rhamilton's blog http://www.mother-child.org/en/blog/56/atom/feed 2008-02-22T13:57:06-05:00 On the Mother-Child Website... http://www.mother-child.org/en/node/228 2008-03-04T01:38:41-05:00 2008-03-04T01:49:57-05:00 rhamilton The www.mother-child.org website has just undergone an extensive revision in an effort to provide a clear, concise image of our basic premises and purpose. We believe that these revisions will improve your access to the site’s facilities thereby helping you to achieve your objectives in research. So it’s a good time for us to question our own motives and methods in developing and promoting this website.

Specifically, we need your responses to the following questions:

]]> The www.mother-child.org website has just undergone an extensive revision in an effort to provide a clear, concise image of our basic premises and purpose. We believe that these revisions will improve your access to the site’s facilities thereby helping you to achieve your objectives in research. So it’s a good time for us to question our own motives and methods in developing and promoting this website.

Specifically, we need your responses to the following questions:

  1. Is our basic premise correct from your perspective? In low income countries, as in rich countries, are sustained improvements in maternal and child health, to a degree, dependent on strong local relevant research and a productive local core group of scientists?
  2. Is professional isolation (lack of access to scientist colleagues and to an environment of discussion, criticism and support) a serious deterrent to sustaining your research career?
  3. Can effective low cost, secure electronic communications compensate for at least some aspects of the actual isolation experienced by many young aspiring scientists? Is our technology appropriate for that task and for your computer facility?

We need your responses to these questions and any other comments you may have on our website. It’s easy to post a weblog!

]]> A COUPLE OF FUNDING OPPORTUNITIES http://www.mother-child.org/en/weblogs/2007/oct/09/1018/couple_funding_opportunities 2007-10-09T10:18:51-04:00 2008-02-22T13:58:03-05:00 rhamilton GLOBAL HEALTH LEADERSHIP AWARDS: CALL FOR APPLICATIONS

]]> GLOBAL HEALTH LEADERSHIP AWARDS: CALL FOR APPLICATIONS
The Global Health Research Initiative (GHRI) is offering these unique awards to support the development of emerging leaders from LMICs currently engaged in research partnerships. Mid-career candidates are invited to propose and undertake a program of professional and career development specifically designed to strengthen the candidate’s technical expertise, leadership abilities, partnership skills and other qualities -- to help the candidates advance in their work as leaders in the execution of research, or in the application of research for better health policy and health-system management. The registration deadline is October 22nd, 2007. For more information: http://www.idrc.ca/en/ev-115521-201-1-DO_TOPIC.html

IDRC DOCTORAL RESEARCH AWARDS
Applications will be accepted for research at the doctoral level in areas corresponding to IDRC's research priorities: 1) Social and Economic Policy , 2) Environment and Natural Resource Management, 3) Information and Communication Technologies(ICTs) for Development, and 4) Innovation, Policy and Science. There are two competitions each year: the 1st deadline is November 1, 2007 and the second one is April 1, 2008. For more information: http://www.crdi.ca/en/ev-23374-201-1-DO_TOPIC.html

GOOD LUCK!
Richard Hamilton

]]> Arsenic Contamination of Drinking Water http://www.mother-child.org/en/weblogs/2007/apr/20/1650/arsenic_contamination_drinking_water 2007-04-20T16:50:21-04:00 2008-02-22T13:58:14-05:00 rhamilton Arsenic contamination of the drinking water used by millions of people in Asia and elsewhere in the Developing World presents a major potential public health crisis.

