Burden of maternal bipolar disorder on at-risk offspring: A controlled study on family planning and maternal care

Introduction: Bipolar disorder (BD) is a highly incapacitating disease typically associated with high rates of familial dysfunction. Despite recent literature suggesting that maternal care is an important environmental factor in the development of behavioral disorders, it is unclear how much maternal care is dysfunctional in BD subjects. Objective: The objective of this study was to characterize maternal care in DSM-IV/SCID diagnosed BD type I subjects compared to healthy controls with (PD) and without (NPD) other psychiatric diagnoses. Materials and methods: Thirty-four BD mothers and 106 controls underwent an interview about family planning and maternal care, obstetrical complications, and mother-child interactions. K-SADS-PL questions about violence exposure were used to ascertain domestic violence and physical/sexual abuse. Results: BD mothers were less likely to have stable unions (45.5%; p < 0.01) or to live with the biological father of their children (33.3%; p < 0.01), but had higher educational level and higher rates of social security use/retirement. They also had fewer children and used less contraceptive methods than controls. Children of BD women had higher rates of neonatal anoxia, and reported more physical abuse (16.1%; p = 0.02) than offspring of NPD mothers. Due to BD mothers' symptoms, 33.3% of offspring suffered physical and/or psychological abuse. Limitations: Post hoc analysis, and the use of questions as a surrogate of symptoms as opposed to validated instruments. Conclusion: This is one of few reports confirming that maternal care given by BD women is dysfunctional. BD psychopathology can lead to poor maternal care and both should be considered important environmental risk factors in BD, suggesting that BD psychoeducation should include maternal care orientation. (C) 2012 Elsevier B.V. All rights reserved.

Assessing Commonality and Differentiation for Packaging-Family Planning with Application to Medication Labels

This thesis presents a metric for assessing the commonality and differentiation of packaging-family planning with application to medical labels along with supporting background research and findings. Consumable products such as medications rely on the package or label to represent the contents. Package confusion has been widely recognized as a major problem for both over-the-counter and pharmacy-dispensed medications with potentially lethal consequences. It is critical to identify a medication as a member of a product family and differentiate its contributing elements based on visual features on the package or label to avoid consumer confusion and reduce dispensing errors. Indices that indicate degrees of commonality and differentiation of features in consumer products such as batteries, light bulbs, handles, etc for platforms have been shown to benefit development of engineered product families [6]. It is possible to take a similar approach for visual features in packaging such as typography, shape/form, imagery and color to benefit packaging-family development. This thesis establishes a commonality differentiation index for prominence of visual features on over-the-counter and pharmacy-dispensed medications based on occurrence, size, and location of features. It provides a quantitative measure to assist package designers in evaluating alternatives to satisfy strategic goals and improve safety. The index is demonstrated with several medications that have been identified by the Institute for Safe Medication Practice as commonly confused.

The influence of ideological interest groups on congressional financial support of international family planning

The World Health Organization estimates there are about 585,000 maternal deaths each year, with 98% of the maternal deaths in developing countries. Access to family planning methods is one method to decrease maternal mortality and morbidity. ^ The U.S. was the leader in providing financial and technical assistance to developing countries to enable women to have this access. The election of Ronald Regan changed the course of U.S. support; abortion became a central factor in the political decision-making with regards to the financial support of international family planning. ^ One factor that may sway policy-makers' decisions is the influence of ideological interest groups, Political Action Committees funding of candidates in relation to votes on bills that impacted on financial support of international family planning and the amount spent by these groups on lobbyist was reviewed. Pro-choice funding of candidates was greater for the four of the fives votes supporting family planning. Pro-Choice lobbyist spending was $185,000 vs. $8,184,000 spent by Pro-Life ideological groups. ^

Relationship between dietary patterns and body mass index in Hispanic children ages 4--19 years of age

