The Experts below are selected from a list of 1407 Experts worldwide ranked by ideXlab platform
Erin Boyd - One of the best experts on this subject based on the ideXlab platform.
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Challenges to the Programmatic Implementation of Ready to Use Infant Formula in the Post-Earthquake
2015Co-Authors: Leisel E. Talley, Erin BoydAbstract:Background and Objectives: Following the 2010 earthquake in Haiti, infant and young child feeding was identified as a priority nutrition intervention. A new approach to support breastfeeding mothers and distribute ready-to-use infant formula (RUIF) to infants unable to breastfeed was established. The objective of the evaluation was to assess the implementation of infant feeding programs using RUIF in displaced persons camps in Port-au-Prince, Haiti during the humanitarian response. Methods: A retrospective record review was conducted from April–July, 2010 to obtain data on infants receiving RUIF in 30 baby tents. A standardized data collection form was created based on data collected across baby tents and included: basic demographics, admission criteria, Primary Caretaker, feeding practices, and admission and follow-up anthropometrics. Main Findings: Orphans and abandoned infants were the most frequent enrollees (41%) in the program. While the program targeted these groups, it is unlikely that this is a true reflection of population demographics. Despite programmatic guidance, admission criteria were not consistently applied across programs. Thirty-four percent of infants were undernourished (weight for age Z score,22) at the time of admission. Defaulting accounted for 50 % of all program exits and there was no follow-up of these children. Low data quality was a significant barrier. Conclusions: The design, implementation and magnitude of the ‘baby tents ’ using RUIF was novel in response to infant and young child feeding (IYCF) in emergencies and presented multiple challenges that should not be overlooked, includin
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challenges to the programmatic implementation of ready to use infant formula in the post earthquake response haiti 2010 a program review
PLOS ONE, 2013Co-Authors: Leisel Talley, Erin BoydAbstract:Background and Objectives: Following the 2010 earthquake in Haiti, infant and young child feeding was identified as a priority nutrition intervention. A new approach to support breastfeeding mothers and distribute ready-to-use infant formula (RUIF) to infants unable to breastfeed was established. The objective of the evaluation was to assess the implementation of infant feeding programs using RUIF in displaced persons camps in Port-au-Prince, Haiti during the humanitarian response. Methods: A retrospective record review was conducted from April–July, 2010 to obtain data on infants receiving RUIF in 30 baby tents. A standardized data collection form was created based on data collected across baby tents and included: basic demographics, admission criteria, Primary Caretaker, feeding practices, and admission and follow-up anthropometrics. Main Findings: Orphans and abandoned infants were the most frequent enrollees (41%) in the program. While the program targeted these groups, it is unlikely that this is a true reflection of population demographics. Despite programmatic guidance, admission criteria were not consistently applied across programs. Thirty-four percent of infants were undernourished (weight for age Z score ,22) at the time of admission. Defaulting accounted for 50% of all program exits and there was no follow-up of these children. Low data quality was a significant barrier. Conclusions: The design, implementation and magnitude of the ‘baby tents’ using RUIF was novel in response to infant and young child feeding (IYCF) in emergencies and presented multiple challenges that should not be overlooked, including adherence to protocols and the adaption of emergency programs to existing programs. The implementation of IYCF programs should be closely monitored to ensure that they achieve the objectives set by the humanitarian community and national government. IYCF is an often overlooked component of emergency preparedness; however to improve response, generic protocols and pre-emergency training and preparedness should be established for humanitarian agencies.
Kim Young-an - One of the best experts on this subject based on the ideXlab platform.
