B/C POPF based on the International Study Group on Pancreatic Fistula criteria. This RCT was registered with ClinicalTrials.gov (NCT01898780). RESULTS: Patients were randomized to either interrupted suture (103 patients) or modified Blumgart mattress suture (107 patients) and were analyzed by intention-to-treat. Grade B/C POPF occurred in 7 patients (6.8%) in the interrupted suture group and 11 (10.3%) in the mattress suture group (P = 0.367). Mortality within 90 days was 0 in both groups. There were no significant differences in all postoperative complications between the interrupted suture group and the modified Blumgart mattress suture group. CONCLUSIONS: Mattress suture of pancreatic parenchyma and the jejunal seromuscular layer during PJ (modified Blumgart technique) did not reduce clinically relevant POPF compared with interrupted suture.

Breast Implant Rupture
Neal Handel, Marianna Garcia, Roger N. Wixtrom
2013· Plastic & Reconstructive Surgery111doi:10.1097/prs.0b013e3182a4c243

BACKGROUND: Rupture has long been considered one of the key complications of silicone-gel breast implants. The incidence of rupture has been correlated with implant generation, and extensive data on current-generation breast implants, including prospective multicenter clinical trials, are now available from numerous sources. METHODS: Device-retrieval data from breast implant manufacturers were reviewed to identify common factors that likely contribute to rupture. The cumulative incidence of rupture from a prospective clinical study was estimated in multiple ways using the Kaplan-Meier method to demonstrate the need for a uniform calculation methodology. RESULTS: The complexity of identifying, analyzing, and understanding rupture is addressed, and the clinical management of rupture in older generation breast implants lacking highly cohesive gels and barrier layers is reviewed. The data suggest that iatrogenic damage is the most frequent cause of rupture. Data from one manufacturer's prospective breast implant core study are presented to address the complexity of rupture-rate calculations-a single-time-point rupture rate varies from 9.0 to 12.2 percent, depending on which statistical parameters are used. CONCLUSIONS: The significant contribution of iatrogenic damage to overall rupture rate suggests that rupture may be more often operator-related than device-dependent. In addition, there is a critical need to implement uniform statistical methodology using follow-up data only through the patient's last magnetic resonance imaging scan, as rupture rates can vary greatly depending on the statistical methodology selected. Adoption of a uniform standard for rupture rate calculations would enable both patients and surgeons to base clinical decisions on more accurate and consistent information. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.

Genetic variation in oxytocin rs2740210 and early adversity associated with postpartum depression and breastfeeding duration
Wibke Jonas, Viara R. Mileva‐Seitz, Amy Girard, Rossana Bisceglia +4 more
2013· Genes Brain & Behavior110doi:10.1111/gbb.12069

Mothers vary in duration of breastfeeding. These individual differences are related to a variety of demographic and individual maternal factors including maternal hormones, mood and early experiences. However, little is known about the role of genetic factors. We studied single-nucleotide polymorphisms (SNPs) in the OXT peptide gene (rs2740210; rs4813627) and the OXT receptor gene (OXTR rs237885) in two samples of mothers from the Maternal adversity, Vulnerability and Neurodevelopment study (MAVAN), a multicenter (Hamilton and Montreal, Canada) study following mothers and their children from pregnancy until 7 years of age. Data from the Hamilton site was the primary sample (n = 201) and data from Montreal was the replication sample (n = 151). Breastfeeding duration, maternal mood (measured by the CES-D scale) and early life adversity (measured by the CTQ scale) were established during 12 months postpartum. In our primary sample, polymorphisms in OXT rs2740210, but not the other SNPs, interacted with early life adversity to predict variation in breastfeeding duration (overall F8,125 = 2.361, P = 0.021; interaction effect b = -8.12, t = -2.3, P = 0.023) and depression (overall F8,118 = 5.751, P ≤ 0.001; interaction effect b = 6.06, t = 3.13, P = 0.002). A moderated mediation model showed that higher levels of depression mediated the inverse relation of high levels of early life adversity to breastfeeding duration, but only in women possessing the CC genotype [effect a' = -3.3401, 95% confidence interval (CI) = -7.9466 to -0.0015] of the OXT SNP and not in women with the AA/AC genotype (a' = -1.2942, ns). The latter findings (moderated mediation model) were replicated in our Montreal sample (a' = -0.277, 95% CI = -0.7987 to -0.0348 for CC; a' = -0.1820, ns for AA/AC).