]]> Arsenic contamination of the drinking water used by millions of people in Asia and elsewhere in the Developing World presents a major potential public health crisis. It is ironical that it is ground water accessed by deep tube wells that contains arsenic; these wells have been seen as a means of avoiding the use of surface water which contains little arsenic but is often full of microbes in many regions of the Developing World.
A recent special issue of the Journal of Health Population and Nutrition (JHPN Vol 24:3, September 2006) provides important new information on the extent of the arsenic problem and on strategies to deal with it. Probably children are particularly vulnerable to the toxic effects of chronic arsenic intake. Of special concern are its possible roles in delayed cognitive development and in inducing malignant and non-malignant lung disease in young adults.
The cited JHPN issue provides an important service by bringing this subject to a wide research-oriented readership. It also highlights how much is still to be learned about arsenic contamination of water and its impact on human health. How does it get there? What does it do when it is ingested? What is its impact on the fetus, on children, on pregnant women? What is the geographical distribution of arsenic contamination and what should be done to reduce it? These are some of the issues for which hard data are needed.
As exemplified by several papers in the above JHPN issue, many of the answers to the above questions will require a multidisciplinary approach; this website, www.mother-child.org, with its weblog and other features should be well placed to facilitate discussion and planning of such strategies.

]]> How might research be mobilized to curb the costly global epidemic of obesity http://www.mother-child.org/en/weblogs/2007/mar/02/1700/how_might_research_be_mobilized_curb_costly_global_epidemic_obesity 2007-03-02T17:00:19-05:00 2008-02-22T13:58:11-05:00 rhamilton In developing countries where Western influence has promoted a lifestyle of little physical activity and high calorie foods, cases of obesity have tripled in the past 20 years.Hassan P et al.

]]> In developing countries where Western influence has promoted a lifestyle of little physical activity and high calorie foods, cases of obesity have tripled in the past 20 years.1 Being poor in the lowest income countries is still associated with being undernourished and underweight but being poor in a middle income country (eg. South East Asia, China, Middle East, Latin America) is associated with an increased risk of obesity. The health and economic implications of these trends are enormous since obesity predisposes to Type 2 diabetes and cardiovascular disease, the incidences of which are skyrocketing.2
Probably there are 1.7 billion overweight children in the world and the number appears to be growing. If effective, preventive programs could be implemented, presumably they should target children.2

  1. 1. Hassan P et al. Obesity and Diabetes in the Developing World - A growing challenge. NEJM 356:213-215,2007
  2. 2. Hassan W and James WP. Obesity. Lancet 366:1197-1209,2005
]]> CHILD DEVELOPMENT IN LOW INCOME COUNTRIES - A RESEARCH CHALLENGE http://www.mother-child.org/en/weblogs/2007/mar/01/1217/child_development_low_income_countries_research_challenge 2007-03-01T12:17:29-05:00 2008-02-22T13:55:45-05:00 rhamilton A series of 3 papers on child development in developing countries indicate that developmental potential is being lost in more than 200 million children in low income countries1,2,3.

]]> A series of 3 papers on child development in developing countries indicate that developmental potential is being lost in more than 200 million children in low income countries1,2,3. These papers identify not only the enormity of the problem, they point to documented risk factors.. It is not surprising that the treatment programs that appear to have the best impact on cognitive development are those that 1) provide direct learning experiences to children; 2) target young and disadvantaged children and 3) are high quality, intense and long term and integrated with family support, health and educational systems.
These multi-authored papers provide a clear and rich source of data for anyone wishing to study the complex relationships between this devastating societal problem and possible risk factors.
I hope that many young low-income country scientists will devote their talents to this problem and use http://www.mother-child.org to expedite their involvement and impact. One research strategy would be to design preventive treatment trials which could yield information on cause while measuring impact of treatment; any such trial demands unusually rigorous attention to defining control groups and their management.
What do people think about the problem and possible strategies for doing something about it?
1. S. Grantham-McGregor et al. Lancet 369: 60-70, 2007
2. S.P. Walker et al. Lancet 369 : 145-157,2007
3. P.L. Engle et al. Lancet 369 : 229-242, 2007

]]> POSTNATAL CARE: An obvious global health priority http://www.mother-child.org/en/weblogs/2007/mar/01/1211/postnatal_care_obvious_global_health_priority 2007-03-01T12:11:27-05:00 2008-02-22T13:58:16-05:00 rhamilton A policy brief has been disseminated recently by the Population Reference Bureau in Washington (www.prb.org).

