Evaluation a Community Maternal Health Programme: Lessons Learnt

Abstract Using the example of a community-based health promotion intervention, this paper explores the important triangle between health promotion theory, intervention design, and evaluation research. This paper first outlines the intervention and then the mixed-method evaluation. In 2007, a non-governmental organisation (NGO) designed and implemented an intervention to improve the uptake of maternal health provision in rural Nepal. A community-based needs assessment preceded this novel health-promotion intervention that empowered women with information on the benefits of seeking care. The intervention had a flexible design and, at several points, the intervention’s progress was assessed and, where necessary, changes were made. The intervention targeted women of childbearing age and people (e.g. mothers-in-law and husbands) who influence these women’s ability to access health services. The intervention attempted to incorporate the diverse and changing needs of the local communities to make it more culturally appropriate (e.g. around traditions and beliefs linked to caste/ethnicity and socio-economic status) and to make the best of the existing resources whether these belong to the government or other NGOs. The research aimed to assess whether the planned health promotion activities improved maternal health service uptake. Greater access to maternal care should result in fewer women suffering from complications during childbirth, especially when complications are detected earlier and dealt with by skilled birth attendants. One key assumption was that health promotion would help improve knowledge, attitudes, and beliefs towards seeking care, especially during pregnancy complications. The programme ran for six years with the final evaluation in 2012

In-Situ Infrared Transmission Study of Rb- and K-Doped Fullerenes

We have measured the four IR active $C_{60}$ molecular vibrations in $M_{x}C_{60}$ $(M = K, Rb)$ as a function of doping $x$. We observe discontinuous changes in the vibrational spectra showing four distinct phases (presumably $x = 0, 3, 4$, and 6). The $1427cm^{-1}$ and $576cm^{-1}$ modes show the largest changes shifting downward in frequency in four steps as the doping increases. Several new very weak modes are visible in the $x=6$ phase and are possibly Raman modes becoming weakly optically active. We present quantitative fits of the data and calculate the electron-phonon coupling of the $1427cm^{-1}$ IR mode.Comment: 3 pages, Figure 1 included, 3 more figures available by request. REVTEX v3.0 IRC60DO

Structure and properties of a novel fulleride Sm6C60

A novel fulleride Sm6C60 has been synthesized using high temperature solid state reaction. The Rietveld refinement on high resolution synchrotron X-ray powder diffraction data shows that Sm6C60 is isostructural with body-centered cubic A6C60 (A=K, Ba). Raman spectrum of Sm6C60 is similar to that of Ba6C60, and the frequencies of two Ag modes in Sm6C60 are nearly the same as that of Ba6C60, suggesting that Sm is divalent and hybridization between C60 molecules and the Sm atom could exist in Sm6C60. Resistivity measurement shows a weak T-linear behavior above 180 K, the transport at low temperature is mainly dominated by granular-metal theory.Comment: 9 pages, 3 figures, submitted to Phys. Rev. B (March 12, 1999

The Value of Information for Populations in Varying Environments

The notion of information pervades informal descriptions of biological systems, but formal treatments face the problem of defining a quantitative measure of information rooted in a concept of fitness, which is itself an elusive notion. Here, we present a model of population dynamics where this problem is amenable to a mathematical analysis. In the limit where any information about future environmental variations is common to the members of the population, our model is equivalent to known models of financial investment. In this case, the population can be interpreted as a portfolio of financial assets and previous analyses have shown that a key quantity of Shannon's communication theory, the mutual information, sets a fundamental limit on the value of information. We show that this bound can be violated when accounting for features that are irrelevant in finance but inherent to biological systems, such as the stochasticity present at the individual level. This leads us to generalize the measures of uncertainty and information usually encountered in information theory

Interaction of quasilocal harmonic modes and boson peak in glasses

The direct proportionality relation between the boson peak maximum in glasses, $\omega_b$, and the Ioffe-Regel crossover frequency for phonons, $\omega_d$, is established. For several investigated materials $\omega_b = (1.5\pm 0.1)\omega_d$. At the frequency $\omega_d$ the mean free path of the phonons $l$ becomes equal to their wavelength because of strong resonant scattering on quasilocal harmonic oscillators. Above this frequency phonons cease to exist. We prove that the established correlation between $\omega_b$ and $\omega_d$ holds in the general case and is a direct consequence of bilinear coupling of quasilocal oscillators with the strain field.Comment: RevTex, 4 pages, 1 figur

Mott Transition in Degenerate Hubbard Models: Application to Doped Fullerenes

The Mott-Hubbard transition is studied for a Hubbard model with orbital degeneracy N, using a diffusion Monte-Carlo method. Based on general arguments, we conjecture that the Mott-Hubbard transition takes place for U/W \propto \sqrt{N}, where U is the Coulomb interaction and W is the band width. This is supported by exact diagonalization and Monte-Carlo calculations. Realistic parameters for the doped fullerenes lead to the conclusion that stoichiometric A_3 C_60 (A=K, Rb) are near the Mott-Hubbard transition, in a correlated metallic state.Comment: 4 pages, revtex, 1 eps figure included, to be published in Phys.Rev.B Rapid Com

