WorldWideScience

Sample records for integrated community-based micronutrient

  1. Beyond vertical integration--Community based medical education.

    Science.gov (United States)

    Kennedy, Emma Margaret

    2006-11-01

    The term 'vertical integration' is used broadly in medical education, sometimes when discussing community based medical education (CBME). This article examines the relevance of the term 'vertical integration' and provides an alternative perspective on the complexities of facilitating the CBME process. The principles of learner centredness, patient centredness and flexibility are fundamental to learning in the diverse contexts of 'community'. Vertical integration as a structural concept is helpful for academic organisations but has less application to education in the community setting; a different approach illuminates the strengths and challenges of CBME that need consideration by these organisations.

  2. Integrated community-based dementia care: the Geriant model

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    Ludo Glimmerveen

    2015-09-01

    Full Text Available This article gives an in-depth description of the service delivery model of Geriant, a Dutch organization providing community-based care services for people suffering from dementia. Core to its model is the provision of clinical case management, embedded in multidisciplinary dementia care teams. As Geriant's client group includes people from the first presumption of dementia until they can no longer live at home, its care model provides valuable lessons about how different mechanisms of integration are flexibly put to use if the complexity of clients” care needs increases. It showcases how the integration of services for a specific sub-population is combined with alignment of these services with generalist network partners. After a detailed description of the programme and its results, this article builds on the work of Walter Leutz for a conceptual discussion of Geriant's approach to care integration

  3. Study Protocol for a Randomized, Double-Blind, Community-Based Efficacy Trial of Various Doses of Zinc in Micronutrient Powders or Tablets in Young Bangladeshi Children

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    M. Munirul Islam

    2018-01-01

    Full Text Available Zinc is essential to supporting growth in young children especially for tissues undergoing rapid cellular differentiation and turnover, such as those in the immune system and gastrointestinal tract. Therapeutic zinc supplementation has been initiated in low-income countries as part of diarrhea treatment programs to support these needs for young children, but the effects of preventive supplemental zinc as a tablet or as a multiple micronutrient powder (MNP on child growth and diarrheal disease are mixed and pose programmatic uncertainties. Thus, a randomized, double-blind community-based efficacy trial of five different doses, forms, and frequencies of preventive zinc supplementation vs. a placebo was designed for a study in children aged 9–11 months in an urban community in Dhaka, Bangladesh. The primary outcomes of this 24-week study are incidence of diarrheal disease and linear growth. Study workers will conduct in-home morbidity checks twice weekly; anthropometry will be measured at baseline, 12 weeks and 24 weeks. Serum zinc and other related biomarkers will be measured in a subsample along with an estimate of the exchangeable zinc pool size using stable isotope techniques in a subgroup. Therapeutic zinc will be provided as part of diarrhea treatment, in accordance with Bangladesh’s national policy. Therefore, the proposed study will determine the additional benefit of a preventive zinc supplementation intervention. The protocol has been approved by the Institutional Review Boards (IRBs of icddr,b and Children’s Hospital Oakland Research Institute (CHORI. The IRB review process is underway at the University of Colorado Denver as well.

  4. Perceptions That Influence the Maintenance of Scientific Integrity in Community-Based Participatory Research

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    Kraemer Diaz, Anne E.; Spears Johnson, Chaya R.; Arcury, Thomas A.

    2015-01-01

    Scientific integrity is necessary for strong science; yet many variables can influence scientific integrity. In traditional research, some common threats are the pressure to publish, competition for funds, and career advancement. Community-based participatory research (CBPR) provides a different context for scientific integrity with additional and…

  5. Integrated Community Based Coastal Management: Lesson From The Field

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    Hadi, Sudharto P.

    2018-02-01

    Coastal abrasion has been occurred throughout coastline of Java reaching 745 km at length, account for 44% of total Java’s coastline. This phenomena is caused by reclamation, cutting of mangrove, land-use change and other human activities specifically at coastal area. Coastal abrasion stimulates flood or tidal flood, when sea level rise, the sea water flows to the land undated fish pond, settlement and other infrastructures standing at coastal area. Tidal flood destroys settlement lead to significant decrease of property value: land and house. Coastal abrasion caused lose people’s job and income. One measure taken by local community is mangrove cultivation intended to prevent sea level rise flowing to the inland. However many efforts taken by community frequently fail because of un-integrated approach. This paper reviews a mangrove plantations in Mangunharjo, district of Tugu, Semarang, Central Java by utilizing an innovative approach integrating environmental, economic and social aspect. These mangrove cultivations environmentally useful to prevent coastal abrasion, economically creating income for local people and socially supported by local community. These three approaches ensure sustainability of mangrove’s culture.

  6. Capacity Enhancement of Hepatitis C Virus Treatment through Integrated, Community-Based Care

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    Warren D Hill

    2008-01-01

    Full Text Available BACKGROUND: An estimated 250,000 Canadians are infected with the hepatitis C virus (HCV. The present study describes a cohort of individuals with HCV referred to community-based, integrated prevention and care projects developed in British Columbia. Treatment outcomes are reported for a subset of individuals undergoing antiviral therapy at four project sites.

  7. Integrating Severely Handicapped Learners: Potential Teacher Liability in Community Based Programs.

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    Brady, Michael P.; Dennis, H. Floyd

    1984-01-01

    The paper examines elements of negligence and other legal concerns in view of the evolving trend to educate severely handicapped persons in integrated, community based settings. Duty, care, risk, and appropriate placement and instruction are discussed. Finally, recommendations for avoiding teacher liability are presented. (Author/CL)

  8. An Integrated Model of Co-ordinated Community-Based Care.

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    Scharlach, Andrew E; Graham, Carrie L; Berridge, Clara

    2015-08-01

    Co-ordinated approaches to community-based care are a central component of current and proposed efforts to help vulnerable older adults obtain needed services and supports and reduce unnecessary use of health care resources. This study examines ElderHelp Concierge Club, an integrated community-based care model that includes comprehensive personal and environmental assessment, multilevel care co-ordination, a mix of professional and volunteer service providers, and a capitated, income-adjusted fee model. Evaluation includes a retrospective study (n = 96) of service use and perceived program impact, and a prospective study (n = 21) of changes in participant physical and social well-being and health services utilization. Over the period of this study, participants showed greater mobility, greater ability to meet household needs, greater access to health care, reduced social isolation, reduced home hazards, fewer falls, and greater perceived ability to obtain assistance needed to age in place. This study provides preliminary evidence that an integrated multilevel care co-ordination approach may be an effective and efficient model for serving vulnerable community-based elders, especially low and moderate-income elders who otherwise could not afford the cost of care. The findings suggest the need for multisite controlled studies to more rigorously evaluate program impacts and the optimal mix of various program components. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  9. A community-based approach for integrating geriatrics and gerontology into undergraduate medical education.

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    Martinez, Iveris L; Mora, Jorge Camilo

    2012-01-01

    Medical school accreditation requirements require educational opportunities in geriatrics. Twenty-six minimum graduating competencies in geriatrics have recently been identified for medical students. The authors describe how these competencies are being integrated into a new medical curriculum through coursework and community-based experiences. This approach is intended to expose students to older adults from diverse communities and adequately prepare students to address the complex and individual needs of these patients. Initial results indicate proficiency in the minimum geriatric competencies covered. The growth and diversity of the older adult population makes it important to integrate and evaluate geriatrics education in undergraduate medical education.

  10. Variation in the Interpretation of Scientific Integrity in Community-based Participatory Health Research

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    Kraemer Diaz, Anne E.; Spears Johnson, Chaya R.; Arcury, Thomas A.

    2013-01-01

    Community-based participatory research (CBPR) has become essential in health disparities and environmental justice research; however, the scientific integrity of CBPR projects has become a concern. Some concerns, such as appropriate research training, lack of access to resources and finances, have been discussed as possibly limiting the scientific integrity of a project. Prior to understanding what threatens scientific integrity in CBPR, it is vital to understand what scientific integrity means for the professional and community investigators who are involved in CBPR. This analysis explores the interpretation of scientific integrity in CBPR among 74 professional and community research team members from of 25 CBPR projects in nine states in the southeastern United States in 2012. It describes the basic definition for scientific integrity and then explores variations in the interpretation of scientific integrity in CBPR. Variations in the interpretations were associated with team member identity as professional or community investigators. Professional investigators understood scientific integrity in CBPR as either conceptually or logistically flexible, as challenging to balance with community needs, or no different than traditional scientific integrity. Community investigators interpret other factors as important in scientific integrity, such as trust, accountability, and overall benefit to the community. This research demonstrates that the variations in the interpretation of scientific integrity in CBPR call for a new definition of scientific integrity in CBPR that takes into account the understanding and needs of all investigators. PMID:24161098

  11. Perceptions that influence the maintenance of scientific integrity in community-based participatory research.

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    Kraemer Diaz, Anne E; Spears Johnson, Chaya R; Arcury, Thomas A

    2015-06-01

    Scientific integrity is necessary for strong science; yet many variables can influence scientific integrity. In traditional research, some common threats are the pressure to publish, competition for funds, and career advancement. Community-based participatory research (CBPR) provides a different context for scientific integrity with additional and unique concerns. Understanding the perceptions that promote or discourage scientific integrity in CBPR as identified by professional and community investigators is essential to promoting the value of CBPR. This analysis explores the perceptions that facilitate scientific integrity in CBPR as well as the barriers among a sample of 74 professional and community CBPR investigators from 25 CBPR projects in nine states in the southeastern United States in 2012. There were variations in perceptions associated with team member identity as professional or community investigators. Perceptions identified to promote and discourage scientific integrity in CBPR by professional and community investigators were external pressures, community participation, funding, quality control and supervision, communication, training, and character and trust. Some perceptions such as communication and training promoted scientific integrity whereas other perceptions, such as a lack of funds and lack of trust could discourage scientific integrity. These results demonstrate that one of the most important perceptions in maintaining scientific integrity in CBPR is active community participation, which enables a co-responsibility by scientists and community members to provide oversight for scientific integrity. Credible CBPR science is crucial to empower the vulnerable communities to be heard by those in positions of power and policy making. © 2015 Society for Public Health Education.

  12. Integrating community based disaster risk reduction and climate change adaptation: examples from the Pacific

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    A. Gero

    2011-01-01

    Full Text Available It is acknowledged by academics and development practitioners alike that many common strategies addressing community based disaster risk reduction and climate change adaptation duplicate each other. Thus, there is a strong push to integrate the two fields to enhance aid effectiveness and reduce confusion for communities. Examples of community based disaster risk reduction (DRR and climate change adaptation (CCA projects are presented to highlight some of the ways these issues are tackled in the Pacific. Various approaches are employed but all aim to reduce the vulnerability and enhance the resilience of local communities to the impacts of climate change and disasters. By focusing on three case studies, elements of best practice are drawn out to illustrate how DRR and CCA can be integrated for enhanced aid effectiveness, and also look at ways in which these two often overlapping fields can be better coordinated in ongoing and future projects. Projects that address vulnerability holistically, and target the overall needs and capacity of the community are found to be effective in enhancing the resilience of communities. By strategically developing a multi-stakeholder and multi-sector approach, community projects are likely to encapsulate a range of experience and skills that will benefit the community. Furthermore, by incorporating local knowledge, communities are far more likely to be engaged and actively participate in the project. From selected case studies, commonly occurring best practice methods to integrate DRR and CCA are identified and discussed and recommendations on how to overcome the common challenges also presented.

  13. The Vanguard of Community-based Integrated Care in Japan: The Effect of a Rural Town on National Policy

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    Yu Hatano

    2017-04-01

    Full Text Available Introduction: Japan has the largest percentage of elderly people in the world. In 2012 the government implemented a community-based integrated care system which provides seamless community healthcare resources for elderly people with chronic diseases and disabilities.  Methods: This paper describes the challenges of establishing a community-based integrated care system in 1974 in Mitsugi, a rural town of Japan. This system has influenced the government and become the model for the nationwide system.  Results: In the 1970s, Mitsugi’s aging population was growing faster than Japan’s, but elder care was fragmented among a variety of service sections. A community-based integrated care system evolved because of the small but aging population size and the initiative of some local leaders of medical care and politics. After the system took effect, the proportion of bedridden people and medical care costs for the elderly dropped in Mitsugi while it continued to rise everywhere else in Japan. Mitsugi’s community-based integrated care system is now shaping national policy.  Conclusion: Mitsugi is in the vanguard of Japan’s community-based integrated care system. The case showed the community-based integrated care system can diffuse from rural to urban areas.

  14. The Vanguard of Community-based Integrated Care in Japan: The Effect of a Rural Town on National Policy

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    Matsumoto, Masatoshi; Okita, Mitsuaki; Inoue, Kazuo; Takeuchi, Keisuke; Tsutsui, Takako; Nishimura, Shuhei; Hayashi, Takuo

    2017-01-01

    Introduction: Japan has the largest percentage of elderly people in the world. In 2012 the government implemented a community-based integrated care system which provides seamless community healthcare resources for elderly people with chronic diseases and disabilities. Methods: This paper describes the challenges of establishing a community-based integrated care system in 1974 in Mitsugi, a rural town of Japan. This system has influenced the government and become the model for the nationwide system. Results: In the 1970s, Mitsugi’s aging population was growing faster than Japan’s, but elder care was fragmented among a variety of service sections. A community-based integrated care system evolved because of the small but aging population size and the initiative of some local leaders of medical care and politics. After the system took effect, the proportion of bedridden people and medical care costs for the elderly dropped in Mitsugi while it continued to rise everywhere else in Japan. Mitsugi’s community-based integrated care system is now shaping national policy. Conclusion: Mitsugi is in the vanguard of Japan’s community-based integrated care system. The case showed the community-based integrated care system can diffuse from rural to urban areas. PMID:28970743

  15. Formulation of an Integrated Community Based Disaster Management for Hydroelectric facilities: The Malaysia Case

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    Hijazzi, Norshamirra; Thiruchelvam, Sivadass; Sabri Muda, Rahsidi; Nasharuddin Mustapha, Kamal; Che Muda, Zakaria; Ghazali, Azrul; Kamal Kadir, Ahmad; Hakimie, Hazlinda; Sahari, Khairul Salleh Mohamed; Hasini, Hasril; Mohd Sidek, Lariyah; Itam, Zarina; Fadhli Mohamad, Mohd; Razad, Azwin Zailti Abdul

    2016-03-01

    Dams, however significant their contributions are to the society, are not immune to failures and diminishing lifespan not unlike other structural elements in our infrastructure. Despite continuing efforts on design, construction, operation, and maintenance of dams to improve the safety of the dams, the possibility of unforeseen events of dam failures is still possible. Seeing that dams are usually integrated into close approximities with the community, dam failures may consequent in tremendous loss of lives and properties. The aims of formulation of Integrated Community Based Disaster Management (ICBDM) is to simulate evacuation modelling and emergency planning in order to minimize loss of life and property damages in the event of a dam-related disaster. To achieve the aim above, five main pillars have been identified for the formulation of ICBDM. A series of well-defined program inclusive of hydrological 2-D modelling, life safety modelling, community based EWS and CBTAP will be conducted. Finally, multiple parties’ engagement is to be carried out in the form of table top exercise to measure the readiness of emergency plans and response capabilities of key players during the state of a crisis.

  16. An Integrated Approach to “Sustainable Community-Based Tourism”

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    Tek B. Dangi

    2016-05-01

    Full Text Available Two rich knowledge domains have been evolving along parallel pathways in tourism studies: sustainable tourism (ST and community-based tourism (CBT. Within both lie diverse definitions, principles, criteria, critical success factors and benefits sought or outcomes desired, advocated by different stakeholders ranging from quasi-governmental and non-profit organizations to public-private sector and academic interests. This poses significant challenges to those interested in theory building, research and practice in the sustainable development and management of tourism. The paper builds on a previous article published in Sustainability by presenting an integrated framework based on a comprehensive, in-depth review and analysis of the tourism-related literature. The study reveals not just common ground and differences that might be anticipated, but also important sustainability dimensions that are lagging or require much greater attention, such as equity, justice, ethical and governance issues. A preliminary framework of “sustainable community-based tourism” (SCBT is forwarded that attempts to bridge the disparate literature on ST and CBT. Critical directions forward are offered to progress research and sustainability-oriented practices towards more effective development and management of tourism in the 21st century.

  17. A Study on Integrated Community Based Flood Mitigation with Remote Sensing Technique in Kota Bharu, Kelantan

    International Nuclear Information System (INIS)

    Ainullotfi, A A; Ibrahim, A L; Masron, T

    2014-01-01

    This study is conducted to establish a community based flood management system that is integrated with remote sensing technique. To understand local knowledge, the demographic of the local society is obtained by using the survey approach. The local authorities are approached first to obtain information regarding the society in the study areas such as the population, the gender and the tabulation of settlement. The information about age, religion, ethnic, occupation, years of experience facing flood in the area, are recorded to understand more on how the local knowledge emerges. Then geographic data is obtained such as rainfall data, land use, land elevation, river discharge data. This information is used to establish a hydrological model of flood in the study area. Analysis were made from the survey approach to understand the pattern of society and how they react to floods while the analysis of geographic data is used to analyse the water extent and damage done by the flood. The final result of this research is to produce a flood mitigation method with a community based framework in the state of Kelantan. With the flood mitigation that involves the community's understanding towards flood also the techniques to forecast heavy rainfall and flood occurrence using remote sensing, it is hope that it could reduce the casualties and damage that might cause to the society and infrastructures in the study area

  18. [How therapists view the contribution of cultural resources for community-based integrative therapy].

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    de Oliveira, Danielle Samara Tavares; Ferreira Filha, Maria de Oliveira

    2011-09-01

    This study aims to investigate the contribution of cultural resources to Community-Based Integrative Care (CBIC), to consolidate it as a model of community-based mental health and a political strategy for local health, and to identify the cultural strategies most used in CBIC sessions. This is a qualitative study, conducted in the city of João Pessoa, state of Paraíba, Brazil, with ten therapists. We used semi-structured interviews and afield diary, from September, 2008, to March, 2009, then proceeded to the interpretive analysis of the data. It was evident that the inclusion of cultural resources contributes to the consolidation of CBIC, for it reclaims and strengthen values, and it underscores the personal and social identity of individuals, encouraging effective participation. The main cultural resources used were music, dynamics and prayers. The conclusion was that cultural resources are an important resource for the work of the therapist, for it strengthens bonds and helps people to give a new meaning to their suffering.

  19. Establishing community-based integrated care for elderly patients through interprofessional teamwork: a qualitative analysis

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    Asakawa T

    2017-10-01

    Full Text Available Tomohiro Asakawa,1 Hidenobu Kawabata,1 Kengo Kisa,2 Takayoshi Terashita,3 Manabu Murakami,4 Junji Otaki1 1Department of Medical Education and General Medicine, Graduate School of Medicine, Hokkaido University, Sapporo, 2Kutchan-Kosei General Hospital, Kutchan, Hokkaido, 3Graduate School of Radiological Technology Gunma Prefectural College of Health Sciences, Kamioki-machi, Maebashi, Gunma, 4International Relations Office, Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan Background: Working in multidisciplinary teams is indispensable for ensuring high-quality care for elderly people in Japan’s rapidly aging society. However, health professionals often experience difficulty collaborating in practice because of their different educational backgrounds, ideas, and the roles of each profession. In this qualitative descriptive study, we reveal how to build interdisciplinary collaboration in multidisciplinary teams. Methods: Semi-structured interviews were conducted with a total of 26 medical professionals, including physicians, nurses, public health nurses, medical social workers, and clerical personnel. Each participant worked as a team member of community-based integrated care. The central topic of the interviews was what the participants needed to establish collaboration during the care of elderly residents. Each interview lasted for about 60 minutes. All the interviews were recorded, transcribed verbatim, and subjected to content analysis. Results: The analysis yielded the following three categories concerning the necessary elements of building collaboration: 1 two types of meeting configuration; 2 building good communication; and 3 effective leadership. The two meetings described in the first category – “community care meetings” and “individual care meetings” – were aimed at bringing together the disciplines and discussing individual cases, respectively. Building good communication referred to the activities

  20. Community-Based Rehabilitation in Bangladesh, Health Components Need to be Integrated with Primary Health Care

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    Md Shahidur Rahman

    2018-01-01

    Full Text Available Community-based rehabilitation (CBR is defined as a strategy within general community development for the rehabilitation, equalization of opportunities, poverty reduction and social inclusion of people with disabilities. The role of CBR is to work closely with the health sector to ensure that the needs of people with disabilities and their family members are addressed in the areas of health promotion, prevention, medical care, rehabilitation and assistive devices. CBR also needs to work with individuals and their families to facilitate their access to health services and to work with other sectors to ensure that all aspects of health are addressed. Health components of CBR as per WHO guidelines are grossly neglected in Bangladesh. Some government and non-government organizations are working independently, but health components are inadequately addressed. We observed that primary health care, if integrated with medical rehabilitation of disabled, will better address the need and help bring disabled into mainstream of development. Health care providers at grass root level need to be trained in CBR activities which can be arranged centrally with health ministry, social welfare ministry and rehabilitation specialists. In this review we have tried to reveal the health components of CBR in global and Bangladesh context and importance of integrating health components of CBR with primary health care.

  1. Feasibility and willingness-to-pay for integrated community-based tuberculosis testing

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    Vickery Carter

    2011-11-01

    Full Text Available Abstract Background Community-based screening for TB, combined with HIV and syphilis testing, faces a number of barriers. One significant barrier is the value that target communities place on such screening. Methods Integrated testing for TB, HIV, and syphilis was performed in neighborhoods identified using geographic information systems-based disease mapping. TB testing included skin testing and interferon gamma release assays. Subjects completed a survey describing disease risk factors, healthcare access, healthcare utilization, and willingness to pay for integrated testing. Results Behavioral and social risk factors among the 113 subjects were prevalent (71% prior incarceration, 27% prior or current crack cocaine use, 35% homelessness, and only 38% had a regular healthcare provider. The initial 24 subjects reported that they would be willing to pay a median $20 (IQR: 0-100 for HIV testing and $10 (IQR: 0-100 for TB testing when the question was asked in an open-ended fashion, but when the question was changed to a multiple-choice format, the next 89 subjects reported that they would pay a median $5 for testing, and 23% reported that they would either not pay anything to get tested or would need to be paid $5 to get tested for TB, HIV, or syphilis. Among persons who received tuberculin skin testing, only 14/78 (18% participants returned to have their skin tests read. Only 14/109 (13% persons who underwent HIV testing returned to receive their HIV results. Conclusion The relatively high-risk persons screened in this community outreach study placed low value on testing. Reported willingness to pay for such testing, while low, likely overestimated the true willingness to pay. Successful TB, HIV, and syphilis integrated testing programs in high risk populations will likely require one-visit diagnostic testing and incentives.

  2. Organizational capacity for service integration in community-based addiction health services.

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    Guerrero, Erick G; Aarons, Gregory A; Palinkas, Lawrence A

    2014-04-01

    We examined factors associated with readiness to coordinate mental health, public health, and HIV testing among community-based addiction health services programs. We analyzed client and program data collected in 2011 from publicly funded addiction health services treatment programs in Los Angeles County, California. We analyzed a sample of 14 379 clients nested in 104 programs by using logistic regressions examining odds of service coordination with mental health and public health providers. We conducted a separate analysis to examine the percentage of clients receiving HIV testing in each program. Motivational readiness and organizational climate for change were associated with higher odds of coordination with mental health and public health services. Programs with professional accreditation had higher odds of coordinating with mental health services, whereas programs receiving public funding and methadone and residential programs (compared with outpatient) had a higher percentage of clients receiving coordinated HIV testing. These findings provide an evidentiary base for the role of motivational readiness, organizational climate, and external regulation and funding in improving the capacity of addiction health services programs to develop integrated care.

  3. Community-based participatory research and integrated knowledge translation: advancing the co-creation of knowledge.

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    Jull, Janet; Giles, Audrey; Graham, Ian D

    2017-12-19

    Better use of research evidence (one form of "knowledge") in health systems requires partnerships between researchers and those who contend with the real-world needs and constraints of health systems. Community-based participatory research (CBPR) and integrated knowledge translation (IKT) are research approaches that emphasize the importance of creating partnerships between researchers and the people for whom the research is ultimately meant to be of use ("knowledge users"). There exist poor understandings of the ways in which these approaches converge and diverge. Better understanding of the similarities and differences between CBPR and IKT will enable researchers to use these approaches appropriately and to leverage best practices and knowledge from each. The co-creation of knowledge conveys promise of significant social impacts, and further understandings of how to engage and involve knowledge users in research are needed. We examine the histories and traditions of CBPR and IKT, as well as their points of convergence and divergence. We critically evaluate the ways in which both have the potential to contribute to the development and integration of knowledge in health systems. As distinct research traditions, the underlying drivers and rationale for CBPR and IKT have similarities and differences across the areas of motivation, social location, and ethics; nevertheless, the practices of CBPR and IKT converge upon a common aim: the co-creation of knowledge that is the result of knowledge user and researcher expertise. We argue that while CBPR and IKT both have the potential to contribute evidence to implementation science and practices for collaborative research, clarity for the purpose of the research-social change or application-is a critical feature in the selection of an appropriate collaborative approach to build knowledge. CBPR and IKT bring distinct strengths to a common aim: to foster democratic processes in the co-creation of knowledge. As research

  4. Integration of Local Ecological Knowledge and Conventional Science: a Study of Seven Community-Based Forestry Organizations in the USA

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    Heidi L. Ballard

    2008-12-01

    Full Text Available Natural resource management decisions can be based on incomplete knowledge when they lack scientific research, monitoring, and assessment and/or simultaneously fail to draw on local ecological knowledge. Many community-based forestry organizations in the United States attempt to address these knowledge gaps with an integrated ecological stewardship approach that balances ecological, social, and economic goals. This paper examines the use and integration of local knowledge and conventional science in ecological stewardship and monitoring by seven community-based forestry demonstration projects. Through document reviews and interviews with both participants and partners of all of these community-based organizations, we found that all the community-based forestry groups incorporated local ecological knowledge into many aspects of their management or monitoring activities, such as collaboratively designing monitoring programs with local ranchers, forest workers, and residents; involving local people in collecting data and interpreting results; and documenting the local ecological knowledge of private forest landowners, long-time residents, and harvesters of nontimber forest products. We found that all the groups also used conventional science to design or conduct ecological assessments, monitoring, or research. We also found evidence, in the form of changes in attitudes on the part of local people and conventional scientists and jointly produced reports, that the two types of knowledge were integrated by all groups. These findings imply that community-based forestry groups are redistributing the power of conventional science through the use of diverse knowledge sources. Still, several obstacles prevented some local, traditionally under-represented groups from being significantly involved in monitoring and management decisions, and their knowledge has not yet been consistently incorporated.

  5. Community Based Integrated Intervention, Lesions Learn from Rural Remote Areas of Bangladesh

    International Nuclear Information System (INIS)

    Talukder, Shamim; Farhana, Dina; Shajedul Haque, Haque; Maruf, Kazi

    2014-01-01

    health and nutrition, special emphasis was given at the WVB project activities. However, projects had great impact on behavior change components and mothers’ knowledge on basic concepts of nutrition has increased vastly, doesn’t effect on reducing severe and moderate malnutrition. The proportions of mildly under nourished children were underweight (30.2%), stunted (29.3%) and wasted (22.8%). The proportions of children being moderately under nourished were underweight (29.6%), stunted (19.9%) and wasted (24.1%). Indeed progress of achieving severe malnutrition, wasting has decreased drastically to 8% which was 17% in the baseline, however, severe underweight and stunting increased compared to baseline and also slightly higher compare to national data. Access in taking services have increased and among the children suffering from Diarrhea, 92.9% treated by the nearest facilities. Among the children eligible for vaccination, around 63.3% has reported to be fully immunized. Conclusions: While such community based intervention has impact on changing knowledge and uptake of services, limited in reducing acute malnutrition indeed. So, nutrition intervention redesign is necessary and food supplementation as well as treatment of acute malnourished children should be prioritized. (author)

  6. Integrating interprofessional education in community-based learning activities: case study.

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    Hosny, Somaya; Kamel, Mohamed H; El-Wazir, Yasser; Gilbert, John

    2013-01-01

    Faculty of Medicine/Suez Canal University (FOM/SCU) students are exposed to clinical practice in primary care settings within the community, in which they encounter patients and begin to work within interprofessional health teams. However, there is no planned curricular interaction with learners from other professions at the learning sites. As in other schools, FOM/SCU faces major challenges with the coordination of community-based education (CBE) program, which include the complexity of the design required for Interprofessional Education (IPE) as well as the attitudinal barriers between professions. The aim of the present review is to: (i) describe how far CBE activities match the requirements of IPE, (ii) explore opinions of graduates about the effectiveness of IPE activities, and (iii) present recommendations for improvement. Graduates find the overall outcome of their IPE satisfactory and believe that it produces physicians who are familiar with the roles of other professions and can work in synergy for the sake of better patient care. However, either a specific IPE complete module needs to be developed or more IPE specific objectives need to be added to current modules. Moreover, coordination with stakeholders from other health profession education institutes needs to be maximized to achieve more effective IPE.

  7. Integrating Faith-based and Community-based Participatory Research Approaches to Adapt the Korean Parent Training Program.

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    Kim, Eunjung; Boutain, Doris; Kim, Sangho; Chun, Jin-Joo; Im, Hyesang

    Faith and community based inquiry approaches are rarely used to develop research interventions. The purpose of this article is to present how a research team worked with six Korean American Christian churches to revise the prototype Korean Parent Training Program (KPTP), based upon the Bright Futures Parenting Program. The collaboration was sought to better integrate and align the KPTP with Korean culture and faith. The KPTP was developed to promote positive parenting practices and decrease mental health disparities of Korean American children. Sixteen church participants completed a Delphi survey, a workshop series, Community Theaters, and focus groups. The participants suggested adding Korean traditional parenting virtues, Christian parenting principles, and revising the standardized parent training and program philosophy. Revisions made KPTP sensitive to Korean culture and faith, and promoted program acceptability. The process demonstrated the importance of working with church volunteers to develop faith-based and community-based health promotion interventions targeting Korean American faith communities. This research presents significant and meaningful implications for working with other faith communities from minority backgrounds. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Integrating an ecological approach into an Aboriginal community-based chronic disease prevention program: a longitudinal process evaluation

    Directory of Open Access Journals (Sweden)

    Maypilama Elaine

    2011-05-01

    Full Text Available Abstract Background Public health promotes an ecological approach to chronic disease prevention, however, little research has been conducted to assess the integration of an ecological approach in community-based prevention programs. This study sought to contribute to the evidence base by assessing the extent to which an ecological approach was integrated into an Aboriginal community-based cardiovascular disease (CVD and type 2 diabetes prevention program, across three-intervention years. Methods Activity implementation forms were completed by interview with implementers and participant observation across three intervention years. A standardised ecological coding procedure was applied to assess participant recruitment settings, intervention targets, intervention strategy types, extent of ecologicalness and organisational partnering. Inter-rater reliability for two coders was assessed at Kappa = 0.76 (p Results 215 activities were implemented across three intervention years by the health program (HP with some activities implemented in multiple years. Participants were recruited most frequently through organisational settings in years 1 and 2, and organisational and community settings in year 3. The most commonly utilised intervention targets were the individual (IND as a direct target, and interpersonal (INT and organisational (ORG environments as indirect targets; policy (POL, and community (COM were targeted least. Direct (HP→ IND and indirect intervention strategies (i.e., HP→ INT→ IND, HP→ POL → IND were used most often; networking strategies, which link at least two targets (i.e., HP→[ORG-ORG]→IND, were used the least. The program did not become more ecological over time. Conclusions The quantity of activities with IND, INT and ORG targets and the proportion of participants recruited through informal cultural networking demonstrate community commitment to prevention. Integration of an ecological approach would have been

  9. Generic model of a community-based microgrid integrating wind turbines, photovoltaics and CHP generations

    International Nuclear Information System (INIS)

    Ma, Xiandong; Wang, Yifei; Qin, Jianrong

    2013-01-01

    Highlights: ► Proposes a generic microgrid model comprising hybrid distributed generation units. ► Examines DG performance due to both environmental condition changes and electrical faults. ► Addresses island and grid connected modes of operation for DG units. ► We demonstrate the feasibility of the proposed residential microgrid system. - Abstract: Development and deployment of low-carbon energy technologies has been a national strategy of both the UK and China for a number of years, including the use of renewable generation technologies and the improvement of energy efficiency of operations and activities. The paper addresses several issues of generic importance to a residential microgrid system such as network modelling, advanced control and integration of intelligent monitoring techniques. The system, comprising representative distributed generation technologies of photovoltaics, wind turbines and combined heat and power, has been simulated by PSCAD/EMTDC under different operational scenarios. Studies include the effect of environmental condition changes, control systems and power electronics on wind turbines and PV cells, and the mixture of wind/solar/CHP energy generation under dominance of each technology. The performance and dynamics of the system are examined against symmetrical and asymmetrical electrical faults to seek an optimal isolation and restoration of the distributed generation unit from the connected grid system. Modelling these system interactions has demonstrated the feasibility of the proposed residential microgrid system

  10. Impact of a community-based integrated management of childhood illnesses (IMCI) programme in Gegharkunik, Armenia.

    Science.gov (United States)

    Thompson, Michael E; Harutyunyan, Tsovinar L

    2009-03-01

    Maternal and child health status in the Martuni region of Gegharkunik marz, Armenia, precipitously declined following Armenia's independence in 1991. In response, the American Red Cross (ARC) and the Armenian Red Cross Society (ARCS) implemented the WHO community-level Integrated Management of Childhood Illnesses (IMCI) strategy, complementing recent clinical IMCI training in the region in which 387 community health volunteers from 16 villages were trained as peer educators, and approximately 5000 caretakers of children under age 5 were counselled on key nutrition and health practices. A pre-post independent sample design was used to assess the programme's impact. The evaluation instrument collected respondent demographic characteristics and knowledge, attitudes and practices consistent with 10 health indicators typical of child survival interventions. At baseline and at follow-up, 300 mothers were interviewed using a stratified simple random sampling of households with at least one child less than age 2. The assessment confirmed the population's poor health status and limited knowledge and application of recommended child care practices. The campaign reached its target: at follow-up, 67% had seen media messages within the past month, 82% had received the IMCI informational booklet, and 30% had seen other materials. Evidence of the success of the programme included the following: exclusive breastfeeding increased 31.4%, maternal knowledge of child illness signs increased 30%, knowledge of HIV increased 28.5%, and physician attended deliveries increased 15%. This evaluation documented the significant and substantial impact of the community IMCI programme on both knowledge and practice in rural areas of Armenia. Consideration should be given to continuing and expanding this project as a complement to health sector development activities in this region.

  11. Integrating Medication Therapy Management (MTM Services Provided by Community Pharmacists into a Community-Based Accountable Care Organization (ACO

    Directory of Open Access Journals (Sweden)

    Brian Isetts

    2017-10-01

    Full Text Available (1 Background: As the U.S. healthcare system evolves from fee-for-service financing to global population-based payments designed to be accountable for both quality and total cost of care, the effective and safe use of medications is gaining increased importance. The purpose of this project was to determine the feasibility of integrating medication therapy management (MTM services provided by community pharmacists into the clinical care teams and the health information technology (HIT infrastructure for Minnesota Medicaid recipients of a 12-county community-based accountable care organization (ACO. (2 Methods: The continuous quality improvement evaluation methodology employed in this project was the context + mechanism = outcome (CMO model to account for the fact that programs only work insofar as they introduce promising ideas, solutions and opportunities in the appropriate social and cultural contexts. Collaborations between a 12-county ACO and 15 community pharmacies in Southwest Minnesota served as the social context for this feasibility study of MTM referrals to community pharmacists. (3 Results: All 15 community pharmacy sites were integrated into the HIT infrastructure through Direct Secure Messaging, and there were 32 recipients who received MTM services subsequent to referrals from the ACO at 5 of the 15 community pharmacies over a 1-year implementation phase. (4 Conclusion: At the conclusion of this project, an effective electronic communication and MTM referral system was activated, and consideration was given to community pharmacists providing MTM in future ACO shared savings agreements.

  12. An integrated approach to preventing cardiovascular disease: community-based approaches, health system initiatives, and public health policy.

    Science.gov (United States)

    Karwalajtys, Tina; Kaczorowski, Janusz

    2010-01-01

    Cardiovascular disease (CVD) is largely the product of interactions among modifiable risk factors that are common in developed nations and increasingly of concern in developing countries. Hypertension is an important precursor to the development of CVD, and although detection and treatment rates have improved in recent years in some jurisdictions, effective strategies and policies supporting a shift in distribution of risk factors at the population level remain paramount. Challenges in managing cardiovascular health more effectively include factors at the patient, provider, and system level. Strategies to reduce hypertension and CVD should be population based, incorporate multilevel, multicomponent, and socioenvironmental approaches, and integrate community resources with public health and clinical care. There is an urgent need to improve monitoring and management of risk factors through community-wide, primary care-linked initiatives, increase the evidence base for community-based prevention strategies, further develop and evaluate promising program components, and develop new approaches to support healthy lifestyle behaviors in diverse age, socioeconomic, and ethnocultural groups. Policy and system changes are critical to reduce risk in populations, including legislation and public education to reduce dietary sodium and trans-fatty acids, food pricing policies, and changes to health care delivery systems to explicitly support prevention and management of CVD.

  13. Evaluation of a Community-Based Program That Integrates Joyful Movement Into Fall Prevention for Older Adults

    Science.gov (United States)

    Carlucci, Celeste; Kardachi, Julie; Bradley, Sara M.; Prager, Jason; Wyka, Katarzyna

    2018-01-01

    Background: Despite the development of evidence-based fall-prevention programs, there remains a need for programming that will engage older adults in real-world settings. Objective: This study aimed to evaluate a community-based group program that integrates joyful movement into fall prevention. The curriculum emphasizes a positive experience of movement, cultivating a healthy body image, and retraining of biomechanics. Design: Program evaluation was conducted using a one-group pre–post test study design. Key outcomes were functional balance and confidence. Qualitative feedback was gathered at the final class sessions. Results: Two hundred fifteen older adults enrolled at four sites over the period from 2010 to 2014. Among 86 participants who provided feedback, most credited the program for an increased sense of optimism and/or confidence (70%), and better walking ability (50%). Among 102 participants who completed both initial and final assessments, there was evidence of significant improvements on the Functional Reach Test (d = .60, p Falls Efficacy Scale (d = .17, p balance and confidence. Future research should examine whether the positive changes encouraged by joyful movement lead to lasting reductions in fall risk and additional health benefits. PMID:29796405

  14. Reach and Effectiveness of an Integrated Community-Based Intervention on Physical Activity and Healthy Eating of Older Adults in a Socioeconomically Disadvantaged Community

    Science.gov (United States)

    Luten, Karla A.; Reijneveld, Sijmen A.; Dijkstra, Arie; de Winter, Andrea F.

    2016-01-01

    The aim of this study is to assess the reach and effectiveness of an integrated community-based intervention designed to promote physical activity and healthy eating among older adults in a socioeconomically disadvantaged community in the Netherlands. The intervention was evaluated with a controlled pre-post quasi-experimental design, with 430…

  15. Reach and effectiveness of an integrated community-based intervention on physical activity and healthy eating of older adults in a socioeconomically disadvantaged community

    NARCIS (Netherlands)

    Luten, Karla A; Reijneveld, Sijmen A; Dijkstra, Arie; de Winter, Andrea F

    2016-01-01

    The aim of this study is to assess the reach and effectiveness of an integrated community-based intervention designed to promote physical activity and healthy eating among older adults in a socioeconomically disadvantaged community in the Netherlands. The intervention was evaluated with a controlled

  16. Integrating community pharmacy into community based anti-retroviral therapy program: A pilot implementation in Abuja, Nigeria.

    Directory of Open Access Journals (Sweden)

    Yohanna Kambai Avong

    Full Text Available The landscape of Human Immunodeficiency Virus (HIV epidemic control is shifting with the United Nations Programme on HIV/AIDS (UNAIDS 90-90-90 benchmarks for epidemic control. Community-based Antiretroviral Therapy (CART models have improved treatment uptake and demonstrated good clinical outcomes. We assessed the feasibility of integrating community pharmacy as a task shift structure for differentiated community ART in Abuja-Nigeria.Stable patients on first line ART regimens from public health facilities were referred to community pharmacies in different locations within the Federal Capital Territory, Abuja for prescription refills and treatment maintenance. Bio-demographic and clinical data were collected from February 25, 2016 to May 31st, 2017 and descriptive statistics analysis applied. The outcomes of measure were prescription refill and patient retention in care at the community pharmacy.Almost 10% of stable patients on treatment were successfully devolved from eight health facilities to ten community pharmacies. Median age of the participants was 35 years [interquartile range (IQR; 30, 41] with married women in the majority. Prescription refill was 100% and almost all the participants (99.3% were retained in care after they were devolved to the community pharmacies. Only one participant was lost-to-follow-up as a result of death.Excellent prescription refill and high retention in care with very low loss-to-follow-up were associated with the community pharmacy model. The use of community pharmacy for community ART is feasible in Nigeria. We recommend the scale up of the model in all the 36 states of Nigeria.

  17. An integrated approach to preventing cardiovascular disease: community-based approaches, health system initiatives, and public health policy

    Directory of Open Access Journals (Sweden)

    Tina Karwalajtys

    2010-09-01

    Full Text Available Tina Karwalajtys1, Janusz Kaczorowski2,31Department of Family Medicine, McMaster University, Hamilton, ON, Canada; 2Primary Care & Community Research, Child & Family Research Institute, Vancouver, BC, Canada; 3Department of Family Practice, University of British Columbia, Vancouver, BC, CanadaAbstract: Cardiovascular disease (CVD is largely the product of interactions among modifiable risk factors that are common in developed nations and increasingly of concern in developing countries. Hypertension is an important precursor to the development of CVD, and although detection and treatment rates have improved in recent years in some jurisdictions, effective strategies and policies supporting a shift in distribution of risk factors at the population level remain paramount. Challenges in managing cardiovascular health more effectively include factors at the patient, provider, and system level. Strategies to reduce hypertension and CVD should be population based, incorporate multilevel, multicomponent, and socioenvironmental approaches, and integrate community resources with public health and clinical care. There is an urgent need to improve monitoring and management of risk factors through community-wide, primary care-linked initiatives, increase the evidence base for community-based prevention strategies, further develop and evaluate promising program components, and develop new approaches to support healthy lifestyle behaviors in diverse age, socioeconomic, and ethnocultural groups. Policy and system changes are critical to reduce risk in populations, including legislation and public education to reduce dietary sodium and trans-fatty acids, food pricing policies, and changes to health care delivery systems to explicitly support prevention and management of CVD.Keywords: risk factors, blood pressure determination, community health services, community health planning, public health practice

  18. Integrating community-based participatory research and informatics approaches to improve the engagement and health of underserved populations.

    Science.gov (United States)

    Unertl, Kim M; Schaefbauer, Chris L; Campbell, Terrance R; Senteio, Charles; Siek, Katie A; Bakken, Suzanne; Veinot, Tiffany C

    2016-01-01

    We compare 5 health informatics research projects that applied community-based participatory research (CBPR) approaches with the goal of extending existing CBPR principles to address issues specific to health informatics research. We conducted a cross-case analysis of 5 diverse case studies with 1 common element: integration of CBPR approaches into health informatics research. After reviewing publications and other case-related materials, all coauthors engaged in collaborative discussions focused on CBPR. Researchers mapped each case to an existing CBPR framework, examined each case individually for success factors and barriers, and identified common patterns across cases. Benefits of applying CBPR approaches to health informatics research across the cases included the following: developing more relevant research with wider impact, greater engagement with diverse populations, improved internal validity, more rapid translation of research into action, and the development of people. Challenges of applying CBPR to health informatics research included requirements to develop strong, sustainable academic-community partnerships and mismatches related to cultural and temporal factors. Several technology-related challenges, including needs to define ownership of technology outputs and to build technical capacity with community partners, also emerged from our analysis. Finally, we created several principles that extended an existing CBPR framework to specifically address health informatics research requirements. Our cross-case analysis yielded valuable insights regarding CBPR implementation in health informatics research and identified valuable lessons useful for future CBPR-based research. The benefits of applying CBPR approaches can be significant, particularly in engaging populations that are typically underserved by health care and in designing patient-facing technology. © The Authors 2015. Published by Oxford University Press on behalf of the American Medical

  19. Using the LOINC Semantic Structure to Integrate Community-based Survey Items into a Concept-based Enterprise Data Dictionary to Support Comparative Effectiveness Research.

    Science.gov (United States)

    Co, Manuel C; Boden-Albala, Bernadette; Quarles, Leigh; Wilcox, Adam; Bakken, Suzanne

    2012-01-01

    In designing informatics infrastructure to support comparative effectiveness research (CER), it is necessary to implement approaches for integrating heterogeneous data sources such as clinical data typically stored in clinical data warehouses and those that are normally stored in separate research databases. One strategy to support this integration is the use of a concept-oriented data dictionary with a set of semantic terminology models. The aim of this paper is to illustrate the use of the semantic structure of Clinical LOINC (Logical Observation Identifiers, Names, and Codes) in integrating community-based survey items into the Medical Entities Dictionary (MED) to support the integration of survey data with clinical data for CER studies.

