MOBILE HEALTH AND ITS ROLE IN ADDRESSING MATERNAL HEALTH IN SUB-SAHARAN AFRICA

ABSTRACT Background: In the last 10-15 years, mobile health (mHealth) interventions have generated considerable interest as tools for sustainable development in the global health sector as well as to improve access to care for remotely isolated populations in Sub-Saharan Africa. This paper explores existing literature on mHealth for clinical data collection for maternal health, discusses some of its benefits and challenges, and addresses mHealth’s limitations, such as 1) inadequate monitoring and evaluation framework; (2) inability for project scalability; and (3) lack of partnerships that are unsustainable and inclusive of all stakeholders. Although the healthcare sector acknowledges the potential benefits of mHealth, there should be further efforts to address these limitations. Methods: Initially, literature reviews were conducted to gain general knowledge about mHealth in Sub-Saharan Africa. After the literature review, 4 interviews with global health professionals working in global health consulting organizations in Boston were interviewed to gain further insight from those directly involved in mHealth projects. Results/Findings: Based on the interviews, it was determined that mHealth project scalability, local and external international partnership, and monitoring and evaluation framework are aspects requiring further investigation before integrating mHealth within a larger national healthcare system in a country in Sub-Saharan Africa. Conclusions: mHealth should be implemented with the intention of incorporating it into existing national health systems rather than as an external supplement. If stakeholders show interest in nationalizing mHealth interventions, project partnership, monitoring and evaluation framework, and project scalability should be give greater attention

What do we mean by 'older adults' persistent pain self-management'? A concept analysis.

Background: No standard definition exists for the concept “persistent pain self-management” or how it should be defined in relation to older adults. Poorly defined concepts can result in misunderstandings in the clinical setting and can hinder research through difficulties identifying or measuring the concept. Objective: To ascertain attributes, referents, antecedents, and consequences of the concept older adults' persistent pain self-management and develop a theoretical definition. Design: Rodgers evolutionary model of concept analysis was used to systematically analyze articles from the academic and grey literature (N = 45). Data were extracted using standardized extraction forms and analyzed using thematic analysis. Findings: This concept was discussed in three ways: as an intervention, in reference to everyday behaviors, and as an outcome. Five defining attributes were identified: multidimensional process, personal development, active individuals, symptom response, and symptom control. Patients' perceived need and ability to manage pain with support from others is necessary for pain self-management to occur. Numerous physical, psychological, and social health consequences were identified. A theoretical definition is discussed. Conclusions: Our findings have clarified existing use and understanding regarding the concept of older adults' persistent pain self-management. We have identified three areas for future development: refinement of the attributes of this concept within the context of older adults, an exploration of how providers can overcome difficulties supporting older adults' persistent pain self-management, and a clarification of the overall theoretical framework of older adults' persistent pain self-management

Comparison between variable flavor number schemes for charm quark electroproduction

Where appropriate, the abbreviation 'VFNS' is replaced by 'CSN' to indicate the scheme using massive heavy quark coefficient functions proposed in this paper. The text below Eq. (2.13) and between Eqs. (2.33) and (2.36) has been considerably changed.Comment: 64 pages, LaTeX, 16 Postscript figure

Yet Another Extension of the Standard Model: Oases in the Desert?

We have searched for conceptually simple extensions of the standard model, and describe here a candidate model which we find attractive. Our starting point is the assumption that off-diagonal CKM mixing matrix elements are directly related by lowest order perturbation theory to the quark mass matrices. This appears to be most easily and naturally implemented by assuming that all off-diagonal elements reside in the down-quark mass matrix. This assumption is in turn naturally realized by introducing three generations of heavy, electroweak-singlet down quarks which couple to the Higgs sector diagonally in flavor, while mass-mixing off-diagonally with the light down-quarks. Anomaly cancellation then naturally leads to inclusion of electroweak vector-doublet leptons. It is then only a short step to completing the extension to three generations of fundamental representations of E(6). Assuming only that the third generation B couples to the Higgs sector at least as strongly as does the top quark, the mass of the B is roughly estimated to lie between 1.7 TeV and 10 TeV, with lower-generation quarks no heavier. The corresponding guess for the new leptons is a factor two lower. Within the validity of the model, flavor and CP violation are ``infrared'' in nature, induced by semi-soft mass mixing terms, not Yukawa couplings. If the Higgs couplings of the new quarks are flavor symmetric, then there necessarily must be at least one ``oasis'' in the desert, induced by new radiative corrections to the top quark and Higgs coupling constants, and roughly at 1000 TeV.Comment: LaTex, 40 page

Dynamical parton distributions of the nucleon and very small-x physics

Utilizing recent DIS measurements (F_{2,L}) and data on dilepton and high-E_{T} jet production we determine the dynamical parton distributions of the nucleon generated radiatively from valence-like positive input distributions at optimally chosen low resolution scales. These are compared with `standard' distributions generated from positive input distributions at some fixed and higher resolution scale. It is shown that up to the next to leading order NLO(\bar{MS}, DIS) of perturbative QCD considered in this paper, the uncertainties of the dynamical distributions are, as expected, smaller than those of their standard counterparts. This holds true in particular in the presently unexplored extremely small-x region relevant for evaluating ultrahigh energy cross sections in astrophysical applications. It is noted that our new dynamical distributions are compatible, within the presently determined uncertainties, with previously determined dynamical parton distributions.Comment: 21 pages, 2 tables, 16 figures, v2: added Ref.[60], replaced Fig.

Dark Force Detection in Low Energy e-p Collisions

We study the prospects for detecting a light boson X with mass m_X < 100 MeV at a low energy electron-proton collider. We focus on the case where X dominantly decays to e+ e- as motivated by recent "dark force" models. In order to evade direct and indirect constraints, X must have small couplings to the standard model (alpha_X 10 MeV). By comparing the signal and background cross sections for the e- p e+ e- final state, we conclude that dark force detection requires an integrated luminosity of around 1 inverse attobarn, achievable with a forthcoming JLab proposal.Comment: 38 pages, 19 figures; v2, references adde

Complete Next to Leading Order QCD Corrections to the Photon Structure Functions F2γ(x,Q2)F^\gamma_2(x,Q^2) and FLγ(x,Q2)F_L^\gamma(x,Q^2)

We present the complete NLO QCD analysis of the photon structure functions $F_2^\gamma(x,Q^2)$ and $F_L^\gamma(x,Q^2)$ for a real photon target. In particular we study the heavy flavor content of the structure functions which is due to two different production mechanisms, namely collisions of a virtual photon with a real photon, and with a parton. We observe that the charm contributions are noticeable for $F_2^\gamma(x,Q^2)$ as well as $F_L^\gamma(x,Q^2)$ in the x-region studied.Comment: Latex 34 pages, 24 figures, uuencoded, attached at end, ITP-SB-93-46, FERMILAB-Pub-93/240-T, SMU HEP 93-1