Challenging Global Advocacy of Biomedical Institution-Based Birth in Nepal: A Review with Reference to Nepal and South Asia

Based on findings from public health, demographic, and anthropological research, this review discusses biomedical institution-based birth in Nepal, in the process asserting that better understanding of maternal health determinants requires biomedical strategies be balanced with greater attention to local social realities and approaches. The paper begins with a summary of evolving international maternal health policies and their manifestations in Nepal, then discusses how recent public health research there indicates existing community support structures, including women’s groups, to have had demonstrably positive impacts on maternal health. The subject of women’s reproductive agency is subsequently considered. While public health and development-based research often equates this to women’s decision-making ability, I draw here upon anthropological examples from the broader South Asian context to reveal a more nuanced appreciation of agency, illuminating the many shifting forces influencing women’s use of available maternal health resources. A case study based on a short piece of ethnographic research I carried out in Nepal in 2011 follows. Findings from this provide further evidence of the significance and positive effects of community networks and groups in maternal health outcomes; they also reflect aspects of the foregoing discussion of agency. Overall, the case made here is that an important and growing body of research exists, which challenges dominant views within international public health—and actively promoted by the Nepali state—that biomedically-managed, institution-based births are the most effective means to reduce maternal mortality. Thus suggest further research, that incorporates ethnographic explorations of Nepali women’s agency in maternal health matters (including impact upon birth outcomes) is needed if more appropriate pregnancy and childbirth-related measures are to be enacted going forwards

Necessity Is the Mother of Invention: How Minimum Wages Affect Innovation

This master's thesis investigates the impact of minimum wages on innovation in the United States. I construct a panel dataset with minimum wages and patent production across US states between 1983 and 2015. My estimates are based on a difference-in-differences approach that exploits the different timing of minimum wage raises across US states and the fact that federal minimum wage is not inflation adjusted. Two-way fixed-effects' estimates suggest that a 1 USD increase in the minimum wage is associated with approximately a 9 percent increase in patent production. Accounting for heterogeneous treatment effects suggests that this effect is potentially larger. Altogether, my results provide support for the Habakkuk thesis that labor scarcity encourages technological innovation. It also provides insights into recent debates surrounding the causes of automation as well as calls for the minimum wage to be raised in the United States.MasteroppgåveECON391PROF-SØKMASV-SØ

Consuming Expectations : an exploration of foodways in relation to health and maternity among Nepalis living in Norway.

This thesis was submitted for the award of Doctor of Philosophy and was awarded by Brunel University LondonThis thesis focuses on Nepalis living in Oslo and Ås, Norway, and ethnographically explores their food perceptions, habits and practices in relation to health and maternal health. With pre-existing experience of both biomedical and other understandings of health and wellbeing, the majority of my respondents could and did move between paradigms, on an individual basis deciding which to apply and when. Consequently, several demonstrated certain reasoned divergences from Norwegian state-endorsed dietary norms and expectations; differences that were, however, not simply reducible to ‘culture’. ‘Culture’ is shown here to be a favoured strategy of explanation within Norwegian public health research, which has dominated state health perceptions of all South Asians. Overall, four key arguments are advanced. Firstly, the need to disaggregate the category of ‘South Asian’, currently readily employed within public health research and policies worldwide to describe and problematise the foodways of highly diverse diaspora populations. The middle-class status of my Nepali respondents is delineated as a central example exposing the inaccuracy of such a homogenising generalisation. Secondly, that despite the hegemony of biomedical models of nutrition within health and ante-/postnatal wellbeing in Norway, my interlocutors moved between these and other ideas and practices of health and wellbeing. Describing their dietary habits and practices makes plain the narrowness of applying purely biomedically-predicated thinking to understanding these Nepalis’ foodways. Thirdly, that in ante-/postnatal care the biomedical model overprivileges the individual mother’s responsibility for her own health in order to benefit her child, ignoring the potential for alternative distributions of responsibility for, as well as emphasis on, both offspring and mother: the Nepalis I encountered showed a notable commitment to the mother’s wellbeing and also sense of pregnancy and postnatal care as a collective enterprise, relationally shaped. Fourthly, my Nepali respondents’ accounts provide a useful example demonstrating limitations to the perceived authority of Norwegian state advice on health in general. Well-informed and often highly educated, these Nepalis engaged only selectively with the state-endorsed guidance and services, instead drawing on other (re)sources – Nepali family and friends especially – to maintain health and wellbeing

Å bli levertransplantert grunnet kolorektalcancer : Pasientopplevelser ved levertransplantasjon på grunn av levermetastaser etter kolorektalcancer