]]> A policy brief has been disseminated recently by the Population Reference Bureau in Washington (www.prb.org). Entitled “Postnatal Care: A Critical Opportunity to Save Mothers and Children”, it strongly advocates the provision of integrated postnatal care for both mother and child during the critical 6 weeks immediately after the baby is born. As a non-neonatologist, I am struck by the apparent lack of data on the efficacy of various intervention strategies which could guide policy. It seems clear that the early postnatal weeks are among the most critical for both mother and child and that the very high infant and maternal mortality rates that persist in several regions of the world warrant urgent action.
Is there sufficient evidence out there to support implementation of a particular effective postnatal intervention strategy? If not, are there ethical research strategies that might be activated to determine which preventive approaches will work best? If enough information is available to guide policy decisions, can the impact of these policies be measured? If these strategies are to involve several centres might the www.mother-child.org serve as a useful devise to foster a collaborative effort?

]]> Vaccination Schedules for Pre-Term Infants http://www.mother-child.org/en/weblogs/2006/nov/29/1140/vaccination_schedules_pre_term_infants 2006-11-29T11:40:20-05:00 2008-02-22T13:55:55-05:00 rhamilton Bonhoeffer et al (Arch Dis Childh 91:929-935, 2006) suggest that vaccinations scheduled at 2, 3 and 4 months after birth for pre

]]> Bonhoeffer et al (Arch Dis Childh 91:929-935, 2006) suggest that vaccinations scheduled at 2, 3 and 4 months after birth for pre-term infants would be safe and effective in reducing the impact of serious infections in these vulnerable babies. An early booster dose would also be required. In many centres, vaccinations for pre-term babies are delayed to 2,4,6 months or even 3-5-11 months based on the fact that antibody responses to the vaccines are relatively low in these immature babies during their early weeks of post-natal life. In their extensive review, the authors point out that while such levels are lower than would be found in term babies, they would be protective, using the 2,3 and 4 month schedule. What do you think? It seems that the issue is of sufficient importance to warrant a full scale evaluation.

]]> Does Breast Feeding Make you Smarter? http://www.mother-child.org/en/weblogs/2006/nov/29/1123/does_breast_feeding_make_you_smarter 2006-11-29T11:23:17-05:00 2008-02-22T13:55:59-05:00 rhamilton In an extensive metaanalysis published in the BMJ (333:945-948, 2006) Der et al provide c

]]> In an extensive metaanalysis published in the BMJ (333:945-948, 2006) Der et al provide compelling evidence that the answer is “no.” Breast-fed babies are smarter than non-breast-fed babies but these relatively small differences are accounted for by characteristics of the children’s mothers and their homes. It seems that breast feeding mothers are more intelligent than non-breast feeding moms. There are many reasons to advocate breast feeding but impact on intellect isn’t one of them

]]> PRE TERM BIRTH AND PERIODONTAL DISEASE http://www.mother-child.org/en/weblogs/2006/nov/13/1442/pre_term_birth_and_periodontal_disease 2006-11-13T14:42:40-05:00 2008-02-22T13:56:02-05:00 rhamilton Preterm birth occurring before 37 weeks gestation is associ

]]> Preterm birth occurring before 37 weeks gestation is associated with the majority of perinatal deaths world wide and almost half of long term neurological complications. In recent years, maternal periodontal disease has been identified as a risk factor but the pathophysiological basis for this association remains unclear. A recent trial [Michalowicz et al, New Eng J Med 335:1885, 2006] showed that treatment was safe and it improved periodontal disease but it failed to alter rates of preterm birth, low birth rate or fetal growth restriction when provided during pregnancy.

I agree with the authors of an editorial accompanying the above cited paper [Goldberg and Culhane, New Eng J Med 355:1925, 2006] that this relationship should be studied further. Given the huge burden of pre term births in many regions of the Developing World, clinical studies might be considered in one or more low income countries. Even if direct treatment of periodontal disease is convincingly shown not to reduce pre-term births, unraveling the pathophysiological basis for the association could suggest alternative strategies for reducing the persisting high rates of preterm birth.