  20. An activity-based cost analysis of the Honduras community-based, integrated child care (AIN-C) programme.

    Science.gov (United States)

    Fiedler, John L; Villalobos, Carlos A; De Mattos, Annette C

    2008-11-01

    The Honduras AIN-C programme is a preventive health and nutrition programme of the Honduras Ministry of Health (MOH) that relies on volunteers to help mothers monitor and maintain the adequate growth of young children. A quasi-experimental, design-based evaluation found that the programme achieved near-universal coverage and was effective in improving mothers' child-rearing knowledge, attitudes and practices, including feeding and appropriate care-giving and care-seeking practices for children with diarrhoea and acute respiratory illness. The programme is widely regarded as a model. This study was undertaken to provide the first comprehensive estimates of the cost of the AIN-C programme, with the goal of providing a programme and financial planning tool for Honduras. An additional comparison of study findings was also undertaken to determine the cost of the AIN-C programme's community-based services relative to a similar facility-based service. Expressed in mid-2005 US dollars, the study found that after the programme is phased-in: (1) the annual, recurrent cost per child under 2 years participating in the programme is $6.43; (2) the annual, incremental budget requirements per child under 2 years participating in the programme are $3.90; (3) the cost of an AIN-C monthly growth monitoring and counselling session per child is 11% of the cost of a traditional MOH, facility-based growth and development consultation per child; and (4) the effect of mothers substituting AIN-C monitor care for MOH facility-based care 'saves' 203 000 outpatient visits a year, with a potential cost saving of $1.66 million, the equivalent of 60% of the recurrent cost of the programme and roughly equal to the annual incremental budget requirements of the programme. Sensitivity analysis of the cost estimates is performed to provide insight, for countries considering introducing a similar programme, into how modifications of key characteristics of the programme affect its costs.

  1. The Impact of Integrated Infant and Young Child Feeding and Micronutrient Powder Intervention on Feeding Practices and Anemia in Children Aged 6-23 Months in Madagascar.

    Science.gov (United States)

    Locks, Lindsey M; Reerink, Ietje; Tucker Brown, Amal; Gnegne, Smaila; Ramalanjaona, Noelimanjaka; Nanama, Simeon; Duggan, Christopher P; Garg, Aashima

    2017-06-07

    This study assesses the impact of an integrated infant and young child feeding (IYCF) and micronutrient powder (MNP) intervention on children's risk of anemia and IYCF practices in Madagascar. Quantitative baseline and endline surveys were conducted in representative households with children 6-23 months from two districts, where an 18-month IYCF-MNP intervention was implemented. Relative risks comparing children's risk of anemia and maternal IYCF knowledge and practices at baseline versus endline, and also at endline among MNP-users versus non-users were estimated using log-binomial regression models. 372 and 475 children aged 6-23 months were assessed at baseline and endline respectively. Prevalence of anemia fell from 75.3% to 64.9% from baseline to endline ( p = 0.002); the reduction in the risk of anemia remained significant in models adjusting for sociodemographic characteristics (ARR (95% CI): 0.86 (0.78, 0.95), p = 0.003). In endline assessments, 229 out of 474 (48.3%) of children had consumed MNPs. MNP-users had a lower risk of anemia (ARR (95% CI): 0.86 (0.74, 0.99), p = 0.04) than non-users, after controlling for child's dietary diversity and morbidity, maternal counseling by community-health-workers, and sociodemographic characteristics. Mothers interviewed at endline also had greater nutrition knowledge and were more likely to feed their children ≥4 food groups (ARR (95% CI): 2.92 (2.24, 3.80), p children's consumption of micronutrients and reducing risk of anemia. The addition of MNP does not negatively impact, and may improve, IYCF practices.

  2. Integrating community-based verbal autopsy into civil registration and vital statistics (CRVS): system-level considerations

    Science.gov (United States)

    de Savigny, Don; Riley, Ian; Chandramohan, Daniel; Odhiambo, Frank; Nichols, Erin; Notzon, Sam; AbouZahr, Carla; Mitra, Raj; Cobos Muñoz, Daniel; Firth, Sonja; Maire, Nicolas; Sankoh, Osman; Bronson, Gay; Setel, Philip; Byass, Peter; Jakob, Robert; Boerma, Ties; Lopez, Alan D.

    2017-01-01

    ABSTRACT Background: Reliable and representative cause of death (COD) statistics are essential to inform public health policy, respond to emerging health needs, and document progress towards Sustainable Development Goals. However, less than one-third of deaths worldwide are assigned a cause. Civil registration and vital statistics (CRVS) systems in low- and lower-middle-income countries are failing to provide timely, complete and accurate vital statistics, and it will still be some time before they can provide physician-certified COD for every death. Proposals: Verbal autopsy (VA) is a method to ascertain the probable COD and, although imperfect, it is the best alternative in the absence of medical certification. There is extensive experience with VA in research settings but only a few examples of its use on a large scale. Data collection using electronic questionnaires on mobile devices and computer algorithms to analyse responses and estimate probable COD have increased the potential for VA to be routinely applied in CRVS systems. However, a number of CRVS and health system integration issues should be considered in planning, piloting and implementing a system-wide intervention such as VA. These include addressing the multiplicity of stakeholders and sub-systems involved, integration with existing CRVS work processes and information flows, linking VA results to civil registration records, information technology requirements and data quality assurance. Conclusions: Integrating VA within CRVS systems is not simply a technical undertaking. It will have profound system-wide effects that should be carefully considered when planning for an effective implementation. This paper identifies and discusses the major system-level issues and emerging practices, provides a planning checklist of system-level considerations and proposes an overview for how VA can be integrated into routine CRVS systems. PMID:28137194

  3. Integrating national community-based health worker programmes into health systems: a systematic review identifying lessons learned from low-and middle-income countries.

    Science.gov (United States)

    Zulu, Joseph Mumba; Kinsman, John; Michelo, Charles; Hurtig, Anna-Karin

    2014-09-22

    Despite the development of national community-based health worker (CBHW) programmes in several low- and middle-income countries, their integration into health systems has not been optimal. Studies have been conducted to investigate the factors influencing the integration processes, but systematic reviews to provide a more comprehensive understanding are lacking. We conducted a systematic review of published research to understand factors that may influence the integration of national CBHW programmes into health systems in low- and middle-income countries. To be included in the study, CBHW programmes should have been developed by the government and have standardised training, supervision and incentive structures. A conceptual framework on the integration of health innovations into health systems guided the review. We identified 3410 records, of which 36 were finally selected, and on which an analysis was conducted concerning the themes and pathways associated with different factors that may influence the integration process. Four programmes from Brazil, Ethiopia, India and Pakistan met the inclusion criteria. Different aspects of each of these programmes were integrated in different ways into their respective health systems. Factors that facilitated the integration process included the magnitude of countries' human resources for health problems and the associated discourses about how to address these problems; the perceived relative advantage of national CBHWs with regard to delivering health services over training and retaining highly skilled health workers; and the participation of some politicians and community members in programme processes, with the result that they viewed the programmes as legitimate, credible and relevant. Finally, integration of programmes within the existing health systems enhanced programme compatibility with the health systems' governance, financing and training functions. Factors that inhibited the integration process included a rapid

  4. MICRONUTRIENT THERAPY FOR SEPSIS

    Directory of Open Access Journals (Sweden)

    Agung Prasetiyo

    2015-05-01

    Full Text Available Micronutrients are nutrients which are needed by the body to perform the function of body. The amounts is less than 100% μg per day and consist of vitamins and minerals. It cannot be synthesized in the body. Research in the US mentioned that the rate prevalence of sepsis is tended to be increased 8.7 % annually. In sepsis, nutrition is one of the important component which could drive the success treatment. Micronutrient, especially a vitamin which is soluble in fats, it would be toxic if the number exceed the capability of body to receive it. Although there are guidance and mutual agreement about sepsis using, it still need to concern on micronutrient which potentially giving bad effect. In sepsis case, micronutrients also determine the success of treatment due to redistribution of vitamin and trace element from circulation to the tissue which involved in the proteins formation and immune system. The conclusions of the latest 7 experiments and 4 random controlled studies of multi-centre support the micronutrients supplementation because it can decrease mortality rate. However, it still need to be aware to the toxicity of fat soluble micronutrient if the doses are excessive.

  5. CMAM integration: Lessons learned from a case study on community-based child survival programmes in Bangladesh

    International Nuclear Information System (INIS)

    Sadler, Kate; Puett, Chloe; Myatt, Mark

    2014-01-01

    Bangladesh ranks among the five countries with the highest burden of acute malnutrition in the world. Barisal Division is one of the poorest areas of southern Bangladesh, with low access to health care and high prevalence of malnutrition. This prospective cohort study examined the effectiveness and feasibility of adding the diagnosis and treatment of severe acute malnutrition (SAM) to the community case management (CCM) package delivered by community health workers (CHWs) outside health facilities in Bhola District, Barisal Division. CHWs were paid a monthly stipend of 800 Taka (US$11.80). A mid-upper arm circumference measurement and an oedema check for all children under three years old were introduced into routine CHW activities, including monthly growth monitoring and promotion sessions and household visits. CHWs provided ongoing sensitization to households and community members on the causes and consequences of SAM, encouraging early treatment seeking. Integration into the CCM package of services supported high quality of care for cases of SAM, and promoted program effectiveness. The recovery rate (92%), length of stay (37.4 days) and rate of weight gain (6.7 g/kg/day) were all significantly better than international Sphere standards. Further, the coverage achieved by CHWs in this program was 89% (CI 78%–96%), one of the highest levels achieved by SAM treatment services. CHWs achieved high quality of care, with 89% of workers attaining 90% error-free case management or higher in managing cases of SAM. In receiving SAM treatment within a package of integrated services, children treated by CHWs in this study had low levels of complications and co-morbidities. Doorstep delivery promoted early treatment in this remote area. Therefore cases were easier to treat and average caseloads appeared to be manageable for CHWs. While SAM treatment increased CHW workloads, this did not negatively affect the quality of other preventive and curative services delivered

  6. Impact of non-clinical community-based promotional campaigns on bowel cancer screening engagement: An integrative literature review.

    Science.gov (United States)

    Martini, Angelita; Morris, Julia N; Preen, David

    2016-10-01

    This paper reviewed the relationship between non-clinical, client-oriented promotional campaigns to raise bowel cancer awareness and screening engagement. An integrative literature review using predefined search terms was conducted to summarise the accumulated knowledge. Data was analysed by coding and categorising, then synthesized through development of themes. Eighteen of 116 studies met inclusion criteria. Promotional campaigns had varying impact on screening uptake for bowel cancer. Mass media was found to moderately increase screening, predominately amongst "worried well". Small media used in conjunction with other promotional activities, thus its effect on screening behaviours was unclear. One-on-one education was less effective and less feasible than group education in increasing intention to screen. Financial support was ineffective in increasing screening rates when compared to other promotional activities. Screening engagement increased because of special events and celebrity endorsement. Non-clinical promotional campaigns did impact uptake of bowel cancer screening engagement. However, little is evident on the effect of single types of promotion and most research is based on clinician-directed campaigns. Cancer awareness and screening promotions should be implemented at community and clinical level to maximize effectiveness. Such an approach will ensure promotional activities are targeting consumers, thus strengthening screening engagement. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  7. Integrating an infectious disease programme into the primary health care service: a retrospective analysis of Chagas disease community-based surveillance in Honduras.

    Science.gov (United States)

    Hashimoto, Ken; Zúniga, Concepción; Nakamura, Jiro; Hanada, Kyo

    2015-03-24

    Integration of disease-specific programmes into the primary health care (PHC) service has been attempted mostly in clinically oriented disease control such as HIV/AIDS and tuberculosis but rarely in vector control. Chagas disease is controlled principally by interventions against the triatomine vector. In Honduras, after successful reduction of household infestation by vertical approach, the Ministry of Health implemented community-based vector surveillance at the PHC services (health centres) to prevent the resurgence of infection. This paper retrospectively analyses the effects and process of integrating a Chagas disease vector surveillance system into health centres. We evaluated the effects of integration at six pilot sites in western Honduras during 2008-2011 on; surveillance performance; knowledge, attitude and practice in schoolchildren; reports of triatomine bug infestation and institutional response; and seroprevalence among children under 15 years of age. The process of integration of the surveillance system was analysed using the PRECEDE-PROCEED model for health programme planning. The model was employed to systematically determine influential and interactive factors which facilitated the integration process at different levels of the Ministry of Health and the community. Overall surveillance performance improved from 46 to 84 on a 100 point-scale. Schoolchildren's attitude (risk awareness) score significantly increased from 77 to 83 points. Seroprevalence declined from 3.4% to 0.4%. Health centres responded to the community bug reports by insecticide spraying. As key factors, the health centres had potential management capacity and influence over the inhabitants' behaviours and living environment directly and through community health volunteers. The National Chagas Programme played an essential role in facilitating changes with adequate distribution of responsibilities, participatory modelling, training and, evaluation and advocacy. We found that Chagas

  8. Spatial distribution and deployment of community-based distributors implementing integrated community case management (iCCM): Geographic information system (GIS) mapping study in three South Sudan states.

    Science.gov (United States)

    Pratt, Abigail; Dale, Martin; Olivi, Elena; Miller, Jane

    2014-12-01

    In late 2012 and in conjunction with South Sudan's Ministry of Health - National Malaria Control Program, PSI (Population Services International) conducted a comprehensive mapping exercise to assess geographical coverage of its integrated community case management (iCCM) program and consider scope for expansion. The operational research was designed to provide evidence and support for low-cost mapping and monitoring systems, demonstrating the use of technology to enhance the quality of programming and to allow for the improved allocation of resources through appropriate and need-based deployment of community-based distributors (CBDs). The survey took place over the course of three months and program staff gathered GPS (global positioning system) data, along with demographic data, for over 1200 CBDs and 111 CBD supervisors operating in six counties in South Sudan. Data was collated, cleaned and quality assured, input into an Excel database, and subsequently uploaded to geographic information system (GIS) for spatial analysis and map production. The mapping results showed that over three-quarters of CBDs were deployed within a five kilometer radius of a health facility or another CBD, contrary to program planning and design. Other characteristics of the CBD and CBD supervisor profiles (age, gender, literacy) were more closely matched with other regional programs. The results of this mapping exercise provided a valuable insight into the contradictions found between a program "deployment plan" and the realities observed during field implementation. It also highlighted an important need for program implementers and national-level strategy makers to consider the natural and community-driven diffusion of CBDs, and take into consideration the strength of the local health facilities when developing a deployment plan.

  9. Community-Based Care

    Science.gov (United States)

    ... our e-newsletter! Aging & Health A to Z Community-Based Care Basic Facts & Information A variety of healthcare options ... day care centers are either in churches or community centers. Adult day care is commonly used to care for people who ...

  10. Challenges and opportunities of integration of community based Management of Acute Malnutrition into the government health system in Bangladesh: a qualitative study.

    Science.gov (United States)

    Ireen, Santhia; Raihan, Mohammad Jyoti; Choudhury, Nuzhat; Islam, M Munirul; Hossain, Md Iqbal; Islam, Ziaul; Rahman, S M Mustafizur; Ahmed, Tahmeed

    2018-04-10

    Severe acute malnutrition (SAM) in children is the most serious form of malnutrition and is associated with very high rates of morbidity and mortality. For sustainable SAM management, United Nations recommends integration of community based management of acute malnutrition (CMAM) into the health system. The objective of the study was to assess the preparedness of the health system to implement CMAM in Bangladesh. The assessment was undertaken during January to May 2014 by conducting document review, key informant interviews, and direct observation. A total of 38 key informant interviews were conducted among government policy makers and program managers (n = 4), nutrition experts (n = 2), health and nutrition implementing partners (n = 2), development partner (n = 1), government health system staff (n = 5), government front line field workers (n = 22), and community members (n = 2). The assessment was based on: workforce, service delivery, financing, governance, information system, medical supplies, and the broad socio-political context. The government of Bangladesh has developed inpatient and outpatient guidelines for the management of SAM. There are cadres of community health workers of government and non-government actors who can be adequately trained to conduct CMAM. Inpatient management of SAM is available in 288 facilities across the country. However, only 2.7% doctors and 3.3% auxiliary staff are trained on facility based management of SAM. In functional facilities, uninterrupted supply of medicines and therapeutic diet are not available. There is resistance and disagreement among nutrition stakeholders regarding import or local production of ready-to-use therapeutic food (RUTF). Nutrition coordination is fragile and there is no functional supra-ministerial coordination platform for multi-sectoral and multi-stakeholder nutrition. There is an enabling environment for CMAM intervention in Bangladesh although health system

  11. Benevolent Paradox: Integrating Community-Based Empowerment and Transdisciplinary Research Approaches into Traditional Frameworks to Increase Funding and Long-Term Sustainability of Chicano-Community Research Programs

    Science.gov (United States)

    de la Torre, Adela

    2014-01-01

    Niños Sanos, Familia Sana (NSFS) is a 5-year multi-intervention study aimed at preventing childhood obesity among Mexican-origin children in rural California. Using a transdisciplinary approach and community-based participatory research (CBPR) methodology, NSFS's development included a diversely trained team working in collaboration with community…

  12. (SWASH-D for Worms: A pilot study investigating the differential impact of school- versus community-based integrated control programs for soil-transmitted helminths.

    Directory of Open Access Journals (Sweden)

    Naomi E Clarke

    2018-05-01

    Full Text Available Soil-transmitted helminths (STH infect nearly 1.5 billion individuals globally, and contribute to poor physical and cognitive development in children. STH control programs typically consist of regular delivery of anthelminthic drugs, targeting school-aged children. Expanding STH control programs community-wide may improve STH control among school-aged children, and combining deworming with improvements to water, sanitation and hygiene (WASH may further reduce transmission. The (SWASH-D for Worms pilot study aims to compare the differential impact of integrated WASH and deworming programs when implemented at primary schools only versus when additionally implemented community-wide.A two-arm, non-randomized cluster intervention study was conducted. Six communities were identified by partner WASH agencies and enrolled in the study. All communities received a school-based WASH and deworming program, while three additionally received a community-based WASH and deworming program. STH infections were measured in school-aged children at baseline and six months after deworming. Over 90% of eligible children were recruited for the study, of whom 92.3% provided stool samples at baseline and 88.9% at follow-up. The school WASH intervention improved school sanitation, while the community WASH intervention reduced open defecation from 50.4% (95% CI 41.8-59.0 to 23.5% (95% CI 16.7-32.0. There was a trend towards reduced odds of N. americanus infection among children who received the community-wide intervention (OR 0.42, 95% CI 0.07-2.36, p = 0.32.This pilot study provides proof of principle for testing the hypothesis that community-wide STH control programs have a greater impact on STH infections among children than school-based programs, and supports the rationale for conducting a full-scale cluster randomized controlled trial. High recruitment and participation rates and successful implementation of school WASH programs demonstrate study feasibility and

  13. ISFAHAN HEALTHY HEART PROGRAM:A COMPREHENSIVE INTEGRATED COMMUNITY-BASED PROGRAM FOR CARDIOVASCULAR DISEASE PREVENTION AND CONTROL. DESIGN, METHODS AND INITIAL EXPERIENCE 2000-2001

    Directory of Open Access Journals (Sweden)

    N MOHAMMADI FARD

    2002-03-01

    Full Text Available Isfahan Healthy Heart Program (IHHP is a five to six year comprehensive integrated community based program for preventing and controlling of cardiovascular diseases (CVD via reducing CVD risk factors and improvement of cardiovascular healthy behavior in target population. IHHP has been started in 1999 and will be last since 2004. Primary survey was done to collect baseline data from interventional (Isfahan and Najafabad Cities and reference (Arak communities. In a multistage sampling method, we select randomly 5 to 10 percent of households in clusters. Then individuals aged equal or higher than 19 years old were selected for entering to survey. In this way, data from 12600 individuals (6300 in interventional counties and 6300 in reference county was collected and stratified due to their living area (urban vs. rural and different age and sex groups. Cardiovascular risk factors (Hypercholesterolemia, Smoking, Hypertension, Diabetes Mellitus, Obesity were investigated by laboratory tests (Lipid profile, FBS, OGTT, physical exam and standard questionnaires, in all ones. Nutritional habits, socioeconomic states, physical activity profiles and other healthy behaviors regarding to cardiovascular disease were assessed by validated questionnaires via interviewing to all individuals. Twelve leads electrocardiogram was done in all persons older than 35 years old. The prevalence of CVDs and distribution of CVD risk factors were estimated in this phase. In the 2nd phase, based on primary survey findings, we arranged a series of teams (worksite, children, women, health personnel, high risk patients, nutrition for planning and implementation of program through interventional community for a 5-year period. Every team has its own target population and objectives and monitors its process during the study. At intervals (annually, some local and small surveys with a random sampling will be conducted to assess and monitor the program and its potency to cope with

  14. Prevention and control of micronutrient deficiencies in developing countries: current perspectives

    Directory of Open Access Journals (Sweden)

    Berti C

    2014-05-01

    Full Text Available Cristiana Berti,1 Mieke Faber,2 Cornelius M Smuts11Centre for Excellence in Nutrition, North-West University, Potchefstroom, South Africa; 2Non-communicable Diseases Research Unit, South African Medical Research Council, Tygerberg, South AfricaAbstract: Despite strategies employed to tackle micronutrient malnutrition, limited progress has been achieved in the developing countries. Of global concern are deficiencies in iron, vitamin A, zinc, folate, and iodine. This review aims to explore up-to-date scientific evidence on the effect of different micronutrient strategies on biomarkers and health outcomes, and for each strategy, to highlight strengths, limitations, and factors contributing to success or failure. PubMed/MEDLINE and EBSCO databases and Google-indexed scientific literature were searched for relevant articles and documents, limited to human studies reported since 2003. Evidence shows that the most cost-effective approaches to address symptoms of micronutrient malnutrition are targeted supplementation and/or fortification with iron, iodine, zinc, folic acid, vitamin A, and multimicronutrients, provided that households have access to primary health care and that there is consistent long-term coverage, monitoring, adequate marketing, and commercial commitment. Dietary diversification/modification interventions are probably the most sustainable strategies to address causes of deficiency, but permanent solutions are still required in controlling micronutrient malnutrition at both research and public health levels. Furthermore, many scientific gaps remain, hindering the development of robust public health guidance. These gaps are due to the paucity of well-designed community-based studies, lack of information on biological mechanisms behind relationships between micronutrients and outcomes, and inconsistent results. Further adequately powered long-term trials are needed to fill these gaps. Lessons learned from large-scale nutritional

  15. Micronutrient problems in Brazilian soils with special emphasis on zinc

    International Nuclear Information System (INIS)

    Stewart, J.W.B.; Neptune, A.M.L.; Sao Paulo Univ., Piracicaba

    1975-01-01

    Brazil, with approximately 50% of the total land area in South America, has areas in which different micronutrient deficiencies (zinc, boron, copper, iron, manganese and molybdenum) have been noted in specific crops. This paper reviews the published research on such deficiencies and puts special emphasis on zinc which appears to be the most widespread deficiency. The need for an integrated approach to determining the extent of micronutrient deficiencies is discussed. (author)

  16. Micronutrients: do small things matter?

    African Journals Online (AJOL)

    prevention of clinical deficiency syndromes, the fast developing field of immunonutrition has added yet another dimension to the importance of foods, nutrition and micronutrients in disease ... micronutrient requirements in the critically ill, a growing body of .... effects thereof.2 Intracellular glutathione and nonenzymatic ROS.

  17. Role of micronutrients for physical growth and mental development.

    Science.gov (United States)

    Singh, Meharban

    2004-01-01

    Due to control of florid and severe cases of protein-energy malnutrition, deficiencies of micronutrients in children have assumed public health importance. According to National Nutrition Monitoring Bureau of India, over 50% of apparently healthy looking children have subclinical or biochemical deficiencies of vitamin A, vitamins B2, B6, folate and vitamin C. Over two-third of children have clinical evidences of iron deficiency while deficiency of trace minerals like iodine and zinc is quite common in certain populations. Children have food preferences and they are quite fussy to take green leafy vegetables and fruits thus compromising their intake of micronutrients from dietary sources. The full genetic potential of the child for physical growth and mental development may be compromised due to subclinical deficiencies of micronutrients which are commonly referred to as "hidden hunger". Micronutrients are required for the integrity and optimal functioning of immune system. Children with subclinical deficiency of micronutrients are more vulnerable to develop frequent and more severe common day-to-day infections thus triggering a vicious cycle of undernutrition and recurrent infections. A number of micronutrients are required for optimal physical growth and neuromotor development. Isolated deficiencies of micronutrients are rare in clinical practice and usually deficiencies of multiple micronutrients co-exist. The first 3 years of life are most crucial and vulnerable to the hazards of undernutrition. All efforts should be made so that preschool children are given a balanced and nutritious home-based diet. However, it has been shown that it is not possible to meet 100% requirements of recommended dietary allowances (RDA's) of micronutrients from dietary sources alone and most preschool children need administration of nutritional supplements to optimize their genetic potential for physical growth and mental development.

  18. A cluster-randomised controlled trial integrating a community-based water, sanitation and hygiene programme, with mass distribution of albendazole to reduce intestinal parasites in Timor-Leste: the WASH for WORMS research protocol

    Science.gov (United States)

    Nery, Susana Vaz; McCarthy, James S; Traub, Rebecca; Andrews, Ross M; Black, Jim; Gray, Darren; Weking, Edmund; Atkinson, Jo-An; Campbell, Suzy; Francis, Naomi; Vallely, Andrew; Williams, Gail; Clements, Archie

    2015-01-01

    Introduction There is limited evidence demonstrating the benefits of community-based water, sanitation and hygiene (WASH) programmes on infections with soil-transmitted helminths (STH) and intestinal protozoa. Our study aims to contribute to that evidence base by investigating the effectiveness of combining two complementary approaches for control of STH: periodic mass administration of albendazole, and delivery of a community-based WASH programme. Methods and analysis WASH for WORMS is a cluster-randomised controlled trial to test the hypothesis that a community-based WASH intervention integrated with periodic mass distribution of albendazole will be more effective in reducing infections with STH and protozoa than mass deworming alone. All 18 participating rural communities in Timor-Leste receive mass chemotherapy every 6 months. Half the communities also receive the community-based WASH programme. Primary outcomes are the cumulative incidence of infection with STH. Secondary outcomes include the prevalence of protozoa; intensity of infection with STH; as well as morbidity indicators (anaemia, stunting and wasting). Each of the trial outcomes will be compared between control and intervention communities. End points will be measured 2 years after the first albendazole distribution; and midpoints are measured at 6 months intervals (12 months for haemoglobin and anthropometric indexes). Mixed-methods research will also be conducted in order to identify barriers and enablers associated with the acceptability and uptake of the WASH programme. Ethics and dissemination Ethics approval was obtained from the human ethics committees at the University of Queensland, Australian National University, Timorese Ministry of Health, and University of Melbourne. The results of the trial will be published in peer-reviewed journals presented at national and international conferences, and disseminated to relevant stakeholders in health and WASH programmes. This study is funded

  19. From micronutrient recommendations to policy

    DEFF Research Database (Denmark)

    Timotijevic, Lada; Raats, Monique M.; Barnett, Julie

    2010-01-01

    towards achieving a greater link between micronutrient recommendations and behaviour. This study aims to examine the rationale and processes associated with consumer and stakeholder involvement in setting micronutrient recommendations across Europe. Subjects/Methods: Using the contacts established through......Background/Objectives: To achieve the nutritional goals stipulated by micronutrient recommendations, greater attention must be paid to the behavioural routes to such nutritional outcomes. Coopting stakeholders and consumers into decisions regarding micronutrient recommendations is an important step...... countries and its effect on final decisions. Stakeholders were not involved at the outset of the process ('framing' of the problem) in any of the countries, and there was no evidence of consumer involvement and open public fora. Conclusions: Some of the key explanatory factors for diversity in the degree...

  20. Micronutrients, N-Acetyl Cysteine, Probiotics and Prebiotics, A Review of Effectiveness in Reducing HIV Progression

    NARCIS (Netherlands)

    R.B.S. Hummelen (Ruben); J. Hemsworth (Jaimie); G.K. Reid (Gregor)

    2010-01-01

    textabstractLow serum concentrations of micronutrients, intestinal abnormalities, and an inflammatory state have been associated with HIV progression. These may be ameliorated by micronutrients, N-acetyl cysteine, probiotics, and prebiotics. This review aims to integrate the evidence from clinical

  1. Micronutrients, N-acetyl cysteine, probiotics and prebiotics, a review of effectiveness in reducing HIV progression

    NARCIS (Netherlands)

    R.B.S. Hummelen (Ruben); J. Hemsworth (Jaimie); G. Reid (Gregor)

    2010-01-01

    textabstractLow serum concentrations of micronutrients, intestinal abnormalities, and an inflammatory state have been associated with HIV progression. These may be ameliorated by micronutrients, N-acetyl cysteine, probiotics, and prebiotics. This review aims to integrate the evidence from clinical

  2. A cluster-randomised controlled trial integrating a community-based water, sanitation and hygiene programme, with mass distribution of albendazole to reduce intestinal parasites in Timor-Leste: the WASH for WORMS research protocol.

    Science.gov (United States)

    Nery, Susana Vaz; McCarthy, James S; Traub, Rebecca; Andrews, Ross M; Black, Jim; Gray, Darren; Weking, Edmund; Atkinson, Jo-An; Campbell, Suzy; Francis, Naomi; Vallely, Andrew; Williams, Gail; Clements, Archie

    2015-12-30

    There is limited evidence demonstrating the benefits of community-based water, sanitation and hygiene (WASH) programmes on infections with soil-transmitted helminths (STH) and intestinal protozoa. Our study aims to contribute to that evidence base by investigating the effectiveness of combining two complementary approaches for control of STH: periodic mass administration of albendazole, and delivery of a community-based WASH programme. WASH for WORMS is a cluster-randomised controlled trial to test the hypothesis that a community-based WASH intervention integrated with periodic mass distribution of albendazole will be more effective in reducing infections with STH and protozoa than mass deworming alone. All 18 participating rural communities in Timor-Leste receive mass chemotherapy every 6 months. Half the communities also receive the community-based WASH programme. Primary outcomes are the cumulative incidence of infection with STH. Secondary outcomes include the prevalence of protozoa; intensity of infection with STH; as well as morbidity indicators (anaemia, stunting and wasting). Each of the trial outcomes will be compared between control and intervention communities. End points will be measured 2 years after the first albendazole distribution; and midpoints are measured at 6 months intervals (12 months for haemoglobin and anthropometric indexes). Mixed-methods research will also be conducted in order to identify barriers and enablers associated with the acceptability and uptake of the WASH programme. Ethics approval was obtained from the human ethics committees at the University of Queensland, Australian National University, Timorese Ministry of Health, and University of Melbourne. The results of the trial will be published in peer-reviewed journals presented at national and international conferences, and disseminated to relevant stakeholders in health and WASH programmes. This study is funded by a Partnership for Better Health--Project grant from the National

  3. Micronutrients and Diabetic Retinopathy A Systematic Review

    NARCIS (Netherlands)

    Lee, Chee-Tin Christine; Gayton, Emma L.; Beulens, Joline W. J.; Flanagan, Declan W.; Adler, Amanda I.

    Background: We have evaluated the evidence for the association between intake and blood levels of micronutrients and diabetic retinopathy. Treatment for diabetic retinopathy requires significant clinical input and specialist ophthalmologic care. Micronutrients, including vitamin C, vitamin E, and

  4. Informing mental health policies and services in the EMR: cost-effective deployment of human resources to deliver integrated community-based care.

    Science.gov (United States)

    Ivbijaro, G; Patel, V; Chisholm, D; Goldberg, D; Khoja, T A M; Edwards, T M; Enum, Y; Kolkiewic, L A

    2015-09-28

    For EMR countries to deliver the expectations of the Global Mental Health Action Plan 2013-2020 & the ongoing move towards universal health coverage, all health & social care providers need to innovate and transform their services to provide evidence-based health care that is accessible, cost-effective & with the best patient outcomes. For the primary and community workforce, this includes general medical practitioners, practice & community nurses, community social workers, housing officers, lay health workers, nongovernmental organizations & civil society, including community spiritual leaders/healers. This paper brings together the current best evidence to support transformation & discusses key approaches to achieve this, including skill mix and/or task shifting and integrated care. The important factors that need to be in place to support skill mix/task shifting and good integrated care are outlined with reference to EMR countries.

  5. Role of public-private partnership in micronutrient food fortification.

    Science.gov (United States)

    Mannar, M G Venkatesh; van Ameringen, Marc

    2003-12-01

    Iron, iodine, and vitamin A deficiencies prevent 30% of the world's population from reaching full physical and mental potential. Fortification of commonly eaten foods with micronutrients offers a cost-effective solution that can reach large populations. Effective and sustainable fortification will be possible only if the public sector (which has the mandate and responsibility to improve the health of the population), the private sector (which has experience and expertise in food production and marketing), and the social sector (which has grass-roots contact with the consumer) collaborate to develop, produce, and promote micronutrient-fortified foods. Food fortification efforts must be integrated within the context of a country's public health and nutrition situation as part of an overall micronutrient strategy that utilizes other interventions as well. Identifying a set of priority actions and initiating a continuous dialogue between the various sectors to catalyze the implementation of schemes that will permanently eliminate micronutrient malnutrition are urgently needed. The partners of such a national alliance must collaborate closely on specific issues relating to the production, promotion, distribution, and consumption of fortified foods. Such collaboration could benefit all sectors: National governments could reap national health, economic, and political benefits; food companies could gain a competitive advantage in an expanding consumer marketplace; the scientific, development, and donor communities could make an impact by achieving global goals for eliminating micronutrient malnutrition; and by demanding fortified foods, consumers empower themselves to achieve their full social and economic potential.

  6. An integrated community-based outpatient therapeutic feeding programme for severe acute malnutrition in rural Southern Ethiopia: Recovery, fatality, and nutritional status after discharge.

    Science.gov (United States)

    Tadesse, Elazar; Worku, Amare; Berhane, Yemane; Ekström, Eva-Charlotte

    2018-04-01

    A scaled up and integrated outpatient therapeutic feeding programme (OTP) brings the treatment of severely malnourished children closer to the community. This study assessed recovery from severe acute malnutrition (SAM), fatality, and acute malnutrition up to 14 weeks after admission to a programme integrated in the primary health care system. In this cohort study, 1,048 children admitted to 94 OTPs in Southern Ethiopia were followed for 14 weeks. Independent anthropometric measurements and information on treatment outcome were collected at four home visits. Only 32.7% (248/759) of children with SAM on admission fulfilled the programme recovery criteria at the time of discharge (i.e., gained 15% in weight, or oedema, if present at admission, was resolved at discharge). Of all children admitted to the programme for whom nutritional assessment was done 14 weeks later, 34.6% (321/928) were severely malnourished, and 37.5% (348/928) were moderately malnourished; thus, 72.1% were acutely malnourished. Of the children, 27/982 (2.7%) had died by 14 weeks, of whom all but one had SAM on admission. Children with severe oedema on admission had the highest fatality rate (12.0%, 9/75). The median length of admission to the programme was 6.6 weeks (interquartile range: 5.3, 8.4 weeks). Despite children participating for the recommended duration of the programme, many children with SAM were discharged still acutely malnourished and without reaching programme criteria for recovery. For better outcome of OTP, constraints in service provision by the health system as well as challenges of service utilization by the beneficiaries should be identified and addressed. © 2017 The Authors. Maternal and Child Nutrition Published by John Wiley & Sons, Ltd.

  7. Essential and Nonessential Micronutrients and Sport

    Science.gov (United States)

    Beavers, Kristen M.; Serra, Monica C.

    The purpose of this chapter is to review the role of micronutrients in sport. Attention is given to the function of micronutrients in the body, examples of quality dietary sources of each micronutrient, and an assessment of the literature examining how the recommended daily intake of a micronutrient may or may not change with exercise. The discussion includes plausible biological mechanisms of proposed performance enhancement and current research to support or negate these claims. Water-soluble vitamins, fat-soluble vitamins, macrominerals, and select microminerals are discussed in detail, and a comprehensive table reviewing all micronutrients recommendations for the athlete is provided. Practical applications for professionals working with athletes conclude the chapter.

  8. Community-based recreational football

    DEFF Research Database (Denmark)

    Bruun, Ditte Marie; Bjerre, Eik; Krustrup, Peter

    2014-01-01

    is limited and the majority of prostate cancer survivors remain sedentary. Hence, novel approaches to evaluate and promote physical activity are warranted. This paper presents the rationale behind the delivery and evaluation of community-based recreational football offered in existing football clubs under...... the Danish Football Association to promote quality of life and physical activity adherence in prostate cancer survivors. The RE-AIM framework will be applied to evaluate the impact of the intervention including outcomes both at the individual and organizational level. By introducing community-based sport...

  9. Reconsidering Community-based Retailing

    OpenAIRE

    Maughan, Rebecca; O'Driscoll, Aidan

    2012-01-01

    One of the areas with great potential for economic, social and environmental benefit is community-based retailing. The concept of community based retailing can incorporate a number of different tenets. We suggest that it is retailing that is based close to the community it serves, usually within the town or village centre rather than out-of-town locations, and which is composed of a diverse range of small and medium sized business that are often independently or co-operatively owned. These co...

  10. Long-term monitoring and evaluation of a new system of community-based psychiatric care. Integrating research, teaching and practice at the University of Verona.

    Science.gov (United States)

    Amaddeo, Francesco; Burti, Lorenzo; Ruggeri, Mirella; Tansella, Michele

    2009-01-01

    The South-Verona community psychiatric service (CPS) was implemented in 1978, according to Law 180, by the Department of Psychiatry of the University of Verona. Since then this CPS provides prompt, comprehensive and coherent answers to patients' needs, psychological and social, as well as practical, while trying to decrease and control symptoms. Special emphasis is given to integrating different interventions, such as medication, rehabilitation, family support, and social work. The South-Verona experience was from the beginning associated with a long-term research project of monitoring and evaluating the new system of care. The research team has grown and expanded over the years and presently includes the following research units: a) environmental, clinical and genetic determinants of the outcome of mental disorders; b) psychiatric register, economics and geography of mental health; c) clinical psychopharmacology and drug epidemiology; d) brain imaging and neuropsychology; e) clinical psychology and communication in medicine; and f) physical comorbidity and health promotion in psychiatric patients. This paper summarises the main results of the coordinated, long-term evaluative studies conducted so far.

  11. Are Pressure Time Integral and Cumulative Plantar Stress Related to First Metatarsophalangeal Joint Pain? Results From a Community-Based Study.

    Science.gov (United States)

    Rao, Smita; Douglas Gross, K; Niu, Jingbo; Nevitt, Michael C; Lewis, Cora E; Torner, James C; Hietpas, Jean; Felson, David; Hillstrom, Howard J

    2016-09-01

    To examine the relationship between plantar stress over a step, cumulative plantar stress over a day, and first metatarsophalangeal (MTP) joint pain among older adults. Plantar stress and first MTP pain were assessed within the Multicenter Osteoarthritis Study. All included participants were asked if they had pain, aching, or stiffness at the first MTP joint on most days for the past 30 days. Pressure time integral (PTI) was quantified as participants walked on a pedobarograph, and mean steps per day were obtained using an accelerometer. Cumulative plantar stress was calculated as the product of regional PTI and mean steps per day. Quintiles of hallucal and second metatarsal PTI and cumulative plantar stress were generated. The relationship between predictors and the odds ratio of first MTP pain was assessed using a logistic regression model. Feet in the quintile with the lowest hallux PTI had 2.14 times increased odds of first MTP pain (95% confidence interval [95% CI] 1.42-3.25, P pain (95% CI 1.01-2.23, P = 0.042). Cumulative plantar stress was unassociated with first MTP pain. Lower PTI was modestly associated with increased prevalence of frequent first MTP pain at both the hallux and second metatarsal. Lower plantar loading may indicate the presence of an antalgic gait strategy and may reflect an attempt at pain avoidance. The lack of association with cumulative plantar stress may suggest that patients do not limit their walking as a pain-avoidance mechanism. © 2016, American College of Rheumatology.

  12. If you build it, they still may not come: outcomes and process of implementing a community-based integrated knowledge translation mapping innovation

    Directory of Open Access Journals (Sweden)

    Zahab Melanie

    2010-06-01

    maps as a decision support tool. Further, it represents an integrated knowledge project in the community setting, calling to question the applicability of traditional KT approaches when community values, minimal resources, and partners play a large role in decision making. The study also takes a unique perspective--where research producers and users work as dyad-pairs in the same organization--that has been under-explored to date in KT studies.

  13. Understanding the Attributes of Implementation Frameworks to Guide the Implementation of a Model of Community-based Integrated Health Care for Older Adults with Complex Chronic Conditions: A Metanarrative Review

    Directory of Open Access Journals (Sweden)

    Ann McKillop

    2017-06-01

    Full Text Available Introduction: Many studies have investigated the process of healthcare implementation to understand better how to bridge gaps between recommended practice, the needs and demands of healthcare consumers, and what they actually receive. However, in the implementation of integrated community-based and integrated health care, it is still not well known which approaches work best.  Methods: We conducted a systematic review and metanarrative synthesis of literature on implementation frameworks, theories and models in support of a research programme investigating CBPHC for older adults with chronic health problems. Results: Thirty-five reviews met our inclusion criteria and were appraised, summarised, and synthesised. Five metanarratives emerged 1 theoretical constructs; 2 multiple influencing factors; 3 development of new frameworks; 4 application of existing frameworks; and 5 effectiveness of interventions within frameworks/models. Four themes were generated that exposed the contradictions and synergies among the metanarratives. Person-centred care is fundamental to integrated CBPHC at all levels in the health care delivery system, yet many implementation theories and frameworks neglect this cornerstone.  Discussion: The research identified perspectives central to integrated CBPHC that were missing in the literature. Context played a key role in determining success and in how consumers and their families, providers, organisations and policy-makers stay connected to implementing the best care possible.  Conclusions: All phases of implementation of a new model of CBPHC call for collaborative partnerships with all stakeholders, the most important being the person receiving care in terms of what matters most to them.

  14. Scaling up a community-based program for maternal and child nutrition in Thailand.

    Science.gov (United States)

    Winichagoon, Pattanee

    2014-06-01

    The first national nutrition survey of Thailand in 1960 revealed that malnutrition among children and women in this rice-exporting country was highly prevalent. Malnutrition received national-level attention in the 1970s, when a national multisectoral nutrition plan was included in the Fourth National Economic and Social Development Plan (NESDP) (1977-81), followed by effective implementation through Thailand's primary healthcare system and poverty alleviation plan in the 1982-87 NESDP. Nutrition was embedded into primary healthcare, and a community-based nutrition program was successfully implemented through community participation via manpower mobilization and capacity-building, financing, and organization. Growth-monitoring, promotion of infant and young child feeding, and joint financing (government and community) of a nutrition fund were implemented. The poverty alleviation plan made it possible to streamline resource allocations at the national level down to priority poverty areas, which also facilitated microlevel planning. Effective, integrated actions were undertaken using the basic minimum needs approach, wherein community people identified problems and participated in actions with inputs from government personnel. This effective process took about 5 years to put in place. In response, child undernutrition declined significantly. Severe malnutrition was practically eradicated, and it remains resilient despite social and economic challenges, such as the Asian economic crisis in 1977. Currently, stunting and subclinical micronutrient deficiencies remain, while overweight and obesity among children are rising rapidly. A different paradigm and strategy will be essential to address the nation's current nutrition challenges.

  15. Cost-effectiveness analysis of the national implementation of integrated community case management and community-based health planning and services in Ghana for the treatment of malaria, diarrhoea and pneumonia.

    Science.gov (United States)

    Escribano Ferrer, Blanca; Hansen, Kristian Schultz; Gyapong, Margaret; Bruce, Jane; Narh Bana, Solomon A; Narh, Clement T; Allotey, Naa-Korkor; Glover, Roland; Azantilow, Naa-Charity; Bart-Plange, Constance; Sagoe-Moses, Isabella; Webster, Jayne

    2017-07-05

    Ghana has developed two main community-based strategies that aim to increase access to quality treatment for malaria, diarrhoea and suspected pneumonia: the integrated community case management (iCCM) and the community-based health planning and services (CHPS). The aim of the study was to assess the cost-effectiveness of these strategies under programme conditions. A cost-effectiveness analysis was conducted. Appropriate diagnosis and treatment given was the effectiveness measure used. Appropriate diagnosis and treatment data was obtained from a household survey conducted 2 and 8 years after implementation of iCCM in the Volta and Northern Regions of Ghana, respectively. The study population was carers of children under-5 years who had fever, diarrhoea and/or cough in the last 2 weeks prior to the interview. Costs data was obtained mainly from the National Malaria Control Programme (NMCP), the Ministry of Health, CHPS compounds and from a household survey. Appropriate diagnosis and treatment of malaria, diarrhoea and suspected pneumonia was more cost-effective under the iCCM than under CHPS in the Volta Region, even after adjusting for different discount rates, facility costs and iCCM and CHPS utilization, but not when iCCM appropriate treatment was reduced by 50%. Due to low numbers of carers visiting a CBA in the Northern Region it was not possible to conduct a cost-effectiveness analysis in this region. However, the cost analysis showed that iCCM in the Northern Region had higher cost per malaria, diarrhoea and suspected pneumonia case diagnosed and treated when compared to the Volta Region and to the CHPS strategy in the Northern Region. Integrated community case management was more cost-effective than CHPS for the treatment of malaria, diarrhoea and suspected pneumonia when utilized by carers of children under-5 years in the Volta Region. A revision of the iCCM strategy in the Northern Region is needed to improve its cost-effectiveness. Long-term financing

  16. Helminth infections and micronutrients in school-age children: a systematic review and meta-analysis.

    Science.gov (United States)

    de Gier, Brechje; Campos Ponce, Maiza; van de Bor, Margot; Doak, Colleen M; Polman, Katja

    2014-06-01

    Helminth infections and micronutrient deficiencies are highly prevalent in developing countries. Neither condition typically causes overt disease, but they do lead to indirect morbidity such as impaired physical and cognitive development. We aimed to systematically review current evidence on the relation of helminth infections with micronutrient status in school-age children worldwide. We included both observational studies and randomized controlled trials (RCTs). We applied a random-effects meta-analysis to estimate 1) cross-sectional associations between helminths and micronutrient status, 2) effects of anthelminthic treatment on micronutrient status, and 3) effects of micronutrient supplementation on helminth infection and reinfection. Meta-analyses of observational studies showed an association between helminth infections and serum retinol [standardized mean difference (SMD): -0.30; 95% CI: -0.48, -0.13] but not serum ferritin (SMD: 0.00; 95% CI: -0.7, 0.7). Conversely, meta-analyses of anthelminthic treatment RCTs showed a positive effect on ferritin (SMD: 0.16; 95% CI: 0.09, 0.22) but not retinol (SMD: 0.04; 95% CI: -0.06, 0.14). The number of studies on micronutrients other than ferritin and retinol was not sufficient for pooling. Meta-analyses of micronutrient-supplementation RCTs showed only a modest protective effect for multimicronutrient interventions on helminth infection and reinfection rates (OR: 0.77; 95% CI: 0.61, 0.97). In this review, we show evidence of distinct associations between helminth infections and micronutrients in school-age children. More studies are needed on micronutrients other than iron and vitamin A and on possible helminth species-specific effects. A thorough comprehension of the interplay between helminth infections and micronutrients will help guide integrated and sustainable intervention strategies in affected children worldwide. © 2014 American Society for Nutrition.