Public Opposition To The Siting Of The High‐Level Nuclear Waste Repository: The Importance Of Trust
K. David Pijawka, Alvin H. Mushkatel
1991· Review of Policy Research109doi:10.1111/j.1541-1338.1991.tb00289.x

This paper examines several dimensions of public opposition to the proposed siting of the high‐level nuclear waste repository at Yucca Mountain. In order to provide a context for the public's views of the repository in metropolitan Clark County, both governmental studies of the repository siting process are analyzed, as well as elements of the Nuclear Waste Policy Act. This analysis suggests that one potentially key component of the public's opposition to the siting, as well as their perceptions of risk of the facility, may be the result of a lack of trust in the Department of Energy. Empirical analysis of survey data collected in Nevada in 1988 confirms the strong relationship between political trust and repository risk perceptions.

Cost-effectiveness of community-based management of acute malnutrition in Malawi
R. Wilford, Kate Golden, Damian Walker
2011· Health Policy and Planning102doi:10.1093/heapol/czr017

This study assessed the cost-effectiveness of community-based management of acute malnutrition (CMAM) to prevent deaths due to severe acute malnutrition among children under-five. The analysis used a decision tree model to compare the costs and effects of two options to treat severe acute malnutrition: existing health services with CMAM vs existing health services without CMAM. The model used outcome and cost data from a CMAM programme in Dowa district, Malawi and a set of key assumptions regarding treatment-seeking behaviour and mortality outcomes. Under our 'base case' scenario, we found that CMAM cost US$42 per disability-adjusted life year (DALY) averted (2007 US$) and US$493 per DALY averted under an assumed 'worst case' scenario for each variable. The results suggest that CMAM was highly cost-effective in the 'base case' as defined by the World Health Organization, as the cost per DALY falls well below Malawi's 2007 gross national income (GNI) per capita of US$250, and is within the range of DALYs reported for other child health interventions. Under a hypothetical 'worst case' for all variables, the model indicates CMAM is still cost-effective. The results indicate the decision to scale-up CMAM within essential health services in Dowa was a cost-effective one and that scaling up CMAM in similar contexts is also likely to be cost-effective. However, several contextual and programmatic factors should be considered when generalizing to diverse contexts.

SEROLOGIC SURVEY OF SELECTED CANINE PATHOGENS AMONG FREE-RANGING JACKALS IN KENYA
Kathleen A. Alexander, Pieter W. Kat, Robert K. Wayne, Todd K. Fuller
1994· Journal of Wildlife Diseases99doi:10.7589/0090-3558-30.4.486

Serum samples from 76 free-ranging adult jackals of three species from four localities in Kenya were examined for circulating antibodies against four canine pathogens: rabies virus, canine parvovirus (CPV-2), canine distemper virus (CDV), and Ehrlichia canis. Samples were collected between April 1987 and January 1988. Among black-backed jackals (Canis mesomelas), the most sampled species, the mean prevalence of antibodies to CPV-2, CDV, rabies virus, and E. canis was 34% (14 positive/55 sampled), 9% (4/55), 3% (1/28), and 2% (1/36), respectively. There were no significantly differences among sampling locations. In one area, antibody prevalence of CPV-2 was significantly higher for golden jackals (C. aureus; 9/16) than for C. mesomelas (5/26). Only three side-striped jackals (C. adustus) were sampled, but antibodies to CPV-2 and CDV were present. As jackals often are the most abundant wild carnivore in African ecosystems, they could serve as an important indicator species to monitor the potential of exposure of rare and endangered canids to specific canine diseases.