Dr. Jim Shelton's Pearls

  • Blog post

    Dr. Jim Shelton's Pearls is an occasional series by USAID’s Global Health Science Advisor that answers commonly asked questions about family planning. 

    Global Health: Science & Practice

    Global Health: Science and Practice 

    Question: I understand USAID is involved in a new online peer reviewed global health journal. Is that right?

    Answer: Yes in collaboration with Johns Hopkins University and George Washington University. It is called Global Health: Science and Practice and is especially oriented toward practical knowledge related to how to implement programs in the field.  At the journal's website you can learn more about the journal and sign up to be a subscriber or peer reviewer.  We are now accepting submissions and project to publish the first issue late 2012 or early 2013. See more description in the image to the right.

  • Blog post

    Dr. Jim Shelton's Pearls is an occasional series by USAID’s Global Health Science Advisor that answers commonly asked questions about family planning. 

    Question: We are working hard on our objective to end preventable child and maternal deaths in our country, and we are trying to decide how much priority to give to nutrition.  What proportion of child deaths in low and middle income countries are attributable to undernutrition?

    Answer: A remarkable 45% according to a recent analysis in a recent Lancet special series on nutrition. When looking at deaths due to undernutrition, the authors identified these key nutrition related factors:

    A mother breastfeeds in Ile district, Zambezia, Mozambique

    A mother breastfeeds in Ile district, Zambezia, Mozambique.

    © 2005 Arturo Sanabria, Courtesy of Photoshare

    • Fetal growth restriction
    • Stunting
    • Underweight
    • Wasting
    • Suboptimal breastfeeding
    • Zinc and Vitamin A deficiency (these to a lesser extent)

    What’s new is appreciation of a key role of fetal growth restriction including small for gestational age (SGA). Notably, addressing that key factor calls for a programmatic shift to emphasize more women’s nutrition during pregnancy and even pre-pregnancy, which of course has additional benefit for women’s health.

    There is considerable interaction among these factors.  For example the joint effect of suboptimal breastfeeding and fetal growth restriction together on newborn mortality alone was 19% of all child mortality. As with any estimate, these are subject to the underlying assumptions. But clearly nutrition is profoundly important.

  • Blog post

    Dr. Jim Shelton's Pearls is an occasional series by USAID’s Global Health Science Advisor that answers commonly asked questions about family planning. 

    Question: This artemisinin resistance in Asia does sound like a potentially big problem. But our malaria program is in Africa. Do I need to worry about this artemisisin resistance? Is there something we can be doing to address it?

  • Blog post

    Dr. Jim Shelton's Pearls is an occasional series by USAID’s Global Health Science Advisor that answers commonly asked questions about family planning. 

    Originally posted on March 8, 2010.

    Question: That’s very interesting that during the chronic phase of HIV infection genital transmission risk is relatively low. Why would that be?

    Answer: At least 4 possible reasons may well explain the relatively low transmission rate during the chronic phase of infection, such as observed in discordant couple studies.

  • Blog post

    Dr. Jim Shelton's Pearls is an occasional series by USAID’s Global Health Science Advisor that answers commonly asked questions about family planning. 

    Originally posted on September 1, 2010.

    Question: I understand the FDA has approved a new emergency contraceptive (EC). Can you please tell me about it?

    Answer: Yes, on August 13, 2010 the FDA approved ella (ulipristal acetate) as a new oral emergency contraceptive. Some of its attributes:

  • Blog post

    Dr. Jim Shelton's Pearls is an occasional series by USAID’s Global Health Science Advisor that answers commonly asked questions about family planning. 

    Question:  Contraceptive implants are becoming very popular in our program here [at USAID], but we are especially concerned about unintended pregnancy among young women. Do you think they are suitable and popular for young women?