  17. The Micronutrient Genomics Project: A community-driven knowledge base for micronutrient research

    NARCIS (Netherlands)

    Ommen, B. van; El-Sohemy, A.; Hesketh, J.; Kaput, J.; Fenech, M.; Evelo, C.T.; McArdle, H.J.; Bouwman, J.; Lietz, G.; Mathers, J.C.; Fairweather-Tait, S.; Kranen, H. van; Elliott, R.; Wopereis, S.; Ferguson, L.R.; Méplan, C.; Perozzi, G.; Allen, L.; Rivero, D.

    2010-01-01

    Micronutrients influence multiple metabolic pathways including oxidative and inflammatory processes. Optimum micronutrient supply is important for the maintenance of homeostasis in metabolism and, ultimately, for maintaining good health. With advances in systems biology and genomics technologies, it

  18. Micronutrient deficiency in urban Indonesia.

    Science.gov (United States)

    Gross, R; Schultink, W

    1997-06-01

    The economic situation of Indonesia is characterized by a large increase in the gross national product which has been on average 7% annually during the last ten years. This was accompanied by rapid urbanization. With the economic improvement, "First World" and "Third World" health and nutrition problems are coexisting in Indonesia. In 1992, the most common of death cause was cardiovascular disease whereas tuberculosis was the second ranking. About 40% of the preschool children are stunted. The main stable food and energy source is rice, although the urban population has a more diverse food pattern than the rural population. In Jakarta, many children receive too late colostrum feeding and mothers are not aware about the importance of correct breastfeeding practices after delivery. Three studies had shown that about one fifth of preschool children and one fourth of elderly take micronutrient supplements. Nevertheless, micronutrient deficiencies are prevalent in Jakarta. About one third of women suffer from moderate vitamin A deficiency (plasma retinol middle class to spend more time and money to solve their own problems.

  19. Common micronutrient deficiencies among food aid beneficiaries ...

    African Journals Online (AJOL)

    admin

    Abstract. Background: Ethiopia is amongst the African countries that have received significant food aid. Nonetheless, the common micronutrient deficiencies among food aid beneficiaries are not well documented. Objective: To find out the common micronutrient deficiencies among food aid beneficiaries in the country based ...

  20. Mapping low intake of micronutrients across Europe

    DEFF Research Database (Denmark)

    Mensink, G. B. M.; Fletcher, R.; Gurinovic, M.

    2013-01-01

    Achieving an understanding of the extent of micronutrient adequacy across Europe is a major challenge. The main objective of the present study was to collect and evaluate the prevalence of low micronutrient intakes of different European countries by comparing recent nationally representative diet...

  1. A preliminary micronutrient investigation in maize

    International Nuclear Information System (INIS)

    Rosales, C.M.; Cabildo, M.S.

    1986-01-01

    This paper is a result of the greenhouse experiments conducted on micronutrient studies in corn. Low yields of corn in some localities despite the application of major elements points out the need for examining the micro-nutrient requirements of corn. Hence, this study aims to determine the fate of added micronutrients on major soil groups with the application of varying levels of nitrogen, phosphorus, and potassium to provide the better understanding of soil micronutrients especially in problem soil. Three soil types, four N-P-K treatments and two micronutrients (Zn and Fe) were used. The test crop was a Tinigib corn variety and sampled at tasseling and silking stages. It was found that NPK combinations of 120-60-30 kg/ha and 60-30-30 kg/ha gave better Fe and Zn fertilizer use efficiency, respectively for a given soil type. Further investigation in major soil types is recommended. (Auth.) 12 refs.; 9 tabs

  2. Suboptimal Micronutrient Intake among Children in Europe

    Directory of Open Access Journals (Sweden)

    Boris Kaganov

    2015-05-01

    Full Text Available Adequate dietary intake of micronutrients is not necessarily achieved even in resource-rich areas of the world wherein overeating is a public health concern. In Europe, population-based data suggests substantial variability in micronutrient intake among children. Two independent surveys of micronutrient consumption among European children were evaluated. Stratified by age, the data regarding micronutrient intake were evaluated in the context of daily requirements, which are typically estimated in the absence of reliable absolute values derived from prospective studies. The proportion of children living in Europe whose intake of at least some vitamins and trace elements are at or below the estimated average requirements is substantial. The most common deficiencies across age groups included vitamin D, vitamin E, and iodine. Specific deficiencies were not uniform across countries or by age or gender.  Micronutrient intake appears to be more strongly influenced by factors other than access to food. Substantial portions of European children may be at risk of reversible health risks from inadequate intake of micronutrients. Despite the growing health threat posed by excess intake of calories, adequate exposure to vitamins, trace elements, and other micronutrients may deserve attention in public health initiatives to optimize growth and development in the European pediatric population.

  3. Evaluation of community-based surveillance for Guinea worm, South ...

    African Journals Online (AJOL)

    2012-08-03

    Aug 3, 2012 ... deleted at the Data Manager Level in Loki. Conclusion. Community-based surveillance for guinea worm is a good example of a surveillance system on which an integrated disease surveillance system can be based in countries with poor surveillance like South Sudan. This makes its potential value to ...

  4. Calibration of Community-based Coral Reef Monitoring Protocols ...

    African Journals Online (AJOL)

    Coral reef monitoring (CRM) has been recognised as an important management tool and has consequently been incorporated in Integrated Coastal Area Management (ICAM) programmes in the Western Indian Ocean (WIO). Community-based coral reef monitoring (CB-CRM), which uses simplified procedures suitable for ...

  5. A Risk Assessment Model for Bacterial Leaf Spot of Pepper (Capsicum annuum), Caused by Xanthomonas euvesicatoria, Based on Concentrations of Macronutrients, Micronutrients, and Micronutrient Ratios.

    Science.gov (United States)

    Dutta, B; Langston, D B; Luo, X; Carlson, S; Kichler, J; Gitaitis, R

    2017-11-01

    The phytopathogenic bacterium Xanthomonas euvesicatoria causes bacterial leaf spot (BLS) of pepper and has a worldwide distribution. BLS is difficult to control and an integrated management strategy that incorporates crop rotation, use of clean seed and clean plants, weed control, resistant varieties, applications of bactericides, biocontrol agents, and systemic acquired resistance (SAR) inducers is generally recommended. However, even with that arsenal of weapons, BLS can still be responsible for severe losses under favorable environmental conditions. Thus, additional tools need to be added to an overall integrated management strategy to combat BLS. In this article, we developed several models from 2012 to 2014 that were based on how macronutrients, micronutrients, and micronutrient ratios affect BLS severity. Factors used to select a model for validation included highly significant P values, high adjusted R 2 values, low variance inflation factor values (macronutrient and micronutrient concentrations affect plant disease resistance genes in the SAR pathway.

  6. Population-based family case-control proband study on familial aggregation of metabolic syndrome: finding from Taiwanese people involved in Keelung community-based integrated screening (KCIS no. 5).

    Science.gov (United States)

    Chiu, Yueh-Hsia; Lin, Wen-Yuan; Wang, Po-En; Chen, Yao-Der; Wang, Ting-Ting; Warwick, Jane; Chen, Tony Hsiu-Hsi

    2007-03-01

    A population-based case-control proband study was undertaken to elucidate familial aggregation, independent environmental factors, and the interaction between them. A total of 7308 metabolic syndrome (MET-S) cases were identified from the Keelung community-based integrated screening programme between 1999 and 2002. The study has a case-control/family sampling design. A total of 1417 case probands were randomly selected from 3225 metabolic syndrome cases and the corresponding 2458 controls selected from 16,519 subjects without metabolic syndrome by matching on sex, age (+/-3 years) and place of residence. The generalized estimation equation model was used to estimate odds ratios and corresponding 95% confidence intervals. The risk for having metabolic syndrome among family members for cases versus control probands was 1.56-fold (1.29-1.89) after controlling for significant environmental factors. Higher risk of metabolic syndrome was found in parents than spouse. Low education against high education had 2.06-fold (1.36-3.13) risk for metabolic syndrome. Betel quid chewing was positively associated with the risk of MET-S, with 1.99-fold (1.13-3.53) risk for 1-9 pieces and 1.76-fold (0.96-3.23) risk for >or=10 pieces compared with non-chewer. Moderate and high intensity of non-occupational exercise led to 21.0% (OR=0.79 (0.63-0.98)) and 26.0% (OR=0.74 (0.59-0.94)) reduction in the risk for metabolic syndrome, respectively. The frequent consumption of vegetable reduced 24.0% (OR=0.76 (0.62-0.92)) risk for MET-S. The frequent consumption of coffee was associated the increased risk for metabolic syndrome (OR=1.32 (1.07-1.64)). The present study confirmed the risk of metabolic syndrome not only has the tendency towards familial aggregation but is affected by independent effect of environmental or individual correlates.

  7. The Importance of Antioxidant Micronutrients in Pregnancy

    Directory of Open Access Journals (Sweden)

    Hiten D. Mistry

    2011-01-01

    Full Text Available Pregnancy places increased demands on the mother to provide adequate nutrition to the growing conceptus. A number of micronutrients function as essential cofactors for or themselves acting as antioxidants. Oxidative stress is generated during normal placental development; however, when supply of antioxidant micronutrients is limited, exaggerated oxidative stress within both the placenta and maternal circulation occurs, resulting in adverse pregnancy outcomes. The present paper summarises the current understanding of selected micronutrient antioxidants selenium, copper, zinc, manganese, and vitamins C and E in pregnancy. To summarise antioxidant activity of selenium is via its incorporation into the glutathione peroxidase enzymes, levels of which have been shown to be reduced in miscarriage and preeclampsia. Copper, zinc, and manganese are all essential cofactors for superoxide dismutases, which has reduced activity in pathological pregnancy. Larger intervention trials are required to reinforce or refute a beneficial role of micronutrient supplementation in disorders of pregnancies.

  8. EURRECA—Framework for Aligning Micronutrient Recommendations

    NARCIS (Netherlands)

    Veer, van 't P.; Grammatikaki, E.; Matthys, C.; Raats, M.M.; Contor, L.

    2013-01-01

    There is currently no standard approach for deriving micronutrient recommendations, and large variations exist across Europe, causing confusion among consumers, food producers, and policy makers. More aligned information could influence dietary behaviors and potentially lead to a healthier

  9. The process of setting micronutrient recommendations

    DEFF Research Database (Denmark)

    Timotijevic, Lada; Barnett, Julie; Brown, Kerry

    2011-01-01

    in the field of micronutrient recommendations and a case study that focused on mandatory folic acid (FA) fortification. Setting: Questionnaire-based data were collected across thirty-five European countries. The FA fortification case study was conducted in the UK, Norway, Denmark, Germany, Spain, Czech...... Republic and Hungary. Results: Varied bodies are responsible for setting micronutrient recommendations, each with different statutory and legal models of operation. Transparency is highest where there are standing scientific advisory committees (SAC). Where the standing SAC is created, the range...... of expertise and the terms of reference for the SAC are determined by the government. Where there is no dedicated SAC, the impetus for the development of micronutrient recommendations and the associated policies comes from interested specialists in the area. This is typically linked with an ad hoc selection...

  10. Efficacy of multiple micronutrient supplementation for improving anemia, micronutrient status, growth, and morbidity of Peruvian infants.

    Science.gov (United States)

    López de Romaña, Guillermo; Cusirramos, Sandra; López de Romaña, Daniel; Gross, Rainer

    2005-03-01

    Anemia, micronutrient deficiencies, and growth faltering are still common in Peru. The study objective was to determine the efficacy of different micronutrient supplements in preventing growth failure, anemia, and micronutrient deficiencies in Peruvian infants. Three hundred and thirteen infants aged 6 to 12 mo participated in a double-blind, masked, controlled trial in which they were randomly assigned to receive either a daily dose of iron (DI), a daily dose of multiple micronutrients (DMM), a weekly dose of multiple micronutrients, or a placebo (P) for 6 mo. None of the supplements tested prevented growth faltering or the morbidities common during infancy. Anemia and plasma homocysteine concentrations fell significantly in all groups during the study, but the mean change of plasma homocysteine during the trial period was significantly smaller in the DI group than in other groups, and the increase in hemoglobin concentrations was smaller in the P group than the micronutrient treatment groups. Plasma ferritin concentrations decreased least in the groups taking daily micronutrient supplements containing iron (DI and DMM). There were no significant differences among groups in mean final values or changes in plasma zinc, retinol, tocopherol, or riboflavin. Although the DMM intervention was the most efficacious for preventing anemia, iron, and zinc deficiencies, 15%, 20%, and 50% of this group still remained anemic, zinc deficient, and iron deficient, respectively, at the end of the study. Further research thus should investigate whether higher doses of iron and zinc, together with infection control measures, are more efficacious.

  11. Gender Responsive Community Based Planning and Budgeting ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    ... Responsive Community Based Planning and Budgeting Tool for Local Governance ... in data collection, and another module that facilitates gender responsive and ... In partnership with UNESCO's Organization for Women in Science for the ...

  12. Micronutrient Profile Of Children And Women In Rural Bangladesh ...

    African Journals Online (AJOL)

    Background: Micronutrient deficiencies are so important to public health ... and significant amounts of donor and national funds have been directed at them. Objectives: This paper makes an attempt to compile the micronutrient profile of ...

  13. EURRECA—Principles and Future for Deriving Micronutrient Recommendations

    NARCIS (Netherlands)

    Claessens, M.; Contor, L.; Dhonukshe-Rutten, R.; Groot, L.C.P.Q.M. de; Fairweather-Tait, S.J.; Gurinovic, M.; Koletzko, B.; Ommen, B. van; Raats, M.M.; Veer, P. van 't

    2013-01-01

    The EURopean micronutrient RECommendations Aligned (EURRECA) Network of Excellence (NoE) explored an approach for settingmicronutrient recommendations, which would address the variation in recommendations across Europe. Therefore, a framework for deriving and using micronutrient Dietary Reference

  14. EURRECA—Evidence-Based Methodology for Deriving Micronutrient Recommendations

    NARCIS (Netherlands)

    Dhonukshe-Rutten, R.A.M.; Bouwman, J.; Brown, K.A.; Cavelaars, A.E.J.M.; Collings, R.; Grammatikaki, E.; Groot, L.C.P.G.M. de; Gurinovic, M.; Harvey, L.J.; Hermoso, M.; Hurst, R.; Kremer, S.H.A.; Ngo, J.; Novakovic, R.; Raats, M.M.; Rollin, F.; Serra-Majem, L.; Souverein, O.W.; Timotijevic, L.; Veer, P. van 't

    2013-01-01

    The EURopean micronutrient RECommendations Aligned (EURRECA) Network of Excellence explored the process of setting micronutrient recommendations to address the variance in recommendations across Europe. Work centered upon the transparent assessment of nutritional requirements via a series of

  15. Micronutrients, N-Acetyl Cysteine, Probiotics and Prebiotics, a Review of Effectiveness in Reducing HIV Progression

    Science.gov (United States)

    Hummelen, Ruben; Hemsworth, Jaimie; Reid, Gregor

    2010-01-01

    Low serum concentrations of micronutrients, intestinal abnormalities, and an inflammatory state have been associated with HIV progression. These may be ameliorated by micronutrients, N-acetyl cysteine, probiotics, and prebiotics. This review aims to integrate the evidence from clinical trials of these interventions on the progression of HIV. Vitamin B, C, E, and folic acid have been shown to delay the progression of HIV. Supplementation with selenium, N-acetyl cysteine, probiotics, and prebiotics has considerable potential, but the evidence needs to be further substantiated. Vitamin A, iron, and zinc have been associated with adverse effects and caution is warranted for their use. PMID:22254046

  16. Common micronutrient deficiencies among food aid beneficiaries ...

    African Journals Online (AJOL)

    Results: Vitamin A and iron deficiencies were the most prevalent micronutrient deficiencies among food aid beneficiaries. Other probable deficiencies prevailing were zinc, vitamins thiamine, riboflavin, niacin folate, cyano-cobalamine, ascorbic acid vitamin D and calcium because of the low intake of dairy products and meat.

  17. Optimizing micronutrient intake of lactating women through ...

    African Journals Online (AJOL)

    Increasing consumption of wild edible plants, which are micronutrient rich, easy to grow, and culturally familiar, has been recommended to combat these deficiencies, but there is a gap in knowledge on which ... This data can provide policy makers with the information necessary to formulate effective nutritional interventions.

  18. Nutrition (Micronutrients) in Child Growth and Development: A Systematic Review on Current Evidence, Recommendations and Opportunities for Further Research.

    Science.gov (United States)

    Yakoob, Mohammad Yawar; Lo, Clifford W

    2017-10-01

    An important aspect of malnutrition is deficiency of different micronutrients during pregnancy or early childhood. We systematically reviewed the role of nutrition in child growth (weight or height gain) and development. A comprehensive literature search was done on PubMed/Cochrane Library browsing through 38,795 abstracts until December 31, 2016 to select systematic reviews/meta-analyses and individual randomized controlled trials (RCTs) of micronutrient supplementation. Micronutrients studied included iron, iodine, folate, zinc, calcium, magnesium, selenium, vitamin D, vitamin A, vitamin B complex, and multiple micronutrients. We summarize evidence with details and results of RCTs, highlight strengths/weaknesses, and critically interpret findings. Effects of breastfeeding-promotion, food-supplementation (complementary and school feeding), conditional-cash-transfers, and integrated nutrition/psychosocial interventions are discussed. Based on this evidence we make policy and programmatic recommendations for supplementation to mothers and children at high-risk of deficiency.

  19. Community-based knowledge translation: unexplored opportunities

    Directory of Open Access Journals (Sweden)

    Armstrong Rebecca

    2011-06-01

    Full Text Available Abstract Background Knowledge translation is an interactive process of knowledge exchange between health researchers and knowledge users. Given that the health system is broad in scope, it is important to reflect on how definitions and applications of knowledge translation might differ by setting and focus. Community-based organizations and their practitioners share common characteristics related to their setting, the evidence used in this setting, and anticipated outcomes that are not, in our experience, satisfactorily reflected in current knowledge translation approaches, frameworks, or tools. Discussion Community-based organizations face a distinctive set of challenges and concerns related to engaging in the knowledge translation process, suggesting a unique perspective on knowledge translation in these settings. Specifically, community-based organizations tend to value the process of working in collaboration with multi-sector stakeholders in order to achieve an outcome. A feature of such community-based collaborations is the way in which 'evidence' is conceptualized or defined by these partners, which may in turn influence the degree to which generalizable research evidence in particular is relevant and useful when balanced against more contextually-informed knowledge, such as tacit knowledge. Related to the issues of evidence and context is the desire for local information. For knowledge translation researchers, developing processes to assist community-based organizations to adapt research findings to local circumstances may be the most helpful way to advance decision making in this area. A final characteristic shared by community-based organizations is involvement in advocacy activities, a function that has been virtually ignored in traditional knowledge translation approaches. Summary This commentary is intended to stimulate further discussion in the area of community-based knowledge translation. Knowledge translation, and exchange

  20. The role of micronutrients in crop production and human health

    International Nuclear Information System (INIS)

    Imtiaz, M.; Rashid, A.

    2010-01-01

    fortification and application of micronutrients containing fertilizers. Food fortification and supplementation are too expensive, not practical to be applied on large scale and not easily accessible to poor masses. The development of micro nutrient efficient genotypes can be a successive tool to overcome the micro nutrient disorders in soil and for improvement in human health. However, the harvesting of micro nutrient enriched grains from field would mine out more micronutrients. The cultivation of these genotypes can be integrated with the application of micronutrients containing fertilizers. Addition of such fertilizers will not only correct the deficiencies but also improve the fruit size and quality of crops. In general, 2-5 kg Zn ha/sup -1/ may be adequate for improved crop production, however, soil applied Fe is generally ineffective except for Fe-sequestrine. Repeated sprays of Ferrous sulphate (FeSO/sub 4/) or chelated Fe cure the chlorosis and improve the quality of food stuff. However, despite being highly cost effective, currently micro nutrient use is negligible. (author)

  1. Community-based natural resource management

    DEFF Research Database (Denmark)

    Treue, Thorsten; Nathan, Iben

    that deliver credible and easily accessible information. Checks and balances can be supported through civil society as well as the media. Finally, the private sector plays a key and potentially beneficial role in the harvest, transport and marketing of CBNRM products. Thus, dialogue partners should include......This technical note is the product of a long process of consultation with a wide range of resource persons who have over the years been involved in the Danish support to Community Based Natural Resource Management. It gives a brief introduction to community-based natural resource management (CBNRM...... from CBNRM will be useful when designing community-based climate adaptation strategies. Thus, this note is a contribution to an ongoing debate as well as a product of the long-standing experiences of Danida's environmental portfolio. CBNRM is not a stand-alone solution to secure poverty reduction...

  2. Community Based Networks and 5G

    DEFF Research Database (Denmark)

    Williams, Idongesit

    2016-01-01

    The deployment of previous wireless standards has provided more benefits for urban dwellers than rural dwellers. 5G deployment may not be different. This paper identifies that Community Based Networks as carriers that deserve recognition as potential 5G providers may change this. The argument....... The findings indicate that 5G connectivity can be extended to rural areas by these networks, via heterogenous networks. Hence the delivery of 5G data rates delivery via Wireless WAN in rural areas can be achieved by utilizing the causal factors of the identified models for Community Based Networks....

  3. Community-based health insurance knowledge, concern ...

    African Journals Online (AJOL)

    Community-based health insurance knowledge, concern, preferences, and financial planning for health care among informal sector workers in a health district of Douala, Cameroon. ... This is mainly due to the lack of awareness and limited knowledge on the basic concepts of a CBHI by this target population. Solidarity ...

  4. Facilitating community-based interprofessional education and ...

    African Journals Online (AJOL)

    Facilitating community-based interprofessional education and collaborative practice in a health sciences faculty: Student perceptions and experiences. ... It became apparent that students need to be prepared to work in interprofessional groups. The overall intervention was perceived positively, allowing students to become ...

  5. Participation in community based natural resource management ...

    African Journals Online (AJOL)

    The study was on participation in Community Based Natural Resource Management Programme (CBNRMP) and its socio-economic effect on rural families in Ikwerre Area, Rivers State Nigeria. A structured questionnaire was administered to 60 beneficiaries of the programme. Data collected were subjected to descriptive ...

  6. The Importance of Antioxidant Micronutrients in Pregnancy

    OpenAIRE

    Mistry, Hiten D.; Williams, Paula J.

    2011-01-01

    Pregnancy places increased demands on the mother to provide not only adequate nutrition to support her own health but also to enable the growth and development of the conceptus. A key role of a number of micronutrients and vitamins is their function as essential cofactors for or themselves acting as antioxidants. Oxidative stress is generated during normal placental development however expression of antioxidant enzymes within the placenta provides protection from undue damage. However, when s...

  7. Mapping low intake of micronutrients across Europe.

    Science.gov (United States)

    Mensink, G B M; Fletcher, R; Gurinovic, M; Huybrechts, I; Lafay, L; Serra-Majem, L; Szponar, L; Tetens, I; Verkaik-Kloosterman, J; Baka, A; Stephen, A M

    2013-08-01

    Achieving an understanding of the extent of micronutrient adequacy across Europe is a major challenge. The main objective of the present study was to collect and evaluate the prevalence of low micronutrient intakes of different European countries by comparing recent nationally representative dietary survey data from Belgium, Denmark, France, Germany, The Netherlands, Poland, Spain and the United Kingdom. Dietary intake information was evaluated for intakes of Ca, Cu, I, Fe, Mg, K, Se, Zn and the vitamins A, B₁, B₂, B₆, B₁₂, C, D, E and folate. The mean and 5th percentile of the intake distributions were estimated for these countries, for a number of defined sex and age groups. The percentages of those with intakes below the lower reference nutrient intake and the estimated average requirement were calculated. Reference intakes were derived from the UK and Nordic Nutrition Recommendations. The impact of dietary supplement intake as well as inclusion of apparently low energy reporters on the estimates was evaluated. Except for vitamin D, the present study suggests that the current intakes of vitamins from foods lead to low risk of low intakes in all age and sex groups. For current minerals, the study suggests that the risk of low intakes is likely to appear more often in specific age groups. In spite of the limitations of the data, the present study provides valuable new information about micronutrient intakes across Europe and the likelihood of inadequacy country by country.

  8. Applying community-based participatory research to better understand and improve kinship care practices

    DEFF Research Database (Denmark)

    Chukwudozie, Oge; Feinstein, Clare; Jensen, Celina

    2015-01-01

    While the principles behind community-based participatory research are firmly established, the process of taking community-based participatory research with children and youth to scale and integrating it into the programming of non-governmental organizations has been scarcely documented. This art...... and highlights how the research process enabled action and advocacy initiatives at different levels-leading to an increase in support and policy attention for children living in kinship care....

  9. Do Chinese Children Get Enough Micronutrients?

    Directory of Open Access Journals (Sweden)

    Huijun Wang

    2017-04-01

    Full Text Available The aim of this study was to examine usual daily micronutrient intake of Chinese children based on data from the 2011 China Health and Nutrition Survey. We analyzed data from 4 to 17-year-old participants, who provided dietary data on three consecutive days combined with the household weighing method in 2011. Usual daily intake of each nutrient was estimated using a mixed effects model based on the China Food Composition published in 2009. The means, medians and percentages below Estimated Average Requirements (EAR were reported for selected micronutrients, including calcium, sodium, potassium, iron, zinc, selenium, vitamin A, thiamine, riboflavin and vitamin C. For sodium and potassium, the means and the distribution of intakes were compared to the Adequate Intake (AI level. The average usual daily intakes of all micronutrients increase with age, and the intakes of boys were found to be higher than girls in the same age group. The average calcium intake increased from 272 mg/day in 4–6 years to 391 mg/day in 14–17 years, but the percentage of inadequate calcium intake remained very high (>96%. The prevalence of inadequacy of calcium was the highest among the mineral nutrients reported in this study. As the requirements of micronutrients increased with age, the percentage of subjects with inadequate intake increased in the 11–17 years age groups. Among 14–17 years group, the percentages of study participants with dietary intakes of calcium, iron, zinc, selenium, vitamin A, thiamine, riboflavin and vitamin C below the EAR were 96.8%, 18.8%, 37.6%, 72.8%, 36.8%, 91.8%. 85.9% and 75.5%, respectively. Among 11–13 years group, the percentages of study participants with dietary intakes of iron, zinc and vitamin A below the EAR were 23.5%, 41.5%, and 41.6%, respectively. Thus, micronutrient deficiency is a problem in Chinese children. Nutrition education and intervention programs are needed to address these nutritional gaps.

  10. Prevalence of micronutrient deficiency in popular diet plans

    Directory of Open Access Journals (Sweden)

    Calton Jayson B

    2010-06-01

    Full Text Available Abstract Background Research has shown micronutrient deficiency to be scientifically linked to a higher risk of overweight/obesity and other dangerous and debilitating diseases. With more than two-thirds of the U.S. population overweight or obese, and research showing that one-third are on a diet at any given time, a need existed to determine whether current popular diet plans could protect followers from micronutrient deficiency by providing the minimum levels of 27 micronutrients, as determined by the U.S. Food and Drug Administrations (FDA Reference Daily Intake (RDI guidelines. Methods Suggested daily menus from four popular diet plans (Atkins for Life diet, The South Beach Diet, the DASH diet, the DASH diet were evaluated. Calorie and micronutrient content of each ingredient, in each meal, were determined by using food composition data from the U.S. Department of Agriculture Nutrient Database for Standard Reference. The results were evaluated for sufficiency and total calories and deficient micronutrients were identified. The diet plans that did not meet 100% sufficiency by RDI guidelines for each of the 27 micronutrients were re-analyzed; (1 to identify a micronutrient sufficient calorie intake for all 27 micronutrients, and (2 to identify a second micronutrient sufficient calorie intake when consistently low or nonexistent micronutrients were removed from the sufficiency requirement. Results Analysis determined that each of the four popular diet plans failed to provide minimum RDI sufficiency for all 27 micronutrients analyzed. The four diet plans, on average, were found to be RDI sufficient in (11.75 ± 2.02; mean ± SEM of the analyzed 27 micronutrients and contain (1748.25 ± 209.57 kcal. Further analysis of the four diets found that an average calorie intake of (27,575 ± 4660.72 would be required to achieve sufficiency in all 27 micronutrients. Six micronutrients (vitamin B7, vitamin D, vitamin E, chromium, iodine and molybdenum were

  11. Are community-based forest enterprises in the tropics financially viable? Case studies from the Brazilian Amazon

    Science.gov (United States)

    Shoana Humphries; Thomas P. Holmes; Karen Kainer; Carlos Gabriel Goncalves Koury; Edson Cruz; Rosana de Miranda Rocha

    2012-01-01

    Community-based forest management is an integral component of sustainable forest management and conservation in the Brazilian Amazon, where it has been heavily subsidized for the last ten years. Yet knowledge of the financial viability and impact of community-based forest enterprises (CFEs) is lacking. This study evaluates the profitability of three CFEs in the...

  12. Community-based wetland comanagement in Bangladesh

    OpenAIRE

    Sherwood, D.B.

    2009-01-01

    Metadata only record This chapter explains new solutions to problems resulting from top-down approaches to resource conservation and sustainability. The management of natural resources - in this case, wetlands - is complicated and risky. To address the risks involved with resource management, a case study was done in Bangladesh to evaluate the effectiveness of community-based comanagement. Using multidisciplinary approaches and adaptive management strategies, the Management of Aquatic Ecos...

  13. The historical evolution of thought regarding multiple micronutrient nutrition.

    Science.gov (United States)

    Semba, Richard D

    2012-01-01

    Multiple micronutrient nutrition is an idea that originated in the 1940s and exemplifies the iterative nutritional paradigm. In the first four decades of the 20th century, scientists sought to separate and characterize the vitamins that were responsible for xerophthalmia, rickets, pellagra, scurvy, and beriberi. The dietary requirements of the different micronutrients began to be established in the early 1940s. Surveys showed that multiple micronutrient deficiencies were widespread in industrialized countries, and the problem was addressed by use of cod-liver oil, iodized salt, fortified margarine, and flour fortification with multiple micronutrients, and, with rising living standards, the increased availability and consumption of animal source foods. After World War II, surveys showed that multiple micronutrient deficiencies were widespread in developing countries. Approaches to the elimination of multiple micronutrient deficiencies include periodic vitamin A supplementation, iodized salt, targeted iron/folate supplementation, fortified flour, other fortified foods, home fortification with micronutrient powders, and homestead food production. The prevention of multiple micronutrient malnutrition is a key factor in achieving the Millennium Development Goals, given the important effects of micronutrients on health and survival.

  14. Micronutrient deficiencies in pregnancy worldwide: health effects and prevention

    Science.gov (United States)

    Gernand, Alison D.; Schulze, Kerry J.; Stewart, Christine P.; West, Keith P.; Christian, Parul

    2016-01-01

    Micronutrients, vitamins and minerals accessible from the diet, are essential for biologic activity. Micronutrient status varies widely throughout pregnancy and across populations. Women in low-income countries often enter pregnancy malnourished, and the demands of gestation can exacerbate micronutrient deficiencies with health consequences to the fetus. Examples of efficacious single micronutrient interventions include folic acid to prevent neural tube defects, iodine to prevent cretinism, zinc to reduce of preterm birth, and iron to reduce the risk of low birth weight. Folic acid and vitamin D might also increase birth weight. While extensive mechanism and association research links antenatal multiple micronutrients to plausible materno-fetal health advantages, hypothesized benefits have often been absent, minimal or unexpected in trials. These findings suggest a role for population context in determining health responses and extensive gaps in knowledge. Multiple micronutrient supplements reduce risks of being born low birth weight, small for gestational age or stillborn in undernourished settings, and justify micronutrient interventions with antenatal care. Measurable health effects of gestational micronutrient exposure may persist into childhood but few data exists on potential long-term benefits. In this Review, we discuss micronutrient intake recommendations, risks and consequences of deficiencies, and the effects of interventions with a particular emphasis on offspring. PMID:27032981

  15. Effect of cooking methods on the micronutrient profile of selected ...

    African Journals Online (AJOL)

    Effect of cooking methods on the micronutrient profile of selected vegetables: okra fruit ( Abelmoshcus esculentus ), fluted pumpkin ( Telfairia occidentalis ), African spinach ( Amarantus viridis ), and scent leaf ( Ocumum gratissimum.

  16. Improving information for community-based adaptation

    Energy Technology Data Exchange (ETDEWEB)

    Huq, Saleemul

    2011-10-15

    Community-based adaptation aims to empower local people to cope with and plan for the impacts of climate change. In a world where knowledge equals power, you could be forgiven for thinking that enabling this type of adaptation boils down to providing local people with information. Conventional approaches to planning adaptation rely on 'expert' advice and credible 'science' from authoritative information providers such as the Intergovernmental Panel on Climate Change. But to truly support the needs of local communities, this information needs to be more site-specific, more user-friendly and more inclusive of traditional knowledge and existing coping practices.

  17. The role of biofortification in the reduction of micronutrient food ...

    African Journals Online (AJOL)

    Micronutrient malnutrition is a global public health problem, especially in developing countries. Hunger and starvation which are causative agents of malnutrition are occasioned by poor food supply and low income purchasing power for the expensive animal sources of micronutrients. Access to adequate, safe and nutritious ...

  18. Effects of micronutrients on oxidative stress in HIV positive patients ...

    African Journals Online (AJOL)

    Micronutrient supplementation was therefore shown to reduce oxidative stress in HIV positive patients on HAART and could possibly be very helpful as an adjunct in the treatment of this disease. Key Words: Antiretroviral, micronutrients, malondialdehyde, ART naïve, reactive oxygen species, supplementation.

  19. Micronutrient deficiencies and gender: social and economic costs.

    Science.gov (United States)

    Darnton-Hill, Ian; Webb, Patrick; Harvey, Philip W J; Hunt, Joseph M; Dalmiya, Nita; Chopra, Mickey; Ball, Madeleine J; Bloem, Martin W; de Benoist, Bruno

    2005-05-01

    Vitamin and mineral deficiencies adversely affect a third of the world's people. Consequently, a series of global goals and a serious amount of donor and national resources have been directed at such micronutrient deficiencies. Drawing on the extensive experience of the authors in a variety of institutional settings, the article used a computer search of the published scientific literature of the topic, supplemented by reports and published and unpublished work from the various agencies. In examining the effect of sex on the economic and social costs of micronutrient deficiencies, the paper found that: (1) micronutrient deficiencies affect global health outcomes; (2) micronutrient deficiencies incur substantial economic costs; (3) health and nutrition outcomes are affected by sex; (4) micronutrient deficiencies are affected by sex, but this is often culturally specific; and finally, (5) the social and economic costs of micronutrient deficiencies, with particular reference to women and female adolescents and children, are likely to be considerable but are not well quantified. Given the potential impact on reducing infant and child mortality, reducing maternal mortality, and enhancing neuro-intellectual development and growth, the right of women and children to adequate food and nutrition should more explicitly reflect their special requirements in terms of micronutrients. The positive impact of alleviating micronutrient malnutrition on physical activity, education and productivity, and hence on national economies suggests that there is also an urgent need for increased effort to demonstrate the cost of these deficiencies, as well as the benefits of addressing them, especially compared with other health and nutrition interventions.

  20. Micronutrients: do small things matter? | Visser | South African ...

    African Journals Online (AJOL)

    Despite the major developments on the importance of micronutrient status in health and disease, understanding of the exact role of the latter in critical illness remains elusive and ill defined, complicating decision-making on the part of the nutrition support practitioner. Micronutrient deficiencies in critically ill patients may ...

  1. Micronutrient Gaps in Three Commercial Weight-Loss Diet Plans

    Directory of Open Access Journals (Sweden)

    Matthew G. Engel

    2018-01-01

    Full Text Available Weight-loss diets restrict intakes of energy and macronutrients but overlook micronutrient profiles. Commercial diet plans may provide insufficient micronutrients. We analyzed nutrient profiles of three plans and compared their micronutrient sufficiency to Dietary Reference Intakes (DRIs for male U.S. adults. Hypocaloric vegan (Eat to Live-Vegan, Aggressive Weight Loss; ETL-VAWL, high-animal-protein low-carbohydrate (Fast Metabolism Diet; FMD and weight maintenance (Eat, Drink and Be Healthy; EDH diets were evaluated. Seven single-day menus were sampled per diet (n = 21 menus, 7 menus/diet and analyzed for 20 micronutrients with the online nutrient tracker CRON-O-Meter. Without adjustment for energy intake, the ETL-VAWL diet failed to provide 90% of recommended amounts for B12, B3, D, E, calcium, selenium and zinc. The FMD diet was low (<90% DRI in B1, D, E, calcium, magnesium and potassium. The EDH diet met >90% DRIs for all but vitamin D, calcium and potassium. Several micronutrients remained inadequate after adjustment to 2000 kcal/day: vitamin B12 in ETL-VAWL, calcium in FMD and EDH and vitamin D in all diets. Consistent with previous work, micronutrient deficits are prevalent in weight-loss diet plans. Special attention to micronutrient rich foods is required to reduce risk of micronutrient deficiency in design of commercial diets.

  2. Micronutrient Gaps in Three Commercial Weight-Loss Diet Plans

    Science.gov (United States)

    J. Kern, Hua; Brenna, J. Thomas; H. Mitmesser, Susan

    2018-01-01

    Weight-loss diets restrict intakes of energy and macronutrients but overlook micronutrient profiles. Commercial diet plans may provide insufficient micronutrients. We analyzed nutrient profiles of three plans and compared their micronutrient sufficiency to Dietary Reference Intakes (DRIs) for male U.S. adults. Hypocaloric vegan (Eat to Live-Vegan, Aggressive Weight Loss; ETL-VAWL), high-animal-protein low-carbohydrate (Fast Metabolism Diet; FMD) and weight maintenance (Eat, Drink and Be Healthy; EDH) diets were evaluated. Seven single-day menus were sampled per diet (n = 21 menus, 7 menus/diet) and analyzed for 20 micronutrients with the online nutrient tracker CRON-O-Meter. Without adjustment for energy intake, the ETL-VAWL diet failed to provide 90% of recommended amounts for B12, B3, D, E, calcium, selenium and zinc. The FMD diet was low (diet met >90% DRIs for all but vitamin D, calcium and potassium. Several micronutrients remained inadequate after adjustment to 2000 kcal/day: vitamin B12 in ETL-VAWL, calcium in FMD and EDH and vitamin D in all diets. Consistent with previous work, micronutrient deficits are prevalent in weight-loss diet plans. Special attention to micronutrient rich foods is required to reduce risk of micronutrient deficiency in design of commercial diets. PMID:29361684

  3. Micronutrient studies in soil-plant system using nuclear techniques

    International Nuclear Information System (INIS)

    Deb, D.L.; Sachdev, P.; Rattan, R.K.

    1996-01-01

    The ranges between the critical levels of deficiency and toxicity of the micronutrients are relatively narrow and the utilisation of these nutrients by the crops from the fertilizer source seldom exceeds two per cent. An attempt is made to review the information generated on various aspects of the radioisotope aided micronutrient studies in soil-plant system. 184 refs

  4. Micronutrient Gaps in Three Commercial Weight-Loss Diet Plans.

    Science.gov (United States)

    G Engel, Matthew; J Kern, Hua; Brenna, J Thomas; H Mitmesser, Susan

    2018-01-20

    Weight-loss diets restrict intakes of energy and macronutrients but overlook micronutrient profiles. Commercial diet plans may provide insufficient micronutrients. We analyzed nutrient profiles of three plans and compared their micronutrient sufficiency to Dietary Reference Intakes (DRIs) for male U.S. adults. Hypocaloric vegan (Eat to Live-Vegan, Aggressive Weight Loss; ETL-VAWL), high-animal-protein low-carbohydrate (Fast Metabolism Diet; FMD) and weight maintenance (Eat, Drink and Be Healthy; EDH) diets were evaluated. Seven single-day menus were sampled per diet ( n = 21 menus, 7 menus/diet) and analyzed for 20 micronutrients with the online nutrient tracker CRON-O-Meter. Without adjustment for energy intake, the ETL-VAWL diet failed to provide 90% of recommended amounts for B 12 , B₃, D, E, calcium, selenium and zinc. The FMD diet was low (90% DRIs for all but vitamin D, calcium and potassium. Several micronutrients remained inadequate after adjustment to 2000 kcal/day: vitamin B 12 in ETL-VAWL, calcium in FMD and EDH and vitamin D in all diets. Consistent with previous work, micronutrient deficits are prevalent in weight-loss diet plans. Special attention to micronutrient rich foods is required to reduce risk of micronutrient deficiency in design of commercial diets.

  5. Intake of macro- and micronutrients in Danish vegans

    DEFF Research Database (Denmark)

    Kristensen, Nadja B; Madsen, Mia L; H Hansen, Tue

    2015-01-01

    Since information about macro- and micronutrient intake among vegans is limited we aimed to determine and evaluate their dietary and supplementary intake. Seventy 18-61 years old Danish vegans completed a four-day weighed food record from which their daily intake of macro- and micronutrients was ...

  6. Community-based faculty: motivation and rewards.

    Science.gov (United States)

    Fulkerson, P K; Wang-Cheng, R

    1997-02-01

    The reasons why practicing physicians precept students in their offices, and the rewards they wish to receive for this work, have not been clearly elucidated. This study determined the reasons for precepting and the rewards expected among a network of preceptors in Milwaukee. A questionnaire was mailed to 120 community-based physician preceptors in a required, third-year ambulatory care clerkship. Respondents were asked to identify why they volunteered and what they considered appropriate recognition or reward. The personal satisfaction derived from the student-teacher interaction was, by far, the most important motivator for preceptors (84%). The most preferred rewards for teaching included clinical faculty appointment, CME and bookstore discounts, computer networking, and workshops for improving skills in clinical teaching. Community-based private physicians who participate in medical student education programs are primarily motivated by the personal satisfaction that they derive from the teaching encounter. An effective preceptor recognition/reward program can be developed using input from the preceptors themselves.

  7. Combating micronutrient deficiency disorders amongst children

    Directory of Open Access Journals (Sweden)

    Umesh Kapil

    2014-11-01

    Full Text Available Micronutrients (MN are the nutrients that are needed by the body in small quantities which play leading roles in the production of enzymes, hormones and other substances that help to regulate growth activity, development and functioning of the immune and reproductive systems. Children, adolescent boys & girls and expectant mothers form a vulnerable group in developing countries where economic stress and food security are issues of concern. MNs deficiencies, which have been considered as major risk factors in child survival are the leading cause of mental retardation, preventable blindness, morbidity, birth defects, morbidity and mortality. Micronutrient malnutrition has many adverse effects on human health, not all of which are clinically evident. Even moderate levels of deficiency (which can be detected by biochemical or clinical measurements can have serious detrimental effects on human function. Thus, in addition to the obvious and direct health effects, the existence of MN deficiency has profound implications for economic development and productivity, particularly in terms of the potentially huge public health costs and the loss of human capital formation.According to WHO mortality data, around 0.8 million deaths (1.5% of the total can be attributed to iron deficiency each year, and a similar number to vitamin A deficiency. In terms of the loss of healthy life, expressed in  disability-adjusted life years (DALYs, iron-deficiency anaemia results in  25 million DALYs lost (or 2.4% of the global total, vitamin A deficiency  in 18 million DALYs lost (or 1.8% of the global total and iodine deficiency  in 2.5 million DALYs lost (or 0.2% of the global total [1].A child belonging to low socio-economic families residing in poor environmental and sanitation settings consume low quantity of foods which deficient not only in 2-3 MNs Deficiencies but also in macronutrients. These children also suffer from recurrent episodes of morbidities which

  8. Combating micronutrient deficiency disorders amongst children

    Directory of Open Access Journals (Sweden)

    Umesh Kapil

    2014-12-01

    Full Text Available Micronutrients (MN are the nutrients that are needed by the body in small quantities which play leading roles in the production of enzymes, hormones and other substances that help to regulate growth activity, development and functioning of the immune and reproductive systems. Children, adolescent boys & girls and expectant mothers form a vulnerable group in developing countries where economic stress and food security are issues of concern. MNs deficiencies, which have been considered as major risk factors in child survival are the leading cause of mental retardation, preventable blindness, morbidity, birth defects, morbidity and mortality. Micronutrient malnutrition has many adverse effects on human health, not all of which are clinically evident. Even moderate levels of deficiency (which can be detected by biochemical or clinical measurements can have serious detrimental effects on human function. Thus, in addition to the obvious and direct health effects, the existence of MN deficiency has profound implications for economic development and productivity, particularly in terms of the potentially huge public health costs and the loss of human capital formation. According to WHO mortality data, around 0.8 million deaths (1.5% of the total can be attributed to iron deficiency each year, and a similar number to vitamin A deficiency. In terms of the loss of healthy life, expressed in  disability-adjusted life years (DALYs, iron-deficiency anaemia results in  25 million DALYs lost (or 2.4% of the global total, vitamin A deficiency  in 18 million DALYs lost (or 1.8% of the global total and iodine deficiency  in 2.5 million DALYs lost (or 0.2% of the global total [1]. A child belonging to low socio-economic families residing in poor environmental and sanitation settings consume low quantity of foods which deficient not only in 2-3 MNs Deficiencies but also in macronutrients. These children also suffer from recurrent episodes of morbidities

  9. Social capital, community-based governance and resilience in an ...

    African Journals Online (AJOL)

    While the Mozambique government policy promotes community-based fisheries management in artisanal fisheries, we argue that under current conditions of ineffective community-based governance, a strong focus on reconstruction of social capital will be required before a community-based resource management process ...