Background. In over 30 years, the prevalence of overweight for children and adolescents has increased across the United States (Barlow et al., 2007; Ogden, Flegal, Carroll, & Johnson, 2002). Childhood obesity is linked with adverse physiological and psychological issues in youth and affects ethnic/minority populations in disproportionate rates (Barlow et al., 2007; Butte et al., 2006; Butte, Cai, Cole, Wilson, Fisher, Zakeri, Ellis, & Comuzzie, 2007). More importantly, overweight in children and youth tends to track into adulthood (McNaughton, Ball, Mishra, & Crawford, 2008; Ogden et al., 2002). Childhood obesity affects body functions such as the cardiovascular, respiratory, gastrointestinal, and endocrine systems, including emotional health (Barlow et al., 2007, Ogden et al., 2002). Several dietary factors have been associated with the development of obesity in children; however, these factors have not been fully elucidated, especially in ethnic/minority children. In particular, few studies have been done to determine the effects of different meal patterns on the development of obesity in children. Purpose. The purpose of the study is to examine the relationships between daily proportions of energy consumed and energy derived from fat across breakfast, lunch, dinner, and snack, and obesity among Hispanic children and adolescents. Methods. A cross-sectional design was used to evaluate the relationship between dietary patterns and overweight status in Hispanic children and adolescents 4-19 years of age who participated in the Viva La Familia Study. The goal of the Viva La Familia Study was to evaluate genetic and environmental factors affecting childhood obesity and its co-morbidities in the Hispanic population (Butte et al., 2006, 2007). The study enrolled 1030 Hispanic children and adolescents from 319 families and examined factors related to increased body weight by focusing on a multilevel analysis of extensive sociodemographic, genetic, metabolic, and behavioral data. Baseline dietary intakes of the children were collected using 24-hour recalls, and body mass index was calculated from measured height and weight, and classified using the CDC standards. Dietary data were analyzed using a GEE population-averaged panel-data model with a cluster variable family identifier to include possible correlations within related data sets. A linear regression model was used to analyze associations of dietary patterns using possible covariates, and to examine the percentage of daily energy coming from breakfast, lunch, dinner, and snack while adjusting for age, sex, and BMI z-score. Random-effects logistic regression models were used to determine the relationship of the dietary variables with obesity status and to understand if the percent energy intake (%EI) derived from fat from all meals (breakfast, lunch, dinner, and snacks) affected obesity. Results. Older children (age 4-19 years) consumed a higher percent of energy at lunch and dinner and less percent energy from snacks compared to younger children. Age was significantly associated with percentage of total energy intake (%TEI) for lunch, as well as dinner, while no association was found by gender. Percent of energy consumed from dinner significantly differed by obesity status, with obese children consuming more energy at dinner (p = 0.03), but no associations were found between percent energy from fat and obesity across all meals. Conclusions. Information from this study can be used to develop interventions that target dietary intake patterns in obesity prevention programs for Hispanic children and adolescents. In particular, intervention programs for children should target dietary patterns with energy intake that is spread throughout the day and earlier in the day. These results indicate that a longitudinal study should be used to further explore the relationship of dietary patterns and BMI in this and other populations (Dubois et al., 2008; Rodriquez & Moreno, 2006; Thompson et al., 2005; Wilson et al., in review, 2008). ^

THE IMPLEMENTATION OF FEDERAL FAMILY PLANNING POLICY: AN ANALYSIS OF FACTORS AFFECTING STATE EXPENDITURES, FISCAL YEARS 1976-1981 (WOMEN, BUDGET, POPULATION)

The purpose of this study was to analyze the implementation of national family planning policy in the United States, which was embedded in four separate statutes during the period of study, Fiscal Years 1976-81. The design of the study utilized a modification of the Sabatier and Mazmanian framework for policy analysis, which defined implementation as the carrying out of statutory policy. The study was divided into two phases. The first part of the study compared the implementation of family planning policy by each of the pertinent statutes. The second part of the study identified factors that were associated with implementation of federal family planning policy within the context of block grants.^ Implemention was measured here by federal dollars spent for family planning, adjusted for the size of the respective state target populations. Expenditure data were collected from the Alan Guttmacher Institute and from each of the federal agencies having administrative authority for the four pertinent statutes, respectively. Data from the former were used for most of the analysis because they were more complete and more reliable.^ The first phase of the study tested the hypothesis that the coherence of a statute is directly related to effective implementation. Equity in the distribution of funds to the states was used to operationalize effective implementation. To a large extent, the results of the analysis supported the hypothesis. In addition to their theoretical significance, these findings were also significant for policymakers insofar they demonstrated the effectiveness of categorical legislation in implementing desired health policy.^ Given the current and historically intermittent emphasis on more state and less federal decision-making in health and human serives, the second phase of the study focused on state level factors that were associated with expenditures of social service block grant funds for family planning. Using the Sabatier-Mazmanian implementation model as a framework, many factors were tested. Those factors showing the strongest conceptual and statistical relationship to the dependent variable were used to construct a statistical model. Using multivariable regression analysis, this model was applied cross-sectionally to each of the years of the study. The most striking finding here was that the dominant determinants of the state spending varied for each year of the study (Fiscal Years 1976-1981). The significance of these results was that they provided empirical support of current implementation theory, showing that the dominant determinants of implementation vary greatly over time. ^

Packages of interventions for family planning, safe abortion care, maternal, newborn and child health

The evidence shows that high maternal, perinatal, neonatal and child mortality rates are associated with inadequate and poor quality health services. Evidence also suggests that explicit, evidence-based, cost effective packages of interventions can improve the processes and outcomes of health care when appropriately implemented. This document describes the key effective interventions organized in packages across the continuum of care through pre-pregnancy, pregnancy, childbirth, postpartum, newborn care and care of the child. The packages are defined for community and/or facility levels in developing countries and provide guidance on the essential components needed to assure adequacy and quality of care