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Deprivation and Hispanic Health Paradox: Neighborhood Effects on Children\u27s Wheezing in El Paso, Texas
ScholarWorks@UTEP, 2013Co-Authors: Kim Young-anAbstract:This study examines the impact of hypothetical health determinants - including objective and relative economic deprivation, as well as foreign-born composition -at the neighborhood-level on respiratory wheezing among Hispanic children in El Paso, Texas while accounting for individual-level covariates based on hierarchical logistic modeling (HLM). Due to El Paso\u27s majority Latino/a population, focus is placed on the so-called Hispanic health paradox through analysis of the impact of neighborhood foreign-born composition on Hispanic children\u27s wheezing. Neighborhood-level variables at the census tract-level are derived from US Census data. The percent of families in poverty and the GINI coefficient for income (income inequality) are used to measure objective and relative economic deprivation, respectively. The percent of foreign-born individuals in census tracts is used to operationalize neighborhood foreign-born composition. Individual-level data come from a survey (N=1904) of parents/guardians of fourth and fifth graders in all 58 elementary schools in the El Paso Independent School District. Child\u27s sex, socioeconomic status, indoor/housing exposures, health behaviors, body mass index, residential duration in El Paso and Primary Caretaker\u27s nativity are utilized at the individual-level, since they are well-established determinants of respiratory health outcomes. Due to the focus on neighborhood contextual effects, only Hispanic children living in the same home or within 1 km of that home for past year are included in the analysis (N=1322 children within 63 census tracts). In addition, this study applies multiple imputation to the individual-level dataset (N=10 datasets) to address missing values and analyzes the multiply imputed data in the HLM statistical software package. Results reveal that the percent of families in poverty at the neighborhood-level consistently predicts less children\u27s wheezing, while income inequality (GINI) has no effect on wheezing. Percent foreign-born also has a significant neighborhood effect associated with reduced wheezing. In terms of cross-level interactions, children in poverty (as opposed to not in poverty), with better health status (as opposed to worse) and with foreign-born (as opposed to US-born) Primary Caretakers enjoy respiratory health benefits from living in neighborhoods with a higher proportion of the population being foreign-born. In conclusion, this study provides evidence of neighborhood effects on children\u27s wheezing in El Paso, Texas; some of those contextual effects conform to the extant literature and others do not
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Deprivation and the Hispanic health paradox: Neighborhood effects on children\u27s wheezing outcomes in El Paso, Texas
ScholarWorks@UTEP, 2013Co-Authors: Kim Young-anAbstract:This study examines the impact of hypothetical health determinants—including objective and relative economic deprivation, as well as foreign-born composition—at the neighborhood-level on respiratory wheezing among Hispanic children in El Paso, Texas while accounting for individual-level covariates based on hierarchical logistic modeling (HLM). Due to El Paso\u27s majority Latino/a population, focus is placed on the so-called Hispanic health paradox through analysis of the impact of neighborhood foreign-born composition on Hispanic children\u27s wheezing. Neighborhood-level variables at the census tract-level are derived from US Census data. The percent of families in poverty and the GINI coefficient for income (income inequality) are used to measure objective and relative economic deprivation, respectively. The percent of foreign-born individuals in census tracts is used to operationalize neighborhood foreign-born composition. Individual-level data come from a survey (N=1904) of parents/guardians of fourth and fifth graders in all 58 elementary schools in the El Paso Independent School District. Child\u27s sex, socioeconomic status, indoor/housing exposures, health behaviors, body mass index, residential duration in El Paso and Primary Caretaker\u27s nativity are utilized at the individual-level, since they are well-established determinants of respiratory health outcomes. Due to the focus on neighborhood contextual effects, only Hispanic children living in the same home or within 1 km of that home for past year are included in the analysis (N=1322 children within 63 census tracts). In addition, this study applies multiple imputation to the individual-level dataset (N=10 datasets) to address missing values and analyzes the multiply imputed data in the HLM statistical software package. Results reveal that the percent of families in poverty at the neighborhood-level consistently predicts less children\u27s wheezing, while income inequality (GINI) has no effect on wheezing. Percent foreign-born also has a significant neighborhood effect associated with reduced wheezing. In terms of cross-level interactions, children in poverty (as opposed to not in poverty), with better health status (as opposed to worse) and with foreign-born (as opposed to US-born) Primary Caretakers enjoy respiratory health benefits from living in neighborhoods with a higher proportion of the population being foreign-born. In conclusion, this study provides evidence of neighborhood effects on children\u27s wheezing in El Paso, Texas; some of those contextual effects conform to the extant literature and others do not
Mark Padilla - One of the best experts on this subject based on the ideXlab platform.
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parental loss and residential instability the impact on young women from low income households in detroit
Journal of Child and Family Studies, 2015Co-Authors: Leslie R Berman, Rachel C Snow, Jessica D Moorman, Deena Policicchio, Arline T Geronimus, Mark PadillaAbstract:High poverty urban areas in the U.S. are over-burdened by early adult death and disability, yet there has been little documentation of how early parental death impacts youth residing in these communities. We conducted qualitative, community-based research on the health and well-being of 20 residentially unstable young women ages 18–24 in Detroit during 2011–2012. Participants were selected through their association with a local social service organization. We found that nine of these 20 young women had experienced the loss of a parent or Primary Caretaker during childhood or adolescence. Using data from in-depth, semi-structured interviews, this paper explores the role of parental loss as a precipitating event for residential instability and episodic homelessness. For these young women, parental loss was a catalyst for subsequent periods of intermittent homelessness and persistent mobility between the households of extended family and friends. These narratives provide unique testimony to the impact of early parental loss on young women from low-income households in an economically-stressed urban context in the U.S. Their stories highlight the dynamic associations between periods of housing insecurity and vulnerability to numerous social risks, including sexual commerce, acute stress, and alienation from social support networks. In this context, parental loss reflects a broader social inequality of early adult mortality in high poverty areas, and the health and social gains to be realized through targeted policies to support areas of urban economic crisis.