  10. Impact of Multi-Micronutrient-Fortified Rice on Micronutrient Status, Health, and Cognitive Performance in Schoolchildren in Cambodia

    DEFF Research Database (Denmark)

    Khov, Kuong

    ferritin concentrations nutritional status of school-age children as well as the reasons of iron deficiency. Food fortification...... with multiple micronutrients has the potential to improve micronutrient status, growth and cognitive performance, and reduce morbidity incidence in developing countries. In Cambodia, rice is a staple food, and therefore fortified rice with multiple micronutrients could be a promising strategy to reduce...... the prevalence of micronutrient deficiencies. However, few studies have investigated the impact of fortified rice on micronutrient status, health and cognitive development in school-age children. Therefore, the aim of this PhD study is to evaluate the impact of fortified rice on nutritional status, health...

  11. Changing micronutrient intake through (voluntary) behaviour change

    DEFF Research Database (Denmark)

    Jensen, Birger Boutrup; Lähteenmäki, Liisa; Grunert, Klaus G

    2012-01-01

    change. The behaviours affecting folate intake were recognised and categorised. Behaviour change mechanisms from “rational model of man”, behavioural economics, health psychology and social psychology were identified and aligned against folate-related behaviours. The folate example demonstrated......The objective of this study was to relate behaviour change mechanisms to nutritionally relevant behaviour and demonstrate how the different mechanisms can affect attempts to change these behaviours. Folate was used as an example to illuminate the possibilities and challenges in inducing behaviour...... the complexity of mechanisms influencing possible behavioural changes, even though this only targets the intake of a single micronutrient. When considering possible options to promote folate intake, the feasibility of producing the desired outcome should be related to the mechanisms of required changes...

  12. Micronutrient Antioxidants and Nonalcoholic Fatty Liver Disease

    Directory of Open Access Journals (Sweden)

    Guanliang Chen

    2016-08-01

    Full Text Available Nonalcoholic fatty liver disease (NAFLD is one of the most important chronic liver diseases worldwide and has garnered increasing attention in recent decades. NAFLD is characterized by a wide range of liver changes, from simple steatosis to nonalcoholic steatohepatitis, cirrhosis, and hepatocellular carcinoma. The blurred pathogenesis of NAFLD is very complicated and involves lipid accumulation, insulin resistance, inflammation, and fibrogenesis. NAFLD is closely associated with complications such as obesity, diabetes, steatohepatitis, and liver fibrosis. During the progression of NAFLD, reactive oxygen species (ROS are activated and induce oxidative stress. Recent attempts at establishing effective NAFLD therapy have identified potential micronutrient antioxidants that may reduce the accumulation of ROS and finally ameliorate the disease. In this review, we present the molecular mechanisms involved in the pathogenesis of NAFLD and introduce some dietary antioxidants that may be used to prevent or cure NAFLD, such as vitamin D, E, and astaxanthin.

  13. Food-based interventions to modify diet quality and diversity to address multiple micronutrient deficiency

    Directory of Open Access Journals (Sweden)

    Madhavan K Nair

    2016-01-01

    Full Text Available Global data indicates a high prevalence of hidden hunger among population. Deficiencies of certain micronutrients such as folic acid, iodine, iron and vitamin A have long lasting effects on growth and development and therefore have been a National priority from many decades. The strategy implemented so far limits to the use of supplemental sources or fortified foods in alleviating the burden of deficiencies. These approaches however undermine the food based strategies involving dietary diversification as the long term sustainable strategy. There is lack of understanding on the level of evidence needed to implement such strategies and the level of monitoring required for impact evaluation. Dietary diversity concerns how to ensure access for each individual to a quality and safe diet with adequate macro and micronutrients. The key to success in using dietary diversity as a strategy to tackle hidden hunger is in integrating it with the principles of bioavailability, translated to efficient food synergies with due emphasis on food accessibility, affordability and outdoor physical activity/ life style modifications. Promoting enabling environment and sustainable agriculture is crucial for practicing dietary diversification with behaviour change communication as an integral segment. It can be concluded that food based strategies require careful understanding of the factors associated with it and moderate it to form an effective strategy for controlling multiple micronutrient deficiencies.

  14. Food-Based Interventions to Modify Diet Quality and Diversity to Address Multiple Micronutrient Deficiency.

    Science.gov (United States)

    Nair, Madhavan K; Augustine, Little Flower; Konapur, Archana

    2015-01-01

    Global data indicate a high prevalence of hidden hunger among population. Deficiencies of certain micronutrients such as folic acid, iodine, iron, and vitamin A have long lasting effects on growth and development and therefore have been a National priority from many decades. The strategy implemented so far limits to the use of supplemental sources or fortified foods in alleviating the burden of deficiencies. These approaches however undermine the food-based strategies involving dietary diversification as the long-term sustainable strategy. There is lack of understanding on the level of evidence needed to implement such strategies and the level of monitoring required for impact evaluation. Dietary diversity concerns how to ensure access for each individual to a quality and safe diet with adequate macro- and micronutrients. The key to success in using dietary diversity as a strategy to tackle hidden hunger is in integrating it with the principles of bioavailability, translated to efficient food synergies with due emphasis on food accessibility, affordability, and outdoor physical activity/life style modifications. Promoting enabling environment and sustainable agriculture is crucial for practicing dietary diversification with behavior change communication as an integral segment. It can be concluded that food-based strategies require careful understanding of the factors associated with it and moderate it to form an effective strategy for controlling multiple micronutrient deficiencies.

  15. COMMUNITY BASED HOME ENERGY MANAGEMENT SYSTEM

    Directory of Open Access Journals (Sweden)

    Muhammad Adnan Aziz

    2017-05-01

    Full Text Available In a Smart Grid (SG scenario, domestic consumers can gain cost reduction benefit by scheduling their Appliance Activation Time (AAT towards the slots of low charge. Minimization in cost is essential in Home Energy Management Systems (HEMS to induce consumers acceptance for power scheduling to accommodate for a Demand Response (DR at peak hours. Despite the fact that many algorithms address the power scheduling for HEMS, community based optimization has not been the focus. This paper presents an algorithm that targets the minimization of energy costs of whole community while keeping a low Peak to Average Ratio (PAR and smooth Power Usage Pattern (PUP. Objective of cost reduction is accomplished by finding most favorable AAT by Particle Swarm Optimization (PSO in conjunction with Inclined Block Rate (IBR approach and Circular Price Shift (CPS. Simulated numerical results demonstrate the effectiveness of CPS to assist the merger of PSO & IBR to enhance the reduction/stability of PAR and cost reduction.

  16. Micronutrients in the life cycle: Requirements and sufficient supply

    Directory of Open Access Journals (Sweden)

    K. Biesalski Hans

    2018-06-01

    Full Text Available Macronutrients (fat, protein, carbohydrates deliver energy and important material to ensure the entire body composition. Micronutrients are needed to keep this process of continuous construction and re-construction running. Consequently, the requirement for micronutrients will differ depending on the individual need which is related to the different metabolic conditions within the life cycle. Within the first 1000 days of life, from conception to the end of the second year of life the requirement for micronutrients is high and if the supply is inadequate that might have consequences for physical and at least cognitive development. In particular, iron, iodine, vitamin D and folate are micronutrients which might become critical during that period. Due to the fact that clinical symptoms of deficiencies develop late, but inadequate supply of one or more micronutrients may have consequences for health the term hidden hunger has been introduced to describe that situation. In particular the time period of pregnancy and early childhood is critical and hidden hunger is a worldwide problem, affecting >2 billion people, primarily females and children. The importance of different requirements during the life cycle is usually not considered. In addition, we do not really know what the individual requirement is. The estimation of the requirement is based on studies calculating the supply of a micronutrient to avoid a deficiency disease within a healthy population and is not based on sound scientific methodology or data. We need to consider that at different moments in the life cycle the supply might become critical in particular in case of a disease or sudden increase of metabolic turnover. In this narrative review we summarize data from studies dealing with different micronutrient requirements in pregnancy, exercise, vegan diet, adolescents and elderly. Knowledge of critical periods and related critical micronutrients might help to avoid hidden hunger and

  17. Assessing Implementation Fidelity and Adaptation in a Community-Based Childhood Obesity Prevention Intervention

    Science.gov (United States)

    Richards, Zoe; Kostadinov, Iordan; Jones, Michelle; Richard, Lucie; Cargo, Margaret

    2014-01-01

    Little research has assessed the fidelity, adaptation or integrity of activities implemented within community-based obesity prevention initiatives. To address this gap, a mixed-method process evaluation was undertaken in the context of the South Australian Obesity Prevention and Lifestyle (OPAL) initiative. An ecological coding procedure assessed…

  18. One Happy Union: Infusing Community-Based Learning Projects through Online Instruction

    Science.gov (United States)

    Lee, Jason W.; Kane, Jennifer; Cavanaugh, Terence

    2015-01-01

    Both community-based learning (CBL) and online learning are popular pedagogical practices, with distinct benefits and issues for teaching and learning. The integration of these practices may seem challenging, but they can be compatible. This article seeks to provide effective examples and support for conducting CBL projects in online courses while…

  19. An Adaptive Community-Based Participatory Approach to Formative Assessment with High Schools for Obesity Intervention

    Science.gov (United States)

    Kong, Alberta S.; Farnsworth, Seth; Canaca, Jose A.; Harris, Amanda; Palley, Gabriel; Sussman, Andrew L.

    2012-01-01

    Background: In the emerging debate around obesity intervention in schools, recent calls have been made for researchers to include local community opinions in the design of interventions. Community-based participatory research (CBPR) is an effective approach for forming community partnerships and integrating local opinions. We used CBPR principles…

  20. Restoring Myanmar’s mangrove forests and coastal communities’ socioeconomic stability with community based mangrove management

    OpenAIRE

    Lindholt, Jonathan Grevstad

    2016-01-01

    Mangrove forests have a significant capacity to provide ecosystem services. However, deforestation from land use changes has led to widespread degradation of these services and consequently jeopardizes coastal populations. Reforestation projects and attempts to develop sustainable management procedures are widely attempted worldwide. However, these projects often have sustainable rural livelihood improvements as a complementary goal. Integrated approaches such as Community Based Mangrove Mana...

  1. The freedom to choose: integrating community- based reproductive ...

    African Journals Online (AJOL)

    All the Issues and articles are freely available at http://www.journalmcd.com ... Madagascar Research and Conservation Program. BP 3391 .... fishery closures, special areas for aquaculture and ecotourism, ... transferred to community-run pens and grown out until they .... education or medical care (Westerman et al. 2012).

  2. Influence of mango mesocarp flour supplement to micronutrient ...

    African Journals Online (AJOL)

    Influence of mango mesocarp flour supplement to micronutrient, physical and organoleptic qualities of wheat-based bread. ... Mango mesocarp flour was incorporated into wheat flour at 15, 20 and 30% levels to ... HOW TO USE AJOL.

  3. Antioxidant micronutrients as intersectoral link between health and ...

    African Journals Online (AJOL)

    Antioxidant micronutrients as intersectoral link between health and agriculture. ... desirable by helping to prevent disease, promoting health and improving the ... for sustainable development of which health should be a goal (Afr. J. Biomed.

  4. the role of industry in micronutrient intervention programmes

    African Journals Online (AJOL)

    food industry, the media, consumer groups, and donor c· agencies, all of which must ... programmes and make them self-supporting and sustainable. The following ... Development of micronutrient product forms which are suitable for food ...

  5. Mental Retardation, Poverty and Community Based Rehabilitation

    Directory of Open Access Journals (Sweden)

    Einar Helander

    2009-10-01

    Full Text Available A person with moderate mental retardation would, in a western country, be "diagnosed" early on in life. Consequently, such a child is likely to be sent for special education. Given the high level of job requirements, such a person is unlikely to be employed in the open market later in life. Mental retardation is one of the most frequent disabilities in most studies, mental retardation is found in about three percent of the population. Persons even with mild mental retardation have very large difficulties finding employment and are for this reason often deprived of opportunities for suitable and productive income generation this is why most stay poor. But disability does not only cause poverty poverty itself causes disability. This study follows an analysis, based on a review of the Swedish programme for mental retardation during the period 1930-2000. It is concluded that in Sweden a very large proportion of mild and moderate mental retardation has been eliminated though the combination of poverty alleviation with a community-based rehabilitation programme. For these situations a pro-active programme analysing and meeting the needs of the target groups should be useful as a means to achieve poverty alleviation.

  6. DESA WISATA SEBAGAI COMMUNITY BASED TOURISM

    Directory of Open Access Journals (Sweden)

    Dhimas Setyo Nugroho

    2017-12-01

    Full Text Available The concept of community-based tourism in the dome house tourism village has succeeded in becoming a tool to trigger the development of the dome house resident and its environment. All of the development can be obviously seen from the economic, social, cultural, environmental and political aspects with a very enthusiastic participation of the resident. The rapid development of the resident and their high participation can emerge a strategy to make the tourist village survive from the tourism industry competition. In this case, the author found that there is a connection between the high level of community participation and the rapid development as the result of it. Therefore, the more the resident willing to participate, the more it will affect the development of the resident and its environment. This research uses qualitative method. The data were obtained by conducting interview, observation, and documentation. After those steps, the data were processed by interactive and SWOT analysis. Then, questionnaire was used to validate the data towards 21 residents.

  7. Monitoring and surveillance for multiple micronutrient supplements in pregnancy.

    Science.gov (United States)

    Mei, Zuguo; Jefferds, Maria Elena; Namaste, Sorrel; Suchdev, Parminder S; Flores-Ayala, Rafael C

    2017-12-22

    The World Health Organization (WHO) recommends iron-folic acid (IFA) supplementation during pregnancy to improve maternal and infant health outcomes. Multiple micronutrient (MMN) supplementation in pregnancy has been implemented in select countries and emerging evidence suggests that MMN supplementation in pregnancy may provide additional benefits compared to IFA alone. In 2015, WHO, the United Nations Children's Fund (UNICEF), and the Micronutrient Initiative held a "Technical Consultation on MMN supplements in pregnancy: implementation considerations for successful incorporation into existing programmemes," which included a call for indicators needed for monitoring, evaluation, and surveillance of MMN supplementation programmes. Currently, global surveillance and monitoring data show that overall IFA supplementation programmes suffer from low coverage and intake adherence, despite inclusion in national policies. Common barriers that limit the effectiveness of IFA-which also apply to MMN programmes-include weak supply chains, low access to antenatal care services, low-quality behaviour change interventions to support and motivate women, and weak or non-existent monitoring systems used for programme improvement. The causes of these barriers in a given country need careful review to resolve them. As countries heighten their focus on supplementation during pregnancy, or if they decide to initiate or transition into MMN supplementation, a priority is to identify key monitoring indicators to address these issues and support effective programmes. National and global monitoring and surveillance data on IFA supplementation during pregnancy are primarily derived from cross-sectional surveys and, on a more routine basis, through health and logistics management information systems. Indicators for IFA supplementation exist; however, the new indicators for MMN supplementation need to be incorporated. We reviewed practice-based evidence, guided by the WHO/Centers for Disease

  8. Education and micronutrient deficiencies: an ecological study exploring interactions between women's schooling and children's micronutrient status.

    Science.gov (United States)

    Harding, Kassandra L; Aguayo, Victor M; Masters, William A; Webb, Patrick

    2018-04-10

    Formal education can be a nutrition-sensitive intervention that supports the scale-up and impact of nutrition-specific actions. Maternal education has long been linked to child survival, growth, and development while adult earnings and nutrition are tied to years in school as a child. However, less is known about the relationship between maternal education and the micronutrient status of children, women and the general population. Using country-level data and an ecological study design, we explored the global associations between women's educational attainment and: a) anemia and vitamin A deficiency (VAD) in children aged 6-59 months; b) anemia in non-pregnant women; and c) zinc deficiency, urinary iodine excretion (UIE), and the proportion of infants protected against iodine deficiency in the general population Cross-sectional relationships (2005-2013) were assessed using linear regression models. Percentage of women without schooling was negatively associated with all outcomes. Number of years of schooling among women was positively associated with all outcomes except for UIE and the proportion of infants protected against iodine deficiency. Income level was a significant effect modifier of the effect of years of women's schooling on child anemia as well as of the proportion of women without formal education on zinc deficiency in the population. The relationship was strongest in low-income countries for child anemia, and was not significant in upper middle-income countries. For zinc deficiency, the relationship was not significant in low or lower middle income countries, which may suggest that a minimum threshold of resources needs to be reached before education can influence zinc status. While relationships between maternal schooling and micronutrient outcomes vary around the globe, more schooling is generally linked to lower rates of deficiency. These findings draw policy-relevant connections between formal education and anemia and micronutrient status

  9. The development of a network for community-based obesity prevention: the CO-OPS Collaboration

    Science.gov (United States)

    2011-01-01

    Background Community-based interventions are a promising approach and an important component of a comprehensive response to obesity. In this paper we describe the Collaboration of COmmunity-based Obesity Prevention Sites (CO-OPS Collaboration) in Australia as an example of a collaborative network to enhance the quality and quantity of obesity prevention action at the community level. The core aims of the CO-OPS Collaboration are to: identify and analyse the lessons learned from a range of community-based initiatives aimed at tackling obesity, and; to identify the elements that make community-based obesity prevention initiatives successful and share the knowledge gained with other communities. Methods Key activities of the collaboration to date have included the development of a set of Best Practice Principles and knowledge translation and exchange activities to promote the application (or use) of evidence, evaluation and analysis in practice. Results The establishment of the CO-OPS Collaboration is a significant step toward strengthening action in this area, by bringing together research, practice and policy expertise to promote best practice, high quality evaluation and knowledge translation and exchange. Future development of the network should include facilitation of further evidence generation and translation drawing from process, impact and outcome evaluation of existing community-based interventions. Conclusions The lessons presented in this paper may help other networks like CO-OPS as they emerge around the globe. It is important that networks integrate with each other and share the experience of creating these networks. PMID:21349185

  10. From micronutrient recommendations to policy: consumer and stakeholder involvement.

    Science.gov (United States)

    Timotijevic, L; Raats, M M; Barnett, J; Brown, K; Shepherd, R; Fernandez, L; Dömölki, L; Ruprich, J; Sonne, A-M; Hermoso, M; Koletzko, B; Frost-Andersen, L; Timmer, A

    2010-06-01

    To achieve the nutritional goals stipulated by micronutrient recommendations, greater attention must be paid to the behavioural routes to such nutritional outcomes. Coopting stakeholders and consumers into decisions regarding micronutrient recommendations is an important step towards achieving a greater link between micronutrient recommendations and behaviour. This study aims to examine the rationale and processes associated with consumer and stakeholder involvement in setting micronutrient recommendations across Europe. Using the contacts established through the Eurreca network of excellence (commissioned by the European Commission), the research involved in-depth desk research of key documents and communication channels linked to the process of setting micronutrient recommendations across seven countries: the United Kingdom, Norway, Denmark, Germany, Spain, the Czech Republic and Hungary. Stakeholder engagement is recognized by most countries as an important aspect of the process of setting micronutrient recommendations and their translation into policy, although there is notable variation in the extent to which this has been achieved across the seven countries and its effect on final decisions. Stakeholders were not involved at the outset of the process ('framing' of the problem) in any of the countries, and there was no evidence of consumer involvement and open public fora. Some of the key explanatory factors for diversity in the degree of involvement include historical sociopolitical context; the extent to which food and nutrition are key policy agenda; and the relative power of stakeholders in influencing food and nutrition policy.

  11. Community Based Networks and 5G Wi-Fi

    DEFF Research Database (Denmark)

    Williams, Idongesit

    2018-01-01

    This paper argues on why Community Based Networks should be recognized as potential 5G providers using 5G Wi-Fi. The argument is hinged on findings in a research to understand why Community Based Networks deploy telecom and Broadband infrastructure. The study was a qualitative study carried out...... inductively using Grounded Theory. Six cases were investigated. Two Community Based Network Mobilization Models were identified. The findings indicate that 5G Wi-Fi deployment by Community Based Networks is possible if policy initiatives and the 5G Wi-Fi standards are developed to facilitate the causal...

  12. Community-Based Wildlife Management In Tanzania: The Policy ...

    African Journals Online (AJOL)

    Community-based wildlife management (CWM) approach – known to others as community-based conservation – was first introduced in Tanzania in 1987/88. The approach intends to reconcile wildlife conservation and rural economic development. In the 1990s Tanzanians witnessed a rush by government Ministries and ...

  13. Micronutrients in Pregnancy in Low- and Middle-Income Countries

    Directory of Open Access Journals (Sweden)

    Ian Darnton-Hill

    2015-03-01

    Full Text Available Pregnancy is one of the more important periods in life when increased micronutrients, and macronutrients are most needed by the body; both for the health and well-being of the mother and for the growing foetus and newborn child. This brief review aims to identify the micronutrients (vitamins and minerals likely to be deficient in women of reproductive age in Low- and Middle-Income Countries (LMIC, especially during pregnancy, and the impact of such deficiencies. A global prevalence of some two billion people at risk of micronutrient deficiencies, and multiple micronutrient deficiencies of many pregnant women in LMIC underline the urgency to establishing the optimal recommendations, including for delivery. It has long been recognized that adequate iron is important for best reproductive outcomes, including gestational cognitive development. Similarly, iodine and calcium have been recognized for their roles in development of the foetus/neonate. Less clear effects of deficiencies of zinc, copper, magnesium and selenium have been reported. Folate sufficiency periconceptionally is recognized both by the practice of providing folic acid in antenatal iron/folic acid supplementation and by increasing numbers of countries fortifying flours with folic acid. Other vitamins likely to be important include vitamins B12, D and A with the water-soluble vitamins generally less likely to be a problem. Epigenetic influences and the likely influence of micronutrient deficiencies on foetal origins of adult chronic diseases are currently being clarified. Micronutrients may have other more subtle, unrecognized effects. The necessity for improved diets and health and sanitation are consistently recommended, although these are not always available to many of the world’s pregnant women. Consequently, supplementation programmes, fortification of staples and condiments, and nutrition and health support need to be scaled-up, supported by social and cultural measures

  14. Global burden of maternal and child undernutrition and micronutrient deficiencies.

    Science.gov (United States)

    Ahmed, Tahmeed; Hossain, Muttaquina; Sanin, Kazi Istiaque

    2012-01-01

    Maternal and child undernutrition and micronutrient deficiencies affect approximately half of the world's population. These conditions include intrauterine growth restriction (IUGR), low birth weight, protein-energy malnutrition, chronic energy deficit of women, and micronutrient deficiencies. Although the rates of stunting or chronic protein-energy malnutrition are increasing in Africa, the absolute numbers of stunted children are much higher in Asia. The four common micronutrient deficiencies include those of iron, iodine, vitamin A, and zinc. All these conditions are responsible directly or indirectly for more than 50% of all under-5 deaths globally. According to more recent estimates, IUGR, stunting and severe wasting are responsible for one third of under-5 mortality. About 12% of deaths among under-5 children are attributed to the deficiency of the four common micronutrients. Despite tremendous progress in different disciplines and unprecedented improvement with many health indicators, persistently high undernutrition rates are a shame to the society. Human development is not possible without taking care to control undernutrition and micronutrient deficiencies. Poverty, food insecurity, ignorance, lack of appropriate infant and young child feeding practices, heavy burden of infectious illnesses, and poor hygiene and sanitation are factors responsible for the high levels of maternal and child undernutrition in developing countries. These factors can be controlled or removed by scaling up direct nutrition interventions and eliminating the root conditions including female illiteracy, lack of livelihoods, lack of women's empowerment, and poor hygiene and sanitation. Copyright © 2013 S. Karger AG, Basel.

  15. [Micronutrient consumption and overweight: is there a relationship?].

    Science.gov (United States)

    Leão, Ana Luisa Marcucci; dos Santos, Luana Caroline

    2012-03-01

    In past decades, the growth in obesity has been associated with changes in the lifestyle of the population, including comprehensive dietary changes, especially in the intake of micronutrients. To describe micronutrient intake and review its consequences on nutritional status. A literature review was performed covering domestic and international articles published over the past 11 years, on the SciELO, LILACS, MEDLINE and governmental databases, using descriptors such as "micronutrients", "food consumption", "excess weight", "health", "nutritional status" in Portuguese and in English. Micronutrient intake deficiency is a global health problem, affecting about 2 billion people and seems to be associated with an increased risk for non-communicable diseases and disorders, including obesity. Insufficient intake of vitamin A favors overweight by altering thyroid metabolism, while vitamin C is related to the synthesis of carnitine and fat oxidation; vitamin D favors the control of satiety and energy expenditure. As for minerals, calcium helps the regulation of thermogenesis and lipogenesis / lipolysis, and zinc is involved in regulating insulin and leptin. The promotion of healthy eating habits through educational practices is necessary for greater public awareness of the implications of micronutrient intake on nutritional status, and should be included in Public Health strategies in order to control obesity and its complications.

  16. Intake of macro- and micronutrients in Danish vegans.

    Science.gov (United States)

    Kristensen, Nadja B; Madsen, Mia L; Hansen, Tue H; Allin, Kristine H; Hoppe, Camilla; Fagt, Sisse; Lausten, Mia S; Gøbel, Rikke J; Vestergaard, Henrik; Hansen, Torben; Pedersen, Oluf

    2015-10-30

    Since information about macro- and micronutrient intake among vegans is limited we aimed to determine and evaluate their dietary and supplementary intake. Seventy 18-61 years old Danish vegans completed a four-day weighed food record from which their daily intake of macro- and micronutrients was assessed and subsequently compared to an age-range-matched group of 1,257 omnivorous individuals from the general Danish population. Moreover, the vegan dietary and supplementary intake was compared to the 2012 Nordic Nutrition Recommendations (NNR). Dietary intake differed significantly between vegans and the general Danish population in all measured macro- and micronutrients (p vegans the intake of macro- and micronutrients (including supplements) did not reach the NNR for protein, vitamin D, iodine and selenium. Among vegan women vitamin A intake also failed to reach the recommendations. With reference to the NNR, the dietary content of added sugar, sodium and fatty acids, including the ratio of PUFA to SFA, was more favorable among vegans. At the macronutrient level, the diet of Danish vegans is in better accordance with the NNR than the diet of the general Danish population. At the micronutrient level, considering both diet and supplements, the vegan diet falls short in certain nutrients, suggesting a need for greater attention toward ensuring recommended daily intake of specific vitamins and minerals.

  17. Building a community-based culture of evaluation.

    Science.gov (United States)

    Janzen, Rich; Ochocka, Joanna; Turner, Leanne; Cook, Tabitha; Franklin, Michelle; Deichert, Debbie

    2017-12-01

    In this article we argue for a community-based approach as a means of promoting a culture of evaluation. We do this by linking two bodies of knowledge - the 70-year theoretical tradition of community-based research and the trans-discipline of program evaluation - that are seldom intersected within the evaluation capacity building literature. We use the three hallmarks of a community-based research approach (community-determined; equitable participation; action and change) as a conceptual lens to reflect on a case example of an evaluation capacity building program led by the Ontario Brian Institute. This program involved two community-based groups (Epilepsy Southwestern Ontarioand the South West Alzheimer Society Alliance) who were supported by evaluators from the Centre for Community Based Research to conduct their own internal evaluation. The article provides an overview of a community-based research approach and its link to evaluation. It then describes the featured evaluation capacity building initiative, including reflections by the participating organizations themselves. We end by discussing lessons learned and their implications for future evaluation capacity building. Our main argument is that organizations that strive towards a community-based approach to evaluation are well placed to build and sustain a culture of evaluation. Copyright © 2017 Elsevier Ltd. All rights reserved.

  18. Habitual micronutrient intake during and after pregnancy in Caucasian Londoners.

    Science.gov (United States)

    Derbyshire, E; Davies, G J; Costarelli, V; Dettmar, P W

    2009-01-01

    Micronutrient status is of fundamental importance both upon conception and throughout pregnancy. There is an abundance of literature investigating nutrient intakes during individual trimesters of pregnancy but few studies have investigated baseline intakes of nutrients throughout gestation as a continuum. The current investigation set out to measure habitual micronutrient intakes at weeks 13, 25, 35 of pregnancy and 6 weeks postpartum using a prospective background information questionnaire, 4-7-day weighed food diary and postnatal questionnaire. Seventy-two primiparous, Caucasian Londoners were recruited at the study start with 42 completing the first, second, third trimester and postpartum study stages respectively. Study findings indicated that sodium intakes were significantly higher than UK guidelines throughout and after pregnancy (P pregnancy, but to varying levels of statistical significance (P health interventions may be required to help expectant mothers achieve an optimal diet, particularly after birth when dietary recommendations increase for some micronutrients.

  19. Micronutrient bioavailability: Dietary Reference Intakes and a future perspective1234

    Science.gov (United States)

    2010-01-01

    This article provides a review of how the challenge of bioavailability was approached in establishing the Dietary Reference Intakes, with a special focus on folic acid, vitamin B-12, β-carotene, iron, selenium, and zinc, the targeted micronutrients for this workshop. In a future perspective, the necessity of having a clear working definition of bioavailability is emphasized. The bioavailability of micronutrients should be considered, with advantage, under subheadings determined by the broad factors that affect bioavailability. Special emphasis is given to giving greater and specific attention to factors involved in the maintenance of homeostasis. These factors, it is argued, are best considered separately from even a broad definition of bioavailability and have the potential to provide new insights into some micronutrient requirements. PMID:20200261

  20. Adverse outcomes of poor micronutrient status in childhood and adolescence.

    Science.gov (United States)

    Viteri, Fernando E; Gonzalez, Horacio

    2002-05-01

    The adverse effects of micronutrient deficiencies and excesses in children up to reproductive age are presented. A summary of risks and adverse functional and health outcomes associated with deficient and excessive intakes and nutrition status of iron, iodine, zinc, vitamins A and D, folate, vitamin B12, and riboflavin is presented. Nutrient-nutrient interactions of micronutrients, age, gender, and other host and environmental conditions, such as pregnancy, genetic conditions, overall nutrition, force of infection, and social conditions are considered as covariates in trying to define causation and outcomes due to specific micronutrients. The outcomes analyzed focus on growth and development, mental and neuromotor performance, immunocompetence, physical working capacity, morbidity, and in the case of pregnancy, overall reproductive performance. The results presented include responses to specific and multiple "experimental" interventions. A brief analysis of possible public health programs is presented, with emphasis on prevention.

  1. Micronutrient-fortified rice can increase hookworm infection risk

    DEFF Research Database (Denmark)

    de Gier, Brechje; Campos Ponce, Maiza; Perignon, Marlene

    2016-01-01

    or inflammation after iron supplementation. OBJECTIVE: To study effects of micronutrient-fortified rice on hookworm infection in Cambodian schoolchildren. METHODS: A double-blinded, cluster-randomized trial was conducted in 16 Cambodian primary schools partaking in the World Food Program school meal program....... Three types of multi-micronutrient fortified rice were tested against placebo rice within the school meal program: UltraRice_original, UltraRice_improved and NutriRice. Four schools were randomly assigned to each study group (placebo n = 492, UltraRice_original n = 479, UltraRice_improved n = 500, NutriRice.......6%, but differed considerably among schools (range 0%- 48.1%).Micronutrient-fortified rice significantly increased risk of new hookworm infection. This effect was modified by baseline hookworm prevalence at the school; hookworm infection risk was increased by all three types of fortified rice in schools where...

  2. Effect of the micronutrient iodine in thyroid carcinoma angiogenesis.

    Science.gov (United States)

    Daniell, Kayla; Nucera, Carmelo

    2016-12-20

    Iodide is a micronutrient essential for thyroid hormone production. The uptake and metabolism of iodide by thyrocytes is crucial to proper thyroid function. Iodide ions are drawn into the thyroid follicular cell via the sodium-iodide symporter (NIS) in the cell membrane and become integrated into tyrosyl residues to ultimately form thyroid hormones. We sought to learn how an abnormal concentration of iodide within thyrocyte can have significant effects on the thyroid, specifically the surrounding vascular network. Insufficient levels of iodide can lead to increased expression or activity of several pathways, including vascular endothelial growth factor (VEGF). The VEGF protein fuel vessel growth (angiogenesis) and therefore enhances the nutrients available to surrounding cells. Alternatively, normal/surplus iodide levels can have inhibitory effects on angiogenesis. Varying levels of iodide in the thyroid can influence thyroid carcinoma cell proliferation and angiogenesis via regulation of the hypoxia inducible factor-1 (HIF-1) and VEGF-dependent pathway. We have reviewed a number of studies to investigate how the effect of iodide on angiogenic and oxidative stress regulation can affect the viability of thyroid carcinoma cells. The various studies outlined give key insights to the role of iodide in thyroid follicles function and vascular growth, generally highlighting that insufficient levels of iodide stimulate pathways resulting in vascular growth, and viceversa normal/surplus iodide levels inhibit such pathways. Intriguingly, TSH and iodine levels differentially regulate the expression levels of angiogenic factors. All cells, including carcinoma cells, increase uptake of blood nutrients, meaning the vascular profile is influential to tumor growth and progression. Importantly, variation in the iodine concentrations also influence BRAF V600E -mediated oncogenic activity and might deregulate tumor proliferation. Although the mechanisms are not well eluted, iodine

  3. Community-based dental education and the importance of faculty development.

    Science.gov (United States)

    McAndrew, Maureen

    2010-09-01

    Community-based dental education offers a variety of positive learning experiences for students while providing needed dental services for the underserved. More dental students are being instructed by a growing body of largely volunteer community-based faculty who practice in a wide range of community settings including community hospitals and clinics, nursing homes, and private practices. These geographically dispersed instructors may have little experience as educators. Their practice styles and their motivation to improve teaching effectiveness are likely to differ from the styles and motivation of school-based faculty members. Moreover, many dental schools have begun to emphasize practices that may be unfamiliar to community-based faculty such as evidence-based practice. Providing faculty development for them is challenging, yet crucial to the success of these programs and dental education in general. Fundamental elements that must be considered for effective community faculty development programming include fostering a culture of respect between school-based and community faculty members, basing programs on the actual needs of these educators, integrating principles of adult learning theory, and establishing ongoing institutional support. This article provides background on this movement, reviews the literature for faculty development programs geared specifically to community-based educators, makes recommendations for development programs for these dental educators, and includes suggestions for future research.

  4. Dietary assessment methods for micronutrient intake in elderly people: a systematic review

    NARCIS (Netherlands)

    Ortiz-Andrellucchi, A.; Sanzech-Villegas, A.; Doreste-Alonso, J.; Vries, de J.H.M.; Groot, de C.P.G.M.; Serra-Majem, L.

    2009-01-01

    The European micronutrient recommendations aligned (EURRECA) Network of Excellence seeks to establish clear guidelines for assessing the validity of reported micronutrient intakes among vulnerable population groups. A systematic literature review identified studies validating the methodology used in

  5. EURRECA: development of tools to improve the alignment of micronutrient recommendations

    NARCIS (Netherlands)

    Matthys, C.; Bucchini, L.; Busstra, M.C.; Cavelaars, A.J.E.M.; Eleftheriou, P.; Garcia-Alvarez, A.; Fairweather-Tait, S.; Gurinovic, M.; Ommen, van B.; Contor, L.

    2010-01-01

    Approaches through which reference values for micronutrients are derived, as well as the reference values themselves, vary considerably across countries. Harmonisation is needed to improve nutrition policy and public health strategies. The EURRECA (EURopean micronutrient RECommendations Aligned,

  6. The Situation and Solutions of Institutional and Community-Based ...

    African Journals Online (AJOL)

    ... of Institutional and Community-Based Rehabilitation for Persons With Mental and ... regardless of the country and the model, reveals a litany of constraints and ... involvement of all stakeholders in decision making and execution and finally, ...

  7. Devising a Community-based Security Regime to Combat Drug ...

    African Journals Online (AJOL)

    economic and political structures, has resulted in the perpetuation of crime and the ... community-based organizations and relevant government ministries. A ...... These changes included collecting equipment from local petrol garages rather.

  8. Community Based Ecological Monitoring of Non Timber Forest ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Community Based Ecological Monitoring of Non Timber Forest Products in the Nilgiri ... This project will allow Keystone Foundation to design, implement and test a ... traders, forest department officials and other stakeholders in the process.

  9. Volume of Home and Community Based Services and...

    Data.gov (United States)

    U.S. Department of Health & Human Services — Volume of Home- and Community-Based Services and Time to Nursing-Home Placement The purpose of this study was to determine whether the volume of Home and Community...

  10. Fighting Poverty with Facts: Community-Based Monitoring Systems

    International Development Research Centre (IDRC) Digital Library (Canada)

    2009-01-01

    Jan 1, 2009 ... Documents and Articles: ... This book presents the Community-Based Monitoring System ( CBMS ) ... Drawing from CBMS experience in Africa and Asia, the authors present recommendations for policymakers, donor agencies ...

  11. Assessing the contribution of Community-Based Natural Resources ...

    African Journals Online (AJOL)

    Adisa, B.O.

    2013-09-20

    Sep 20, 2013 ... environmental sustainability in Ondo State, Nigeria. Adisa, Banji O. ... Key words: Assessment, community-based, natural resources, socio-environmental sustainability, ... Natural resources occur within environments that are.

  12. Renewal strategy and community based organisations in community ...

    African Journals Online (AJOL)

    Renewal strategy and community based organisations in community ... the local population and resources to do that which the governments had failed to do. ... country with a view to reducing poverty and developmental imbalance in Nigeria.

  13. Tribal Community-Based Social Marketing Training Guide

    Science.gov (United States)

    The Community-Based Social Marketing (CBSM) Training Guide and recycling toolkit provides an overview of how to increase the adoption of sustainable behaviors and recycling practices with a community.

  14. Community Based Organizations in HIV/AIDS Prevention, Patient ...

    African Journals Online (AJOL)

    Community Based Organizations in HIV/AIDS Prevention, Patient. ... behavioral change communication methods that may contribute significantly to overcoming ... Towards that objective, CBOs need both internal strengthening of programs and ...

  15. Exploring the scope of community-based rehabilitation in ensuring ...

    African Journals Online (AJOL)

    ... the scope of community-based rehabilitation in ensuring the holistic ... Rehabilitation is defined as the process of combined ... psychological measures for enabling individuals to at- ... inclusion, meeting basic needs and facilitating access to.

  16. CSC Tip Sheets: Community-Based Social Marketing

    Science.gov (United States)

    Use community-based social marketing (CBSM) to facilitate direct neighbor-to-neighbor communication and influence to promote behavior change. In-person communications are often complemented by electronic social media tools.

  17. Community Based Health Insurance Knowledge and Willingness to ...

    African Journals Online (AJOL)

    Community Based Health Insurance Knowledge and Willingness to Pay; A Survey of a Rural Community in ... Journal Home > Vol 6, No 1 (2012) > ... and is the most appropriate insurance model for rural areas where incomes are unstable.

  18. The ASEAN community-based tourism standards: looking beyond certification

    OpenAIRE

    Novelli, M.; Klatte, N.; Dolezal, C.

    2017-01-01

    This paper reports findings from an opportunity study on the appropriateness of implementing community-based tourism standards (CBTS) certification through the Association of Southeast Asian Nations (ASEAN) criteria, as a way to improve sustainable tourism provision in the region. Framed by critical reflections on community-based tourism (CBT) literature and existing sustainable tourism standards (STS) practices, qualitative research consisting of interviews with six key industry experts prov...

  19. A review of studies on community based early warning systems

    Directory of Open Access Journals (Sweden)

    Margaret Macherera

    2016-04-01

    Full Text Available Community-based early warning systems involve community driven collection and analysis of information that enable warning messages to help a community to react to a hazard and reduce the resulting loss or harm. Most early warning systems are designed at the national or global level. Local communities’ capacity to predict weather conditions using indigenous knowledge has been demonstrated in studies focusing on climate change and agriculture in some African countries. This review was motivated by successes made in non-disease specific community-based early warning systems with a view to identify opportunities for developing similar systems for malaria. This article reviewed the existing community-based early warning systems documented in literature. The types of disasters that are addressed by these systems and the methodologies utilised in the development of the systems were identified. The review showed that most of the documented community-based early warning systems focus on natural disasters such as floods, drought, and landslides. Community-based early warning systems for human diseases are very few, even though such systems exist at national and regional and global levels. There is a clear gap in terms of community-based malaria early warning systems. The methodologies for the development of the community-based early warning systems reviewed mainly derive from the four elements of early warning systems; namely risk knowledge, monitoring, warning communication and response capability. The review indicated the need for the development of community based early warning systems for human diseases. Keywords: community; early warning; disaster; hazards

  20. The association between maternal dietary micronutrient intake and neonatal anthropometry - secondary analysis from the ROLO study.

    LENUS (Irish Health Repository)

    Horan, Mary K

    2015-01-01

    Micronutrients are necessary for fetal growth. However increasingly pregnant women are nutritionally replete and little is known about the effect of maternal micronutrient intakes on fetal adiposity in mothers with increased BMI. The aim of this study was to examine the association of maternal dietary micronutrient intake with neonatal size and adiposity in a cohort at risk of macrosomia.

  1. Levels of micronutrients and heavy metals in cord blood and ...

    African Journals Online (AJOL)

    The basis of the impact of HAP on maternal and fetal health was assessed by determining the levels of teratogenic heavy metals [Lead (Pb), Mercury (Hg)] and micronutrients associated with DNA methylation [Zinc (Zn), Iodine (I), vitamins B6 and B12, folic acid and homocysteine] in cord blood of babies and maternal blood ...

  2. Variability of micronutrient content in enriched dairy and fruit products

    NARCIS (Netherlands)

    Jong, de N.; Adam, S.G.N.; Groot, de C.P.G.M.; Graaf, de C.

    2000-01-01

    Accurate measures of micronutrient levels in newly developed enriched foods are indispensable for valid labelling, for determination of ultimate levels for possible claimed health effects and for safety. To date, only a limited amount of public literature is available on the reproducibility of

  3. Do multiple micronutrient interventions improve child health, growth, and development?

    Science.gov (United States)

    Ramakrishnan, Usha; Goldenberg, Tamar; Allen, Lindsay H

    2011-11-01

    Micronutrient deficiencies are common and often co-occur in many developing countries. Several studies have examined the benefits of providing multiple micronutrient (MMN) interventions during pregnancy and childhood, but the implications for programs remain unclear. The key objective of this review is to summarize what is known about the efficacy of MMN interventions during early childhood on functional outcomes, namely, child health, survival, growth, and development, to guide policy and identify gaps for future research. We identified review articles including meta-analyses and intervention studies that evaluated the benefits of MMN interventions (3 or more micronutrients) in children (growth. Two studies found no effects on child mortality. The findings for respiratory illness and diarrhea are mixed, although suggestive of benefit when provided as fortified foods. There is evidence from several controlled trials (>25) and 2 meta-analyses that MMN interventions improve hemoglobin concentrations and reduce anemia, but the effects were small compared to providing only iron or iron with folic acid. Two recent meta-analyses and several intervention trials also indicated that MMN interventions improve linear growth compared to providing a placebo or single nutrients. Much less is known about the effects on MMN interventions during early childhood on motor and mental development. In summary, MMN interventions may result in improved outcomes for children in settings where micronutrient deficiencies are widespread.

  4. Status of micronutrient nutrition in Zimbabwe: A review | Gadaga ...

    African Journals Online (AJOL)

    malnutrition including vitamin and mineral malnutrition. This paper constitutes a review of the micronutrient malnutrition status of the Zimbabwean population, focusing on the period from 1980 to 2006, using data from nutrition surveys, the demographic health surveys, sentinel surveillance and monitoring programmes. Data

  5. Socioeconomic differences in micronutrient intake and status in Europe

    NARCIS (Netherlands)

    Novakovic, R.N.

    2013-01-01

    The aim of this thesis was to evaluate micronutrient intake and status of socioeconomic disadvantaged populations, such as from Central and Eastern European (CEE) as compared to other European populations, and low socioeconomic status (SES) groups as compared to high SES groups within European

  6. ABOVE GROUND BIOMASS MICRONUTRIENTS IN A SEASONAL SUBTROPICAL FOREST

    Directory of Open Access Journals (Sweden)

    Hamilton Luiz Munari Vogel

    2015-06-01

    Full Text Available In the above ground biomass of a native forest or plantation are stored large quantities of nutrients, with few studies in the literature, especially concerning micronutrients. The present work aimed to quantify the micronutrients in above ground biomass in a Seasonal Subtropical forest in Itaara-RS, Brazil. For the above ground biomass evaluation, 20 trees of five different diameter classes were felled. The above ground biomass was separated in the following compartments: stem wood, stem bark, branches and leaves. The contents of B, Cu, Fe, Mn and Zn in the biomass samples were determined. The stock of micronutrients in the biomass for each component was obtained based on the estimated dry biomass, multiplied by the nutrient content. The total production of above ground biomass was estimated at 210.0 Mg.ha-1. The branches, stem wood, stem bark and leaves corresponded to 48.8, 43.3, 5.4 and 2.4% of the above ground biomass. The lower levels of B, Cu, Fe and Mn are in stem wood, except for Zn; in the branches and trunk wood are the largest stocks of B, Cu, Fe and Mn. In the branches, leaves and trunk bark are stored most micronutrients, pointing to the importance of these to remain on the soil.

