Inequalities in maternity care and newborn outcomes: one-year surveillance of births in vulnerable slum communities in Mumbai

Background: Aggregate urban health statistics mask inequalities. We described maternity care in vulnerable slum communities in Mumbai, and examined differences in care and outcomes between more and less deprived groups. Methods: We collected information through a birth surveillance system covering a population of over 280 000 in 48 vulnerable slum localities. Resident women identified births in their own localities and mothers and families were interviewed at 6 weeks after delivery. We analysed data on 5687 births over one year to September 2006. Socioeconomic status was classified using quartiles of standardized asset scores. Results: Women in higher socioeconomic quartile groups were less likely to have married and conceived in their teens (Odds ratio 0.74, 95% confidence interval 0.69–0.79, and 0.82, 0.78–0.87, respectively). There was a socioeconomic gradient away from public sector maternity care with increasing socioeconomic status (0.75, 0.70–0.79 for antenatal care and 0.66, 0.61–0.71 for institutional delivery). Women in the least poor group were five times less likely to deliver at home (0.17, 0.10–0.27) as women in the poorest group and about four times less likely to deliver in the public sector (0.27, 0.21–0.35). Rising socioeconomic status was associated with a lower prevalence of low birth weight (0.91, 0.85–0.97). Stillbirth rates did not vary, but neonatal mortality rates fell non-significantly as socioeconomic status increased (0.88, 0.71–1.08). Conclusion: Analyses of this type have usually been applied across the population spectrum from richest to poorest, and we were struck by the regularly stepped picture of inequalities within the urban poor, a group that might inadvertently be considered relatively homogeneous. The poorest slum residents are more dependent upon public sector health care, but the regular progression towards the private sector raises questions about its quality and regulation. It also underlines the need for healthcare provision strategies to take account of both sectors

The Weak Lensing Signal and the Clustering of BOSS Galaxies I: Measurements

A joint analysis of the clustering of galaxies and their weak gravitational lensing signal is well-suited to simultaneously constrain the galaxy-halo connection as well as the cosmological parameters by breaking the degeneracy between galaxy bias and the amplitude of clustering signal. In a series of two papers, we perform such an analysis at the highest redshift ($z\sim0.53$) in the literature using CMASS galaxies in the Sloan Digital Sky Survey-III Baryon Oscillation Spectroscopic Survey Eleventh Data Release (SDSS-III/BOSS DR11) catalog spanning 8300~deg$^2$. In this paper, we present details of the clustering and weak lensing measurements of these galaxies. We define a subsample of 400,916 CMASS galaxies based on their redshifts and stellar mass estimates so that the galaxies constitute an approximately volume-limited and similar population over the redshift range $0.47\le z\le 0.59$. We obtain a signal-to-noise ratio $S/N\simeq 56$ for the galaxy clustering measurement. We also explore the redshift and stellar mass dependence of the clustering signal. For the weak lensing measurement, we use existing deeper imaging data from the CFHTLS with publicly available shape and photometric redshift catalogs from CFHTLenS, but only in a 105~deg$^2$ area which overlaps with BOSS. This restricts the lensing measurement to only 5,084 CMASS galaxies. After careful systematic tests, we find a highly significant detection of the CMASS weak lensing signal, with total $S/N\simeq 26$. These measurements form the basis of the halo occupation distribution and cosmology analysis presented in More et al. (Paper II).Comment: 15 pages, 13 figures. Accepted for publication in the Astrophysical Journa

First impressions and perceived roles: Palestinian perceptions on foreign aid

This paper summarizes some results of a wider research on foreign aid that was conducted in the West Bank and Gaza Strip in 2010. It seeks to describe the impressions and feelings of Palestinian aid beneficiaries as well as the roles and functions they attached to foreign aid. To capture and measure local perceptions on Western assistance a series of individual in depth interviews and few focus group interviews were conducted in the Palestinian territories. The interview transcripts were processed by content analysis. As research results show — from the perspective of aid beneficiaries — foreign aid is more related to human dignity than to any economic development. All this implies that frustration with the ongoing Israeli-Palestinian conflict inevitably embraces the donor policies and practices too