Ilaria Bianchi - One of the best experts on this subject based on the ideXlab platform.
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from infant attachment disorganization to adult dissociation relational adaptations or traumatic experiences
Psychiatric Clinics of North America, 2006Co-Authors: Karlen Lyonsruth, Lissa Dutra, Michelle Schuder, Ilaria BianchiAbstract:In 1997, Putnam [1] pointed out that relatively little was known about the etiology and development of dissociation other than the presumed etiologic role of trauma; however, the fact that nontraumatized individuals sometimes demonstrated dissociation and that not all trauma survivors dissociate suggested that there may be more to the etiology and development of dissociation than trauma alone. Putnam [1] explored the role of various potential moderating variables including age, sex, culture, genetic factors, and education/intelligence in the development of dissociation, and although moderating trends were found for some of these variables, existing research has not convincingly demonstrated that any of these variables significantly influence dissociation. Family environmental factors, however, are the one set of factors that have been most consistently related to dissociation. Factors such as inconsistent parenting or disciplining, [2–4] level of family risk [5], and parental dissociation, as measured by the Dissociative Experiences Scale [6], have been shown to be associated significantly with higher levels of dissociation in adulthood. Most available research on dissociation, however, has focused on trauma, leaving many unanswered questions regarding how other family factors intersect with familial abuse in the developmental trajectories leading to dissociative disorders. Barach [7] was one of the first theorists to connect dissociation with attachment theory. In his article, Barach [7] suggested that multiple personality disorder (now known as dissociative identity disorder) was a variant of an “attachment disorder.” He pointed out that individuals who had this disorder tended to demonstrate the extreme detachment, or emotional unresponsiveness, experienced by children faced with a loss of their Primary Caretaker, as described by Bowlby [8]. Barach [7] further suggested that children of unresponsive Caretakers were also likely to engage in dissociative or “detached” behaviors. As one offshoot of attachment studies, developmental theorists and researchers have begun to explore the role of early childhood attachment and parenting in the etiology and development of dissociative symptomatology. Liotti’s [9] theorizing has more specifically implicated disorganized patterns of infant attachment behavior as potential precursors to the development of dissociation later in life. He pointed out that there are parallels between infant disorganization and dissociation. Both phenomena reflect a pervasive lack of behavioral or mental integration. This Primary failure of integration in infancy may result in vulnerability to dissociative organization of mental life in the developing child and grown adult. Liotti’s view might be best conceptualized as a vulnerability model in which early dyadic processes lead to a “Primary breakdown” or lack of integration of a coherent sense of self. Liotti’s model offers an alternative to the theory that the Primary function and etiology of dissociation is as a defense against trauma. Although Liotti [9] did not suggest that disorganized attachment is the only etiologic factor in dissociation, he hypothesized that disorganized attachment patterns constitute an initial step in the developmental trajectories that leave an individual vulnerable to developing dissociation in response to later experiences of trauma. Bowlby [8] first suggested that infants may internalize unintegrated internal working models of their relationships with Primary caregivers and of themselves in relation to those caregivers. Main and Hesse [10] further hypothesized that parents of disorganized infants may engage in frightened or frightening interactions with their children, thereby presenting the infant with the paradox that the parent is a source of threat and a source of protection. Under these paradoxic conditions, during times of stress when the attachment system is activated, contradictory internal working models of self and other may become evident. These seemingly incompatible models of the parent as a source of fear and a source of protection from fear are similar to Barach’s [7] model of an abusive parent causing a child to be faced with the incompatible notion that his parent is his protector and his persecutor. Main and Hesse [10] further theorized that when the parent appears frightened in his or her interactions with the infant, the infant may infer that there is something threatening in the environment that should be feared. Although such a perceived environmental threat would lead a securely attached infant to approach his parent for protection, a frightened parent may communicate apprehension to the child. Under these conditions, the infant may sense the helplessness of the parent in the face of threat and demonstrate conflict about approaching him or her for protection by displaying contradictory simultaneous or sequential approach-avoidance behaviors typical of disorganized detachment. Alternatively, the parent’s frightened stance may cause the child to infer that he, himself, is frightening the parent, again