  7. Changes of micronutrients, dry weight and plant development in ...

    African Journals Online (AJOL)

    User

    2011-05-09

    May 9, 2011 ... This study was carried out to determine the effects of salt stress on the growth, dry weights and micronutrient contents of canola (Brassica napus L.) cultivars grown in greenhouse ... crop productivity in the arid and semiarid regions of the ... fertilizer equivalent to 150 kg ha-1 and triple-superphosphate (80 kg.

  8. Volume 9 No. 4 2009 June 2009 992 MICRONUTRIENT ...

    African Journals Online (AJOL)

    Deficiencies in zinc, folate (particularly in pregnancy), vitamins B-12, C, and D, thiamine .... for zinc deficiency is likely high in pregnant women in developing countries, as ..... Vitamin C (ascorbic acid) – Clinical vitamin C deficiency (scurvy) has been .... micronutrient delivery to beneficiaries of U.S. food aid commodities.

  9. A meta-analysis of pica and micronutrient status.

    Science.gov (United States)

    Miao, Diana; Young, Sera L; Golden, Christopher D

    2015-01-01

    Pica is the craving for and consumption of nonfood items, including the ingestion of earth (geophagy), raw starch (amylophagy), and ice (pagophagy). Pica has long been associated with micronutrient deficiencies, but the strength of this relationship is unclear. We aimed to evaluate the association between pica behavior and the risk of being anemic or having low hemoglobin (Hb), hematocrit (Hct), or plasma zinc (Zn) concentrations. We systematically reviewed studies in which micronutrient levels were reported by pica status. We calculated the pooled odds ratio for anemia or weighted mean difference in Hb, Hct, or Zn concentrations between groups practicing or not practicing pica behaviors. Forty-three studies including 6,407 individuals with pica behaviors and 10,277 controls were identified. Pica was associated with 2.35 times greater odds of anemia (95% CI: 1.94-2.85, P < 0.001), lower Hb concentration (-0.65 g/dl, 95% CI: -0.83 to -0.48 g/dl, P < 0.001), lower Hct concentration (-1.15%, 95% CI: -1.61 to -0.70%, P < 0.001), and lower Zn concentration (-34.3 μg/dl, 95% CI: -59.58 to -9.02 μg/dl, P = 0.008). Statistical significance persisted after excluding outliers and in subgroup analyses by pica type and life stage. Pica is significantly associated with increased risk for anemia and low Hb, Hct, and plasma Zn. Although the direction of the causal relationship between pica and micronutrient deficiency is unknown, the magnitude of these relationships is comparable to other well-recognized causes of micronutrient deficiencies. Pica warrants greater public health attention; specifically the potential physiological mechanisms underpinning the relationship between pica and micronutrient deficiencies merit further study. © 2014 Wiley Periodicals, Inc.

  10. Forests, Trees, and Micronutrient-Rich Food Consumption in Indonesia.

    Science.gov (United States)

    Ickowitz, Amy; Rowland, Dominic; Powell, Bronwen; Salim, Mohammad Agus; Sunderland, Terry

    2016-01-01

    Micronutrient deficiency remains a serious problem in Indonesia with approximately 100 million people, or 40% of the population, suffering from one or more micronutrient deficiencies. In rural areas with poor market access, forests and trees may provide an essential source of nutritious food. This is especially important to understand at a time when forests and other tree-based systems in Indonesia are being lost at unprecedented rates. We use food consumption data from the 2003 Indonesia Demographic Health Survey for children between the ages of one and five years and data on vegetation cover from the Indonesian Ministry of Forestry to examine whether there is a relationship between different tree-dominated land classes and consumption of micronutrient-rich foods across the archipelago. We run our models on the aggregate sample which includes over 3000 observations from 25 provinces across Indonesia as well as on sub-samples from different provinces chosen to represent the different land classes. The results show that different tree-dominated land classes were associated with the dietary quality of people living within them in the provinces where they were dominant. Areas of swidden/agroforestry, natural forest, timber and agricultural tree crop plantations were all associated with more frequent consumption of food groups rich in micronutrients in the areas where these were important land classes. The swidden/agroforestry land class was the landscape associated with more frequent consumption of the largest number of micronutrient rich food groups. Further research needs to be done to establish what the mechanisms are that underlie these associations. Swidden cultivation in is often viewed as a backward practice that is an impediment to food security in Indonesia and destructive of the environment. If further research corroborates that swidden farming actually results in better nutrition than the practices that replace it, Indonesian policy makers may need to

  11. Micronutrients in HIV: a Bayesian meta-analysis.

    Directory of Open Access Journals (Sweden)

    George M Carter

    Full Text Available Approximately 28.5 million people living with HIV are eligible for treatment (CD4<500, but currently have no access to antiretroviral therapy. Reduced serum level of micronutrients is common in HIV disease. Micronutrient supplementation (MNS may mitigate disease progression and mortality.We synthesized evidence on the effect of micronutrient supplementation on mortality and rate of disease progression in HIV disease.We searched MEDLINE, EMBASE, the Cochrane Central, AMED and CINAHL databases through December 2014, without language restriction, for studies of greater than 3 micronutrients versus any or no comparator. We built a hierarchical Bayesian random effects model to synthesize results. Inferences are based on the posterior distribution of the population effects; posterior distributions were approximated by Markov chain Monte Carlo in OpenBugs.From 2166 initial references, we selected 49 studies for full review and identified eight reporting on disease progression and/or mortality. Bayesian synthesis of data from 2,249 adults in three studies estimated the relative risk of disease progression in subjects on MNS vs. control as 0.62 (95% credible interval, 0.37, 0.96. Median number needed to treat is 8.4 (4.8, 29.9 and the Bayes Factor 53.4. Based on data reporting on 4,095 adults reporting mortality in 7 randomized controlled studies, the RR was 0.84 (0.38, 1.85, NNT is 25 (4.3, ∞.MNS significantly and substantially slows disease progression in HIV+ adults not on ARV, and possibly reduces mortality. Micronutrient supplements are effective in reducing progression with a posterior probability of 97.9%. Considering MNS low cost and lack of adverse effects, MNS should be standard of care for HIV+ adults not yet on ARV.

  12. The influence of micronutrients on oral and general health

    Directory of Open Access Journals (Sweden)

    Willershausen B

    2011-11-01

    Full Text Available Abstract Objective The aim of the present clinical pilot study was to examine the influence of a combination of micronutrients on individuals with high stress experience. Methods 40 healthy students (28 female, 12 male with a mean age of 27.1 ± 3.0 years, experiencing high examination stress, were chosen. After approval of the ethics commission, one group of students (n = 19 took a combination of micronutrients (Orthomol vital m/f for three months, whereas other students (n = 21 served as control group. All participants underwent at the beginning and at the end of the trial a dental examination, a determination of 10 periodontal pathogens, a salivary and a blood analysis. In addition, the participants filled in a questionnaire on nutrition, quality of life and degree of stress experienced during their final examinations. Results The evaluation of the results, obtained at the end of the trial period, showed that for all students a slight worsening of oral hygiene and an increased consumption of unhealthy food could be observed. The intake of the micronutrients led to a slight improvement of the degree of gingival inflammation in comparison to the control group. The blood analysis showed an increase in vitamin (vitamin C, vitamin E and zinc concentrations, and a lower increase in CRP. In the male subjects, a decrease in the serum concentrations of triglycerides (p = 0.073 and LDL (p = 0.048 was observed. Conclusions This pilot study shows that micronutrients, taken during periods of high stress experience, had a beneficial effect on inflammatory processes and helped reduce the level of some of the plasma lipids in males, and thus can be recommended for supplementing the diet. However, additional studies with a higher number of subjects, also suffering from periodontal disease, are necessary to show the effect of a micronutrient supplementation more clearly.

  13. A Micronutrient Fortified Beverage Given at Different Dosing Frequencies Had Limited Impact on Anemia and Micronutrient Status in Filipino Schoolchildren

    Science.gov (United States)

    Angeles-Agdeppa, Imelda; Magsadia, Clarita R.; Aaron, Grant J.; Lloyd, Beate B.; Hilmers, David C.; Bhutta, Zulfiqar A.

    2017-01-01

    This study evaluated the effects of a multi-micronutrient fortified juice drink given in different frequencies of consumption on hemoglobin (Hb) concentration of schoolchildren. Hb was measured in 2423 schoolchildren aged 6- to 9-years-old at baseline. All anemic children (n = 246) were randomly allocated into groups: Daily dose (HD: high dose), 5X/week (MD: Moderate Dose), 3X/week (LD: Low Dose) and unfortified (Control). Pre- and post-study measurements of micronutrients were collected from 228 children. At the endpoint, significant Hb increases were observed in all groups, but there was no significant difference between groups. There was a significant reduction in anemia prevalence in all groups from 100% to 36% (Control), 30% (LD), 23% (MD) and 26% (HD). No dose-response effect was observed in Hb in this population. Most likely, this resulted from better than expected micronutrient status and lower than expected severity of anemia and micronutrient deficiencies in this cohort. It is unlikely that the addition of a fortified beverage to school feeding programs in this population would have a positive impact. Whether such an intervention would be cost-effective as a preventative approach needs to be assessed. This study demonstrates the importance of targeting such interventions to appropriate populations. PMID:28895887

  14. Drug-micronutrient interactions: food for thought and thought for action.

    Science.gov (United States)

    Karadima, Vasiliki; Kraniotou, Christina; Bellos, George; Tsangaris, George Th

    2016-01-01

    Micronutrients are indispensable for a variety of vital functions. Micronutrient deficiencies are a global problem concerning two billion people. In most cases, deficiencies are treatable with supplementation of the elements in lack. Drug-nutrient interactions can also lead to micronutrient reduce or depletion by various pathways. Supplementation of the elements and long-term fortification programs for populations at risk can prevent and restore the related deficiencies. Within the context of Predictive, Preventive, and Personalized Medicine, a multi-professional network should be developed in order to identify, manage, and prevent drug-micronutrient interactions that can potentially result to micronutrient deficiencies.

  15. Violent Extremism, Community-Based Violence Prevention, and Mental Health Professionals.

    Science.gov (United States)

    Weine, Stevan M; Stone, Andrew; Saeed, Aliya; Shanfield, Stephen; Beahrs, John; Gutman, Alisa; Mihajlovic, Aida

    2017-01-01

    New community-based initiatives being developed to address violent extremism in the United States are utilizing mental health services and leadership. This article reviews current approaches to preventing violent extremism, the contribution that mental illness and psychosocial problems can make to violent extremism, and the rationale for integrating mental health strategies into preventing violent extremism. The authors describe a community-based targeted violence prevention model and the potential roles of mental health professionals. This model consists of a multidisciplinary team that assesses at-risk individuals with comprehensive threat and behavioral evaluations, arranges for ongoing support and treatment, conducts follow-up evaluations, and offers outreach, education, and resources for communities. This model would enable mental health professionals in local communities to play key roles in preventing violent extremism through their practice and leadership.

  16. Adaptive capacity and community-based natural resource management.

    Science.gov (United States)

    Armitage, Derek

    2005-06-01

    Why do some community-based natural resource management strategies perform better than others? Commons theorists have approached this question by developing institutional design principles to address collective choice situations, while other analysts have critiqued the underlying assumptions of community-based resource management. However, efforts to enhance community-based natural resource management performance also require an analysis of exogenous and endogenous variables that influence how social actors not only act collectively but do so in ways that respond to changing circumstances, foster learning, and build capacity for management adaptation. Drawing on examples from northern Canada and Southeast Asia, this article examines the relationship among adaptive capacity, community-based resource management performance, and the socio-institutional determinants of collective action, such as technical, financial, and legal constraints, and complex issues of politics, scale, knowledge, community and culture. An emphasis on adaptive capacity responds to a conceptual weakness in community-based natural resource management and highlights an emerging research and policy discourse that builds upon static design principles and the contested concepts in current management practice.

  17. Undernutrition, the Acute Phase Response to Infection, and Its Effects on Micronutrient Status Indicators12

    Science.gov (United States)

    Bresnahan, Kara A.; Tanumihardjo, Sherry A.

    2014-01-01

    Infection and undernutrition are prevalent in developing countries and demonstrate a synergistic relation. Undernutrition increases infection-related morbidity and mortality. The acute phase response (APR) is an innate, systemic inflammatory reaction to a wide array of disruptions in a host’s homeostasis, including infection. Released from immune cells in response to deleterious stimuli, proinflammatory cytokines act on distant tissues to induce behavioral (e.g., anorexia, weakness, and fatigue) and systemic effects of the APR. Cytokines act to increase energy and protein requirements to manifest fever and support hepatic acute phase protein (APP) production. Blood concentrations of glucose and lipid are augmented to provide energy to immune cells in response to cytokines. Additionally, infection decreases intestinal absorption of nutrients and can cause direct loss of micronutrients. Traditional indicators of iron, zinc, and vitamin A status are altered during the APR, leading to inaccurate estimations of deficiency in populations with a high or unknown prevalence of infection. Blood concentrations of APPs can be measured in nutrition interventions to assess the time stage and severity of infection and correct for the APR; however, standardized cutoffs for nutrition applications are needed. Protein-energy malnutrition leads to increased gut permeability to pathogens, abnormal immune cell populations, and impaired APP response. Micronutrient deficiencies cause specific immune impairments that affect both innate and adaptive responses. This review describes the antagonistic interaction between the APR and nutritional status and emphasizes the need for integrated interventions to address undernutrition and to reduce disease burden in developing countries. PMID:25398733

  18. Experiences and lessons learned for planning and supply of micronutrient powders interventions

    Science.gov (United States)

    Schauer, Claudia; Sunley, Nigel; Nyhus Dhillon, Christina; Roca, Claudia; Tapia, Gustavo; Mathema, Pragya; Walton, Shelley; Situma, Ruth; Zlotkin, Stanley; DW Klemm, Rolf

    2017-01-01

    Abstract Realistic planning for a nutrition intervention is a critical component of implementation, yet effective approaches have been poorly documented. Under the auspices of “The Micronutrient Powders Consultation: Lessons Learned for Operational Guidance,” 3 working groups were formed to summarize experiences and lessons across countries regarding micronutrient powders (MNP) interventions for young children. This paper focuses on programmatic experiences in the planning stages of an MNP intervention, encompassing assessment, enabling environment and adaptation, as well as considerations for supply. Methods included a review of published and grey literature, key informant interviews, and deliberations throughout the consultation process. We found that assessments helped justify adopting an MNP intervention, but these assessments were often limited by their narrow scope and inadequate data. Establishing coordinating bodies and integrating MNP into existing policies and programmes have helped foster an enabling environment and support programme stability. Formative research and pilots have been used to adapt MNP interventions to specific contexts, but they have been insufficient to inform scale‐up. In terms of supply, most countries have opted to procure MNP through international suppliers, but this still requires understanding and navigating the local regulatory environment at the earliest stages of an intervention. Overall, these findings indicate that although some key planning and supply activities are generally undertaken, improvements are needed to plan for effective scale‐up. Much still needs to be learned on MNP planning, and we propose a set of research questions that require further investigation. PMID:28960875

  19. Negotiation of values as driver in community-based PD

    DEFF Research Database (Denmark)

    Gronvall, Erik; Malmborg, Lone; Messeter, Jörn

    2016-01-01

    Community-based PD projects are often characterized by the meeting of conflicting values among stakeholder groups, but in research there is no uncontested account of the relation between design and conflicting values. Through analysis of three community-based PD cases in Denmark and South Africa......, this paper identifies and discusses challenges for community-based PD that exist in these settings based on the emergence of contrasting and often conflicting values among participants and stakeholders. Discussions of participation are shaped through two theoretical perspectives: the notion of thinging...... and design things; and different accounts of values in design. Inspired by the concept of design things, and as a consequence of the need for continuous negotiation of values observed in all three cases, we suggest the concept of thinging as fruitful for creating productive agonistic spaces with a stronger...

  20. Le Bon Samaritain: A Community-Based Care Model Supported by Technology.

    Science.gov (United States)

    Gay, Valerie; Leijdekkers, Peter; Gill, Asif; Felix Navarro, Karla

    2015-01-01

    The effective care and well-being of a community is a challenging task especially in an emergency situation. Traditional technology-based silos between health and emergency services are challenged by the changing needs of the community that could benefit from integrated health and safety services. Low-cost smart-home automation solutions, wearable devices and Cloud technology make it feasible for communities to interact with each other, and with health and emergency services in a timely manner. This paper proposes a new community-based care model, supported by technology, that aims at reducing healthcare and emergency services costs while allowing community to become resilient in response to health and emergency situations. We looked at models of care in different industries and identified the type of technology that can support the suggested new model of care. Two prototypes were developed to validate the adequacy of the technology. The result is a new community-based model of care called 'Le Bon Samaritain'. It relies on a network of people called 'Bons Samaritains' willing to help and deal with the basic care and safety aspects of their community. Their role is to make sure that people in their community receive and understand the messages from emergency and health services. The new care model is integrated with existing emergency warning, community and health services. Le Bon Samaritain model is scalable, community-based and can help people feel safer, less isolated and more integrated in their community. It could be the key to reduce healthcare cost, increase resilience and drive the change for a more integrated emergency and care system.

  1. Food synergies for improving bioavailability of micronutrients from plant foods.

    Science.gov (United States)

    Nair, K Madhavan; Augustine, Little Flower

    2018-01-01

    Plant foods are endowed with micronutrients but an understanding of bioavailability is essential in countries primarily dependent on plant based foods. Bioavailability depends majorly on food synergies. This review examines the nature of certain food synergies and methods to screen and establish it as a strategy to control micronutrient deficiency in the populations. Strong evidence on the synergistic effect of inclusion of vitamin C rich fruits and non-vegetarian foods in enhancing the bioavailability of iron has been demonstrated. Fat is found to be synergistic for vitamin A absorption. Red wine and protein have been explored for zinc absorption and effect of fat has been studied for vitamin D. Methods for screening of bioavailability, and biomarkers to demonstrate the synergistic effects of foods are required. Translation of food synergy as a strategy requires adaptation to the context and popularization of intelligent food synergies. Copyright © 2016 Elsevier Ltd. All rights reserved.

  2. Micronutrient problems in Thailand - extent, past and present research

    International Nuclear Information System (INIS)

    Snitwongse, P.

    1975-01-01

    Micronutrient problems in Thailand are briefly discussed, particularly with reference to rice. At present, the relative amounts of zinc in rice-growing areas (soils) are being analyzed for total and available zinc. Fertilizer (N, P, K) uptake by rice is being studied in the field by means of zinc-65. Observations on the relative uptake of P by rice associated with different zinc levels are made on pot cultures, using phosphorus-32

  3. Fertilization with filter cake and micronutrients in plant cane

    Directory of Open Access Journals (Sweden)

    Jaqueline Cristiane Adorna

    2013-06-01

    Full Text Available The response of sugarcane to application of micronutrients is still not very well known. In view of the need for this information, the aim of this study was to evaluate the application of the micronutrients Zn, Cu, Mn, Fe, B, and Mo to plant cane in three soils, with and without application of filter cake. This study consisted of three experiments performed in the State of São Paulo, Brazil, (in Igaraçu do Tiete, on an Oxisol; in Santa Maria da Serra, on an Entisol, both in the 2008/2009 growing season; and in Mirassol, on an Ultisol, in the 2009/2010 growing season in a randomized block design with four replications with a 8 x 2 factorial combination of micronutrients (1 - no application/control, 2 - addition of Zn, 3 - addition of Cu, 4 - addition of Mn 5 - addition of Fe, 6 - addition of B, 7 - addition of Mo, 8 - Addition of Zn, Cu, Mn, Fe, B, and Mo and filter cake (0 and 30 t ha-1 of filter cake in the furrow at planting. The application of filter cake was more efficient than of Borax in raising leaf B concentration to sufficiency levels for sugarcane in the Entisol, and it increased mean stalk yield in the Oxisol. In areas without filter cake application, leaf concentrations were not affected by the application of Zn, Cu, Mn, Fe, B, and Mo in the furrow at planting; however, Zn and B induced an increase in stalk and sugar yield in micronutrient-poor sandy soil.

  4. Micronutrients, Essential Fatty Acids and Bone Health in Phenylketonuria.

    Science.gov (United States)

    Demirdas, Serwet; van Spronsen, Francjan J; Hollak, Carla E M; van der Lee, J Hanneke; Bisschop, Peter H; Vaz, Fred M; Ter Horst, Nienke M; Rubio-Gozalbo, M Estela; Bosch, Annet M

    2017-01-01

    In phenylketonuria (PKU), a natural protein-restricted dietary treatment prevents severe cognitive impairment. Nutrient deficiencies may occur due to strict diet. This study is aimed at evaluating the dietary intake and blood concentrations of micronutrients and essential fatty acids (FA), bone mineral density (BMD) and fracture history in patients on long-term dietary treatment. Sixty early diagnosed Dutch patients (aged 1-39 years) were included in a multi-center cross-sectional study. Their dietary intake, blood concentrations of micronutrients, FA, fracture history and BMD were assessed. Selenium dietary intake and serum concentrations were low in 14 and 46% of patients, respectively. The serum 25-OH vitamin D2 + D3 concentration was low in 14% of patients while 20% of patients had a low vitamin D intake. Zinc serum concentrations were below normal in 14% of patients, despite adequate intake. Folic acid serum concentrations and intake were elevated. Despite safe total protein and fat intake, arginine plasma concentrations and erythrocyte eicosapentaenoic acid were below reference values in 19 and 6% of patients, respectively. Low BMD (Z-score <-2) was slightly more prevalent in patients, but the lifetime fracture prevalence was comparable to the general population. Dutch patients with PKU on long-term dietary treatment have a near normal nutrient status. Supplementation of micronutrients of which deficiency may be deleterious (e.g., vitamin D and selenium) should be considered. BMD warrants further investigation. © 2017 S. Karger AG, Basel.

  5. Radioisotope aided micronutrient research for increasing fertiliser use efficiency

    International Nuclear Information System (INIS)

    Deb, D.L.; Gupta, G.N.; Meisheri, M.B.; Rattan, R.K.; Sarkar, A.K.

    1986-01-01

    Results of fundamental studies involving the use of radioisotopes of micronutrients especially of Zn, Fe, Mn, Cu and Cl to find out the effect of soi l characteristics on the diffusion coefficient of these ions and the availability of micronutrient fertilisers to the crops have been reported for a large number of soils. The usefulness of mathematical models for evolving rational basis of micronutrient fertiliser recommendation for crops from soil factors such as intensity, capacity and rate factors of a nutrient in a given soil and plant characteristics such as root morphology and nutrient demand of a crop have been studied. Results showed good agreement between observed and predicted uptake of fertiliser Zn by wheat roots. Results of fundamental studies on severa l soils strongly suggest that the diffusion coefficient to Zn to plant root in a soil can be increased by appropriate manipulation of soil characters even without the application of fertiliser Zn. The effects of various sources, methods and rate of application of fertilizer Zn on the grain yield and fertiliz er Zn use efficiency in rice under water-logged conditions have been studied in alluvial and black soils of Delhi and Hyderabad, respectively. The fate of fe rtilizer Zn in these soils has been studied and the results are reported. (author). 5 figs., 9 tabs., 25 refs

  6. Radioisotope aided micronutrient research for increasing fertiliser use efficiency

    Energy Technology Data Exchange (ETDEWEB)

    Deb, D L; Gupta, G N; Meisheri, M B; Rattan, R K; Sarkar, A K

    1986-02-01

    Results of fundamental studies involving the use of radioisotopes of micronutrients especially of Zn, Fe, Mn, Cu and Cl to find out the effect of soi l characteristics on the diffusion coefficient of these ions and the availability of micronutrient fertilisers to the crops have been reported for a large number of soils. The usefulness of mathematical models for evolving rational basis of micronutrient fertiliser recommendation for crops from soil factors such as intensity, capacity and rate factors of a nutrient in a given soil and plant characteristics such as root morphology and nutrient demand of a crop have been studied. Results showed good agreement between observed and predicted uptake of fertiliser Zn by wheat roots. Results of fundamental studies on severa l soils strongly suggest that the diffusion coefficient to Zn to plant root in a soil can be increased by appropriate manipulation of soil characters even without the application of fertiliser Zn. The effects of various sources, methods and rate of application of fertilizer Zn on the grain yield and fertiliz er Zn use efficiency in rice under water-logged conditions have been studied in alluvial and black soils of Delhi and Hyderabad, respectively. The fate of fe rtilizer Zn in these soils has been studied and the results are reported. (author). 5 figs., 9 tabs., 25 refs.

  7. The Queuine Micronutrient: Charting a Course from Microbe to Man

    Directory of Open Access Journals (Sweden)

    Claire Fergus

    2015-04-01

    Full Text Available Micronutrients from the diet and gut microbiota are essential to human health and wellbeing. Arguably, among the most intriguing and enigmatic of these micronutrients is queuine, an elaborate 7-deazaguanine derivative made exclusively by eubacteria and salvaged by animal, plant and fungal species. In eubacteria and eukaryotes, queuine is found as the sugar nucleotide queuosine within the anticodon loop of transfer RNA isoacceptors for the amino acids tyrosine, asparagine, aspartic acid and histidine. The physiological requirement for the ancient queuine molecule and queuosine modified transfer RNA has been the subject of varied scientific interrogations for over four decades, establishing relationships to development, proliferation, metabolism, cancer, and tyrosine biosynthesis in eukaryotes and to invasion and proliferation in pathogenic bacteria, in addition to ribosomal frameshifting in viruses. These varied effects may be rationalized by an important, if ill-defined, contribution to protein translation or may manifest from other presently unidentified mechanisms. This article will examine the current understanding of queuine uptake, tRNA incorporation and salvage by eukaryotic organisms and consider some of the physiological consequence arising from deficiency in this elusive and lesser-recognized micronutrient.

  8. Laparoscopic Gastric Sleeve and Micronutrients Supplementation: Our Experience

    Directory of Open Access Journals (Sweden)

    D. Capoccia

    2012-01-01

    Full Text Available Background. Laparoscopic gastric sleeve (LGS has been recently introduced as a stand-alone, restrictive bariatric surgery. Theoretically, LGS attenuates micronutrients deficiencies and associated complications that were typically observed following malabsorptive procedures. The aim of this study was to assess some micronutrients and mineral deficiencies in patients undergoing LGS. Methods. In the period between July 2008 and April 2010, 138 obese patients (110 females and 28 males with mean BMI 44.4 kg/m2 ± 6.5, mean age 43.9±10.9 years were enrolled and underwent LGS. Patients were followed up with routine laboratory tests and anthropometric measurements and assessed for nutritional status, as regards vitamin B12, folic acid, iron, hemoglobin, calcium, and vitamin D, every three months throughout 12 months. Results. 12 months after sleeve, patients did not show iron deficiency and/or anemia; plasma calcium levels were in the normal range without supplementation from the sixth month after the operation. Vitamin B12 and folic acid were adequately supplemented for all the follow-up period. Vitamin D was in suboptimal levels, despite daily multivitamin supplementation. Conclusion. In this study, we showed that LGS is an effective surgery for the management of morbid obesity. An adequate supplementation is important to avoid micronutrients deficiencies and greater weight loss does not require higher dosage of multivitamins.

  9. Creatinine, diet, micronutrients, and arsenic methylation in West Bengal, India.

    Science.gov (United States)

    Basu, Arin; Mitra, Soma; Chung, Joyce; Guha Mazumder, D N; Ghosh, Nilima; Kalman, David; von Ehrenstein, Ondine S; Steinmaus, Craig; Liaw, Jane; Smith, Allan H

    2011-09-01

    Ingested inorganic arsenic (InAs) is methylated to monomethylated (MMA) and dimethylated metabolites (DMA). Methylation may have an important role in arsenic toxicity, because the monomethylated trivalent metabolite [MMA(III)] is highly toxic. We assessed the relationship of creatinine and nutrition--using dietary intake and blood concentrations of micronutrients--with arsenic metabolism, as reflected in the proportions of InAS, MMA, and DMA in urine, in the first study that incorporated both dietary and micronutrient data. We studied methylation patterns and nutritional factors in 405 persons who were selected from a cross-sectional survey of 7,638 people in an arsenic-exposed population in West Bengal, India. We assessed associations of urine creatinine and nutritional factors (19 dietary intake variables and 16 blood micronutrients) with arsenic metabolites in urine. Urinary creatinine had the strongest relationship with overall arsenic methylation to DMA. Those with the highest urinary creatinine concentrations had 7.2% more arsenic as DMA compared with those with low creatinine (p creatinine concentration was the strongest biological marker of arsenic methylation efficiency, and therefore should not be used to adjust for urine concentration in arsenic studies. The new finding that animal fat intake has a positive relationship with MMA% warrants further assessment in other studies. Increased MMA% was also associated, to a lesser extent, with low serum selenium and folate.

  10. Siderophore production by mycorrhizal sorghum roots under micronutrient deficient condition

    Directory of Open Access Journals (Sweden)

    N. Aliasgharzad

    2009-05-01

    Full Text Available It has widely been accepted that mycorrhizal symbiosis improves micronutrients uptake by most of the plants. In this study, sorghum (Sorghum bicolor L. plants were grown in sterile perlite and were inoculated with either Glomus etunicatum (GE or G.intraradices (GI, while the control set was left un-inoculated. Rorison's nutrient solution with three levels of 0, half and full strength (C0, C0.5 and C1, respectively of Fe, Cu, Zn and Mn was applied to the pots during 85 days of growth period. Chrome azurol-S assay was used for determination of siderophores in root leachates on 45, 65 and 85 days after sowing (DAS. Siderophore production per unit volume of root was higher in mycorrhizal than non-mycorrhizal plants. Both GE and GI were efficient fungi in this respect. Siderophore production was significantly induced at C0 level of the micronutrients. Amount of siderophores produced on 45 and 85 DAS was more than 65 DAS. Mycorrhizal root colonization by GE or GI was not significantly affected by micronutrient levels.

  11. Placental adaptations to micronutrient dysregulation in the programming of chronic disease.

    Science.gov (United States)

    Hofstee, Pierre; McKeating, Daniel; Perkins, Anthony V; Cuffe, James S M

    2018-04-21

    Poor nutrition during pregnancy is known to impair foetal development and increase the risk of chronic disease in offspring. Both macronutrients and micronutrients are required for a healthy pregnancy although significantly less is understood about the role of micronutrients in the programming of chronic disease. This is despite the fact that modern calorie rich diets are often also deficient in key micronutrients. The importance of micronutrients in gestational disorders is clearly understood but how they impact long term disease in humans requires further investigation. In contrast, animal studies have demonstrated how diets high or low in specific micronutrients influence offspring physiology. Many of these studies highlight the importance of the placenta in determining disease risk. This review will explore the effects of individual vitamins, minerals and trace elements on offspring disease outcomes and discuss several key placental adaptations that are affected by multiple micronutrients. These placental adaptations include micronutrient induced dysregulation of oxidative stress, altered methyl donor availability and its impact on epigenetic mechanisms as well as endocrine dysfunction. Critical gaps in our current knowledge and the relative importance of different micronutrients at different gestational ages will also be highlighted. Finally, this review will discuss the need for further studies to characterise the micronutrient status of Australian women of reproductive age and correlate micronutrient status to placental adaptations, pregnancy complications and offspring disease. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  12. The challenge of assessing MTech community-based-visual arts ...

    African Journals Online (AJOL)

    The article explores specific challenges in supervising, accommodating and evaluating diverse candidates who pursue an action-led and community-based research approach rooted within the visual arts. I contend that there is a specific challenge in the field of postgraduate supervision of engaging evaluation strategies.

  13. Community-based survey versus sentinel site sampling in ...

    African Journals Online (AJOL)

    rural children. Implications for nutritional surveillance and the development of nutritional programmes. G. c. Solarsh, D. M. Sanders, C. A. Gibson, E. Gouws. A study of the anthropometric status of under-5-year-olds was conducted in the Nqutu district of Kwazulu by means of a representative community-based sample and.

  14. Community Based Health Insurance Schemes and Protection of the ...

    African Journals Online (AJOL)

    The objectives of this study are two folds: firstly to explore the magnitude of catastrophic expenditure, and secondly to determine its contributing factor,s including the protective impact of the voluntary community based health insurance schemes in Tanzania. The study covered 274 respondents. Study findings have shown ...

  15. Risk assessment and model for community-based construction ...

    African Journals Online (AJOL)

    It, therefore, becomes necessary to systematically manage uncertainty in community-based construction in order to increase the likelihood of meeting project objectives using necessary risk management strategies. Risk management, which is an iterative process due to the dynamic nature of many risks, follows three main ...

  16. Community-based co-design in Okomakuara

    DEFF Research Database (Denmark)

    Kapuire, Gereon Koch; Winschiers-Theophilus, Heike; Chivuno-Kuria, Shilumbe

    2014-01-01

    Although the wider motivation and principles of Participatory Design (PD) are universal its concepts and techniques are highly contextual. Community-based codesign is a variation of PD, where processes are negotiated within the interaction. Thus this workshop gives participants the opportunity...

  17. Changes in smoking during a community-based cardiovascular ...

    African Journals Online (AJOL)

    Changes in smoking during a community-based cardiovascular disease intervention programme - The Coronary Risk Factor Study. ... South African Medical Journal ... Smoking quit rates were strongly " associated with initial smoking level, with light smokers being significanty more successful quitters than heavy smokers.

  18. Barriers and Strategies to Engaging Our Community-Based Preceptors.

    Science.gov (United States)

    Graziano, Scott C; McKenzie, Margaret L; Abbott, Jodi F; Buery-Joyner, Samantha D; Craig, LaTasha B; Dalrymple, John L; Forstein, David A; Hampton, Brittany S; Page-Ramsey, Sarah M; Pradhan, Archana; Wolf, Abigail; Hopkins, Laura

    2018-03-26

    This article, from the "To the Point" series that is prepared by the Association of Professors of Gynecology and Obstetrics Undergraduate Medical Education Committee, is a review of commonly cited barriers to recruiting and retaining community-based preceptors in undergraduate medical education and potential strategies to overcome them. Community-based preceptors have traditionally served as volunteer, nonsalaried faculty, with academic institutions relying on intrinsic teaching rewards to sustain this model. However, increasing numbers of learners, the burdens of incorporating the electronic medical record in practice, and increasing demands for clinical productivity are making recruitment and retention of community-based preceptors more challenging. General challenges to engaging preceptors, as well as those unique to women's health, are discussed. Potential solutions are reviewed, including alternative recruitment strategies, faculty development to emphasize efficient teaching practices in the ambulatory setting, offers of online educational resources, and opportunities to incorporate students in value-added roles. Through examples cited in this review, clerkship directors and medical school administrators should have a solid foundation to actively engage their community-based preceptors.

  19. Reducing carbon transaction costs in community based forest management

    NARCIS (Netherlands)

    Skutsch, Margaret

    The paper considers the potential for community based forest management (of existing forests) in developing countries, as a future CDM strategy, to sequester carbon and claim credits in future commitment periods. This kind of forestry is cost effective, and should bring many more benefits to local

  20. Community Based Distribution of Child Spacing Methods at ...

    African Journals Online (AJOL)

    uses volunteer CBD agents. Mrs. E.F. Pelekamoyo. Service Delivery Officer. National Family Welfare Council of Malawi. Private Bag 308. Lilongwe 3. Malawi. Community Based Distribution of. Child Spacing Methods ... than us at the Hospital; male motivators by talking to their male counterparts help them to accept that their ...

  1. Connect: An Effective Community-Based Youth Suicide Prevention Program

    Science.gov (United States)

    Bean, Gretchen; Baber, Kristine M.

    2011-01-01

    Youth suicide prevention is an important public health issue. However, few prevention programs are theory driven or systematically evaluated. This study evaluated Connect, a community-based youth suicide prevention program. Analysis of pre and posttraining questionnaires from 648 adults and 204 high school students revealed significant changes in…

  2. Teaching Community-Based Learning Course in Retailing Management

    Science.gov (United States)

    Rhee, Eddie

    2018-01-01

    This study outlines the use of a community-based learning (CBL) applied to a Retailing Management course conducted in a 16-week semester in a private institution in the East Coast. The study addresses the case method of teaching and its potential weaknesses, and discusses experiential learning for a real-world application. It further addresses CBL…

  3. Assessing the contribution of Community-Based Natural Resources ...

    African Journals Online (AJOL)

    This study assessed Community-Based Natural Resources Management Programme (CBNRMP) for environmental sustainability in Ondo State, Nigeria. Data were gathered through a structured interview schedule from 120 rural dwellers participating in CBNRMP. Data collected were described with descriptive statistical ...

  4. Reflective learning in community-based dental education.

    Science.gov (United States)

    Deogade, Suryakant C; Naitam, Dinesh

    2016-01-01

    Community-based dental education (CBDE) is the implementation of dental education in a specific social context, which shifts a substantial part of dental clinical education from dental teaching institutional clinics to mainly public health settings. Dental students gain additional value from CBDE when they are guided through a reflective process of learning. We propose some key elements to the existing CBDE program that support meaningful personal learning experiences. Dental rotations of 'externships' in community-based clinical settings (CBCS) are year-long community-based placements and have proven to be strong learning environments where students develop good communication skills and better clinical reasoning and management skills. We look at the characteristics of CBDE and how the social and personal context provided in communities enhances dental education. Meaningfulness is created by the authentic context, which develops over a period of time. Structured reflection assignments and methods are suggested as key elements in the existing CBDE program. Strategies to enrich community-based learning experiences for dental students include: Photographic documentation; written narratives; critical incident reports; and mentored post-experiential small group discussions. A directed process of reflection is suggested as a way to increase the impact of the community learning experiences. We suggest key elements to the existing CBDE module so that the context-rich environment of CBDE allows for meaningful relations and experiences for dental students and enhanced learning.

  5. An Honors Interdisciplinary Community-Based Research Course

    Science.gov (United States)

    Dunbar, David; Terlecki, Melissa; Watterson, Nancy; Ratmansky, Lisa

    2013-01-01

    This article describes how two faculty members at Cabrini College--one from biology and the other from psychology--incorporated interdisciplinary community-based research in an honors course on environmental watershed issues. The course, Environmental Psychology, was team-taught in partnership with a local watershed organization, the Valley Creek…

  6. Community-Based Solid Waste Management: A Training Facilitator's Guide.

    Science.gov (United States)

    Peace Corps, Washington, DC. Information Collection and Exchange Div.

    Urban environmental management and environmental health issues are of increasing concern worldwide. The need for urban environmental management work at the local level where the Peace Corps works most effectively is significant, but training materials dedicated specifically to community-based solid waste management work in urban areas are lacking.…

  7. Economic performance of community based bean seed production ...

    African Journals Online (AJOL)

    Limited access to seed of improved varieties is an impediment to agricultural productivity in sub-Saharan Africa. Researchers in the national and international agricultural research systems have been piloting a community based seed multiplication and marketing enterprises (CBSME) model, as an alternative to the formal ...

  8. Community based monitoring: engaging and empowering Alberta ranchers

    Science.gov (United States)

    Michael S. Quinn; Jennifer E. Dubois

    2005-01-01

    Community based monitoring (CBM), a form of citizen science, is presented as a potential contributor to ecosystem management and sustainable development. A conceptual model for CBM and lessons learned from a Canadian national pilot program, the Canadian Community Monitoring Network, are summarized along with a description of the European university-based “science shop...

  9. Design implications for a community-based social recipe system

    NARCIS (Netherlands)

    Lim, V.; Yalvac, F.; Funk, M.; Hu, J.; Rauterberg, G.W.M.; Regazzoni, C.S.; Marcenaro, L.

    2014-01-01

    We introduced the concept of a community-based social recipe system which suggests recipes to groups of users based on available ingredients from these users (i.e. who can be from the same household or different households). In this paper we discuss the relevance and desirability of such a system

  10. Heterogeneous Community-based mobility model for human opportunistic network

    DEFF Research Database (Denmark)

    Hu, Liang; Dittmann, Lars

    2009-01-01

    a heterogeneous community-based random way-point (HC-RWP) mobility model that captures the four important properties of real human mobility. These properties are based on both intuitive observations of daily human mobility and analysis of empirical mobility traces. By discrete event simulation, we show HC...

  11. Community-based conservation of critical sites: Uganda's experience

    African Journals Online (AJOL)

    ... of natural resources, first and foremost for their own good, and then for national and global benefit. Ecotourism and adding value to locally produced materials in communities can translate into support for conservation. This paper highlights the importance of community-based conservation for important biodiversity sites.

  12. Water, sanitation and hygiene in community based care ...

    African Journals Online (AJOL)

    Majority of the HIV/AIDS patients in South Africa receive health care services at home. However, limited studies have been conducted to examine the water, sanitation and hygiene (WASH) situation in the homes of the care receivers and its impact on community-based care. The main objective of this study was to explore ...

  13. A community-based framework for aquatic ecosystem models

    NARCIS (Netherlands)

    Trolle, D.; Hamilton, D.P.; Hipsey, M.R.; Bolding, K.; Bruggeman, J.; Mooij, W.M.; Janse, J.H.; Nielsen, A.; Jeppesen, E.; Elliott, J.A.; Makler-Pick, V.; Petzoldt, T.; Rinke, K.; Flindt, M.R.; Arhonditsis, G.B.; Gal, G.; Bjerring, R.; Tominaga, K.; Hoen, 't J.; Downing, A.S.; Marques, D.M.; Fragoso, C.R.; Sondergaard, M.; Hanson, P.C.

    2012-01-01

    Here, we communicate a point of departure in the development of aquatic ecosystem models, namely a new community-based framework, which supports an enhanced and transparent union between the collective expertise that exists in the communities of traditional ecologists and model developers. Through a

  14. Implementing and managing community-based education and ...

    African Journals Online (AJOL)

    Background. A current challenge in the training of healthcare professionals is to produce socially responsive graduates who are prepared for work in community settings. Community-based education (CBE) and service learning (SL) are teaching approaches used in the Faculty of Health Sciences at the University of the Free ...

  15. From Campuses to Communities: Community-Based Cultism and ...

    African Journals Online (AJOL)

    Due to the criminal activities of the cult groups in the NDR and ineptitude of the police, communities have responded by creating vigilante groups but this has only promoted cycle of violence. The paper recommended that government should tackle community-based cultism and also strengthen the Nigeria Police Force to be ...

  16. Frameworks: A Community-Based Approach to Preventing Youth Suicide

    Science.gov (United States)

    Baber, Kristine; Bean, Gretchen

    2009-01-01

    Few youth suicide prevention programs are theory based and systematically evaluated. This study evaluated the pilot implementation of a community-based youth suicide prevention project guided by an ecological perspective. One hundred fifty-seven adults representing various constituencies from educators to health care providers and 131 ninth-grade…

  17. Renewal Strategy and Community Based Organisations in Community

    African Journals Online (AJOL)

    FBL

    organisations in the study areas and Community-Based Poverty Reduction. Programme ... regions or areas. In Nigeria, for ... industries in the growing and developing urban areas. ..... Security network is also provided by the community. To ..... Development Efforts in Nigeria: Case Study of Anambra and Oyo State, NISER.

  18. Capacity of Community-Based Organisations to disseminate ...

    African Journals Online (AJOL)

    Objective: To assess the capacity of established community based organisations (CBOs) to disseminate information on sleeping sickness control. Design: Participatory interview process administered to randomly selected CBOs in a tsetse and trypanosomosis endemic area. Setting: Busia district, Western, Kenya. Results: ...

  19. Whose forests, whose voices? Mining and community- based nature ...

    African Journals Online (AJOL)

    This paper explores local experiences of private - sector led community - based nature conservation near Fort Dauphin, southeastern Madagascar through the analysis of a conservation zone managed in partnership between the Rio Tinto mining corporation, local government and local communities. The article assesses ...

  20. The operational challenges of community-based tourism ventures in ...

    African Journals Online (AJOL)

    Community-based tourism is increasingly being developed and promoted as a means of reducing poverty in developing countries, assisting local communities to meet their needs through the offering of a tourism product. The Swaziland Tourism Authority with the support of the European Union Fund has made significant ...

  1. How to move towards community based service delivery?

    NARCIS (Netherlands)

    Meuwissen, L.; Voorham, T.; Bakker, D. de

    2007-01-01

    Aim: Community based primary health care offers in potential the opportunity to tailor health service delivery to the needs and demands of the local population. Up to now, there is no clear cut method to do this. In a pilot benchmark for general practices, data were collected on demand and

  2. Three Initiatives for Community-Based Art Education Practices

    Science.gov (United States)

    Lim, Maria; Chang, EunJung; Song, Borim

    2013-01-01

    Art educators should be concerned with teaching their students to make critical connections between the classroom and the outside world. One effective way to make these critical connections is to provide students with the opportunity to engage in community-based art endeavors. In this article, three university art educators discuss engaging…

  3. Local natural and cultural heritage assets and community based ...

    African Journals Online (AJOL)

    Community based tourism (CBT) is seen as an opportunity which mass tourism does not offer for, especially, rural communities to develop their natural and cultural assets into tourism activities for the benefit of the community. The point of CBT is that the community, collectively and individually, gains a livelihood from ...

