No description available.

No description available.

No description available.

No description available.

Newborn morbidity and mortality remains high despite a remarkable decline in the infant mortality and under five mortality rates in Nepal over the last decade (1996-2006). Research shows that newborns’ health outcome is associated with maternal and other factors. This study was designed to understand the factors that have an impact on three good newborn care practices: safe cord cutting, early breastfeeding and delayed bathing. The study used the interview data of 815 married women aged 15-49 years who delivered a live baby between February 2008 and February 2009, collected for the baseline survey of the Community-Based Maternal and Newborn Health program implemented in the Sindhuli district of Nepal. The mean age of the sample women was 26 years. Two-thirds of them were from disadvantaged indigenous caste/ethnicity groups, about 70% were uneducated and the majority were poor. Safe cord cutting, early breastfeeding and delayed bathing practices were studied for 803, 810 and 812 women respectively and 70.7%, 46.7%, and 16.6% of the eligible samples demonstrated the practices respectively. The logistic regression method was used to examine the association of independent factors with the outcome variables. Social gradient was found to be associated with all three practices. Rich women were more likely to demonstrate good practices and bearing a child at the prime age (20-34 years) was likely to result in safe cord cutting. Disadvantaged indigenous and ‘other’ caste/ethnicity women demonstrated unsafe cord cutting practices and dalit caste/ethnicity women demonstrated poor bathing practices. Maternal knowledge also emerged as a strong predictor of early breastfeeding and delayed bathing practices. Antenatal care from a SBA determined good breastfeeding and advice from a FCHV determined good bathing practices. The results showed that the uptake of antenatal and delivery services from a skilled birth attendant is unacceptably low in rural Nepal, which is a challenge for meeting the millennium development goals. The study recommends programmes for improving economic status as a key to improving newborn care practices. As the vast majority of the deliveries are still assisted by traditional birth attendants; including them in maternal health programmes is crucial. Increasing women’s access to a skilled birth attendant and boosting the spirit of the FCHVs to increase their efficiency is also recommended. Future research on newborn health should focus on identifying other determinants of newborn care practices and survival. Qualitative studies to understand the cultural perspectives of newborn care practices are also recommended.

Wheelchair propulsion is an important part of daily living for many people with spinal cord injuries (SCI's). The aim of this project was to establish the validity of using a new approach for measuring wheelchair propulsion ability. The variation in methods observed by subject's hands in contacting and propelling their wheelchair, namely, using the push rims only; wedging the hands between push rims and tyre and grasping both push rims and tyres, highlighted that earlier studies using instrumented push rims (including the SMART ) for people with tetraplegia would not provide a true indication of propulsion ability for the participants in this study. As a result, a new inertia dynamometer was built and calibrated for measuring wheelchair propulsion ability. Kinetic and kinematic models were developed to calculate wheelchair propulsion parameters such as power output, wheelchair velocity and arm motion patterns. After testing 22 subjects with different SCI levels, the results indicated that arm function was a more important factor in wheelchair propulsion, in terms of power output, than trunk stability and strength. More importantly, people with C5/C6 tetraplegia had a significantly reduced capability in terms of wheelchair propulsion compared with other subjects with a lower lesion (T1-T8, T9-T12 and L1-S5). A further study for quantifying the contribution of triceps function on improving wheelchair propulsion for people with tetraplegia was performed by comparing kinetic and kinematics parameters in C5/C6 tetraplegia subjects. Depending on the control of elbow extension, the subjects were divided into groups with: no active elbow extension, deltoid to triceps transfer surgery (TROIDS) to provide elbow extension, and incomplete C5/C6 tetraplegia with retained active triceps function providing elbow extension. The results demonstrated that the restoration of triceps following TROIDS surgery not only allows active elbow extension, but also increased the amplitude and strength as well as the speed of arm movement. Finally, the results also point to TROIDS allowing a more pronounced and natural push phase and an improved arm movement pattern during both propulsion and recovery phase under normal and extreme conditions.

It was hypothesized that superparamagnetic nanoparticles encapsulated in a silica shell with a fluorescent dye could be functionalized with axonal tracers and could be used for serial, non-invasive imaging with magnetic resonance imaging (MRI) for axon tract tracing. Nanoparticles functionalized with amine, octadecyl, silica, and biotinylated dextran amine were manufactured and characterized with MRI, scanning electron microscopy, and UV-visible, infrared, and fluorescence spectroscopy. Nanoparticle concentrations of 10 mM were not toxic to adult rat neural progenitor cells (NPCs) and labeled approximately 90% of cells. Nanoparticles were assessed for anterograde and retrograde tract tracing in adult rat models. With MRI and microscopy, the nanoparticles did not appear to trace axons but did provide an MRI signal for up to 3 weeks post implantation. While functionalized nanoparticles did not appear to trace axons, they are not toxic to NPCs and may be used as a MRI contrast agent in the neural axis.

At the author’s request, the abstract has been removed due to the confidential nature of the thesis. It will be added once the embargo period has passed.

Sociologists have only recently paid attention to how men experience physical disability. However, current research continues to ignore how different racial groups experience it. The goal of this study was to examine how black and white men experience life with a physical disability. Using qualitative research techniques involving in-depth, face-to-face interviews with 10 black and 10 white men, I focus on how meanings of disability and masculinity shift after a traumatic injury. Using symbolic interactionism and social construction as theoretical frameworks, I examine how these men formed and modified meanings for disability and masculinity through social interactions. I also analyze the strategies they use to manage a stigmatized identity. Finally, I explore how they negotiate a masculine identity within larger social contexts. My findings suggest that black and white men’s constructions of masculinity and disability are more similar than different on all levels. Furthermore, these men used three strategies to negotiate their new social identities: reinforcing idealized masculinity, modified masculinity, and lost masculinity.

Spinal cord injury (SCI) is a devastating condition that causes its victims to experience functional deficits. Inflammation plays a complex role in the progression of SCI. While some inflammatory cells attenuate further damage to the spinal cord tissue, other inflammatory mediators exacerbate the damage. Attenuating the detrimental aspects of inflammation after SCI is an attractive neuroprotective strategy that could potentially lead to significant functional improvement. In this regard, intravenous immunoglobulin G (IgG), which has many proposed immuno-modulatory mechanisms, is a potential treatment candidate. In this study, we investigated the neuroprotective properties of IgG by examining its effects after SCI at the molecular, cellular, and neurobehavioral levels. We observed that IgG treatment after SCI is associated with significant reduction in pro-inflammatory mediators and significant improvement in neurobehavioral recovery compared to the control. The results of the study suggest that IgG could potentially be used as an immuno-modulatory therapy for SCI.