The Impact of Water, Sanitation, and Hygiene on Key Health and Social Outcomes: Review of Evidence

This evidence paper looks at 10 areas identified collaboratively with the United Nations Children's Fund (UNICEF) on which WASH can plausibly have a strong impact: diarrhea, nutrition, complementary food hygiene, female psychosocial stress, violence, maternal and newborn health, menstrual hygiene management, school attendance, oral vaccine performance, and neglected tropical diseases. Together, these areas cover the most significant sector outcomes associated with the distinct life course phases that UNICEF seeks to help to address through its WASH activities

Breast support garments are ineffective at reducing breast motion during an aqua aerobics jumping exercise

The buoyant forces of water during aquatic exercise may provide a form of ‘natural’ breast support and help to minimise breast motion and alleviate exercise induced breast pain. Six larger-breasted females performed standing vertical land and water-based jumps, whilst wearing three breast support conditions. Underwater video cameras recorded the motion of the trunk and right breast. Trunk and relative breast kinematics were calculated as well as exercised induced breast pain scores. Key results showed that the swimsuit and sports bra were able to significantly reduce the superioinferior breast range of motion by 0.04 and 0.05 m, respectively, and peak velocity by 0.23 and 0.33 m/s, respectively, during land-based jumping when compared to the bare-breasted condition, but were ineffective at reducing breast kinematics during water-based jumping. Furthermore, the magnitude of the swimsuit superioinferior breast range of motion during water-based jumping was significantly greater than land-based jumping (0.13 m and 0.06 m), yet there were no significant differences in exercise induced breast pain, thus contradicting previously published relationships between these parameters on land. Furthermore, the addition of an external breast support garment was able to reduce breast kinematics on land but not in water, suggesting the swimsuit and sports bras were ineffective and improvements in swimwear breast support garments may help to reduce excessive breast motion during aqua aerobic jumping exercises

Acute changes in clinical breast measurements following bra removal:implications for surgical practice

AbstractBackgroundStable measurement of breast position is crucial for objective pre-operative planning and post-operative evaluation. In clinical practice, breast measures are often taken immediately following bra removal. However, research shows that restrictive clothing (such as a bra) can cause acute anatomical changes, leading to the hypothesis that clinical breast measures may change over time following bra removal. This cross-sectional observational study aimed to provide simple clinical guidelines for the measurement of breast position which account for any acute changes in breast position following bra removal.MethodsThirteen participants of varying breast sizes had markers attached to their thorax and nipples to determine clinical measures of sternal notch to nipple distance, internipple distance, breast projection, and vertical nipple position. The positions of these landmarks were recorded using a motion capture system during 10 min of controlled sitting following bra removal.ResultsInternipple distance and breast projection remained unchanged over 10 min, while the resultant sternal notch to nipple distance extended by 2.8 mm in 299 s (right) and 3.7 mm in 348 s (left). The greatest change occurred in the vertical nipple position, which migrated an average of 4.1 mm in 365 s (right) and 6.6 mm in 272 s (left), however, for one participant vertical migration was up to 20 mm.ConclusionsInternipple distance and breast projection can be measured first following bra removal, followed by sternal notch to nipple distance, any measures associated with the vertical nipple position should be made more than 6 min after bra removal. These guidelines have implications for breast surgery, particularly for unilateral reconstruction based on the residual breast position

Variable Selection in Additive Models by Nonnegative Garrote

We adapt Breiman's (1995) nonnegative garrote method to perform variable selection in nonparametric additive models. The technique avoids methods of testing for which no reliable distributional theory is available. In addition it removes the need for a full search of all possible models, something which is computationally intensive, especially when the number of variables is moderate to high. The method has the advantages of being conceptually simple and computationally fast. It provides accurate predictions and is effective at identifying the variables generating the model. For illustration, we consider both a study of Boston housing prices as well as two simulation settings. In all cases our methods perform as well or better than available alternatives like the Component Selection and Smoothing Operator (COSSO).cross-validation, nonnegative garrote, nonparametric regression, shrinkage methods, variable selection

Longitudinal variable selection by cross-validation in the case of many covariates

Longitudinal models are commonly used for studying data collected on individuals repeatedly through time. While there are now a variety of such models available (Marginal Models, Mixed Effects Models, etc.), far fewer options appear to exist for the closely related issue of variable selection. In addition, longitudinal data typically derive from medical or other large-scale studies where often large numbers of potential explanatory variables and hence even larger numbers of candidate models must be considered. Cross-validation is a popular method for variable selection based on the predictive ability of the model. Here, we propose a cross-validation Markov Chain Monte Carlo procedure as a general variable selection tool which avoids the need to visit all candidate models. Inclusion of a “one-standard error” rule provides users with a collection of good models as is often desired. We demonstrate the effectiveness of our procedure both in a simulation setting and in a real application.