  4. Community-based Natural Resource Management of the Jozani ...

    African Journals Online (AJOL)

    Community-based Natural Resource Management (CBNRM) is an approach that has generally .... rules in use across a broad range of CPR user- communities .... identified these social clusters and vocational groupings as ..... satisfied with the agreement and the villagers .... protection measures for the red colobus monkey ...

  5. Participatory land use planning for community based forest ...

    African Journals Online (AJOL)

    Participatory land use planning for community based forest management in South-Eastern Nigeria. FE Bisong, A Animashaun. Abstract. No Abstract. Lwati: A Journal of Contemporary Research Vol. 4 () 2007: pp.329-347. Full Text: EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT.

  6. Do Community-based Institutions Build Resilience to Climate Change in Mongolia?

    Science.gov (United States)

    Fernandez-Gimenez, M.

    2012-12-01

    Climate change impacts are inherently local, yet relatively little is known about the role of local people and institutions in adapting to climate change. Mongolia has experienced one of the strongest warming trends on Earth over the past 40 years, associated declines in streamflow, and increases in the frequency of extreme winter weather events. Environmental changes are compounded by rapid political, economic and social transformations beginning in 1990. We investigate the complex interactions of social, ecological and climate changes across multiple levels from local to regional to national. We hypothesize that community-based institutions increase resilience by strengthening self-regulating feedbacks between social and ecological systems through development and enforcement of formal management rules, implementation of innovative management practices, strengthening of social networks and information exchange within and across levels of social organization, and enhanced monitoring. These result in better ecological and socio-economic conditions and greater adaptive capacity in areas under formal community-based management compared to adjacent areas without formal community management institutions. Evaluation of this hypothesis involves integrated collection and analysis of quantitative and qualitative ecological, social and hydro-climatic data at household, community and regional levels of spatial and social organization. Here, we present preliminary results evaluating these hypotheses from 10 counties (soum) in 3 provinces (aimag) in the Gobi desert-steppe of southern Mongolia based on household-level social data and plot-level ecological data representing. Our initial findings support the hypothesis that community-based institutions are associated with greater household adaptive capacity and healthier pasture ecological conditions, characterized by greater perennial vegetation cover and biomass, especially in the functional group most important for livestock

  7. Enrichment of tropical peat with micronutrients for agricultural applications: evaluation of adsorption and desorption processes

    Energy Technology Data Exchange (ETDEWEB)

    Melo, Camila de A.; Oliveira, Lilian K. de; Fraceto, Leonardo F.; Rosa, Andre H., E-mail: ahrosa@sorocaba.unesp.br [Universidade Estadual Paulista Julio de Mesquita Filho (UNESP), Sorocaba, SP (Brazil). Dept. de Engenharia Ambiental; Goveia, Danielle [Universidade Estadual Paulista Julio de Mesquita Filho (UNESP), Araraquara, SP (Brazil). Inst. de Quimica

    2014-01-15

    The objective of this work was to evaluate the adsorption and desorption of micronutrients in tropical peats, from the perspective of potential agricultural applications. Adsorption experiments were performed at different pH values, using solutions containing individual and multiple metal ions. Maximum adsorption capacity occurred at pH 6.0, and the order of affinity was Cu > Fe > Co > Ni > Zn = Mn. Release of the micronutrients was evaluated at different pH values, using an aqueous medium as well as soil and plants. Release of the micronutrients was most efficient at pH 6.0, and followed the order: Fe > Zn > Mn > Co = Ni > Cu. Micronutrient release to the soil was accompanied by uptake by the plant. The use of tropical peat enriched with micronutrients could contribute to improved agricultural productivity, since the release profile of the micronutrients can effectively stimulate plant growth. (author)

  8. Interactions between leaf macro, micronutrients and soil properties in pistachio (Pistacia vera L.) orchards

    OpenAIRE

    Koukoulakis, Prodromos; Chatzissavvidis, Christos; Papadopoulos, Aristotelis; Pontikis, Dimitrios

    2013-01-01

    The interactions between: (i) leaf dry matter macronutrients, micronutrients and soil chemical properties, (ii) leaf macro- and micronutrients, (iii) soil macro- and micronutrients and (iv) soil chemical properties, and soil micro- and macronutrients in 50 pistachio orchards were investigated in leaves and soils by means of regression analysis. Most of the soils were deficient in plant-available P, Zn, Mn, Fe, and B, while they were excessively supplied with Cu. Leaf analysis showed that most...

  9. Drug-micronutrient interactions: food for thought and thought for action

    OpenAIRE

    Karadima, Vasiliki; Kraniotou, Christina; Bellos, George; Tsangaris, George Th.

    2016-01-01

    Micronutrients are indispensable for a variety of vital functions. Micronutrient deficiencies are a global problem concerning two billion people. In most cases, deficiencies are treatable with supplementation of the elements in lack. Drug-nutrient interactions can also lead to micronutrient reduce or depletion by various pathways. Supplementation of the elements and long-term fortification programs for populations at risk can prevent and restore the related deficiencies. Within the context of...

  10. Community based rehabilitation: a strategy for peace-building

    OpenAIRE

    Hodgson Jennifer; Koros Michael; Boyce William

    2002-01-01

    Abstract Background Certain features of peace-building distinguish it from peacekeeping, and make it an appropriate strategy in dealing with vertical conflict and low intensity conflict. However, some theorists suggest that attempts, through peace-building, to impose liberal values upon non-democratic cultures are misguided and lack an ethical basis. Discussion We have been investigating the peace-building properties of community based approaches to disability in a number of countries. This p...

  11. "Psychological Boarding" and Community-Based Behavioral Health Crisis Stabilization.

    Science.gov (United States)

    Mukherjee, Dhrubodhi; Saxon, Verletta

    2018-01-27

    This exploratory paper presents a case study where a community based mental health organization forging a partnership with a local hospital system to establish a crisis stabilization unit (CSU) to address behavioral health emergency care. The study takes a mixed methods case study approach to address two research questions; (a) did this approach reduce the overall length of stay in the hospital emergency departments? (b) What challenges did the taskforce face in implementing this CSU model? The paper shares recommendation from the findings.

  12. Community-based tourism in Cape Verde - a case study

    OpenAIRE

    Tomas Lopez-Guzman; Osvaldo Borges; Ana Maria Castillo-Canalejo

    2011-01-01

    Community-based tourism is taking its place in the world as an alternative to traditional tourist destinations, especially in developing countries. This form of tourism allows for greater contact with the local community and for the tourist to experience new sensations while enabling the economic and social development of the geographic area. In this paper, the results of fieldwork carried out in the island of Fogo (Cape Verde) are presented, assessing the opinion and perception tourists visi...

  13. A review of studies on community based early warning systems

    OpenAIRE

    Margaret Macherera; Moses J. Chimbari

    2016-01-01

    Community-based early warning systems involve community driven collection and analysis of information that enable warning messages to help a community to react to a hazard and reduce the resulting loss or harm. Most early warning systems are designed at the national or global level. Local communities’ capacity to predict weather conditions using indigenous knowledge has been demonstrated in studies focusing on climate change and agriculture in some African countries. This review was motivated...

  14. Future Scope of Community Based Tourism in Nepal

    OpenAIRE

    Gurung, Sunita

    2015-01-01

    This Bachelor’s thesis is based on the tourism and community based tourism in Nepal. The purpose of selecting tourism as a main topic is to find out the future scope of CBT in Nepal. Despite having small size, Nepal holds many attractive and adventurous tourist destinations. Nepal is famous from its cultural and traditional diversity, natural beauty, trekking trails, moun-taineering and warm and welcoming hospitality. Tourism in Nepal is undoubtedly the most important source for the econo...

  15. Efficient community-based control strategies in adaptive networks

    International Nuclear Information System (INIS)

    Yang Hui; Tang Ming; Zhang Haifeng

    2012-01-01

    Most studies on adaptive networks concentrate on the properties of steady state, but neglect transient dynamics. In this study, we pay attention to the emergence of community structure in the transient process and the effects of community-based control strategies on epidemic spreading. First, by normalizing the modularity, we investigate the evolution of community structure during the transient process, and find that a strong community structure is induced by the rewiring mechanism in the early stage of epidemic dynamics, which, remarkably, delays the outbreak of disease. We then study the effects of control strategies started at different stages on the prevalence. Both immunization and quarantine strategies indicate that it is not ‘the earlier, the better’ for the implementation of control measures. And the optimal control effect is obtained if control measures can be efficiently implemented in the period of a strong community structure. For the immunization strategy, immunizing the susceptible nodes on susceptible–infected links and immunizing susceptible nodes randomly have similar control effects. However, for the quarantine strategy, quarantining the infected nodes on susceptible–infected links can yield a far better result than quarantining infected nodes randomly. More significantly, the community-based quarantine strategy performs better than the community-based immunization strategy. This study may shed new light on the forecast and the prevention of epidemics among humans. (paper)

  16. Community Based Nutrition Rehabilitation in Tanzania: Challenges and Lessons Learned

    International Nuclear Information System (INIS)

    Urio, Elisaphinate Moses; Jeje, Benedict; Ndossi, Godwin

    2014-01-01

    Full text: Malnutrition among children under the age of five continues to be a significant public health problem in Tanzania. Despite numerous nutritional interventions that have been implemented, the country still experiences high rates of malnutrition. According to Tanzania Demographic and Health Survey of 2010 the prevalence of underweight was estimated to be 16%, wasting 5% and stunting 42 %. Factors contributing to causes of malnutrition include immediate, underlying and basic causes. All these factors are interlinked and operate synergistically and not independently. Approaches for managing malnourished children in Tanzania evolved from facility based Nutrition Rehabilitation Units (NURU) in the late 1960s to Community Based Nutrition Rehabilitation (CBNR) in late 1980s. In the latter approach, malnourished children are rehabilitated in the same environment (village, home) that precipitated the condition, using resources and infrastructures available in the community. Mothers are taught about child feeding using family foods to make good food mixtures and of the importance of feeding frequency for the young child. Limitations for this approach include inadequate advocacy to leaders from districts down to the community level, few trained health providers and community health workers on knowledge and skills on community based nutrition rehabilitation, inadequate equipment and supplies for identification and categorization of malnutrition, low awareness of parents, care givers and community leaders on home rehabilitation of malnourished children. Nonetheless, Community Based Nutrition Rehabilitation approach has the potential to address malnutrition in children given political will and resources. (author)

  17. Cost Effective Community Based Dementia Screening: A Markov Model Simulation

    Directory of Open Access Journals (Sweden)

    Erin Saito

    2014-01-01

    Full Text Available Background. Given the dementia epidemic and the increasing cost of healthcare, there is a need to assess the economic benefit of community based dementia screening programs. Materials and Methods. Markov model simulations were generated using data obtained from a community based dementia screening program over a one-year period. The models simulated yearly costs of caring for patients based on clinical transitions beginning in pre dementia and extending for 10 years. Results. A total of 93 individuals (74 female, 19 male were screened for dementia and 12 meeting clinical criteria for either mild cognitive impairment (n=7 or dementia (n=5 were identified. Assuming early therapeutic intervention beginning during the year of dementia detection, Markov model simulations demonstrated 9.8% reduction in cost of dementia care over a ten-year simulation period, primarily through increased duration in mild stages and reduced time in more costly moderate and severe stages. Discussion. Community based dementia screening can reduce healthcare costs associated with caring for demented individuals through earlier detection and treatment, resulting in proportionately reduced time in more costly advanced stages.

  18. Lessons Learned From Community-Based Approaches to Sodium Reduction

    Science.gov (United States)

    Kane, Heather; Strazza, Karen; Losby PhD, Jan L.; Lane, Rashon; Mugavero, Kristy; Anater, Andrea S.; Frost, Corey; Margolis, Marjorie; Hersey, James

    2017-01-01

    Purpose This article describes lessons from a Centers for Disease Control and Prevention initiative encompassing sodium reduction interventions in six communities. Design A multiple case study design was used. Setting This evaluation examined data from programs implemented in six communities located in New York (Broome County, Schenectady County, and New York City); California (Los Angeles County and Shasta County); and Kansas (Shawnee County). Subjects Participants (n = 80) included program staff, program directors, state-level staff, and partners. Measures Measures for this evaluation included challenges, facilitators, and lessons learned from implementing sodium reduction strategies. Analysis The project team conducted a document review of program materials and semi structured interviews 12 to 14 months after implementation. The team coded and analyzed data deductively and inductively. Results Five lessons for implementing community-based sodium reduction approaches emerged: (1) build relationships with partners to understand their concerns, (2) involve individuals knowledgeable about specific venues early, (3) incorporate sodium reduction efforts and messaging into broader nutrition efforts, (4) design the program to reduce sodium gradually to take into account consumer preferences and taste transitions, and (5) identify ways to address the cost of lower-sodium products. Conclusion The experiences of the six communities may assist practitioners in planning community-based sodium reduction interventions. Addressing sodium reduction using a community-based approach can foster meaningful change in dietary sodium consumption. PMID:24575726

  19. Lessons learned from community-based approaches to sodium reduction.

    Science.gov (United States)

    Kane, Heather; Strazza, Karen; Losby, Jan L; Lane, Rashon; Mugavero, Kristy; Anater, Andrea S; Frost, Corey; Margolis, Marjorie; Hersey, James

    2015-01-01

    This article describes lessons from a Centers for Disease Control and Prevention initiative encompassing sodium reduction interventions in six communities. A multiple case study design was used. This evaluation examined data from programs implemented in six communities located in New York (Broome County, Schenectady County, and New York City); California (Los Angeles County and Shasta County); and Kansas (Shawnee County). Participants (n = 80) included program staff, program directors, state-level staff, and partners. Measures for this evaluation included challenges, facilitators, and lessons learned from implementing sodium reduction strategies. The project team conducted a document review of program materials and semistructured interviews 12 to 14 months after implementation. The team coded and analyzed data deductively and inductively. Five lessons for implementing community-based sodium reduction approaches emerged: (1) build relationships with partners to understand their concerns, (2) involve individuals knowledgeable about specific venues early, (3) incorporate sodium reduction efforts and messaging into broader nutrition efforts, (4) design the program to reduce sodium gradually to take into account consumer preferences and taste transitions, and (5) identify ways to address the cost of lower-sodium products. The experiences of the six communities may assist practitioners in planning community-based sodium reduction interventions. Addressing sodium reduction using a community-based approach can foster meaningful change in dietary sodium consumption.

  20. Micronutrient Synergy in the Fight against Hepatocellular Carcinoma

    International Nuclear Information System (INIS)

    Roomi, M. Waheed; Roomi, Nusrath W.; Kalinovsky, Tatiana; Niedzwiecki, Aleksandra; Rath, Matthias

    2012-01-01

    The incidence of hepatocellular carcinoma (HCC), once thought to be a rare tumor in North America, has rapidly increased in recent years in the United States. Current treatment modalities to halt the progression of this disease are only marginally effective. The mainstay treatment is liver transplantation, which is often confronted with donor shortage. Invasion, metastasis and recurrence contribute to the high mortality rate of this disease. Matrix metalloproteinases (MMPs) that degrade the extracellular matrix (ECM) have been associated with the progression, invasion and metastasis of the disease. We have developed strategies to strengthen the ECM collagen and inhibit MMPs through micronutrients such as lysine, proline and ascorbic acid. Addition of epigallocatechin gallate or green tea extract to these micronutrients synergistically enhanced anti-carcinogenic activity in HepG2 cells. Addition of certain other micronutrients, such as N-acetylcysteine, selenium, copper and zinc (NM) synergistically enhanced the anticancer activity of the mixture in a model of hepatocellular carcinoma using HepG2 cells. In vitro studies using HepG2 demonstrated that NM was very effective in inhibiting cell proliferation (by MTT assay), MMPs secretion (by gelatinase zymography), cell invasion (through Matrigel) and induction of apoptosis (by live green caspase). In addition, NM was shown to down-regulate urokinase plasminogen activator (by fibrin zymography) and up-regulate tissue inhibitors of metalloproteinases (by reverse zymography) in another HCC cell line, SK-Hep-1. MMP-2 and MMP-9 activities were further modulated by phorbol 12-myristate 13-acetate (PMA) induction and inhibited by NM. In previous studies, NM inhibited Sk-Hep-1 xenografts in nude mice and also inhibited hepatic metastasis of B16FO melanoma cells. Our results suggest that NM is an excellent candidate for therapeutic use in the treatment HCC by inhibiting critical parameters in cancer development and progression

  1. Meeting the challenges of micronutrient malnutrition in the developing world.

    Science.gov (United States)

    Bhutta, Zulfiqar A; Salam, Rehana A; Das, Jai K

    2013-01-01

    Malnutrition still remains one of the major public health challenges, particularly in developing countries. Major risk factors for undernutrition such as suboptimal breastfeeding and micronutrient deficiencies (vitamin A and zinc) are responsible for more than one-third of all under five child deaths and 11% of the global total disease burden. Several strategies have been employed to supplement micronutrients. These include education, dietary modification, food provision, supplementation and fortification either alone or in combination. Supplementation is the most widely practiced intervention while fortification can also be a potentially cost-effective public health intervention and target a larger population through a single strategy. Universal coverage with the full bundle of interventions including micronutrient provision, complementary foods, treatments for worms and diarrheal diseases and behavior change programs package could be the way forward in achieving the Millennium Development Goals (MDGs). Bio-fortification and agricultural interventions including home and school gardening are relatively newer strategies and require further research as they have the potential to impact nutritional status of populations at large. Effectiveness of the various interventions is well recognized; however, consensus needs to be built around approaches to scale up coverage and delivery strategies to reduce disparities and provide equitable access. Future studies should focus on evaluating various approaches to address malnutrition with a standard methodology and defined outcomes. This will help gauge the actual morbidity and mortality impacts of these specific interventions and the long-term viability of these programs. On a broader scale, strategies to address food insecurity and poverty alleviation are the key as these are complex sustainable development issues, linked to health through malnutrition, but also to sustainable economic development, environment and trade.

  2. Micronutrient Synergy in the Fight against Hepatocellular Carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Roomi, M. Waheed; Roomi, Nusrath W.; Kalinovsky, Tatiana; Niedzwiecki, Aleksandra, E-mail: a.niedz@drrath.com; Rath, Matthias [Dr. Rath Research Institute, 1260 Memorex Drive, Santa Clara, CA 95050 (United States)

    2012-03-23

    The incidence of hepatocellular carcinoma (HCC), once thought to be a rare tumor in North America, has rapidly increased in recent years in the United States. Current treatment modalities to halt the progression of this disease are only marginally effective. The mainstay treatment is liver transplantation, which is often confronted with donor shortage. Invasion, metastasis and recurrence contribute to the high mortality rate of this disease. Matrix metalloproteinases (MMPs) that degrade the extracellular matrix (ECM) have been associated with the progression, invasion and metastasis of the disease. We have developed strategies to strengthen the ECM collagen and inhibit MMPs through micronutrients such as lysine, proline and ascorbic acid. Addition of epigallocatechin gallate or green tea extract to these micronutrients synergistically enhanced anti-carcinogenic activity in HepG2 cells. Addition of certain other micronutrients, such as N-acetylcysteine, selenium, copper and zinc (NM) synergistically enhanced the anticancer activity of the mixture in a model of hepatocellular carcinoma using HepG2 cells. In vitro studies using HepG2 demonstrated that NM was very effective in inhibiting cell proliferation (by MTT assay), MMPs secretion (by gelatinase zymography), cell invasion (through Matrigel) and induction of apoptosis (by live green caspase). In addition, NM was shown to down-regulate urokinase plasminogen activator (by fibrin zymography) and up-regulate tissue inhibitors of metalloproteinases (by reverse zymography) in another HCC cell line, SK-Hep-1. MMP-2 and MMP-9 activities were further modulated by phorbol 12-myristate 13-acetate (PMA) induction and inhibited by NM. In previous studies, NM inhibited Sk-Hep-1 xenografts in nude mice and also inhibited hepatic metastasis of B16FO melanoma cells. Our results suggest that NM is an excellent candidate for therapeutic use in the treatment HCC by inhibiting critical parameters in cancer development and progression

  3. Do dietary supplements improve micronutrient sufficiency in children and adolescents?

    Science.gov (United States)

    Bailey, Regan L.; Fulgoni, Victor L.; Keast, Debra R.; Lentino, Cindy V.; Dwyer, Johanna T.

    2012-01-01

    Objective To examine if children use supplements to fill gaps in nutritionally inadequate diets or whether supplements contribute to already adequate or excessive micronutrient intakes from foods. Study design Data were analyzed for children (2–18 y) from the NHANES 2003–2006, a nationally representative, cross-sectional survey (n=7,250). Diet was assessed using two 24-hour recalls, and dietary supplement use was assessed with a 30-day questionnaire. Results Prevalence of supplements use was 21% (Supplement users had higher micronutrient intakes than nonusers. Calcium and vitamin D intakes were low for all children. Inadequate intakes of phosphorus, copper, selenium, folate, and vitamins B-6 and B-12 were minimal from foods alone among 2–8 y olds. However, among 9–18 y olds, a higher prevalence of inadequate intakes of magnesium, phosphorus, and vitamins A, C, and E were observed. Supplement use increased the likelihood of intakes above the Upper Tolerable Intake Level for iron, zinc, copper, selenium, folic acid, and vitamins A and C. Conclusions Even with the use of supplements, more than a one-third of children failed to meet calcium and vitamin D recommendations. Children 2–8 y had nutritionally adequate diets regardless of supplement use. However, in children older than 8 y dietary supplements added micronutrients to diets that would have otherwise been inadequate for magnesium, phosphorus, vitamins A,C, and E. Supplement use contributed to the potential for excess intakes of some nutrients. These findings may have implications for reformulating dietary supplements for children. PMID:22717218

  4. Micronutrient Synergy in the Fight against Hepatocellular Carcinoma

    Directory of Open Access Journals (Sweden)

    Aleksandra Niedzwiecki

    2012-03-01

    Full Text Available The incidence of hepatocellular carcinoma (HCC, once thought to be a rare tumor in North America, has rapidly increased in recent years in the United States. Current treatment modalities to halt the progression of this disease are only marginally effective. The mainstay treatment is liver transplantation, which is often confronted with donor shortage. Invasion, metastasis and recurrence contribute to the high mortality rate of this disease. Matrix metalloproteinases (MMPs that degrade the extracellular matrix (ECM have been associated with the progression, invasion and metastasis of the disease. We have developed strategies to strengthen the ECM collagen and inhibit MMPs through micronutrients such as lysine, proline and ascorbic acid. Addition of epigallocatechin gallate or green tea extract to these micronutrients synergistically enhanced anti-carcinogenic activity in HepG2 cells. Addition of certain other micronutrients, such as N-acetylcysteine, selenium, copper and zinc (NM synergistically enhanced the anticancer activity of the mixture in a model of hepatocellular carcinoma using HepG2 cells. In vitro studies using HepG2 demonstrated that NM was very effective in inhibiting cell proliferation (by MTT assay, MMPs secretion (by gelatinase zymography, cell invasion (through Matrigel and induction of apoptosis (by live green caspase. In addition, NM was shown to down-regulate urokinase plasminogen activator (by fibrin zymography and up-regulate tissue inhibitors of metalloproteinases (by reverse zymography in another HCC cell line, SK-Hep-1. MMP-2 and MMP-9 activities were further modulated by phorbol 12-myristate 13-acetate (PMA induction and inhibited by NM. In previous studies, NM inhibited Sk-Hep-1 xenografts in nude mice and also inhibited hepatic metastasis of B16FO melanoma cells. Our results suggest that NM is an excellent candidate for therapeutic use in the treatment HCC by inhibiting critical parameters in cancer development and

  5. ECONOMICAL BASIS TO ADDRESS MICRONUTRIENT DEFICIENCIES IN DEVELOPING WORLD

    Directory of Open Access Journals (Sweden)

    Amirul Hassan

    2015-12-01

    Full Text Available Malnutrition has been called by economists at the World Bank as the “non-human face” of poverty,1 Adults who were malnourished as children earn at least 20% less on average than those who weren’t , 2.Malnutrition is often caused by underlying economics, i.e. the lack of money. Economics is very important in regards to malnutrition; it allows an individual to purchase nutrients. In many places around the world, a lack of money prevents the purchase of a variety of foods. The lack in variety usually leads to micronutrient malnutrition. Economics also decides the production of food in all countries around the world and the ability of a country to overcome difficult times. Thus economics affects ALL people at ALL levels of society, 3.Micronutrient deficiencies also known as ‘hidden hunger’ are determining and aggravating factors for health status and quality of life. It is estimated half of anaemia cases are due to iron deficiency , 4.  Almost half of children in low- and middle-income countries – 47% of under-fives are affected by anaemia, impairing cognitive and physical development,5. Iodine deficiency is the greatest single cause of mental retardation and brain damage. Coincidently,  the number of countries in which iodine-deficiency disorders were considered a public health concern reduced by 43% between 1993 and 2007,6.  Zinc deficiency affects children’s health and physical growth; it is also essential for mothers during pregnancy. It is estimated to cause 4% of deaths in pre-school aged children in lower-income countries. 7 . The Global Burden of Disease estimates showed that among the 26 major risk factors of the global burden of disease,8 iron deficiency ranks ninth overall, zinc deficiency is eleventh, and vitamin A deficiency, is thirteenth. Annually each developing country of the world are losing over millions or billions US $ in Gross Domestic Product (GDP to vitamins and minerals deficiencies. But scaling up

  6. ECONOMICAL BASIS TO ADDRESS MICRONUTRIENT DEFICIENCIES IN DEVELOPING WORLD

    Directory of Open Access Journals (Sweden)

    Amirul Hassan

    2015-01-01

    Full Text Available Malnutrition has been called by economists at the World Bank as the “non-human face” of poverty,1 Adults who were malnourished as children earn at least 20% less on average than those who weren’t , 2.Malnutrition is often caused by underlying economics, i.e. the lack of money. Economics is very important in regards to malnutrition; it allows an individual to purchase nutrients. In many places around the world, a lack of money prevents the purchase of a variety of foods. The lack in variety usually leads to micronutrient malnutrition. Economics also decides the production of food in all countries around the world and the ability of a country to overcome difficult times. Thus economics affects ALL people at ALL levels of society, 3.Micronutrient deficiencies also known as ‘hidden hunger’ are determining and aggravating factors for health status and quality of life. It is estimated half of anaemia cases are due to iron deficiency , 4.  Almost half of children in low- and middle-income countries – 47% of under-fives are affected by anaemia, impairing cognitive and physical development,5. Iodine deficiency is the greatest single cause of mental retardation and brain damage. Coincidently,  the number of countries in which iodine-deficiency disorders were considered a public health concern reduced by 43% between 1993 and 2007,6.  Zinc deficiency affects children’s health and physical growth; it is also essential for mothers during pregnancy. It is estimated to cause 4% of deaths in pre-school aged children in lower-income countries. 7 . The Global Burden of Disease estimates showed that among the 26 major risk factors of the global burden of disease,8 iron deficiency ranks ninth overall, zinc deficiency is eleventh, and vitamin A deficiency, is thirteenth. Annually each developing country of the world are losing over millions or billions US $ in Gross Domestic Product (GDP to vitamins and minerals deficiencies. But scaling up core

  7. Establishing the Canadian HIV Women's Sexual and Reproductive Health Cohort Study (CHIWOS): Operationalizing Community-based Research in a Large National Quantitative Study.

    Science.gov (United States)

    Loutfy, Mona; Greene, Saara; Kennedy, V Logan; Lewis, Johanna; Thomas-Pavanel, Jamie; Conway, Tracey; de Pokomandy, Alexandra; O'Brien, Nadia; Carter, Allison; Tharao, Wangari; Nicholson, Valerie; Beaver, Kerrigan; Dubuc, Danièle; Gahagan, Jacqueline; Proulx-Boucher, Karène; Hogg, Robert S; Kaida, Angela

    2016-08-19

    Community-based research has gained increasing recognition in health research over the last two decades. Such participatory research approaches are lauded for their ability to anchor research in lived experiences, ensuring cultural appropriateness, accessing local knowledge, reaching marginalized communities, building capacity, and facilitating research-to-action. While having these positive attributes, the community-based health research literature is predominantly composed of small projects, using qualitative methods, and set within geographically limited communities. Its use in larger health studies, including clinical trials and cohorts, is limited. We present the Canadian HIV Women's Sexual and Reproductive Health Cohort Study (CHIWOS), a large-scale, multi-site, national, longitudinal quantitative study that has operationalized community-based research in all steps of the research process. Successes, challenges and further considerations are offered. Through the integration of community-based research principles, we have been successful in: facilitating a two-year long formative phase for this study; developing a novel survey instrument with national involvement; training 39 Peer Research Associates (PRAs); offering ongoing comprehensive support to PRAs; and engaging in an ongoing iterative community-based research process. Our community-based research approach within CHIWOS demanded that we be cognizant of challenges managing a large national team, inherent power imbalances and challenges with communication, compensation and volunteering considerations, and extensive delays in institutional processes. It is important to consider the iterative nature of community-based research and to work through tensions that emerge given the diverse perspectives of numerous team members. Community-based research, as an approach to large-scale quantitative health research projects, is an increasingly viable methodological option. Community-based research has several

  8. Space for innovation for sustainable community-based biofuel production and use: Lessons learned for policy from Nhambita community, Mozambique

    International Nuclear Information System (INIS)

    Schut, Marc; Paassen, Annemarie van; Leeuwis, Cees; Bos, Sandra; Leonardo, Wilson; Lerner, Anna

    2011-01-01

    This paper provides insights and recommendations for policy on the opportunities and constrains that influence the space for innovation for sustainable community-based biofuel production and use. Promoted by the Mozambican government, Nhambita community established jatropha trials in 2005. Initial results were promising, but crop failure and the absence of organized markets led to scepticism amongst farmers. We start from the idea that the promotion of community-based biofuel production and use requires taking interactions between social-cultural, biophysical, economic, political and legal subsystems across different scales and levels of analysis through time into account. Our analysis demonstrates that heterogeneous farming strategies and their synergies at community level should be carefully assessed. Furthermore, national and international political and legal developments, such as the development of biofuel sustainability criteria, influence the local space in which community-based biofuel developments take place. We conclude that ex-ante integrated assessment and creating an enabling environment can enhance space for sustainable community-based biofuel production and use. It may provide insights into the opportunities and constraints for different types of smallholders, and promote the development of adequate policy mechanisms to prevent biofuels from becoming a threat rather than an opportunity for smallholders. - Highlights: → This paper explores space for innovation for community-based biofuel production and use. → Heterogeneous farming strategies and their synergies at community level are key. → Farmers have little trust in jatropha due to crop failure and absence of markets. → (Inter)national biofuel policies influence space for local biofuel production and use. → Policies should focus on ex-ante integrated assessment and creating an enabling environment.

  9. Nutrition meets the microbiome: micronutrients and the microbiota.

    Science.gov (United States)

    Biesalski, Hans K

    2016-05-01

    There is increasing evidence that food is an important factor that influences and shapes the composition and configuration of the gut microbiota. Most studies have focused on macronutrients (fat, carbohydrate, protein) in particular and their effects on the gut microbiota. Although the microbiota can synthesize different water-soluble vitamins, the effects of vitamins synthesized within the microbiota on systemic vitamin status are unclear. Few studies exist on the shuttling of vitamins between the microbiota and intestine and the impact of luminal vitamins on the microbiota. Studying the interactions between vitamins and the microbiota may help to understand the effects of vitamins on the barrier function and immune system of the intestinal tract. Furthermore, understanding the impact of malnutrition, particularly low micronutrient supply, on microbiota development, composition, and metabolism may help in implementing new strategies to overcome the deleterious effects of malnutrition on child development. This article reviews data on the synthesis of different micronutrients and their effects on the human microbiota, and further discusses the consequences of malnutrition on microbiota composition. © 2016 New York Academy of Sciences.

  10. Do dietary supplements improve micronutrient sufficiency in children and adolescents?

    Science.gov (United States)

    Bailey, Regan L; Fulgoni, Victor L; Keast, Debra R; Lentino, Cindy V; Dwyer, Johanna T

    2012-11-01

    To examine if children use supplements to fill gaps in nutritionally inadequate diets or whether supplements contribute to already adequate or excessive micronutrient intakes from foods. Data were analyzed for children (2-18 years) from the National Health and Nutrition Examination Survey 2003-2006, a nationally representative, cross-sectional survey (n = 7250). Diet was assessed using two 24-hour recalls, and dietary supplement use was assessed with a 30-day questionnaire. Prevalence of supplements use was 21% (vitamin D intakes were low for all children. Inadequate intakes of phosphorus, copper, selenium, folate, and vitamins B-6 and B-12 were minimal from foods alone among 2-8 year olds. However, among 9-18 year olds, a higher prevalence of inadequate intakes of magnesium, phosphorus, and vitamins A, C, and E were observed. Supplement use increased the likelihood of intakes above the upper tolerable intake level for iron, zinc, copper, selenium, folic acid, and vitamins A and C. Even with the use of supplements, more than a one-third of children failed to meet calcium and vitamin D recommendations. Children 2-8 years old had nutritionally adequate diets regardless of supplement use. However, in children older than 8 years, dietary supplements added micronutrients to diets that would have otherwise been inadequate for magnesium, phosphorus, vitamins A, C, and E. Supplement use contributed to the potential for excess intakes of some nutrients. These findings may have implications for reformulating dietary supplements for children. Published by Mosby, Inc.

  11. Periodontal disease severity is associated with micronutrient intake.

    Science.gov (United States)

    Luo, P-P; Xu, H-S; Chen, Y-W; Wu, S-P

    2018-03-06

    This study aimed to examine if specific micronutrients were associated with periodontal disease using data from the US National Health and Nutrition Examination Survey (NHANES) from 2011 to 2014. Participants who were aged 30 years or more and received complete periodontal examinations were included. Regression analyses were performed to determine associations of variables of interest with periodontal disease. Data of 6415 NHANES participants were included in the analysis. Multivariable analysis revealed that less intake of vitamin A (adjusted odds ratio (aOR) = 1.784), vitamin B1 (aOR = 1.334), vitamin C (aOR = 1.401), vitamin E (aOR = 1.576), iron (aOR = 1.234), folate (aOR = 1.254) and phosphorus (aOR = 1.280) was associated with increased severity of periodontal disease. Compared with the highest level of vitamin D intake, the second highest level of vitamin D intake was associated with lower severity of periodontal disease (aOR = 0.727). Insufficient intake of vitamin A, B1, C and E, iron, folate and phosphorus was significantly associated with severity of periodontal disease. Results of the present study suggest that the above micronutrients may be increased in the diet or taken as dietary supplements in order to reduce severity of periodontal disease. © 2018 Australian Dental Association.

  12. Micronutrient Supplement Use and Diet Quality in University Students

    Directory of Open Access Journals (Sweden)

    Adam R. Wiltgren

    2015-02-01

    Full Text Available Many national and international public health organisations recommend achieving nutrient adequacy through consumption of a wide variety of nutritious foods. Despite this, dietary supplement sales continue to increase. Understanding the characteristics of micronutrient supplement users and the relationship with diet quality can help develop effective public health interventions to reduce unnecessary consumption of vitamin and mineral supplements. Participants (n = 1306 were a convenience sample of students studying first year food and nutrition. Data was collected via a Food and Diet Questionnaire (FDQ and a Food Frequency Questionnaire (FFQ. Supplement users were defined as participants who indicated consuming any listed supplement as frequently as once a month or more. Diet quality was assessed using a Dietary Guideline Index (DGI score. Prevalence of supplement use was high in this study population with 56% of participants reporting supplement use; the most popular supplements consumed were multivitamins (28% and vitamin C (28%. A higher DGI score was significantly associated with an increased likelihood of supplement use (mean: 105 ± 18 vs. 109 ± 17, p = 0.001. Micronutrient supplement use was associated with a higher DGI score, suggesting that supplements are more likely to be used by those who are less likely to require them.

  13. Micronutrients as Impurities of Inorganic Fertilizers Marketed in Saudi Arabia

    Directory of Open Access Journals (Sweden)

    A.S. Modaihsh

    2000-06-01

    Full Text Available Inorganic fertilizers with major nutrients are likely to be contaminated with some micronutrients. Fertilizers, utilized in Saudi Arabia, were analyzed for their total and water-soluble content of Fe, Zn, Mn and Cu. They represented three categories namely: phosphatic, solid multiple nutrient fertilizers (SMNF and water-soluble multiple nutrient fertilizers (WSMF. Total iron content in examined fertilizers was higher in phosphatic fertilizers and lower in WSMF. Nevertheless, only a very small portion of the total iron content is likely to be available to plants. It was estimated, on the basis of total content, that almost 2 g of iron would be applied to soil for each added kg of phosphatic fertilizer. The highest total content of Zn was recorded for phosphatic fertilizers. The data suggested that less than half kg of Zn would be accumulated in soil if 500 kg of phosphatic fertilizers were applied in one year. This value however, fell dramatically, to one fourth of the value, when only the available forms of Zn were considered. Fertilizer content of manganese and copper were lower than both Fe and Zn. Micronutrient impurities present in inorganic fertilizers might not have an immediate influence on plant nutrition due to their lower solubility.

  14. Micronutrient status in anemic and non-anemic Chinese women in the third trimester of pregnancy

    NARCIS (Netherlands)

    Ma, A.G.; Schouten, E.G.; Wang, Y.; Xu, R.X.; Zheng, M.C.; Li, Y.; Wang, Q.Z.; Sun, Y.Y.

    2009-01-01

    Background: Anemia is a major nutrition related problem in China. In addition to iron deficiency this may be due to deficiencies of other micronutrients. Objective: To describe the micronutrient status of anemic and non-anemic pregnant women in China. Subjects and Methods: 734 clinically normal

  15. The road to micronutrient biofortification of rice:Progress and prospects

    Directory of Open Access Journals (Sweden)

    Khurram eBashir

    2013-02-01

    Full Text Available Biofortification (Increasing the contents of vitamins and minerals through plant breeding or biotechnology of food crops with micronutrient elements has the potential to combat widespread micronutrient deficiencies in humans. Rice (Oryza sativa L. feeds more than half of the world’s population and is used as a staple food in many parts of Asia. As in other plants, micronutrient transport in rice is controlled at several stages, including uptake from soil, transport from root to shoot, careful control of subcellular micronutrient transport, and finally, and most importantly, transport to seeds. To enhance micronutrient accumulation in rice seeds, we need to understand and carefully regulate all of these processes. During the last decade, numerous attempts such as increasing the contents/expression of genes encoding metal chelators (mostly phytosiderophores and metal transporters; overexpressing Fe storage protein ferritin and phytase were successfully undertaken to significantly increase the micronutrient content of rice. However, despite the rapid progress in biofortification of rice, the commercialization of biofortified crops has not yet been achieved. Here, we briefly review the progress in biofortification of rice with micronutrient elements (Fe, Zn and Mn and discuss future prospects to mitigate widespread micronutrient deficiencies in humans.

  16. Micronutrient intake of HIV-infected women in Mangaung, Free State ...

    African Journals Online (AJOL)

    Conclusions. Insufficient micronutrient intakes are common in both HIV-infected and uninfected women. A well-balanced diet and micronutrient supplementation seem warranted to ensure optimal health and survival, particularly in HIV-infected women. South African Journal of Clinical Nutrition Vol. 20 (1) 2007: pp. 28-36 ...

  17. Nutri-RecQuest: a web-based search engine on current micronutrient recommendations

    NARCIS (Netherlands)

    Cavelaars, A.J.E.M.; Kadvan, A.; Doets, E.L.; Tepsic, J.; Novakovic, R.N.; Dhonukshe-Rutten, R.A.M.; Renkema, M.; Glibetic, M.; Bucchini, L.; Matthys, C.; Smith, R.; Veer, van 't P.; Groot, de C.P.G.M.; Gurinovic, M.

    2010-01-01

    Background: The EURRECA (EURopean micronutrient RECommendations Aligned) Network of Excellence collated current micronutrient recommendations. A user-friendly tool, Nutri-RecQuest, was developed to allow access to the collated data and to create a database source for use in other nutritional

  18. Micronutrient intake and status in Central and Eastern Europe compared with other European countries, results from the EURRECA network

    NARCIS (Netherlands)

    Novakovic, R.N.; Cavelaars, A.J.E.M.; Bekkering, G.E.; Roman-Vinas, B.; Ngo, J.; Gurinovic, M.; Glibetic, M.; Golesorkhi, M.; Warthon-Medina, M.; Satalic, Z.; Geelen, A.; Serra Majem, L.; Veer, van 't P.; Groot, de C.P.G.M.

    2013-01-01

    Objective: To compare micronutrient intakes and status in Central and Eastern Europe (CEE) with those in other European countries and with reference values. Design: Review of the micronutrient intake/status data from open access and grey literature source

  19. Do Medicaid home and community based service waivers save money?

    Science.gov (United States)

    Harrington, Charlene; Ng, Terence; Kitchener, Martin

    2011-10-01

    This article estimates the potential savings to the Medicaid program of using 1915c Home and Community Based Services (HCBS) waivers rather than institutional care. For Medicaid HCBS waiver expenditures of $25 billion in 2006, we estimate the national savings to be over $57 billion, or $57,338 per waiver participant in 2006 compared with the cost of Medicaid institutional care (for which all waiver participants are eligible). When taking into account a potential 50% "woodwork effect" (for people who might have refused institutional services), the saving would be $21 billion. This analysis demonstrates that HCBS waiver programs present significant direct financial savings to Medicaid long-term care (LTC) programs.

  20. Planning for Community Based Tourism in a Remote Location

    Directory of Open Access Journals (Sweden)

    Sharon Harwood

    2010-07-01

    Full Text Available Remote areas are difficult to access, tend to lack critical infrastructure, are highly susceptible to shocks in the marketplace, and are perceived by industry to possess limited development opportunities. Accordingly a community orientated and territorial approach to development planning in a remote area will be more successful than a top down industry based approach [1]. Given the limitations of being remote, the case study community examined in this research manages and sustains a bird watching tourism product within a global market place. This paper examines how a remotely located community in the Arfak Mountains of West Papua overcomes these difficulties and plans for community based tourism (CBT in their locale.

  1. Community-based dental education: history, current status, and future.

    Science.gov (United States)

    Formicola, Allan J; Bailit, Howard L

    2012-01-01

    This article examines the history, current status, and future direction of community-based dental education (CBDE). The key issues addressed include the reasons that dentistry developed a different clinical education model than the other health professions; how government programs, private medical foundations, and early adopter schools influenced the development of CBDE; the societal and financial factors that are leading more schools to increase the time that senior dental students spend in community programs; the impact of CBDE on school finances and faculty and student perceptions; and the reasons that CBDE is likely to become a core part of the clinical education of all dental graduates.

  2. Micronutrient intake in relation to all-cause mortality in a prospective Danish cohort

    DEFF Research Database (Denmark)

    Roswall, Nina; Olsen, Anja; Christensen, Jane

    2012-01-01

    and supplements, and overall mortality. Furthermore, to examine effect modification by smoking, alcohol intake, and BMI and to investigate if the effect of supplement use differs with dietary micronutrient intake. Methods and Material: In a prospective cohort study of 55,453 middle-aged Danes, information...... regarding diet, supplement use, and lifestyle was collected through questionnaires. During follow-up, 6,767 deaths were identified and incidence rate ratios (IRRs) of mortality related to micronutrient intake were calculated using Cox proportional hazards models. Results: The present study found no effect......, was suggested in relation to some dietary micronutrients. The effect of supplements did not differ in groups defined by dietary micronutrient intake. Conclusion: This study suggests no effect of dietary micronutrients in relation to overall mortality. Supplemental folic acid was found to be associated...

  3. A peer evaluation of the community-based education programme for ...

    African Journals Online (AJOL)

    A peer evaluation of the community-based education programme for medical ... The University of Zimbabwe College of Health Sciences (UZCHS), Harare, which ... of community-based activities and the availability of a large teaching platform, ...

  4. Smoking effects on milk's micronutrient content and infant growth

    International Nuclear Information System (INIS)

    Salazar Rodriguez, G.; Berlanga, R.; Garcia, C.

    1999-01-01

    Smoking during pregnancy negatively affects birth weight and during breast-feeding alters volume and duration of lactation. As consequence of both effects, breast fed infants of smoking mothers have lower growth rates, compared to those of non-smoking mothers. In smoking mothers, at the end of pregnancy, there is an inverse association between cadmium content in maternal plasma and zinc content in fetal blood, while their newborns exhibited increased copper and diminished iron concentrations. No information exists on micronutrient content of breast milk of smoking mothers, associated to longitudinal growth. Ten smoking mothers (mean of cigarettes: 7.1) and 22 non-smoker controls and their infants, have been recruited within one month after delivery, at a Public Hospital in Santiago, Chile. Infant's weight, height, tricipital skinfold, arm and head circumferences and mother's weight were registered. Milk volume has been assessed by deuterium dilution and cotinine concentrations by radio-immuno-assay (RIA). No significant differences existed in age and nutritional status, between mothers. Cotinine levels were 50 times higher in smoking mothers (2576±2341 mU/L vs 54±25) and 12 times higher in their infants compared with those of non smokers (121±99 mU/L vs 10±5 mU/L). Birth weight was significantly different (3290±327 g vs 3558±432 g, p=0.01) but not so at 3 months of age (6026±550 g vs 6099±510 g, p=0.8). Infants' height was significantly smaller in smokers' infants at birth and 3 months of age (50±1 cm vs 51±1 cm and 59±1 cm vs 61±2 cm). The evidence so far indicates that infant's height is compromised which could be related to an altered transference of essential micronutrients, due to a lesser amount of breast-milk and micronutrient concentrations. These objectives will be proved in the second year of the Coordinated Research Project. (author)

  5. Evaluation of complex community-based childhood obesity prevention interventions.

    Science.gov (United States)

    Karacabeyli, D; Allender, S; Pinkney, S; Amed, S

    2018-05-16

    Multi-setting, multi-component community-based interventions have shown promise in preventing childhood obesity; however, evaluation of these complex interventions remains a challenge. The objective of the study is to systematically review published methodological approaches to outcome evaluation for multi-setting community-based childhood obesity prevention interventions and synthesize a set of pragmatic recommendations. MEDLINE, CINAHL and PsycINFO were searched from inception to 6 July 2017. Papers were included if the intervention targeted children ≤18 years, engaged at least two community sectors and described their outcome evaluation methodology. A single reviewer conducted title and abstract scans, full article review and data abstraction. Directed content analysis was performed by three reviewers to identify prevailing themes. Thirty-three studies were included, and of these, 26 employed a quasi-experimental design; the remaining were randomized control trials. Body mass index was the most commonly measured outcome, followed by health behaviour change and psychosocial outcomes. Six themes emerged, highlighting advantages and disadvantages of active vs. passive consent, quasi-experimental vs. randomized control trials, longitudinal vs. repeat cross-sectional designs and the roles of process evaluation and methodological flexibility in evaluating complex interventions. Selection of study designs and outcome measures compatible with community infrastructure, accompanied by process evaluation, may facilitate successful outcome evaluation. © 2018 World Obesity Federation.