Formål: Å beskrive unike pasientopplevelser hos pasienter som har gjennomgått levertransplantasjon grunnet levermetastaser etter kolorektalcancer. Teoretisk forankring: Begrepsdefinisjon med aktuell teori og forskning rundt begrepene livskvalitet og håp. Metode: Utforskende og beskrivende studie med dybdeintervju av informanter 6 måneder etter transplantasjonen. Totalt 9 intervjuer ble gjennomført. Datamaterialet ble transkribert verbatim kort tid etter at intervjuene fant sted. For analysen ble det brukt kvalitativ innholdsanalyse slik den beskrives av Kvale (1997). Resultater: Median alder på pasientene var 56 år. Totalt 10 pasienter ble inkludert, hvorav 9 intervjuer ble gjennomført. En informant døde ved intervjutidspunktet grunnet spredning av kreftsykdom. Tre temaer fremkom gjennom analyseprosessen: Livet i gave på nytt, å leve mellom håp og fortvilelse og tilbake til hverdagen. Første temaet tar for seg gleden og takknemligheten respondentene følte etter å ha fått mulighet til å gå gjennom behandling som kunne forlenge deres liv. Det å få behandling i en så alvorlig situasjon resulterte blant annet i at de fikk et nytt perspektiv på livet. Det andre temaet beskriver utfordringen respondentene opplevde i forhold til det å leve i et skifte mellom håp og fortvilelse. Det siste temaet omhandler respondentenes ønske om å leve hverdagen som de tidligere hadde gjort. Det omhandler deres fysiske form, eventuelle bivirkninger av medisiner og deres forhold til sine nærmeste. Konklusjon: Studien indikerer at de pasienter som blir levertransplantert grunnet kolorektalcancer og levermetastaser opplevde dette som en god erfaring. Pasientene opplevde å leve et godt liv etter transplantasjonen. Sjansen for et forlenget liv ble sett på som mer betydningsfullt enn risikoen knyttet til transplantasjonen og bivirkninger grunnet medisinering

Opinions on dental erosive lesions, knowledge of diagnosis, and treatment strategies among Norwegian dentists: a questionnaire survey

This study aimed to investigate dentists' general experience, knowledge about diagnosis, and treatment of dental erosive wear in young adults. A questionnaire was sent to 1262 Norwegian public dental health-employed dentists. The response rate was 60%. Results indicated that most dentists recorded erosive wear, half of them used a specific scoring system, and half registered lesions at the tooth surface level. Lesions were reported most often on palatal surfaces of upper anterior teeth (79% of dentists), on occlusal surfaces of lower 1st molars (74%), and on upper 1st molars (32%). Half the dentists used clinical photographs for documentation and 60% made study models. While 40% reported more erosive lesions in males, 36% reported no gender differences. High intake of carbonated beverages and acidic juices were reported as the most common cause by 97% and 72% of the dentists, respectively. Only 21% of dentists recorded the patient's dietary history, and 73% never measured saliva secretion. The majority (78%) of the dentists treated patients with erosive wear themselves. In general, the survey suggests that the dentists are relatively up to date regarding the clinical recording, diagnosis, and treatment of dental erosive wear. However, dietary and salivary analyses were not given priority, and early, preventive treatment was lacking

"A bit of everything": Health literacy interventions in chronic conditions- a systematic review

Objective: To systematically evaluate health literacy (HL) interventions in chronic conditions by exploring theoretical perspectives, intervention content and effectiveness. Method: We searched MEDLINE, Cochrane, CINAHL, EMBASE, ERIC, Web of Science and PsycINFO. Standardised systematic review methods were used, and sequences informing our research question were extracted and analysed. The study includes a descriptive summary of the included papers. Results: We included 39 unique interventions, with diabetes and heart disease as the most targeted chronic conditions. Fifty-four percent of papers included a definition of HL, but the studies showed significant hetero-geneity of theoretical underpinnings, modes, measures and content. We identified 23 HL measures, mostlyassessing functional HL. The HL interventions were often more complex than the measures indicated. A significant change in HL was found in 28 studies. Study quality was generally poor. Conclusions: Interventions optimizing HL appear important to improve health outcomes in chronic conditions. To ensure cumulative knowledge development of this field we need theory-based interventions, consistency in methods and more tailored and comprehensive measures to capture the interventions’ complexity. Practice implications: A more valid understanding of HL interventions and measurements is needed to reach an agreed understanding of their components and intentions.publishedVersio

Gradient descent algorithm incorporating stochastic pointlocation schemes and its application in multidimensional scaling analysis