leading to conflict in approaching and further threatening an already frightened parent. Lyons-Ruth and colleagues [11, 12] demonstrated that parental withdrawal from the infant’s attachment overtures at times of infant arousal is also associated with infant disorganization, whether or not the parent’s behavior is directly frightened or frightening to the infant. Thus, the infant’s internalization of contradictory models of the self as frightened or threatening and of the parent as hostile or helpless/withdrawing can be conceptualized in terms of contradictory models that generate incompatible behavioral and mental tendencies. This Primary lack of integration around basic strategies for seeking comfort and protection under stress is what Liotti [9] suggested may confer vulnerability to dissociative processes later in life. Liotti [9] further speculated that there are three pathways that disorganized infants might take toward (or away from) the development of dissociative symptomatology. In the first pathway, there is no further trauma, and interactions with the parent become less fear imbued and more consistent over the childhood years. Regardless of whether this consistency is positive or negative, Liotti [9] posited that this would result in the child’s eventually choosing one of the available incompatible working models of attachment relationships and developing in accordance with that working model. The second pathway, in which parent-child interactions continue to be inconsistent and contradictory but the child does not encounter severe trauma, would lead to infrequent dissociation during times of extreme stress. In this scenario, although the child is viewed as vulnerable to the development of dissociative symptoms, there arc not sufficient environmental stressors to potentiate this vulnerability, leaving the child asymptomatic or displaying only mild or fleeting dissociative symptoms. In the third pathway, the disorganized/disoriented infant is predisposed to dissociation, has ongoing severe stressors, and vulnerability is potentiated. Here, the child experiences continued reinforcement of increasingly unintegrated simultaneous/sequential contradictory internal working models of self-other relatedness and repetitive severe trauma. This child is likely to move toward the extreme of developing dissociative identity disorder. Liotti’s model of early difficulties in achieving an integrated set of behavioral and mental responses to fear or threat offers a strong hypothesis for why it is that some people exposed to trauma develop dissociation, whereas others do not. This model suggests that disorganized attachment negatively impacts the onset of early individually based processes of mental integration that become the basis for later dissociation. Although Liotti’s model sets forth the notion that infant disorganization lays the groundwork and acts as a key precursor for the development of dissociation, experiences of significant trauma remain an important and necessary factor in this diathesis-stress model.
Leisel Talley - One of the best experts on this subject based on the ideXlab platform.
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challenges to the programmatic implementation of ready to use infant formula in the post earthquake response haiti 2010 a program review
PLOS ONE, 2013Co-Authors: Leisel Talley, Erin BoydAbstract:Background and Objectives: Following the 2010 earthquake in Haiti, infant and young child feeding was identified as a priority nutrition intervention. A new approach to support breastfeeding mothers and distribute ready-to-use infant formula (RUIF) to infants unable to breastfeed was established. The objective of the evaluation was to assess the implementation of infant feeding programs using RUIF in displaced persons camps in Port-au-Prince, Haiti during the humanitarian response. Methods: A retrospective record review was conducted from April–July, 2010 to obtain data on infants receiving RUIF in 30 baby tents. A standardized data collection form was created based on data collected across baby tents and included: basic demographics, admission criteria, Primary Caretaker, feeding practices, and admission and follow-up anthropometrics. Main Findings: Orphans and abandoned infants were the most frequent enrollees (41%) in the program. While the program targeted these groups, it is unlikely that this is a true reflection of population demographics. Despite programmatic guidance, admission criteria were not consistently applied across programs. Thirty-four percent of infants were undernourished (weight for age Z score ,22) at the time of admission. Defaulting accounted for 50% of all program exits and there was no follow-up of these children. Low data quality was a significant barrier. Conclusions: The design, implementation and magnitude of the ‘baby tents’ using RUIF was novel in response to infant and young child feeding (IYCF) in emergencies and presented multiple challenges that should not be overlooked, including adherence to protocols and the adaption of emergency programs to existing programs. The implementation of IYCF programs should be closely monitored to ensure that they achieve the objectives set by the humanitarian community and national government. IYCF is an often overlooked component of emergency preparedness; however to improve response, generic protocols and pre-emergency training and preparedness should be established for humanitarian agencies.