  6. Stylized facts in social networks: Community-based static modeling

    Science.gov (United States)

    Jo, Hang-Hyun; Murase, Yohsuke; Török, János; Kertész, János; Kaski, Kimmo

    2018-06-01

    The past analyses of datasets of social networks have enabled us to make empirical findings of a number of aspects of human society, which are commonly featured as stylized facts of social networks, such as broad distributions of network quantities, existence of communities, assortative mixing, and intensity-topology correlations. Since the understanding of the structure of these complex social networks is far from complete, for deeper insight into human society more comprehensive datasets and modeling of the stylized facts are needed. Although the existing dynamical and static models can generate some stylized facts, here we take an alternative approach by devising a community-based static model with heterogeneous community sizes and larger communities having smaller link density and weight. With these few assumptions we are able to generate realistic social networks that show most stylized facts for a wide range of parameters, as demonstrated numerically and analytically. Since our community-based static model is simple to implement and easily scalable, it can be used as a reference system, benchmark, or testbed for further applications.

  7. Scoping study into community-based renewable energy projects

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2000-07-01

    This scoping study has been carried out by the Centre for Sustainable Energy (CSE), a charity which promotes energy efficiency and renewable energy. CSE have used their involvement in the development of the Energy Club (the first energy service company for householders in the UK) and the Bristol Environment and Energy Trust (a cross-sector organisation initiating environmental projects) as the basis of the study. This study is the first phase of a long term project to set up two small-scale renewable energy schemes to demonstrate the benefits of a community based approach. Specific objectives of the study were: to identify, quantify and cost, renewable energy resources for interested community organisations; to evaluate two routes for developing community based projects - Environment Trusts and Energy Clubs'; to organise a seminar with the objective of bringing together community interest groups with experts in renewable energy; to identify two communities with viable renewable projects for the next phase - full feasibility studies/pilot projects. (author)

  8. A rural, community-based suicide awareness and intervention program.

    Science.gov (United States)

    Jones, Sharon; Walker, Coralanne; Miles, Alison C J; De Silva, Eve; Zimitat, Craig

    2015-01-01

    Suicide is a prominent public health issue in rural Australia and specifically in Tasmania, which has one of the highest suicide rates in the country. The Community Response to Eliminating Suicide (CORES) program was developed in rural Tasmania in response to a significant number of suicides over a short period of time. CORES is unique in that it is both a community-based and gatekeeper education model. CORES aims to build and empower communities to take ownership of suicide prevention strategies. It also aims to increase the individual community member's interpersonal skills and awareness of suicide risks, while building peer support and awareness of suicide prevention support services within the community itself. Pre- and post-test surveys after the CORES 1-day suicide awareness and intervention program (SAIP) showed significant increases in levels of comfort and confidence in discussing suicide with those who may be contemplating that action. CORES builds community capital through establishing new connections within communities. Establishment of local executive groups, funding and SAIP are key activities of successful CORES programs in communities around Australia. Over half of the initial leaders are still actively involved after a decade, which reflects positively on the quality and outcomes of the program. This study supports CORES as a beneficial and feasible community-based suicide intervention program for rural communities.

  9. Management initiatives in a community-based health insurance scheme.

    Science.gov (United States)

    Sinha, Tara; Ranson, M Kent; Chatterjee, Mirai; Mills, Anne

    2007-01-01

    Community-based health insurance (CBHI) schemes have developed in response to inadequacies of alternate systems for protecting the poor against health care expenditures. Some of these schemes have arisen within community-based organizations (CBOs), which have strong links with poor communities, and are therefore well situated to offer CBHI. However, the managerial capacities of many such CBOs are limited. This paper describes management initiatives undertaken in a CBHI scheme in India, in the course of an action-research project. The existing structures and systems at the CBHI had several strengths, but fell short on some counts, which became apparent in the course of planning for two interventions under the research project. Management initiatives were introduced that addressed four features of the CBHI, viz. human resources, organizational structure, implementation systems, and data management. Trained personnel were hired and given clear roles and responsibilities. Lines of reporting and accountability were spelt out, and supportive supervision was provided to team members. The data resources of the organization were strengthened for greater utilization of this information. While the changes that were introduced took some time to be accepted by team members, the commitment of the CBHI's leadership to these initiatives was critical to their success. Copyright (c) 2007 John Wiley & Sons, Ltd.

  10. Effect of community based behavioural change communication intervention to improve neonatal mortality in developing countries: A Systematic Review.

    Science.gov (United States)

    Tilahun, Dejene; Birhanu, Zewdie

    2011-01-01

    % respectively.Conclusions Community-based behavioural change communication interventions such as health education, information education and communication, behavioural change communication, social mobilisation, community mobilisation, community conversation, and home based counselling were found to be associated with a significant reduction in neonatal mortality, early neonatal mortality and post neonatal mortality. The findings of this systematic review call for integration of such interventions into conventional strategies in developing countries.Implications for practice This systematic review has shown that community based behavioural change communication interventions that are implemented through community health volunteers and other community based health workers, targeted at pregnant women and also involving influential people such as mothers-in-law, fathers-in-law and husbands/partners, consistently demonstrated that community based intervention packages significantly reduced early neonatal, late neonatal and neonatal mortality rates and also have a pivotal role in improving household newborn care practice. Thus, this review provides encouraging evidence of the value of integrating newborn care and neonatal mortality reduction strategies into community based approaches.Implications for research The review findings were largely derived from a limited number of community trials from developing regions, particularly the African setting. Thus, there is a clear need for additional research on a larger scale and in more varied settings. There is also a need for more evidence based on higher quality research. The cost effectiveness of these community based interventions may impact on their adoption; however it was outside the scope of this review. Cost-effectiveness of these interventions should become a priority area for future research.

  11. Community-based Monitoring of Water Resources in Remote Mountain Regions

    Science.gov (United States)

    Buytaert, W.; Hannah, D. M.; Dewulf, A.; Clark, J.; Zulkafli, Z. D.; Karpouzoglou, T.; Mao, F.; Ochoa-Tocachi, B. F.

    2016-12-01

    Remote mountain regions are often represented by pockets of poverty combined with accelerated environmental change. The combination of harsh climatic and topographical conditions with limited infrastructure puts severe pressures on local livelihoods, many of which rely strongly on local ecosystem services (ESS) such as agricultural production and water supply. It is therefore paramount to optimise the management of ESS for the benefit of local people. This is hindered by a scarcity of quantitative data about physical processes such as precipitation and river flow as well as qualitative data concerning the management of water and land. National and conventional scientific monitoring networks tend to be insufficient to cover adequately the spatial and temporal gradients. Additionally, the data that are being collected often fail to be converted into locally relevant and actionable knowledge for ESS management. In such conditions, community-based monitoring of natural resources may be an effective way to reduce this knowledge gap. The participatory nature of such monitoring also enhances knowledge co-production and integration in locally-based decision-making processes. Here, we present the results of a 4-year consortium project on the use of citizen science technologies for ecosystem services management (Mountain-EVO). The project analyzed ecosystem service dynamics and decision-making processes and implemented a comparative analysis of experiments with community-based monitoring of water resources in 4 remote mountain regions, i.e. Peru, Nepal, Kyrgyzstan, and Ethiopia. We find that community-based monitoring can have a transformative impact on local ESS management, because of its potential to be more inclusive, polycentric, and context-driven as compared to conventional monitoring. However, the results and effectiveness of community-based approaches depend strongly on the natural and socio-economic boundary conditions. As such, this requires a tailored and bottom

  12. Community-based medical education: is success a result of meaningful personal learning experiences?

    Science.gov (United States)

    Kelly, Len; Walters, Lucie; Rosenthal, David

    2014-01-01

    Community-based medical education (CBME) is the delivery of medical education in a specific social context. Learners become a part of social and medical communities where their learning occurs. Longitudinal integrated clerkships (LICs) are year-long community-based placements where the curriculum and clinical experience is typically delivered by primary care physicians. These programs have proven to be robust learning environments, where learners develop strong communication skills and excellent clinical reasoning. To date, no learning model has been offered to describe CBME. The characteristics of CBME are explored by the authors who suggest that the social and professional context provided in small communities enhances medical education. The authors postulate that meaningfulness is engendered by the authentic context, which develops over time. These relationships with preceptors, patients and the community provide meaningfulness, which in turn enhances learning. The authors develop a novel learning model. They propose that the context-rich environment of CBME allows for meaningful relationships and experiences for students and that such meaningfulness enhances learning.

  13. Community-based approaches to address childhood undernutrition and obesity in developing countries.

    Science.gov (United States)

    Shetty, Prakash

    2009-01-01

    Community-based approaches have been the mainstay of interventions to address the problem of child malnutrition in developing societies. Many programs have been in operation in several countries for decades and originated largely as social welfare, food security and poverty eradication programs. Increasingly conceptual frameworks to guide this activity have been developed as our understanding of the complex nature of the determinants of undernutrition improves. Alongside this evolution, is the accumulation of evidence on the types of interventions in the community that are effective, practical and sustainable. The changing environment is probably determining the altering scenario of child nutrition in developing societies, with rapid developmental transition and urbanization being responsible for the emerging problems of obesity and other metabolic disorders that are largely the result of the now well-recognized linkages between child undernutrition and early onset adult chronic diseases. This dramatic change is contributing to the double burden of malnutrition in developing countries. Community interventions hence need to be integrated and joined up to reduce both aspects of malnutrition in societies. The evidence that community-based nutrition interventions can have a positive impact on pregnancy outcomes and child undernutrition needs to be evaluated to enable programs to prioritize and incorporate the interventions that work in the community. Programs that are operational and successful also need to be evaluated and disseminated in order to enable countries to generate their own programs tailored to tackling the changing nutritional problems of the children in their society. Copyright (c) 2009 S. Karger AG, Basel.

  14. A model for partnering first-year student pharmacists with community-based older adults.

    Science.gov (United States)

    Martin, Beth A; Porter, Andrea L; Shawl, Lauren; Motl Moroney, Susannah E

    2012-06-18

    To design, integrate, and assess the effectiveness of an introductory pharmacy practice experience intended to redefine first-year student pharmacists' views on aging and medication use through their work with a healthy, community-based older-adult population. All students (N = 273) completed live skills training in an 8-hour boot camp provided during orientation week. Teams were assigned an independently living senior partner, completed 10 visits and reflections, and documented health-related information using an electronic portfolio (e-portfolio). As determined by pre- and post-experience survey instruments, students gained significant confidence in 7 skill areas related to communication, medication interviews, involving the partner in health care, and applying patient-care skills. Student reflections, in-class presentations, and e-portfolios documented that personal attitudes toward seniors changed over time. Senior partners enjoyed mentoring and interacting with students and many experienced health improvements as a result of the interaction. The model for partnering first-year student pharmacists with community-based older adults improved students' skills and fostered their connections to pharmacist roles and growth as person-centered providers.

  15. 75 FR 67751 - Medicare Program: Community-Based Care Transitions Program (CCTP) Meeting

    Science.gov (United States)

    2010-11-03

    ...] Medicare Program: Community-Based Care Transitions Program (CCTP) Meeting AGENCY: Centers for Medicare... guidance and ask questions about the upcoming Community-based Care Transitions Program. The meeting is open... conference will also provide an overview of the Community-based Care Transitions Program (CCTP) and provide...

  16. 76 FR 21372 - Medicare Program; Solicitation for Proposals for the Medicare Community-Based Care Transitions...

    Science.gov (United States)

    2011-04-15

    ...] Medicare Program; Solicitation for Proposals for the Medicare Community-Based Care Transitions Program... interested parties of an opportunity to apply to participate in the Medicare Community-based Care Transitions.... 111-148, enacted on March 23, 2010) (Affordable Care Act) authorized the Medicare Community-based Care...

  17. Identifying and Assessing Community-Based Social Behavior of Adolescents and Young Adults with EBD.

    Science.gov (United States)

    Bullis, Michael; And Others

    1994-01-01

    A battery of three measures for assessing the community-based social behavior of adolescents and young adults with emotional and behavioral disorders is described. The measures, in male and female forms, are "Test of Community-Based Social Skill Knowledge,""Scale of Community-Based Social Skill Performance," and "Behaviors That Are Undesirable for…

  18. Strategies to improve treatment coverage in community-based public health programs: A systematic review of the literature.

    Directory of Open Access Journals (Sweden)

    Katrina V Deardorff

    2018-02-01

    Full Text Available Community-based public health campaigns, such as those used in mass deworming, vitamin A supplementation and child immunization programs, provide key healthcare interventions to targeted populations at scale. However, these programs often fall short of established coverage targets. The purpose of this systematic review was to evaluate the impact of strategies used to increase treatment coverage in community-based public health campaigns.We systematically searched CAB Direct, Embase, and PubMed archives for studies utilizing specific interventions to increase coverage of community-based distribution of drugs, vaccines, or other public health services. We identified 5,637 articles, from which 79 full texts were evaluated according to pre-defined inclusion and exclusion criteria. Twenty-eight articles met inclusion criteria and data were abstracted regarding strategy-specific changes in coverage from these sources. Strategies used to increase coverage included community-directed treatment (n = 6, pooled percent change in coverage: +26.2%, distributor incentives (n = 2, +25.3%, distribution along kinship networks (n = 1, +24.5%, intensified information, education, and communication activities (n = 8, +21.6%, fixed-point delivery (n = 1, +21.4%, door-to-door delivery (n = 1, +14.0%, integrated service distribution (n = 9, +12.7%, conversion from school- to community-based delivery (n = 3, +11.9%, and management by a non-governmental organization (n = 1, +5.8%.Strategies that target improving community member ownership of distribution appear to have a large impact on increasing treatment coverage. However, all strategies used to increase coverage successfully did so. These results may be useful to National Ministries, programs, and implementing partners in optimizing treatment coverage in community-based public health programs.

  19. Control of micronutrient deficiencies in India: obstacles and strategies.

    Science.gov (United States)

    Vijayaraghavan, K

    2002-05-01

    Micronutrient deficiencies of vitamin A, iron, and iodine continue to be of public health significance in India. The government of India initiated national programs to prevent, control and combat these deficiencies and their serious consequences. The interventions involved (1) distribution of iodized salt in the endemic areas, (2) administration of semiannual massive dose of vitamin A to young children, and (3) distribution of iron-folic acid tablets to the vulnerable groups. Evaluations revealed that the biologic impact of these interventions was unsatisfactory. Inadequate allocation of funds (10% of the actual needs) necessary to cover the enormous number of beneficiaries was one of the important obstacles. Consequently, the allocation of supplies to different provinces was far short of the requirements (10-30%). As a result of poor orientation, the functionaries were not adhering to the guidelines, leading to woefully inadequate (1-20%) and irregular coverage. There was no proper monitoring or supervision to make midcourse corrections to improve the functioning. The community was not informed of the purpose and details of each intervention. Hence, it did not utilize the resources completely and remained passive recipients. The community was not aware of the dietary approaches to prevent micronutrient disorders owing to absence of nutrition education. With the adoption of National Nutrition Policy by the government of India, a concerted and focused approach should be adopted. The future strategies should include a mix of short-term supplementation and food-based strategy encompassing food fortification and home gardening. Innovative approaches in information, education, and communication (such as social marketing strategy) for making the interventions sustainable should be adopted.

  20. Decreased serum homocysteine levels after micronutrient supplementation in older people

    Directory of Open Access Journals (Sweden)

    Pusparini Pusparini

    2016-02-01

    Full Text Available Aging is associated with a gradual impairment in cognitive function. The elderly also show a high prevalence of undernutrition, whereas nutrition plays an important role in the metabolism of neuronal cells and enzymes. Homocysteine is an amino acid resulting from methionine metabolism and is dependent on intake of vitamin B12, vitamin B6 and folic acid. Homocysteine is said to play a role in cognitive function. The objective of this study was to evaluate the effect of micronutrient supplementation for 6 months on serum homocysteine levels and cognitive function in older people. This study was an experimental study of pre-post test design, carried out in Mampang subdistrict, South Jakarta. A total of 94 elderly people was recruited for this study, consisting of 44 females and 50 males. Serum homocysteine level was assessed by fluorescent polarization immunoassay and cognitive function by means of the mini mental state examination (MMSE before and after micronutrient supplementation. Mean serum homocysteine concentration after supplementation decreased significantly to 14.8 ± 5.8 mmol/L, compared with mean serum homocysteine level of 15.9 ± 5.9 mmol/L before supplementation (p=0.000. Multiple regression analysis indicated that the factors influencing post-supplementation MMSE scores were gender (â=-0.350; p=0.000, education (â=0.510; p=0.000 and post-supplementation homocysteine levels (â=-0.201; p=0.000, while age, pre-supplementation homocysteine levels and BMI did not affect MMSE scores. Homocysteine concentration decreased significantly after 6 months of supplementation. The factors affecting post-supplementation MMSE scores were gender, level of education, and post-supplementation homocysteine level.

  1. Decreased serum homocysteine levels after micronutrient supplementation in older people

    Directory of Open Access Journals (Sweden)

    Pusparini

    2010-12-01

    Full Text Available Aging is associated with a gradual impairment in cognitive function. The elderly also show a high prevalence of undernutrition, whereas nutrition plays an important role in the metabolism of neuronal cells and enzymes. Homocysteine is an amino acid resulting from methionine metabolism and is dependent on intake of vitamin B12, vitamin B6 and folic acid. Homocysteine is said to play a role in cognitive function. The objective of this study was to evaluate the effect of micronutrient supplementation for 6 months on serum homocysteine levels and cognitive function in older people. This study was an experimental study of pre-post test design, carried out in Mampang subdistrict, South Jakarta. A total of 94 elderly people was recruited for this study, consisting of 44 females and 50 males. Serum homocysteine level was assessed by fluorescent polarization immunoassay and cognitive function by means of the mini mental state examination (MMSE before and after micronutrient supplementation. Mean serum homocysteine concentration after supplementation decreased significantly to 14.8 ± 5.8 mmol/L, compared with mean serum homocysteine level of 15.9 ± 5.9 mmol/L before supplementation (p=0.000. Multiple regression analysis indicated that the factors influencing post-supplementation MMSE scores were gender (â=-0.350; p=0.000, education (â=0.510; p=0.000 and post-supplementation homocysteine levels (â=-0.201; p=0.000, while age, pre-supplementation homocysteine levels and BMI did not affect MMSE scores. Homocysteine concentration decreased significantly after 6 months of supplementation. The factors affecting post-supplementation MMSE scores were gender, level of education, and post-supplementation homocysteine level.

  2. Food prices and poverty negatively affect micronutrient intakes in Guatemala.

    Science.gov (United States)

    Iannotti, Lora L; Robles, Miguel; Pachón, Helena; Chiarella, Cristina

    2012-08-01

    Limited empirical evidence exists for how economic conditions affect micronutrient nutrition. We hypothesized that increasing poverty and rising food prices would reduce consumption of high-quality "luxury" foods, leading to an increased probability of inadequacy for several nutrients. The 2006 Guatemala National Living Conditions Survey was analyzed. First, energy and nutrient intakes and adequacy levels were calculated. Second, the income-nutrient relationships were investigated by assessing disparities in intakes, determining income-nutrient elasticities, and modeling nutrient intakes by reductions in income. Third, the food price-nutrient relationships were explored through determination of price-nutrient elasticities and modeling 2 price scenarios: an increase in food prices similar in magnitude to the food price crisis of 2007-2008 and a standardized 10% increase across all food groups. Disparities in nutrient intakes were greatest for vitamin B-12 (0.38 concentration index) and vitamin A (0.30 concentration index); these nutrients were highly and positively correlated with income (r = 0.22-0.54; P < 0.05). Although the baseline probability of inadequacy was highest for vitamin B-12 (83%), zinc showed the greatest increase in probability of inadequacy as income was reduced, followed by folate and vitamin A. With rising food prices, zinc intake was most acutely affected under both scenarios (P < 0.05) and folate intake in the poorest quintile (+7 percentage points) under the 10% scenario. Price-nutrient elasticities were highest for vitamin B-12 and the meat, poultry, and fish group (-0.503) and for folate and the legumes group (-0.343). The economic factors of food prices and income differentially influenced micronutrient intakes in Guatemala, notably zinc and folate intakes.

  3. Efficacy of a foodlet-based multiple micronutrient supplement for preventing growth faltering, anemia, and micronutrient deficiency of infants: the four country IRIS trial pooled data analysis.

    Science.gov (United States)

    Smuts, Cornelius M; Lombard, Carl J; Benadé, A J Spinnler; Dhansay, Muhammad A; Berger, Jacques; Hop, Le Thi; López de Romaña, Guillermo; Untoro, Juliawati; Karyadi, Elvina; Erhardt, Jürgen; Gross, Rainer

    2005-03-01

    Diets of infants across the world are commonly deficient in multiple micronutrients during the period of growth faltering and dietary transition from milk to solid foods. A randomized placebo controlled trial was carried out in Indonesia, Peru, South Africa, and Vietnam, using a common protocol to investigate whether improving status for multiple micronutrients prevented growth faltering and anemia during infancy. The results of the pooled data analysis of the 4 countries for growth, anemia, and micronutrient status are reported. A total of 1134 infants were randomized to 4 treatment groups, with 283 receiving a daily placebo (P), 283 receiving a weekly multiple micronutrient supplement (WMM), 280 received a daily multiple micronutrient (DMM) supplement, and 288 received daily iron (DI) supplements. The DMM group had a significantly greater weight gain, growing at an average rate of 207 g/mo compared with 192 g/mo for the WMM group, and 186 g/mo for the DI and P groups. There were no differences in height gain. DMM was also the most effective treatment for controlling anemia and iron deficiency, besides improving zinc, retinol, tocopherol, and riboflavin status. DI supplementation alone increased zinc deficiency. The prevalence of multiple micronutrient deficiencies at baseline was high, with anemia affecting the majority, and was not fully controlled even after 6 mo of supplementation. These positive results indicate the need for larger effectiveness trials to examine how to deliver supplements at the program scale and to estimate cost benefits. Consideration should also be given to increasing the dosages of micronutrients being delivered in the foodlets.

  4. Aibika (Abelmoschus manihot L.): Genetic variation, morphology and relationships to micronutrient composition.

    Science.gov (United States)

    Rubiang-Yalambing, Lydia; Arcot, Jayashree; Greenfield, Heather; Holford, Paul

    2016-02-15

    Aibika (Abelmoschus manihot L.) is believed to be a good source of micronutrients. However, although many varieties of aibika are commonly consumed in Papua New Guinea, their micronutrient content is unknown. Therefore, the mineral (Ca, Fe, K, Mg, Mn, Na, Zn & Cu), folate composition and the genetic variation of 23 aibika accessions from the collection at the National Agricultural Research Institute were studied over a 3year period to provide data for nutritional studies and to inform breeding programs. The data showed that aibika is, potentially, a crop of high nutritional value with the potential to boost the micronutrient status of local PNG communities. However, there were substantial differences in the micronutrient concentrations of the accessions from year to year and accessions that had the highest concentration of a particular mineral in 1year did not have the high concentrations in other years. Clusters determined using unweighted pair group method with arithmetic mean analysis (UPGMA) of the micronutrient contents differed in each of the 3years. Genetic analysis made using random amplification of polymorphic DNA and directed amplification of mini satellite region DNA placed the accessions into five groups. There was no correlation between these groups and leaf morphology, nor were there correlations with the clusters determined from the UPGMA analyses. There appears to be considerable interaction between genotype and environmental factors determining micronutrient composition and environmental factors may play a greater role than genotype in influencing micronutrient composition. Copyright © 2014 Elsevier Ltd. All rights reserved.

  5. Effect of Micronutrient Powder Addition on Sensory Properties of Foods for Older Adults.

    Science.gov (United States)

    Field, Katherine M; Duncan, Alison M; Keller, Heather H; Stark, Ken D; Duizer, Lisa M

    2017-10-01

    Micronutrient fortification can improve nutrient intake of older adults in long-term care. However, previous studies indicate that micronutrient fortification can alter food sensory attributes and, potentially, consumer liking. Others have found no effect of fortification on liking. This research investigates the effect of micronutrient powder addition on the sensory properties of selected foods commonly served in long-term care. A micronutrient powder containing 9 vitamins and 3 minerals was added to tomato soup and oatmeal at different levels. Using projective mapping, changes in sensory properties were observed with powder addition. Descriptive analysis, used to quantify these changes, showed that both the tomato soup and oatmeal had reduced flavor as the amount of added micronutrient powder increased. Oatmeal also showed changes in texture with fortification. Consumer liking scores for tomato soup showed that micronutrient addition affected liking when 100% of a daily dose was added into the soup. Addition of 50% of the daily dose did not affect liking. Oatmeal liking did not differ between fortified and unfortified samples. Results from this research can be used to decide whether a micronutrient powder of selected vitamins and minerals can be added to foods served to older adults in long-term care. Although sensory properties of the foods will be altered, fortification of both tomato soup and oatmeal with the developed powder is possible without reducing consumer liking to the point where it is disliked. © 2017 Institute of Food Technologists®.

  6. Determination of Micronutrient Accumulation in Greenhouse Cucumber Crop Using a Modeling Approach

    Directory of Open Access Journals (Sweden)

    Lino J. Ramírez-Pérez

    2017-11-01

    Full Text Available The control of micronutrient application in cucumber cultivation has great importance as they participate in many functions of metabolism. In addition, micronutrient application efficiency is fundamental to avoid periods of overconsumption or deficits in the crop. To determine micronutrient accumulation using a dynamic model, two cycles of Vitaly and Luxell cucumber crops were grown. During the development of the crop, micronutrient content (Fe, B, Mn, Cu, and Zn in the different organs of the cucumber plant was quantified. The model dynamically simulated the accumulation of biomass and micronutrients using climatic variables recorded inside the greenhouse as inputs. It was found that a decrease in photosynthetically active radiation and temperature significantly diminished the accumulation of biomass by the cucumber plants. On the other hand, the results demonstrated that the model efficiently simulated both the accumulation of biomass and micronutrients in a cucumber crop. The efficiency evaluation showed values higher than R2 > 0.95. This dynamic model can be useful to define adequate strategies for the management of cucumber cultivation in greenhouses as well as the application of micronutrients.

  7. A community-based program evaluation of community competency trainings.

    Science.gov (United States)

    Hanssmann, Christoph; Morrison, Darius; Russian, Ellery; Shiu-Thornton, Sharyne; Bowen, Deborah

    2010-01-01

    Transgender and gender-nonconforming individuals encounter a multitude of barriers to accessing clinically and culturally competent health care. One strategy to increase the quality and competence of care delivery is workplace trainings. This study describes a community-based program for the evaluation of this type of training. Using a mixed-methods approach, the research team assessed the effectiveness of three competency trainings administered by a local nonprofit organization in the Northwest United States. Quantitative data indicated a significant shift in self-assessed knowledge associated with completion of the training. Qualitative data confirmed this result and revealed a number of important themes about the effect of the trainings on providers and their ability to implement knowledge and skills in practice. Clinical considerations are proposed for providers who seek similar trainings and who aim to increase clinical and cultural competency in delivering care to transgender and gender-nonconforming patients and clients.

  8. A community-based, interdisciplinary rehabilitation engineering course.

    Science.gov (United States)

    Lundy, Mary; Aceros, Juan

    2016-08-01

    A novel, community-based course was created through collaboration between the School of Engineering and the Physical Therapy program at the University of North Florida. This course offers a hands-on, interdisciplinary training experience for undergraduate engineering students through team-based design projects where engineering students are partnered with physical therapy students. Students learn the process of design, fabrication and testing of low-tech and high-tech rehabilitation technology for children with disabilities, and are exposed to a clinical experience under the guidance of licensed therapists. This course was taught in two consecutive years and pre-test/post-test data evaluating the impact of this interprofessional education experience on the students is presented using the Public Service Motivation Scale, Civic Actions Scale, Civic Attitudes Scale, and the Interprofessional Socialization and Valuing Scale.

  9. Community-Based Rural Tourism: A Proposed Sustainability Framework

    Directory of Open Access Journals (Sweden)

    Kayat Kalsom

    2014-01-01

    Full Text Available Many tourism projects run by community in the rural areas are labelled as Community-based Rural Tourism (CBRT, a type of a more ‘responsible’ tourism that contributes to sustainable development. However, a framework is needed to enable planners and managers to understand its criteria thus ensuring that the CBRTs fulfil the sustainability requirement. This paper presents findings from a literature review on previous writings in this topic. Findings from an analysis on the criteria of a sustainable CBRT product are discussed. It is found that in order for it to play a role in sustainable development, a CBRT product must focus on competitive management, resource conservation, and benefit creation to the community. The three elements need to be supported, in turn, by community involvement and commitment. As the proposed conceptual framework of sustainable CBRT product can be a basis for further research in CBRT, it offers producing theoretical and practical implications.

  10. Penerapan Corporate Social Responsibility dengan Konsep Community Based Tourism

    Directory of Open Access Journals (Sweden)

    Linda Suriany

    2013-12-01

    Full Text Available Abstract: Business is not only economic institution, but social institution too. As social institution, business has responsibility to help society in solving social problem. This responsibility called Corporate Social Responsibility (CSR. CSR pays attention about social problem and environment, so CSR support continuous development to help government role. Nowadays, our government has national development’s agenda. One of them is tourism sector (Visit Indonesia Year 2008 programmed. But tourism sector has challenge in human resources. In this case, business role in practice CSR is needed to help tourism sector. With CSR activities, the quality of local community will increase to participate in tourism activities. CSR activities include training that based on research. When the quality of local community increase, local community can practice the concept of community based tourism (CBT. In the future, Indonesia has a power to compete with other countries.

  11. Public participatory GIS in community-based disaster risk reduction

    Directory of Open Access Journals (Sweden)

    Randall B. Kemp

    2008-12-01

    Introducing PPGIS tools into community-based DRR is not a neutral effort. The information and communication technologies (ICT embedded in GIS can both aid the DRR efforts as well as impact the community in unintended ways. ICTs may be common in communities engaged in DRR efforts so the introduction of PPGIS may have minimal impact. What are the societal ramifications, however, of PPGIS methods in DRR efforts when ICTs are a relatively new aspect of a given community?  What are the communication methods pertinent to PPGIS in the DRR context?  How does the ICT literature address PPGIS methods?  The paper addresses these and other influences of ICT on societies prone to natural hazards.

  12. A community-based framework for aquatic ecosystem models

    DEFF Research Database (Denmark)

    Trolle, Didde; Hamilton, D. P.; Hipsey, M. R.

    2012-01-01

    Here, we communicate a point of departure in the development of aquatic ecosystem models, namely a new community-based framework, which supports an enhanced and transparent union between the collective expertise that exists in the communities of traditional ecologists and model developers. Through...... a literature survey, we document the growing importance of numerical aquatic ecosystem models while also noting the difficulties, up until now, of the aquatic scientific community to make significant advances in these models during the past two decades. Through a common forum for aquatic ecosystem modellers we...... aim to (i) advance collaboration within the aquatic ecosystem modelling community, (ii) enable increased use of models for research, policy and ecosystem-based management, (iii) facilitate a collective framework using common (standardised) code to ensure that model development is incremental, (iv...

  13. Community-based adaptation to climate change: an update

    Energy Technology Data Exchange (ETDEWEB)

    Ayers, Jessica; Huq, Saleemul

    2009-06-15

    Over a billion people - the world's poorest and most bulnerable communities – will bear the brunt of climate change. For them, building local capacity to cope is a vital step towards resilience. Community-based adaptation (CBA) is emerging as a key response to this challenge. Tailored to local cultures and conditions, CBA supports and builds on autonomous adaptations to climate variability, such as the traditional baira or floating gardens of Bangladesh, which help small farmers' crops survive climate-driven floods. Above all, CBA is participatory – a process involving both local stakeholders, and development and disaster risk reduction practitioners. As such, it builds on existing cultural norms while addressing local development issues that contribute to climate vulnerability. CBA is now gaining ground in many regions, and is ripe for the reassessment offered here.

  14. Strategy Development of Community Base Tourism in Tidung Island, Jakarta

    Directory of Open Access Journals (Sweden)

    Dhian Tyas Untari

    2018-05-01

    Full Text Available The aim of thus study is to establish a community-based tourism development strategy in Tidung Island. Researcher use Strategy Management matrix, In this research, tourist entrepreneurs and tourist as an observation unit and is determined as an analysis unit of the company that is the decision makers are very influential in the company itself, including related Human Resources, Finance, Production, and Marketing. Eigen Factor score is use ase the weighting input data from the results of questionnaires. From the questionnaire, a score is obtained from the average given by the respondents at each key success factors, where in the input process the researcher used IFAS / IFAS Matrix, and in the process of strategy formulation, the researcher used the recommendation from the Grand Matrix Strategy output. The results of the output recommendations, which will then be implemented in the development of community-based tourism on the island of Tidung. Based on the Grand Matrix Strategy chart seen that the outline of Tidung Island tourism into the weak category, where the quadrant Challenges and Weaknesses is much greater than the strength and opportunities. Thus the strategy that can be done is with; improve tourism governance by maximizing the function of tourism development programs of DKI Jakarta Province, encouraging the Provincial Government of DKI Jakarta to allocate funds and attention to alternative tourism such as marine tourism located in Kepulauan Seribu, maximizing Community Service Activities of Higher Education as a medium of knowladge community transfer Tidung Island, improving the mode of transportation and increasing the frequency of ship felling Jakarta - Pulau Tidung.

  15. Evaluating community-based public health leadership training.

    Science.gov (United States)

    Ceraso, Marion; Gruebling, Kirsten; Layde, Peter; Remington, Patrick; Hill, Barbara; Morzinski, Jeffrey; Ore, Peggy

    2011-01-01

    Addressing the nation's increasingly complex public health challenges will require more effective multisector collaboration and stronger public health leadership. In 2005, the Healthy Wisconsin Leadership Institute launched an annual, year-long intensive "community teams" program. The goal of this program is to develop collaborative leadership and public health skills among Wisconsin-based multisectoral teams mobilizing their communities to improve public health. To measure the scope of participation and program impacts on individual learning and practice, including application of new knowledge and collective achievements of teams on coalition and short-term community outcomes. End-of-year participant program evaluations and follow-up telephone interviews with participants 20 months after program completion. Community-based public health leadership training program. Sixty-eight participants in the Community Teams Program during the years 2006 to 2007 and 2007 to 2008. Professional diversity of program participants; individual learning and practice, including application of new knowledge; and collective achievements of teams, including coalition and short-term community outcomes. Participants in the Community Teams Program represent a diversity of sectors, including nonprofit, governmental, academic, business, and local public health. Participation increased knowledge across all public health and leadership competency areas covered in the program. Participating teams reported outcomes, including increased engagement of community leadership, expansion of preventive services, increased media coverage, strengthened community coalitions, and increased grant funding. Evaluation of this community-based approach to public health leadership training has shown it to be a promising model for building collaborative and public health leadership skills and initiating sustained community change for health improvement.

  16. Variability in ADHD care in community-based pediatrics.

    Science.gov (United States)

    Epstein, Jeffery N; Kelleher, Kelly J; Baum, Rebecca; Brinkman, William B; Peugh, James; Gardner, William; Lichtenstein, Phil; Langberg, Joshua

    2014-12-01

    Although many efforts have been made to improve the quality of care delivered to children with attention-deficit/hyperactivity disorder (ADHD) in community-based pediatric settings, little is known about typical ADHD care in these settings other than rates garnered through pediatrician self-report. Rates of evidence-based ADHD care and sources of variability (practice-level, pediatrician-level, patient-level) were determined by chart reviews of a random sample of 1594 patient charts across 188 pediatricians at 50 different practices. In addition, the associations of Medicaid-status and practice setting (ie, urban, suburban, and rural) with the quality of ADHD care were examined. Parent- and teacher-rating scales were used during ADHD assessment with approximately half of patients. The use of Diagnostic and Statistical Manual of Mental Disorders criteria was documented in 70.4% of patients. The vast majority (93.4%) of patients with ADHD were receiving medication and only 13.0% were receiving psychosocial treatment. Parent- and teacher-ratings were rarely collected to monitor treatment response or side effects. Further, fewer than half (47.4%) of children prescribed medication had contact with their pediatrician within the first month of prescribing. Most variability in pediatrician-delivered ADHD care was accounted for at the patient level; however, pediatricians and practices also accounted for significant variability on specific ADHD care behaviors. There is great need to improve the quality of ADHD care received by children in community-based pediatric settings. Improvements will likely require systematic interventions at the practice and policy levels to promote change. Copyright © 2014 by the American Academy of Pediatrics.

  17. Redefining community based on place attachment in a connected world.

    Science.gov (United States)

    Gurney, Georgina G; Blythe, Jessica; Adams, Helen; Adger, W Neil; Curnock, Matthew; Faulkner, Lucy; James, Thomas; Marshall, Nadine A

    2017-09-19

    The concept of community is often used in environmental policy to foster environmental stewardship and public participation, crucial prerequisites of effective management. However, prevailing conceptualizations of community based on residential location or resource use are limited with respect to their utility as surrogates for communities of shared environment-related interests, and because of the localist perspective they entail. Thus, addressing contemporary sustainability challenges, which tend to involve transnational social and environmental interactions, urgently requires additional approaches to conceptualizing community that are compatible with current globalization. We propose a framing for redefining community based on place attachment (i.e., the bonds people form with places) in the context of Australia's Great Barrier Reef, a World Heritage Area threatened by drivers requiring management and political action at scales beyond the local. Using data on place attachment from 5,403 respondents residing locally, nationally, and internationally, we identified four communities that each shared a type of attachment to the reef and that spanned conventional location and use communities. We suggest that as human-environment interactions change with increasing mobility (both corporeal and that mediated by communication and information technology), new types of people-place relations that transcend geographic and social boundaries and do not require ongoing direct experience to form are emerging. We propose that adopting a place attachment framing to community provides a means to capture the neglected nonmaterial bonds people form with the environment, and could be leveraged to foster transnational environmental stewardship, critical to advancing global sustainability in our increasingly connected world.

  18. Systematic Review of Community-Based Childhood Obesity Prevention Studies

    Science.gov (United States)

    Segal, Jodi; Wu, Yang; Wilson, Renee; Wang, Youfa

    2013-01-01

    OBJECTIVE: This study systematically reviewed community-based childhood obesity prevention programs in the United States and high-income countries. METHODS: We searched Medline, Embase, PsychInfo, CINAHL, clinicaltrials.gov, and the Cochrane Library for relevant English-language studies. Studies were eligible if the intervention was primarily implemented in the community setting; had at least 1 year of follow-up after baseline; and compared results from an intervention to a comparison group. Two independent reviewers conducted title scans and abstract reviews and reviewed the full articles to assess eligibility. Each article received a double review for data abstraction. The second reviewer confirmed the first reviewer’s data abstraction for completeness and accuracy. RESULTS: Nine community-based studies were included; 5 randomized controlled trials and 4 non–randomized controlled trials. One study was conducted only in the community setting, 3 were conducted in the community and school setting, and 5 were conducted in the community setting in combination with at least 1 other setting such as the home. Desirable changes in BMI or BMI z-score were found in 4 of the 9 studies. Two studies reported significant improvements in behavioral outcomes (1 in physical activity and 1 in vegetable intake). CONCLUSIONS: The strength of evidence is moderate that a combined diet and physical activity intervention conducted in the community with a school component is more effective at preventing obesity or overweight. More research and consistent methods are needed to understand the comparative effectiveness of childhood obesity prevention programs in the community setting. PMID:23753099

  19. Sustainability of a Community-Based Enterprise through shared value. Case: Mallay Communal Company

    Directory of Open Access Journals (Sweden)

    William Munoz Marticorena

    2018-01-01

    Full Text Available The relationship of a community-based enterprise (CBE and a mining company was reviewed from the perspective of shared value creation. Specifically, through the study of the Mallay CBE and its interaction with the Buenaventura mining company, the opportunity to create economic value by creating value for the community was verified. The CBE is an organizational innovation whose management is oriented towards the market, integrating its activities with the operative dynamics of the mining company through the provision of services. CBE focuses on member’s economic benefit and the social welfare of the broader community. There are, however, barriers that limit the growth and optimization of the desired impacts caused by this articulation. Despite this, the economic and social value generated is significant and the defined growth model under certain circumstances could be replicable and scalable.

  20. Community-based Ontology Development, Annotation and Discussion with MediaWiki extension Ontokiwi and Ontokiwi-based Ontobedia

    Science.gov (United States)

    Ong, Edison; He, Yongqun

    2016-01-01

    Hundreds of biological and biomedical ontologies have been developed to support data standardization, integration and analysis. Although ontologies are typically developed for community usage, community efforts in ontology development are limited. To support ontology visualization, distribution, and community-based annotation and development, we have developed Ontokiwi, an ontology extension to the MediaWiki software. Ontokiwi displays hierarchical classes and ontological axioms. Ontology classes and axioms can be edited and added using Ontokiwi form or MediaWiki source editor. Ontokiwi also inherits MediaWiki features such as Wikitext editing and version control. Based on the Ontokiwi/MediaWiki software package, we have developed Ontobedia, which targets to support community-based development and annotations of biological and biomedical ontologies. As demonstrations, we have loaded the Ontology of Adverse Events (OAE) and the Cell Line Ontology (CLO) into Ontobedia. Our studies showed that Ontobedia was able to achieve expected Ontokiwi features. PMID:27570653

  1. Effect of micronutrient supplementation on treatment outcomes in children with intrathoracic tuberculosis

    DEFF Research Database (Denmark)

    Lodha, Rakesh; Mukherjee, Aparna; Singh, Varinder

    2014-01-01

    BACKGROUND: Micronutrients play an important role in immune function. To our knowledge, there have been no comprehensive studies on the role of micronutrient supplementation in children with tuberculosis. OBJECTIVE: We assessed the effect of micronutrient supplementation in children treated...... with antituberculosis therapy (ATT). DESIGN: A randomized, double-blind, placebo-controlled trial that used a 2 × 2 factorial design was undertaken at 2 teaching hospitals in Delhi. Children with newly diagnosed intrathoracic tuberculosis were enrolled, and they received ATT together with daily supplementation for 6 mo...

  2. [Micronutrients in oncology. Current data about vitamin D, selenium, L-carnitine and vitamin C].

    Science.gov (United States)

    Gröber, Uwe; Mücke, Ralph; Holzhauer, Peter; Kisters, Klaus

    2013-04-01

    Many patients receiving cancer treatment use micronutrient supplements, with the intention to complement their cancer treatment, or help them cope with the therapy- and disease-associated side-effects. Up to 90% of the cancer patients are adding antioxidants without the knowledge of the treating physician. There are many concerns that antioxidants might decrease the effectiveness of chemotherapy, but increasing evidence suggests a benefit when antioxidants and other micronutrients, such as selenium, L-carnitine and vitamin D are added to conventional cytotoxic therapies. It is imperative that physicians discuss the use ofantioxidant and other micronutrient supplements with their cancer patients and educate them about potentially negative, but also potentially beneficial effects.