Design, Commissioning and Performance of the PIBETA Detector at PSI

We describe the design, construction and performance of the PIBETA detector built for the precise measurement of the branching ratio of pion beta decay, pi+ -> pi0 e+ nu, at the Paul Scherrer Institute. The central part of the detector is a 240-module spherical pure CsI calorimeter covering 3*pi sr solid angle. The calorimeter is supplemented with an active collimator/beam degrader system, an active segmented plastic target, a pair of low-mass cylindrical wire chambers and a 20-element cylindrical plastic scintillator hodoscope. The whole detector system is housed inside a temperature-controlled lead brick enclosure which in turn is lined with cosmic muon plastic veto counters. Commissioning and calibration data were taken during two three-month beam periods in 1999/2000 with pi+ stopping rates between 1.3*E3 pi+/s and 1.3*E6 pi+/s. We examine the timing, energy and angular detector resolution for photons, positrons and protons in the energy range of 5-150 MeV, as well as the response of the detector to cosmic muons. We illustrate the detector signatures for the assorted rare pion and muon decays and their associated backgrounds.Comment: 117 pages, 48 Postscript figures, 5 tables, Elsevier LaTeX, submitted to Nucl. Instrum. Meth.

The uses and abuses of power: teaching school leadership through children's literature

There are relatively few studies of how representations of teachers, schools and educational administrators in popular films and television might be, and are, used in leadership preparation. This paper seeks to add to this small body of work; it reports on an exploratory study of the representation of headteachers in contemporary children's fiction. Thirty-one texts are analysed to ascertain key themes and the major characterisations. The paper draws on children's literature scholars to argue that both the historical school story and its contemporary counterpart focus heavily on the power of the head to control the micro-world of the school. Because these fictional accounts deal with issues of power and justice more openly than many mainstream educational administration texts, this makes them particularly useful in the preparation of potential school leaders

Customer emotions in service failure and recovery encounters

Emotions play a significant role in the workplace, and considerable attention has been given to the study of employee emotions. Customers also play a central function in organizations, but much less is known about customer emotions. This chapter reviews the growing literature on customer emotions in employee–customer interfaces with a focus on service failure and recovery encounters, where emotions are heightened. It highlights emerging themes and key findings, addresses the measurement, modeling, and management of customer emotions, and identifies future research streams. Attention is given to emotional contagion, relationships between affective and cognitive processes, customer anger, customer rage, and individual differences

Global surveillance of cancer survival 1995-2009: analysis of individual data for 25,676,887 patients from 279 population-based registries in 67 countries (CONCORD-2)

BACKGROUND: Worldwide data for cancer survival are scarce. We aimed to initiate worldwide surveillance of cancer survival by central analysis of population-based registry data, as a metric of the effectiveness of health systems, and to inform global policy on cancer control. METHODS: Individual tumour records were submitted by 279 population-based cancer registries in 67 countries for 25·7 million adults (age 15-99 years) and 75,000 children (age 0-14 years) diagnosed with cancer during 1995-2009 and followed up to Dec 31, 2009, or later. We looked at cancers of the stomach, colon, rectum, liver, lung, breast (women), cervix, ovary, and prostate in adults, and adult and childhood leukaemia. Standardised quality control procedures were applied; errors were corrected by the registry concerned. We estimated 5-year net survival, adjusted for background mortality in every country or region by age (single year), sex, and calendar year, and by race or ethnic origin in some countries. Estimates were age-standardised with the International Cancer Survival Standard weights. FINDINGS: 5-year survival from colon, rectal, and breast cancers has increased steadily in most developed countries. For patients diagnosed during 2005-09, survival for colon and rectal cancer reached 60% or more in 22 countries around the world; for breast cancer, 5-year survival rose to 85% or higher in 17 countries worldwide. Liver and lung cancer remain lethal in all nations: for both cancers, 5-year survival is below 20% everywhere in Europe, in the range 15-19% in North America, and as low as 7-9% in Mongolia and Thailand. Striking rises in 5-year survival from prostate cancer have occurred in many countries: survival rose by 10-20% between 1995-99 and 2005-09 in 22 countries in South America, Asia, and Europe, but survival still varies widely around the world, from less than 60% in Bulgaria and Thailand to 95% or more in Brazil, Puerto Rico, and the USA. For cervical cancer, national estimates of 5-year survival range from less than 50% to more than 70%; regional variations are much wider, and improvements between 1995-99 and 2005-09 have generally been slight. For women diagnosed with ovarian cancer in 2005-09, 5-year survival was 40% or higher only in Ecuador, the USA, and 17 countries in Asia and Europe. 5-year survival for stomach cancer in 2005-09 was high (54-58%) in Japan and South Korea, compared with less than 40% in other countries. By contrast, 5-year survival from adult leukaemia in Japan and South Korea (18-23%) is lower than in most other countries. 5-year survival from childhood acute lymphoblastic leukaemia is less than 60% in several countries, but as high as 90% in Canada and four European countries, which suggests major deficiencies in the management of a largely curable disease. INTERPRETATION: International comparison of survival trends reveals very wide differences that are likely to be attributable to differences in access to early diagnosis and optimum treatment. Continuous worldwide surveillance of cancer survival should become an indispensable source of information for cancer patients and researchers and a stimulus for politicians to improve health policy and health-care systems