A spectral function tour of electron-phonon coupling outside the Migdal limit

We simulate spectral functions for electron-phonon coupling in a filled band system - far from the asymptotic limit often assumed where the phonon energy is very small compared to the Fermi energy in a parabolic band and the Migdal theorem predicting 1+lambda quasiparticle renormalizations is valid. These spectral functions are examined over a wide range of parameter space through techniques often used in angle-resolved photoemission spectroscopy (ARPES). Analyzing over 1200 simulations we consider variations of the microscopic coupling strength, phonon energy and dimensionality for two models: a momentum-independent Holstein model, and momentum-dependent coupling to a breathing mode phonon. In this limit we find that any `effective coupling', lambda_eff, inferred from the quasiparticle renormalizations differs from the microscopic dimensionless coupling characterizing these Hamiltonians, lambda, and could drastically either over- or under-estimate it depending on the particular parameters and model. In contrast, we show that perturbation theory retains good predictive power for low coupling and small momenta, and that the momentum-dependence of the self-energy can be revealed via the relationship between velocity renormalization and quasiparticle strength. Additionally we find that (although not strictly valid) it is often possible to infer the self-energy and bare electronic structure through a self-consistent Kramers-Kronig bare-band fitting; and also that through lineshape alone, when Lorentzian, it is possible to reliably extract the shape of the imaginary part of a momentum-dependent self-energy without reference to the bare-band.Comment: 15 pages, 11 figures. High resolution available here: http://www.physics.ubc.ca/~quantmat/ARPES/PUBLICATIONS/Articles/sf_tour.pd

Instabilities in the Nuclear Energy Density Functional

In the field of Energy Density Functionals (EDF) used in nuclear structure and dynamics, one of the unsolved issues is the stability of the functional. Numerical issues aside, some EDFs are unstable with respect to particular perturbations of the nuclear ground-state density. The aim of this contribution is to raise questions about the origin and nature of these instabilities, the techniques used to diagnose and prevent them, and the domain of density functions in which one should expect a nuclear EDF to be stable.Comment: Special issue "Open Problems in Nuclear Structure Theory" of Jour.Phys.G - accepted. 7 pages, 2 figure

Community resource centres to improve the health of women and children in Mumbai slums: study protocol for a cluster randomized controlled trial

Background: The trial addresses the general question of whether community resource centers run by a non-government organization improve the health of women and children in slums. The resource centers will be run by the Society for Nutrition, Education and Health Action, and the trial will evaluate their effects on a series of public health indicators. Each resource center will be located in a vulnerable Mumbai slum area and will serve as a base for salaried community workers, supervised by officers and coordinators, to organize the collection and dissemination of health information, provision of services, home visits to identify and counsel families at risk, referral of individuals and families to appropriate services and support for their access, meetings of community members and providers, and events and campaigns on health issues. Methods/design: A cluster randomized controlled trial in which 20 urban slum areas with resource centers are compared with 20 control areas. Each cluster will contain approximately 600 households and randomized allocation will be in three blocked phases, of 12, 12 and 16 clusters. Any resident of an intervention cluster will be able to participate in the intervention, but the resource centers will target women and children, particularly women of reproductive age and children under 5. The outcomes will be assessed through a household census after 2 years of resource center operations. The primary outcomes are unmet need for family planning in women aged 15 to 49 years, proportion of children under 5 years of age not fully immunized for their ages, and proportion of children under 5 years of age with weight for height less than 2 standard deviations below the median for age and sex. Secondary outcomes describe adolescent pregnancies, home deliveries, receipt of conditional cash transfers for institutional delivery, other childhood anthropometric indices, use of public sector health and nutrition services, indices of infant and young child feeding, and consultation for violence against women and children