]]> ZINC DEFICIENCY AND DIARRHEAL DISEASES http://www.mother-child.org/en/weblogs/2006/nov/07/1602/zinc_deficiency_and_diarrheal_diseases 2006-11-07T16:02:21-05:00 2008-02-22T13:56:12-05:00 rhamilton Roy et al (J.

]]> Roy et al (J. Health, Population and Nutrition 24:1, 2006) recently found reduced intestinal absorption of electrolytes and an enhanced secretory response to cholera toxin in young rats deprived of dietary zinc. These interesting findings warrant further study but they also emphasize some of the difficulties in interpreting nutrititional studies.

 

Two questions that arise from this paper are:

1. Were the study rats truly zinc deficient?

Apparently their zinc status was not measured. Judging from body weight data which leveled off in the Zn-deprived group, these rats had global deficiencies of most macro- and micro nutrients. Dietary intake data are not provided. In general, rats are not good models for studying human nutritional problems for various reasons including their dependence on coprophagy and because their food intake is very difficult to measure reliably.

 

2. Were the abnormalities observed in transport a response to zinc deficiency, to protein-calorie malnutrition, to folic acid depletion, etc. or all of the above?

Exploration of the relationships between enteric infections and nutritional deficiencies continues to be an important research priority. The complexities of these relationships have many possible pitfalls which means that study designs and data interpretation must be rigorous.

Do you have comments on the study cited above or on the nutritional research issues it raises?

]]> Why blog? http://www.mother-child.org/en/weblogs/2006/may/08/1513/why_blog 2006-05-08T15:13:00-04:00 2008-02-22T13:56:18-05:00 rhamilton Just as an electronic network can provide many of the assets of an actual research institute, its weblogging facility provides an easily accessed substitute for those corridor conversations and discus

]]> Just as an electronic network can provide many of the assets of an actual research institute, its weblogging facility provides an easily accessed substitute for those corridor conversations and discussions of techniques, data or teaching strategies that abound in such institutions.

The factors that contribute to a dynamic blogging culture within a network are not fully understood- at least not by me! I believe that potential bloggers can be intimidated by self doubts about their technical competence and by a mistaken concept that blogs must be carefully crafted and polished when it is their informality and immediacy that encourages responses and dialogue. Also as with actual discussion sessions, there can be an initial inertia which tends to make potential discussants reluctant to join in until an animator has broken the ice.

To achieve its objectives, http://www.mother-child.org must foster a dynamic culture of scientist-to-scientist dialogue. Probably, it is the under 30’s who will lead the way; they have grown up with computers, are unfazed by concerns about the technology or the formality of their postings. In addition, it will be necessary for several committed participants from developed and developing world centers to assume the role of animators taking the time to post blogs and get the ball rolling.

In advocating the view that the future of our network depends on our capacity to foster an actively blogging culture, I am asking for your comments and for any suggestions you may have for overcoming inertia and generating blog frenzy.

]]> Research Ethics http://www.mother-child.org/en/weblogs/2004/nov/26/1243/research_ethics 2004-11-26T12:43:22-05:00 2008-02-22T13:57:01-05:00 rhamilton The 10/90 Gap between health research resources in rich and in poor countries is a major ethical issue. What do developing world scientists think about the relative merits of national vs.

]]> The 10/90 Gap between health research resources in rich and in poor countries is a major ethical issue. What do developing world scientists think about the relative merits of national vs. international research centres as mechanisms to address this persisting inequity? The former would be owned and managed by nationals, the latter governed by international boards.

]]> Strategies to support health research in developing countries http://www.mother-child.org/en/weblogs/2004/nov/26/1238/strategies_support_health_research_developing_countries 2004-11-26T12:38:57-05:00 2008-02-22T13:57:06-05:00 rhamilton The Mother-Child Health International Research Network facilitates scientist-to-scientist communications as one measure to encourage sustained health research capacity in developing regions of the wor

]]> The Mother-Child Health International Research Network facilitates scientist-to-scientist communications as one measure to encourage sustained health research capacity in developing regions of the world? What additional cost-effective strategies might be applied to achieve this goal? I would particularly like to receive comments and suggestions from developing world scientists. Might the strategies be linked to our network?

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