Knowledge-action integration through the media in indigenous communities in Ecuador

The binomial knowledge/action understood under the biunivocal relationship of both components is the basis of planning from a postmodern approach. Within this binomial, social communication gives appropriate information, nurtures the knowledge that leads to transformative action, promotes participation and enhances the community?s self-esteem and recognition; to deeply reflect on action is a source of new knowledge; and communication fosters the adoption of the new knowledge by the community with new actions that feed the process knowledge/action as a planning source. From this approach the project Radio Message is born as a new communication channel with the aim of offering Andean indigenous communities from the area of Cayambe (Ecuador), a series of multidisciplinary training programs that enable transformative action with a strong effect on the life quality in these communities and their importance as social actors. The contents are designed through participatory communication between the training authorities and the communities themselves, analyzing their opportunities and needs. In this research the impact of social media in the development of more than 100 indigenous communities in Cayambe is analyzed.

The role of authenticity in tourism planning: empirical findings from southeast Spain

Tourism is the main economic activity in many towns in the province of Alicante in southeast Spain and has turned this area into a paradigmatic example of mass tourism on the Mediterranean coast. Since the 1960s, the province's coastal towns have opted for a development model centred on what is known as 'residential tourism' or 'second-home tourism', with few exceptions, such as Benidorm. We wish to put forward the argument that the main social agents in the tourism sector have not perceived the 'search for authenticity' as a factor that may attract tourists to this area. To this end, we will start by reviewing critically the theoretical discourse about the role played by authenticity in the motivation of tourists. Then we will discuss some of the results obtained from empirical, qualitative research that included 37 in-depth interviews. As a guide for our empirical research, we use a model based on the stakeholder theory. The epistemological difficulties faced by researchers do not justify certain critical arguments that try to highlight the impossibility of operationalising essential concepts and approaches such as that of authenticity. Therefore, it is necessary that empirical research continues to delve into the sociological keys that determine the 'search for authenticity' in the tourists' experience.

Beyond megaprojects?. Water alternatives for mass tourism in coastal Mediterranean Spain

Water availability in adequate quantities and qualities is a fundamental requirement for tourism. In the Mediterranean, one of the world’s leading tourist destinations, water availability is subject to modest and erratic precipitation figures which may decline with climate change. The tourist industry therefore may have to assure future supplies by either recurring to new technologies such as desalination or increasing efficiency in water use. A third and yet little explored alternative would be to seek for complementary of uses with irrigation, the traditional user in many coastal Mediterranean areas and holder of substantial amounts of water. In this paper we present the example of the Consorcio de Aguas de la Marina Baja to show how Benidorm, in Mediterranean Spain and one of the most important tourist centers of the Mediterranean, obtains part of its water through agreements with farmers by which these trade their water with Benidorm and other towns’ treated wastewater of enough quality to be used for irrigation, and obtain several compensations in return. The advantages and disadvantages of the water trade between farmers and tourist interests in the Benidorm area are discussed and we argue that solutions to the pending water crisis of many coastal Mediterranean tourist areas may not need to rely uniquely on expensive technologies to generate new resources but may attempt other alternatives.

A Construction Management Framework for Mass Customisation in Traditional Construction

A Mass Customisation model is discussed as a competitive positioning strategy in the marketplace adding value to the customer’s end-use. It includes the user as part of the construction process responding to the customer’s demands and wishes. To the present day, almost all proposals for Mass Customisation have been focused on the design phase and single family houses. The reality is that the processes carried out in the work execution are so inefficient that the costs of the Mass Customisation models are assumed by the customer and they do not offer solutions that support the change management. Furthermore, this inefficiency often makes Mass Customisation unfeasible in terms of deadlines and site management. Therefore, the present proposal focuses on achieving the paradigm of Mass Customisation in the traditional residential construction complementary to the existing proposals in the design phase. All this through the proposal of a framework for the integral management in the work execution, which will address change management introduced by the users offering an efficient and productive model that reduces costs in the process. This model will focus on the synergy between different strategies, techniques and technologies currently used in the construction management (such as Lean Construction or Six Sigma), together with, other strategies and technologies that have proven to be valid solutions in other fields (such as Business Process Management, Service Oriented Architecture, etc.).

Family planning methods and practice : Africa.

Item 504

The new mass media; challenge to a free society.

Includes bibliography.

Cost-effectiveness of mass media communications as related to highway safety.

National Highway Safety Bureau, Washington, D.C.

The Role of women in family transportation behavior : final report /

"This report is based on Teresa Bayes' and Sandra Hough's masters theses ... "--Pref.