Gradient descent (GD) is a popular approach for solving optimisation problems. A disadvantage of the method is the di culties with choosing a proper learning rate that sets the step size for the algorithm. If the learning rate is too small, the convergence is unnecessarily slow, whereas if the learning rate is too large, the process will overshoot or even diverge. Solving optimisation problems that are stochastic in nature introduces additional challenges to the GD algorithm hindering the convergence process. According to [7], the use of Stochastic Point Location (SPL) schemes can potentially improve any optimisation algorithm by learning the best parameter (the learning rate for GD) during optimisation. In this thesis we have enhanced the classical Gradient descent algorithm by incorporation Linear SPL and Hierarchical SPL schemes. As a result, two new GD based algorithms, GD-LSPL and GD-HSPL, have been developed. The new algorithms iteratively determine the learning rate of the GD in stochastic environments. To evaluate whether GD-LSPL and GD-HSPL algorithms improve the performance of the GD based optimisation we have compared them with GD with constant learning rate (GD-Classic) and with GD with Line search (GD-LS) algorithms. Three di erent environments have been used for the empirical evaluation. They are minimising mathematical functions, arti cial Multidimen- sional Scaling (MDS) problems as well as a practical MDS problem concerning the classi cation of Word-Of-Mouth (WoM) discussions. MDS is a statistical technique used in information visualisation for exploring similarities or dissimilarities in data. Note that we have proposed and empirically evaluated three di erent schemes for applying GD- LSPL and GD-HSPL algorithms when identifying the learning rate in the GD based MDS. In brief, the schemes consist of either identifying a global learning rate that is applied to all the points, an unique learning rate for each individual point, or an unique learning rate for every pair of points. These proposed schemes have been rigorously evaluated for arti cial MDS problems and for classifying WoM discussions. The observed results are conclusive | GD-LSPL and GD-HSPL algorithms introduce a clear improvement compared to GD-Classic. Since GD-LSPL and GD-HSPL regulate the learning rate during execution, they achieve faster and more accurate convergence without any manual adjustment of parameters. While dealing with minimising mathematical functions, we have introduced randomness to the problem data. In these environments GD-HSPL is the fastest and the most accurately converg- ing, the least in uenced by variation in the start value and the most frequently converging to the global minimum algorithm. In solving arti cial MDS problems the most accurately converging algorithms are GD-LS and GD-HSPL applying learning rate point-wise. These algorithms also perform quite well in Classifying WoM discussions. However, in the latter environment, when the number of points increases, GD-LSPL with the learning rate applied pair-wise has shown the fastest performance. In solving MDS problems randomness is located in the algorithm itself. GD-LS handles ran- domness in the algorithm quite well and improvement achieved by GD-HSPL and GD-LSPL is statistically insigni cant. However, under certain conditions GD-HSPL and GD-LSPL algo- rithms have shown potential in improving the performance of GD-LS in solving MDS problems. Moreover, they obviously have shown a great improvement in minimising mathematical func- tions. We, therefore, believe that GD-HSPL and GD-LSPL algorithms can be utilised in various GD based applications, particularly when randomness of the task is located in the problem data

Tekniske problemområder ved bruk av honeynett for analyse av datainntrengere

Honeynett er en forholdsvis ny teknologi som kan benyttes for å innhente informasjon om datainntrengere. Det kan innhentes informasjon om blant annet motiver, taktikk, verktøy og arbeidsmetoder. Denne teknologien er ikke et bestemt produkt, men er en arkitektur som kan ha mange forskjellige sammensetninger og funksjoner, og som kan brukes til ulike formål. Oppgavens hensikt er å teste honeynett med hensyn til definerte kriterier for innhenting av informasjon om datainntrengere. Ettersom det i litteraturen ikke er funnet tilfredsstillende kriterier for testing av honeynett, defineres disse i oppgaven. Forskjellige varianter av honeynett bygges opp, delt inn i faser. For hver fase testes honeynettet i forhold til kriteriene. Honeynettet testes ved hjelp av ubudne datainntrengere fra Internett. Resultatene viser mangler ved funksjonalitet en i honeynett, og et stort forbedringspotensiale. En av de største utfordringene er å skjule funksjonene i honeynettet, slik at datainntrengere ikke finner ut at de har brutt seg inn i et honeynett. En løsning på dette er å benytte programvare som ikke er publisert, enten ved å utvikle nytt, eller ved å modifisere eksisterende. Dette bidrar til at inntrengere ikke vet hva de skal se etter for å påvise et honeynett. Det er behov for å utvikle bedre verktøy for bruk i honeynett. I tillegg er det mulig å definere andre, mer omfattende kriterier. Hvilke kriterier det er behov for avhenger i stor grad av hvilken funksjonalitet som kreves i hvert enkelt tilfelle, og hva honeynettet skal benyttes til