  3. Stakeholder views of rural community-based medical education: a narrative review of the international literature.

    Science.gov (United States)

    Somporn, Praphun; Ash, Julie; Walters, Lucie

    2018-03-30

    Rural community-based medical education (RCBME), in which medical student learning activities take place within a rural community, requires students, clinical teachers, patients, community members and representatives of health and government sectors to actively contribute to the educational process. Therefore, academics seeking to develop RCBME need to understand the rural context, and the views and needs of local stakeholders. The aim of this review is to examine stakeholder experiences of RCBME programmes internationally. This narrative literature review of original research articles published after 1970 utilises Worley's symbiosis model of medical education as an analysis framework. This model proposes that students experience RCBME through their intersection with multiple clinical, social and institutional relationships. This model seeks to provide a framework for considering the intersecting relationships in which RCBME programmes are situated. Thirty RCBME programmes are described in 52 articles, representing a wide range of rural clinical placements. One-year longitudinal integrated clerkships for penultimate-year students in Anglosphere countries were most common. Such RCBME enables students to engage in work-integrated learning in a feasible manner that is acceptable to many rural clinicians and patients. Academic results are not compromised, and a few papers demonstrate quality improvement for rural health services engaged in RCBME. These programmes have delivered some rural medical workforce outcomes to communities and governments. Medical students also provide social capital to rural communities. However, these programmes have significant financial cost and risk student social and educational isolation. Rural community-based medical education programmes are seen as academically acceptable and can facilitate symbiotic relationships among students, rural clinicians, patients and community stakeholders. These relationships can influence students' clinical

  4. Vitamin D: a critical and essential micronutrient for human health.

    Science.gov (United States)

    Bendik, Igor; Friedel, Angelika; Roos, Franz F; Weber, Peter; Eggersdorfer, Manfred

    2014-01-01

    Vitamin D is a micronutrient that is needed for optimal health throughout the whole life. Vitamin D3 (cholecalciferol) can be either synthesized in the human skin upon exposure to the UV light of the sun, or it is obtained from the diet. If the photoconversion in the skin due to reduced sun exposure (e.g., in wintertime) is insufficient, intake of adequate vitamin D from the diet is essential to health. Severe vitamin D deficiency can lead to a multitude of avoidable illnesses; among them are well-known bone diseases like osteoporosis, a number of autoimmune diseases, many different cancers, and some cardiovascular diseases like hypertension are being discussed. Vitamin D is found naturally in only very few foods. Foods containing vitamin D include some fatty fish, fish liver oils, and eggs from hens that have been fed vitamin D and some fortified foods in countries with respective regulations. Based on geographic location or food availability adequate vitamin D intake might not be sufficient on a global scale. The International Osteoporosis Foundation (IOF) has collected the 25-hydroxy-vitamin D plasma levels in populations of different countries using published data and developed a global vitamin D map. This map illustrates the parts of the world, where vitamin D did not reach adequate 25-hydroxyvitamin D plasma levels: 6.7% of the papers report 25-hydroxyvitamin D plasma levels below 25 nmol/L, which indicates vitamin D deficiency, 37.3% are below 50 nmol/Land only 11.9% found 25-hydroxyvitamin D plasma levels above 75 nmol/L target as suggested by vitamin D experts. The vitamin D map is adding further evidence to the vitamin D insufficiency pandemic debate, which is also an issue in the developed world. Besides malnutrition, a condition where the diet does not match to provide the adequate levels of nutrients including micronutrients for growth and maintenance, we obviously have a situation where enough nutrients were consumed, but lacked to reach sufficient

  5. Vitamin D: a critical and essential micronutrient for human health

    Directory of Open Access Journals (Sweden)

    Igor eBendik

    2014-07-01

    Full Text Available Vitamin D is a micronutrient that is needed for optimal health throughout the whole life. Vitamin D3 (cholecalciferol can be either synthesized in the human skin upon exposure to the UV light of the sun, or it is obtained from the diet. If the photoconversion in the skin due to reduced sun exposure (e.g. in wintertime is insufficient, intake of adequate vitamin D from the diet is essential to health. Severe vitamin D deficiency can lead to multitude of avoidable illnesses; among them are well known bone diseases like osteoporosis, a number of autoimmune diseases, many different cancers and some cardiovascular diseases like hypertension are being discussed. Vitamin D is found naturally in only very few foods. Foods containing vitamin D include some fatty fish, fish liver oils, and eggs from hens that have been fed vitamin D and some fortified foods in countries with respective regulations. Base on geographic location or food availability adequate vitamin D intake might not be sufficient on a global scale. The International Osteoporosis Foundation (IOF has collected the 25-hydroxy-vitamin D plasma levels in populations of different countries using published data and developed a global vitamin D map. This map illustrates the parts of the world, where vitamin D did not reach adequate 25-hydroxyvitamin D plasma levels: 6.7 % of the papers report 25-hydroxyvitamin D plasma levels below 25 nmol/L, which indicates vitamin D deficiency, 37.3 % are below 50 nmol/Land only 11.9% found 25-hydroxy-vitamin D plasma levels above 75 nmol/L target as suggested by vitamin D experts. The vitamin D map is adding further evidence to the vitamin D insufficiency pandemic debate, which is also an issue in the developed world. Besides malnutrition, a condition where the diet does not match to provide the adequate levels of nutrients including micronutrients for growth and maintenance, we obviously have a situation where enough nutrients were consumed, but lacked to

  6. Helminth infections and micronutrients in school-age children: a systematic review and meta-analysis

    NARCIS (Netherlands)

    de Gier, B.; Campos Ponce, M.; van de Bor, M.; Doak, C.M.; Polman, K.

    2014-01-01

    Background: Helminth infections and micronutrient deficiencies are highly prevalent in developing countries. Neither condition typically causes overt disease, but they do lead to indirect morbidity such as impaired physical and cognitive development. Objective: We aimed to systematically review

  7. Improving Tolerance of Faba Bean during Early Growth Stages to Salinity through Micronutrients Foliar Spray

    Directory of Open Access Journals (Sweden)

    Mohamed M. EL FOULY

    2010-06-01

    Full Text Available Salinity, either of soil or of irrigation water, causes disturbances in plant growth and nutrient balance. Previous work indicates that applying nutrients by foliar application increases tolerance to salinity. A pot experiment with three replicates was carried out in the green house of NRC, Cairo, Egypt, to study the effect of micronutrients foliar application on salt tolerance of faba bean. Two concentrations of a micronutrient compound (0.1% and 0.15% were sprayed in two different treatments prior to or after the salinity treatments. Levels of NaCl (0.00-1000-2000-5000 ppm were supplied to irrigation water. Results indicated that 2000 and 5000 ppm NaCl inhibited growth and nutrient uptake. Spraying micronutrients could restore the negative effect of salinity on dry weight and nutrients uptake, when sprayed either before or after the salinity treatments. It is suggested that micronutrient foliar sprays could be used to improve plant tolerance to salinity.

  8. A framework to explore micronutrient deficiency in maternal and child health in Malawi, Southern Africa

    OpenAIRE

    Nisbet Zoe; Cummings Maria; Rankin Jean; Atkinson John; MacPherson Gordon; Gulliver John; Dickinson Natalie; Hursthouse Andrew; Taylor Avril; Robertson Chris; Burghardt Wolfgang

    2009-01-01

    Abstract Background Global food insecurity is associated with micronutrient deficiencies and it has been suggested that 4.5 billion people world-wide are affected by deficiencies in iron, vitamin A and iodine. Zinc has also been identified to be of increasing concern. The most vulnerable are young children and women of childbearing age. A pilot study has been carried out in Southern Malawi, to attempt to link the geochemical and agricultural basis of micronutrient supply through spatial varia...

  9. Hair Zinc Level Analysis and Correlative Micronutrients in Children Presenting with Malnutrition and Poor Growth

    OpenAIRE

    Han, Tae Hwan; Lee, Jin; Kim, Yong Joo

    2016-01-01

    Purpose Zinc deficiency can induce serious clinical problems in the gastrointestinal (GI) system and immune system and can affect growth and development. It is more severe in younger patients. Chronic zinc deficiency is reflected more precisely in hair than in serum. We studied hair zinc levels and other hair and serum micronutrients in chronic malnourished children to identify which micronutrients are affected or correlated with the other ones. Methods Hair mineral analyses were performed in...

  10. Relative influence of soil chemistry and topography on soil available micronutrients by structural equation modeling

    OpenAIRE

    Zhu, Hongfen; Zhao, Ying; Nan, Feng; Duan, Yonghong; Bi, Rutian

    2016-01-01

    Soil chemical and topographic properties are two important factors influencing available micronutrient distribution of soil in the horizontal dimension. The objective of this study was to explore the relative influence of soil chemistry (including soil pH, soil organic matter, total nitrogen, available phosphorus, and available potassium) and topography (including elevation, slope, aspect, and wetness index) on the availability of micronutrients (Fe, Mn, Cu, Zn, and B) using structural equati...

  11. Integration

    DEFF Research Database (Denmark)

    Emerek, Ruth

    2004-01-01

    Bidraget diskuterer de forskellige intergrationsopfattelse i Danmark - og hvad der kan forstås ved vellykket integration......Bidraget diskuterer de forskellige intergrationsopfattelse i Danmark - og hvad der kan forstås ved vellykket integration...

  12. Effects of a multi-micronutrient-fortified beverage, with and without sugar, on growth and cognition in South African schoolchildren: a randomised, double-blind, controlled intervention

    OpenAIRE

    Taljaard, Christine; Covic, Namukolo M.; Van Graan, Averalda E.; Kruger, Herculina S.; Smuts, Cornelius M.; Baumgartner, Jeannine; Wright, Hattie H.; Jerling, Johann C.

    2013-01-01

    Little is known about the effects of combined micronutrient and sugar consumption on growth and cognition. In the present study, we investigated the effects of micronutrients and sugar, alone and in combination, in a beverage on growth and cognition in schoolchildren. In a 2 £ 2 factorial design, children (n 414, 6–11 years) were randomly allocated to consume beverages containing (1) micronutrients with sugar, (2) micronutrients with a non-nutritive sweetener, (3) no micronutrients w...

  13. [Pica diagnosis during pregnancy and micronutrient dificiency in Argentine women].

    Science.gov (United States)

    Poy, M S; Weisstaub, A; Iglesias, C; Fernández, S; Portela, Ma L; López, L B

    2012-01-01

    To evaluate by biochemical parameters iron and zinc nutritional status in women with and without pica diagnosis during pregnancy. During puerperium 109 women were evaluated at Fiorito Hospital, Argentina. Pica diagnosis was made in 42 women while 67 did not refer the practice. Fasting blood samples were obtained and analyzed in a hematology analyzer for values of red blood cells, hemoglobin, mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, and hematocrit. Serum zinc and erythrocyte zinc was analyzed by atomic absorption spectrophotometry. Substances consumed during pica practice were: earth, ice, brick, paper, desinfectant and dog food. Women with pica diagnosis had higher a rate of family history of pica and personal antecedents of pica in childhood (OR: 15.9). Sociodemographic and anthropometric characteristics and neonatal birth weight were similar between both groups, although women with pica diagnosis had lower values in mean corpuscular volume (p = 0,008), mean corpuscular hemoglobin (p = 0,009) and erythrocyte zinc (0,008). Applying a logistic regression model, erythrocyte zinc was the only biochemical indicator associated with pica practice (p = 0,028). At puerperium, women with pica during pregnancy could have lower levels in biochemical parameters for iron and zinc status so we suggest that early diagnosis of pica could help to identify micronutrient deficient.

  14. The role of micronutrients in the response to air pollutants ...

    Science.gov (United States)

    People living in regions of low socioeconomic status are thought to be prone to higher exposures to environmental pollutants, poor nutrition, and numerous preventable diseases and infections. Poverty correlates with pollution and malnutrition, however limited studies examined their interrelationship. The well-studied, deleterious health effects attributed to environmental pollutants and poor nutrition may act in combination to produce more severe adverse health outcomes than any one factor alone. Deficiency in specific nutrients render the body more susceptible to injury which may influence the pathways that serve as the mechanistic responses to air pollutants. This review (1) explores specific micronutrients that are of global concern, (2) explains how these nutrients may impact the body’s response to ambient air pollution, and (3) provides guidance on designing animal models of nutritional deficiency. It is likely that those individuals who reside in regions of high ambient air pollution are similarly malnourished. Therefore, it is important that research identifies specific nutrients of concern and their impact in identified regions of high ambient air pollution. The purpose of the current paper is to (1) provide an understanding of the known nutrients of concern worldwide. Selected nutrients will be discussed in depth in the following sections based on information from the World Health Organization, World Food Programme data, and also demonstrate risk of

  15. Food Group Intake and Micronutrient Adequacy in Adolescent Girls

    Directory of Open Access Journals (Sweden)

    M. Loring Bradlee

    2012-11-01

    Full Text Available This study explores the contribution of food group intakes to micronutrient adequacy among 2379 girls in the National Growth and Health Study during three age periods (9–13, 14–18, and 19–20 years. Data on food and nutrient intakes from 3-day diet records over 10 years were used to estimate mean intakes and percent meeting Dietary Guidelines (DGA recommendations for food intakes and Institute of Medicine’s recommendations for vitamins and minerals. More than 90% of girls failed to consume the recommended amounts of fruit, vegetables and dairy; 75% consumed less than the recommended amounts in the “meat” group. The vast majority of girls of all ages had inadequate intakes of calcium, magnesium, potassium, and vitamins D and E. In contrast, they consumed >750 kcal/day (~40% of total energy from the DGA category of solid fat and added sugars, about five times the recommended maximum intakes. This study shows the importance of consuming a variety of foods in all five food groups, including those that are more energy dense such as dairy and meats, in order to meet a broad range of nutrient guidelines. Diet patterns that combined intakes across food groups led to greater improvements in overall nutritional adequacy.

  16. Micronutrient Intake in Healthy Toddlers: A Multinational Perspective

    Directory of Open Access Journals (Sweden)

    Jennifer Hilger

    2015-08-01

    Full Text Available Adequate nutrient intake during early childhood is of particular importance for optimal growth and future health. However, cross-national comparative research on nutrient intake of toddlers is still limited. We conducted a literature review to examine the nutrient intake in healthy toddlers from some of the world’s most populous nations currently on different stages of socioeconomic development: Brazil, Germany, Russia and the United States. We aimed to identify national surveys reporting mean intakes of the following nutrients: vitamins A, D, E, folate, calcium, iron and zinc. To calculate the prevalence of inadequate nutrient intake, we used a modified version of the Estimated Average Requirement cut-point method. Overall, five studies with 6756 toddlers were eligible for inclusion in this review. In countries where data were available, a prevalence of inadequate intake higher than 20% was found for vitamins A, D, E and calcium. In Germany, folate intake also appeared to be inadequate. The results of our review indicate that inadequate micronutrient intake in toddlers might be a global challenge affecting also affluent countries. However, to explore the full scope of this important public health issue joint efforts of researchers worldwide are needed to combine existing data and fill in data gaps.

  17. Food Group Intake and Micronutrient Adequacy in Adolescent Girls

    Science.gov (United States)

    Moore, Lynn L.; Singer, Martha R.; Qureshi, M. Mustafa; Bradlee, M. Loring; Daniels, Stephen R.

    2012-01-01

    This study explores the contribution of food group intakes to micronutrient adequacy among 2379 girls in the National Growth and Health Study during three age periods (9–13, 14–18, and 19–20 years). Data on food and nutrient intakes from 3-day diet records over 10 years were used to estimate mean intakes and percent meeting Dietary Guidelines (DGA) recommendations for food intakes and Institute of Medicine’s recommendations for vitamins and minerals. More than 90% of girls failed to consume the recommended amounts of fruit, vegetables and dairy; 75% consumed less than the recommended amounts in the “meat” group. The vast majority of girls of all ages had inadequate intakes of calcium, magnesium, potassium, and vitamins D and E. In contrast, they consumed >750 kcal/day (~40% of total energy) from the DGA category of solid fat and added sugars, about five times the recommended maximum intakes. This study shows the importance of consuming a variety of foods in all five food groups, including those that are more energy dense such as dairy and meats, in order to meet a broad range of nutrient guidelines. Diet patterns that combined intakes across food groups led to greater improvements in overall nutritional adequacy. PMID:23201841

  18. Dietary diversity scores: an indicator of micronutrient inadequacy instead of obesity for Chinese children.

    Science.gov (United States)

    Zhao, Wenzhi; Yu, Kai; Tan, Shengjie; Zheng, Yingdong; Zhao, Ai; Wang, Peiyu; Zhang, Yumei

    2017-05-12

    Micronutrient malnutrition affects the well-being of both adults and children. Dietary diversity score (DDS) is a useful evaluation index with a relatively well-developed guideline by FAO. It's meaningful to assess and predict inadequate micronutrient intakes using DDS in Chinese children, after ruling out the risk of obesity coming with more dietary diversity. Data for evaluation were extracted from the Nutrition Study of Preschool Children and School Children, which is a cross-sectional study covering 8 cities of China, including 1694 children in kindergartens and primary schools. This study applied DDS to Chinese children to test the validity for micronutrient inadequacy, and then explored the relationship between dietary diversity and obesity. It reveals that dietary diversity varied with age and place of residence; the older ones and the ones living in rural areas tend to have poorer dietary diversity. Another discovery is that DDS is positively correlated with indicators of micronutrient adequacy, with a score of 6-8 indicating the lowest risk of micronutrient inadequacy in different groups of children. In our study population, dietary diversity is not related with obesity. Dietary diversity score is a valid indicator to evaluate micronutrient inadequacy in Chinese children, though there is still room for improvement of the method. Besides, the relationship between increase of dietary diversity and risk of obesity should be treated circumspectly.

  19. The influence of micronutrients in cell culture: a reflection on viability and genomic stability.

    Science.gov (United States)

    Arigony, Ana Lúcia Vargas; de Oliveira, Iuri Marques; Machado, Miriana; Bordin, Diana Lilian; Bergter, Lothar; Prá, Daniel; Henriques, João Antonio Pêgas

    2013-01-01

    Micronutrients, including minerals and vitamins, are indispensable to DNA metabolic pathways and thus are as important for life as macronutrients. Without the proper nutrients, genomic instability compromises homeostasis, leading to chronic diseases and certain types of cancer. Cell-culture media try to mimic the in vivo environment, providing in vitro models used to infer cells' responses to different stimuli. This review summarizes and discusses studies of cell-culture supplementation with micronutrients that can increase cell viability and genomic stability, with a particular focus on previous in vitro experiments. In these studies, the cell-culture media include certain vitamins and minerals at concentrations not equal to the physiological levels. In many common culture media, the sole source of micronutrients is fetal bovine serum (FBS), which contributes to only 5-10% of the media composition. Minimal attention has been dedicated to FBS composition, micronutrients in cell cultures as a whole, or the influence of micronutrients on the viability and genetics of cultured cells. Further studies better evaluating micronutrients' roles at a molecular level and influence on the genomic stability of cells are still needed.

  20. Assessment of Micronutrient Status in Critically Ill Children: Challenges and Opportunities

    Directory of Open Access Journals (Sweden)

    Duy T. Dao

    2017-10-01

    Full Text Available Micronutrients refer to a group of organic vitamins and inorganic trace elements that serve many functions in metabolism. Assessment of micronutrient status in critically ill children is challenging due to many complicating factors, such as evolving metabolic demands, immature organ function, and varying methods of feeding that affect nutritional dietary intake. Determination of micronutrient status, especially in children, usually relies on a combination of biomarkers, with only a few having been established as a gold standard. Almost all micronutrients display a decrease in their serum levels in critically ill children, resulting in an increased risk of deficiency in this setting. While vitamin D deficiency is a well-known phenomenon in critical illness and can predict a higher need for intensive care, serum concentrations of many trace elements such as iron, zinc, and selenium decrease as a result of tissue redistribution in response to systemic inflammation. Despite a decrease in their levels, supplementation of micronutrients during times of severe illness has not demonstrated clear benefits in either survival advantage or reduction of adverse outcomes. For many micronutrients, the lack of large and randomized studies remains a major hindrance to critically evaluating their status and clinical significance.

  1. Accountability for Community-Based Programs for the Seriously Ill.

    Science.gov (United States)

    Teno, Joan M; Montgomery, Russ; Valuck, Tom; Corrigan, Janet; Meier, Diane E; Kelley, Amy; Curtis, J Randall; Engelberg, Ruth

    2018-03-01

    Innovation is needed to improve care of the seriously ill, and there are important opportunities as we transition from a volume- to value-based payment system. Not all seriously ill are dying; some recover, while others are persistently functionally impaired. While we innovate in service delivery and payment models for the seriously ill, it is important that we concurrently develop accountability that ensures a focus on high-quality care rather than narrowly focusing on cost containment. The Gordon and Betty Moore Foundation convened a meeting of 45 experts to arrive at guiding principles for measurement, create a starter measurement set, specify a proposed definition of the denominator and its refinement, and identify research priorities for future implementation of the accountability system. A series of articles written by experts provided the basis for debate and guidance in formulating a path forward to develop an accountability system for community-based programs for the seriously ill, outlined in this article. As we innovate in existing population-based payment programs such as Medicare Advantage and develop new alternative payment models, it is important and urgent that we develop the foundation for accountability along with actionable measures so that the healthcare system ensures high-quality person- and family-centered care for persons who are seriously ill.

  2. Functional outcomes of community-based brain injury rehabilitation clients.

    Science.gov (United States)

    Curran, Christine; Dorstyn, Diana; Polychronis, Con; Denson, Linley

    2015-01-01

    Community-based rehabilitation can help to maximize function following acquired brain injury (ABI); however, data on treatment outcome is limited in quantity. To describe and evaluate client outcomes of an outpatient programme for adults with moderate-to-severe traumatic and non-traumatic ABI. Two phase design involving retrospective and longitudinal study of programme completers with ABI (n = 47). Changes in functioning were measured with the Mayo-Portland Inventory (MPAI-4), administered pre- and immediately post-rehabilitation and at 3 years follow-up. Self-ratings were supplemented with MPAI-4 data from significant others (n = 32) and staff (n = 32). Injured individuals and informants reported improved physical and psychosocial functioning immediately following the completion of community rehabilitation, with medium-to-large and significant treatment gains noted on the MPAI-4 ability, adjustment and participation sub-scales (Cohen's d range = 0.31-1.10). A deterioration in individuals' adjustment was further reported at follow-up, although this was based on limited data. Issues with longer-term rehabilitation service provision were additionally noted. The data support the need for continuity of care, including ongoing emotional support, to cater to the complex and dynamic needs of the ABI population. However, these results need to be considered in the context of a small sample size and quasi-experimental design.

  3. Restricted grouper reproductive migrations support community-based management

    KAUST Repository

    Waldie, Peter A.

    2016-03-09

    Conservation commonly requires trade-offs between social and ecological goals. For tropical small-scale fisheries, spatial scales of socially appropriate management are generally small—the median no-take locally managed marine area (LMMA) area throughout the Pacific is less than 1 km2. This is of particular concern for large coral reef fishes, such as many species of grouper, which migrate to aggregations to spawn. Current data suggest that the catchment areas (i.e. total area from which individuals are drawn) of such aggregations are at spatial scales that preclude effective community-based management with no-take LMMAs. We used acoustic telemetry and tag-returns to examine reproductive migrations and catchment areas of the grouper Epinephelus fuscoguttatus at a spawning aggregation in Papua New Guinea. Protection of the resultant catchment area of approximately 16 km2 using a no-take LMMA is socially untenable here and throughout much of the Pacific region. However, we found that spawning migrations were skewed towards shorter distances. Consequently, expanding the current 0.2 km2 no-take LMMA to 1–2 km2 would protect approximately 30–50% of the spawning population throughout the non-spawning season. Contrasting with current knowledge, our results demonstrate that species with moderate reproductive migrations can be managed at scales congruous with spatially restricted management tools.

  4. Community-based research as a mechanism to reduce ...

    Science.gov (United States)

    Racial and ethnic minority communities, including American Indian and Alaska Natives, have been disproportionately impacted by environmental pollution and contamination. This includes siting and location of point sources of pollution, legacies of contamination of drinking and recreational water, and mining, military and agricultural impacts. As a result, both quantity and quality of culturally important subsistence resources are diminished, contributing to poor nutrition and obesity, and overall reductions in quality of life and life expectancy. Climate change is adding to these impacts on Native American communities (Wildcat 2013), variably causing drought, increased flooding and forced relocation (Maldonado et al. 2013), affecting Tribal water resources (Cozzetto et al. 2013), traditional foods (Lynn et al. 2013; Gautam et al. 2013), forests and forest resources (Voggesser et al. 2013) and Tribal health (Donatuto et al 2014; Doyle et al. 2013). This article will highlight several extramural research projects supported by the United States Environmental Protection Agency (USEPA) Science to Achieve Results (STAR) Tribal environmental research grants as a mechanism to address the environmental health inequities and disparities faced by Tribal communities (USEPA, 2014a, www.epa.gov/ncer/tribalresearch). The Tribal Research portfolio has focused on addressing tribal environmental health risks through community based participatory research. Specifically, the STA

  5. Partnership readiness for community-based participatory research.

    Science.gov (United States)

    Andrews, Jeannette O; Newman, Susan D; Meadows, Otha; Cox, Melissa J; Bunting, Shelia

    2012-08-01

    The use of a dyadic lens to assess and leverage academic and community partners' readiness to conduct community-based participatory research (CBPR) has not been systematically investigated. With a lack of readiness to conduct CBPR, the partnership and its products are vulnerable. The purpose of this qualitative study was to explore the dimensions and key indicators necessary for academic and community partnership readiness to conduct CBPR. Key informant interviews and focus groups (n = 36 participants) were conducted with academic and community participants who had experiences with CBPR partnerships. A 'framework analysis' approach was used to analyze the data and generate a new model, CBPR Partnership Readiness Model. Antecedents of CBPR partnership readiness are a catalyst and mutual interest. The major dimensions of the CBPR Partnership Readiness Model are (i) goodness of fit, (ii) capacity, and (iii) operations. Preferred outcomes are sustainable partnership and product, mutual growth, policy and social and health impact on the community. CBPR partnership readiness is an iterative and dynamic process, partnership and issue specific, influenced by a range of environmental and contextual factors, amenable to change and essential for sustainability and promotion of health and social change in the community.

  6. Community Based Educational Model on Water Conservation Program

    Science.gov (United States)

    Sudiajeng, L.; Parwita, I. G. L.; Wiraga, I. W.; Mudhina, M.

    2018-01-01

    The previous research showed that there were indicators of water crisis in the northern and eastern part of Denpasar city and most of coastal area experienced on seawater intrusion. The recommended water conservation programs were rainwater harvesting and educate the community to develop a water saving and environmentally conscious culture. This research was conducted to built the community based educational model on water conservation program through ergonomics SHIP approach which placed the human aspect as the first consideration, besides the economic and technically aspects. The stakeholders involved in the program started from the problem analyses to the implementation and the maintenance as well. The model was built through three main steps, included determination of accepted design; building the recharge wells by involving local communities; guidance and assistance in developing a water saving and environmentally conscious culture for early childhood, elementary and junior high school students, community and industry. The program was implemented based on the “TRIHITA KARANA” concept, which means the relationship between human to God, human-to-human, and human to environment. Through the development of the model, it is expected to grow a sense of belonging and awareness from the community to maintain the sustainability of the program.

  7. A Community Based Systems Diagram of Obesity Causes.

    Directory of Open Access Journals (Sweden)

    Steven Allender

    Full Text Available Application of system thinking to the development, implementation and evaluation of childhood obesity prevention efforts represents the cutting edge of community-based prevention. We report on an approach to developing a system oriented community perspective on the causes of obesity.Group model building sessions were conducted in a rural Australian community to address increasing childhood obesity. Stakeholders (n = 12 built a community model that progressed from connection circles to causal loop diagrams using scripts from the system dynamics literature. Participants began this work in identifying change over time in causes and effects of childhood obesity within their community. The initial causal loop diagram was then reviewed and elaborated by 50 community leaders over a full day session.The process created a causal loop diagram representing community perceptions of determinants and causes of obesity. The causal loop diagram can be broken down into four separate domains; social influences; fast food and junk food; participation in sport; and general physical activity.This causal loop diagram can provide the basis for community led planning of a prevention response that engages with multiple levels of existing settings and systems.

  8. Community-Based Ecotourism: The Transformation of Local Community

    Directory of Open Access Journals (Sweden)

    Pookhao Nantira

    2014-01-01

    Full Text Available Community-based ecotourism (CBET is considered a sustainable form of tourism that improves the quality of life of hosts at the tourist destination. Scholars have yet to explore the long-term operation of CBET in relation to its effects on the local way of life. Consequently, the purpose of this paper is to examine the transformation of a local community due to the operation of CBET in relation to sociocultural, economic and environmental aspects. The findings reveal that the community encounters both positive and negative impacts of transformation. However, unintended impacts of the CBET operation lay embedded in the transformation of relationships among the community members. The study identifies that close relationships among the villagers has been initially transformed to loose relationships due to forgotten communal goals; CBET has transformed from being a conservation tool to being a business-oriented goal which causes conflicts of interest among local people and alters traditional social structure. The study also agrees with the notion of social exchange theory for villagers to enhance environmental sustainability, and proposes that slight inequalities of benefits received from CBET causes social transformation at the local level.

  9. Developing a theoretical framework for complex community-based interventions.

    Science.gov (United States)

    Angeles, Ricardo N; Dolovich, Lisa; Kaczorowski, Janusz; Thabane, Lehana

    2014-01-01

    Applying existing theories to research, in the form of a theoretical framework, is necessary to advance knowledge from what is already known toward the next steps to be taken. This article proposes a guide on how to develop a theoretical framework for complex community-based interventions using the Cardiovascular Health Awareness Program as an example. Developing a theoretical framework starts with identifying the intervention's essential elements. Subsequent steps include the following: (a) identifying and defining the different variables (independent, dependent, mediating/intervening, moderating, and control); (b) postulating mechanisms how the independent variables will lead to the dependent variables; (c) identifying existing theoretical models supporting the theoretical framework under development; (d) scripting the theoretical framework into a figure or sets of statements as a series of hypotheses, if/then logic statements, or a visual model; (e) content and face validation of the theoretical framework; and (f) revising the theoretical framework. In our example, we combined the "diffusion of innovation theory" and the "health belief model" to develop our framework. Using the Cardiovascular Health Awareness Program as the model, we demonstrated a stepwise process of developing a theoretical framework. The challenges encountered are described, and an overview of the strategies employed to overcome these challenges is presented.

  10. Community-based livestock breeding programmes: essentials and examples.

    Science.gov (United States)

    Mueller, J P; Rischkowsky, B; Haile, A; Philipsson, J; Mwai, O; Besbes, B; Valle Zárate, A; Tibbo, M; Mirkena, T; Duguma, G; Sölkner, J; Wurzinger, M

    2015-04-01

    Breeding programmes described as community-based (CBBP) typically relate to low-input systems with farmers having a common interest to improve and share their genetic resources. CBBPs are more frequent with keepers of small ruminants, in particular smallholders of local breeds, than with cattle, pigs or chickens with which farmers may have easier access to alternative programmes. Constraints that limit the adoption of conventional breeding technologies in low-input systems cover a range of organizational and technical aspects. The analysis of 8 CBBPs located in countries of Latin-America, Africa and Asia highlights the importance of bottom-up approaches and involvement of local institutions in the planning and implementation stages. The analysis also reveals a high dependence of these programmes on organizational, technical and financial support. Completely self-sustained CBBPs seem to be difficult to realize. There is a need to implement and document formal socio-economic evaluations of CBBPs to provide governments and other development agencies with the information necessary for creating sustainable CBBPs at larger scales. © 2015 Blackwell Verlag GmbH.

  11. Comprendiendo el community-based tourism desde la comunidad

    Directory of Open Access Journals (Sweden)

    Esteban Ruiz

    2008-01-01

    Full Text Available El creciente impulso del Community-based tourism (CBT como vía para un turismo sostenible y estrategia para el desarrollo social nos obliga a profundizar en su comprensión. En este artículo proponemos como táctica teórico-metodológica la focalización analítica en la comunidad. El referente empírico de la investigación es el turismo comunitario (TC en Ecuador, donde se han seleccionado cinco comunidades para llevar a cabo un estudio etnográfico en profundidad. Como conclusión planteamos un marco comprensivo del TC que tiene tres pilares básicos: la centralidad analítica de las comunidades, la consideración del TC como `traducción´ antes que como `adaptación´ al mercado, y el carácter fortalecedor —antes que debilitador— del TC para las comunidades. De aquí se derivan una serie de indicadores cualitativos que sirven para encarar, desde el punto de vista teórico, la comprensión general del CBT y asimismo son útiles para la evaluación de la sostenibilidad de proyectos y experiencias de CBT

  12. A Community-Based Surveillance on Determinants of Rodent Infestation

    Directory of Open Access Journals (Sweden)

    Hsiu-Hua Pai

    2003-01-01

    Full Text Available Rodent infestation is an important factor in the transmission of infectious diseases of public health importance. From October to November 1998, surveillance stations were established in 110 boroughs of Kaohsiung City in southern Taiwan. Boroughs were chosen by random sampling 10 boroughs from each of 11 districts (464 boroughs in the city. The extent of rodent infestation was determined by cage trapping. The possibility of applying a community-based control program was evaluated by investigating associated demographic and environmental factors as well as related knowledge, attitudes, and behaviors. A total of 90 rodents were trapped in 41% of the 110 boroughs. Using univariate analyses, 17 factors were significantly associated with rodent infestation. A lack of knowledge that rodent control relies on community cooperation was the most important factor among the seven variables associated with the extent of rodent infestation (OR 3.1 by logistic multiple regression. This revealed the importance of community cooperation in controlling rodent infestation. Moreover, improvement of environmental hygiene associated with garbage problems, such as cleanliness of storage rooms and closets, and the hygiene of empty space and resource recycling stations should not be ignored.

  13. Community Priority Index: utility, applicability and validation for priority setting in community-based participatory research

    Directory of Open Access Journals (Sweden)

    Hamisu M. Salihu

    2015-07-01

    Full Text Available Background. Providing practitioners with an intuitive measure for priority setting that can be combined with diverse data collection methods is a necessary step to foster accountability of the decision-making process in community settings. Yet, there is a lack of easy-to-use, but methodologically robust measures, that can be feasibly implemented for reliable decision-making in community settings. To address this important gap in community based participatory research (CBPR, the purpose of this study was to demonstrate the utility, applicability, and validation of a community priority index in a community-based participatory research setting. Design and Methods. Mixed-method study that combined focus groups findings, nominal group technique with six key informants, and the generation of a Community Priority Index (CPI that integrated community importance, changeability, and target populations. Bootstrapping and simulation were performed for validation. Results. For pregnant mothers, the top three highly important and highly changeable priorities were: stress (CPI=0.85; 95%CI: 0.70, 1.00, lack of affection (CPI=0.87; 95%CI: 0.69, 1.00, and nutritional issues (CPI=0.78; 95%CI: 0.48, 1.00. For non-pregnant women, top priorities were: low health literacy (CPI=0.87; 95%CI: 0.69, 1.00, low educational attainment (CPI=0.78; 95%CI: 0.48, 1.00, and lack of self-esteem (CPI=0.72; 95%CI: 0.44, 1.00. For children and adolescents, the top three priorities were: obesity (CPI=0.88; 95%CI: 0.69, 1.00, low self-esteem (CPI=0.81; 95%CI: 0.69, 0.94, and negative attitudes toward education (CPI=0.75; 95%CI: 0.50, 0.94. Conclusions. This study demonstrates the applicability of the CPI as a simple and intuitive measure for priority setting in CBPR.

  14. Performance of Community-Based Rehabilitation (CBR in Rural Areas of Islamic Republic of Iran

    Directory of Open Access Journals (Sweden)

    H. Nahvinejad

    2003-09-01

    Full Text Available The situation of people with disabilities in the developing countries should be a matter of great concern. There are today close to 250 million severely and moderately disabled persons in these countries; the annual increase is 10 million. Most of them are poor, dependent neglected, excluded from education, training and jobs; They die early and have no power while alive. Between 15 and 20% of all people new living below the poverty line have a disability: The majority of them have no share in community development programs and are virtually excluded from the public services they need to be prepared for a life in the community. Their human rights are not well protected. It is clear that in this situation an effort should be made to improve the quality of life of persons with disabilities. Countries acting to assist disabled people are motivated by a belief in equality and the desire to limit the severity of disability and the hardship it imposes on individuals and families, as well as to limit the loss that occurs when a part of the population is economically unproductive. All people have the right to health. In order to ensure that right for all citizens, a nation provides opportunities for disabled people to develop and use their physical and mental abilities. The World Health organization is striving to realize health for all. In 1978, the International conference on Primary Health Care, held in Alma-Ata, declared that primary health care would address the main health problems in the community and thus promote Health for All through the provision of promotive, preventive, curative, and rehabilitative services. Following the declaration, WHO developed the strategy of community-based rehabilitation (CBR as a means of integrating rehabilitation with health and development activities at the community level. The community-based rehabilitation system has in a very short time been introduced to about 90 developing countries.

  15. Mobile devices for community-based REDD+ monitoring: a case study for Central Vietnam.

    Science.gov (United States)

    Pratihast, Arun Kumar; Herold, Martin; Avitabile, Valerio; de Bruin, Sytze; Bartholomeus, Harm; Souza, Carlos M; Ribbe, Lars

    2012-12-20

    Monitoring tropical deforestation and forest degradation is one of the central elements for the Reduced Emissions from Deforestation and Forest Degradation in developing countries (REDD+) scheme. Current arrangements for monitoring are based on remote sensing and field measurements. Since monitoring is the periodic process of assessing forest stands properties with respect to reference data, adopting the current REDD+ requirements for implementing monitoring at national levels is a challenging task. Recently, the advancement in Information and Communications Technologies (ICT) and mobile devices has enabled local communities to monitor their forest in a basic resource setting such as no or slow internet connection link, limited power supply, etc. Despite the potential, the use of mobile device system for community based monitoring (CBM) is still exceptional and faces implementation challenges. This paper presents an integrated data collection system based on mobile devices that streamlines the community-based forest monitoring data collection, transmission and visualization process. This paper also assesses the accuracy and reliability of CBM data and proposes a way to fit them into national REDD+ Monitoring, Reporting and Verification (MRV) scheme. The system performance is evaluated at Tra Bui commune, Quang Nam province, Central Vietnam, where forest carbon and change activities were tracked. The results show that the local community is able to provide data with accuracy comparable to expert measurements (index of agreement greater than 0.88), but against lower costs. Furthermore, the results confirm that communities are more effective to monitor small scale forest degradation due to subsistence fuel wood collection and selective logging, than high resolution remote sensing SPOT imagery.

  16. Studi evaluasi penerapan Community Based Tourism (CBT) sebagai pendukung agrowisata berkelanjutan

    OpenAIRE

    Sri Endah Nurhidayati

    2015-01-01

    The role of government in the development of Community Based Tourism (CBT) is very important to strengthen communities around the tourism destination. Government has significant role to ensure that the community has accesses, opportunities and an important power in the development of tourism. The objectives of this research are: (1) describe the government's perception of the  Community Based Tourism (CBT) development, (2) identifying government policies to support the Community Based Tourism...

  17. Studi Evaluasi Penerapan Community Based Tourism (CBT) Sebagai Pendukung Agrowisata Berkelanjutan

    OpenAIRE

    Nurhidayati, Sri Endah

    2015-01-01

    The role of government in the development of Community Based Tourism (CBT) is very important to strengthen communities around the tourism destination. Government has significant role to ensure that the community has accesses, opportunities and an important power in the development of tourism. The objectives of this research are: (1) describe the government's perception of the Community Based Tourism (CBT) development, (2) identifying government policies to support the Community Based Tourism...

  18. Uptake of Community-Based Peer Administered HIV Point-of-Care Testing: Findings from the PROUD Study.

    Directory of Open Access Journals (Sweden)

    Lisa Lazarus

    Full Text Available HIV prevalence among people who inject drugs (PWID in Ottawa is estimated at about 10%. The successful integration of peers into outreach efforts and wider access to HIV point-of-care testing (POCT create opportunities to explore the role of peers in providing HIV testing. The PROUD study, in partnership with Ottawa Public Health (OPH, sought to develop a model for community-based peer-administered HIV POCT.PROUD draws on community-based participatory research methods to better understand the HIV risk environment of people who use drugs in Ottawa. From March-October 2013, 593 people who reported injecting drugs or smoking crack cocaine were enrolled through street-based recruitment. Trained peer or medical student researchers administered a quantitative survey and offered an HIV POCT (bioLytical INSTI test to participants who did not self-report as HIV positive.550 (92.7% of the 593 participants were offered a POCT, of which 458 (83.3% consented to testing. Of those participants, 74 (16.2% had never been tested for HIV. There was no difference in uptake between testing offered by a peer versus a non-peer interviewer (OR = 1.05; 95% CI = 0.67-1.66. Despite testing those at high risk for HIV, only one new reactive test was identified.The findings from PROUD demonstrate high uptake of community-based HIV POCT. Peers were able to successfully provide HIV POCT and reach participants who had not previously been tested for HIV. Community-based and peer testing models provide important insights on ways to scale-up HIV prevention and testing among people who use drugs.

  19. [Integrity].

    Science.gov (United States)

    Gómez Rodríguez, Rafael Ángel

    2014-01-01

    To say that someone possesses integrity is to claim that that person is almost predictable about responses to specific situations, that he or she can prudentially judge and to act correctly. There is a closed interrelationship between integrity and autonomy, and the autonomy rests on the deeper moral claim of all humans to integrity of the person. Integrity has two senses of significance for medical ethic: one sense refers to the integrity of the person in the bodily, psychosocial and intellectual elements; and in the second sense, the integrity is the virtue. Another facet of integrity of the person is la integrity of values we cherish and espouse. The physician must be a person of integrity if the integrity of the patient is to be safeguarded. The autonomy has reduced the violations in the past, but the character and virtues of the physician are the ultimate safeguard of autonomy of patient. A field very important in medicine is the scientific research. It is the character of the investigator that determines the moral quality of research. The problem arises when legitimate self-interests are replaced by selfish, particularly when human subjects are involved. The final safeguard of moral quality of research is the character and conscience of the investigator. Teaching must be relevant in the scientific field, but the most effective way to teach virtue ethics is through the example of the a respected scientist.

  20. The effect of a micronutrient-fortified complementary food on micronutrient status, growth and development of 6- to 12-month-old disadvantaged urban South-African infants

    NARCIS (Netherlands)

    Oelofse, A.; Raaij, van J.M.A.; Benade, A.J.S.; Dhansay, M.A.; Tolboom, J.J.M.; Hautvast, J.G.A.J.

    2003-01-01

    The study was conducted to look at the effectiveness of a multimicronutrient-fortified complementary food on the micronutrient status, linear growth and psychomotor development of 6- to 12-month-old infants from a black urban disadvantaged community in the Western Cape, South Africa. The study was

  1. Developing accreditation for community based surgery: the Irish experience.

    Science.gov (United States)

    Ní Riain, Ailís; Collins, Claire; O'Sullivan, Tony

    2018-02-05

    Purpose Carrying out minor surgery procedures in the primary care setting is popular with patients, cost effective and delivers at least as good outcomes as those performed in the hospital setting. This paper aims to describe the central role of clinical leadership in developing an accreditation system for general practitioners (GPs) undertaking community-based surgery in the Irish national setting where no mandatory accreditation process currently exists. Design/methodology/approach In all, 24 GPs were recruited to the GP network. Ten pilot standards were developed addressing GPs' experience and training, clinical activity and practice supporting infrastructure and tested, using information and document review, prospective collection of clinical data and a practice inspection visit. Two additional components were incorporated into the project (patient satisfaction survey and self-audit). A multi-modal evaluation was undertaken. A majority of GPs was included at all stages of the project, in line with the principles of action learning. The steering group had a majority of GPs with relevant expertise and representation of all other actors in the minor surgery arena. The GP research network contributed to each stage of the project. The project lead was a GP with minor surgery experience. Quantitative data collected were analysed using Predictive Analytic SoftWare. Krueger's framework analysis approach was used to analyse the qualitative data. Findings A total of 9 GPs achieved all standards at initial review, 14 successfully completed corrective actions and 1 GP did not achieve the required standard. Standards were then amended to reflect findings and a supporting framework was developed. Originality/value The flexibility of the action-learning approach and the clinical leadership design allowed for the development of robust quality standards in a short timeframe.

  2. Team sponsors in community-based health leadership programs.

    Science.gov (United States)

    Patterson, Tracy Enright; Dinkin, Donna R; Champion, Heather

    2017-05-02

    Purpose The purpose of this article is to share the lessons learned about the role of team sponsors in action-learning teams as part of community-based health leadership development programs. Design/methodology/approach This case study uses program survey results from fellow participants, action learning coaches and team sponsors to understand the value of sponsors to the teams, the roles they most often filled and the challenges they faced as team sponsors. Findings The extent to which the sponsors were perceived as having contributed to the work of the action learning teams varied greatly from team to team. Most sponsors agreed that they were well informed about their role. The roles sponsors most frequently played were to provide the teams with input and support, serve as a liaison to the community and serve as a sounding board, motivator and cheerleader. The most common challenges or barriers team sponsors faced in this role were keeping engaged in the process, adjusting to the role and feeling disconnected from the program. Practical implications This work provides insights for program developers and community foundations who are interested in building the capacity for health leadership by linking community sponsors with emerging leaders engaged in an action learning experience. Originality/value This work begins to fill a gap in the literature. The role of team sponsors has been studied for single organization work teams but there is a void of understanding about the role of sponsors with multi-organizational teams working to improve health while also learning about leadership.

  3. A community based study of failure to thrive in Israel.

    Science.gov (United States)

    Wilensky, D S; Ginsberg, G; Altman, M; Tulchinsky, T H; Ben Yishay, F; Auerbach, J

    1996-01-01

    OBJECTIVE: To examine the characteristics of infants suffering from failure to thrive in a community based cohort in Israel and to ascertain the effect of failure to thrive on their cognitive development. METHODS: By review of records maintained at maternal and child health clinics in Jerusalem and the two of Beit Shemesh, epidemiological data were obtained at age 15 months on a cohort of all babies born in 1991. For each case of failure to thrive, a matched control was selected from the same maternal and child health clinic. At age 20 months, cognitive development was measured, and at 25 months a home visit was carried out to assess maternal psychiatric status by questionnaire, and the HOME assessment was performed to assess the home environment. RESULTS: 3.9% of infants were found to have fallen below the third centile in weight for at least three months during the first year of life. Infants with failure to thrive did not differ from the general population in terms of obstetric or neonatal complications, birth order, or parents' ethnic origin, age, or years of education. The infants with failure to thrive did have lower birthweights and marginally smaller head circumferences at birth. Developmental assessment at 20 months of age showed a DQ of 99.7 v 107.2 in the matched controls, with 11.5% having a DQ below 80, as opposed to only 4.6% of the controls. No differences were found in maternal psychiatric problems as measured by a self report questionnaire. There were, however, significant differences in subscales of the HOME scale. CONCLUSIONS: (1) Infants who suffered from failure to thrive had some physiological predispositions that put them at risk; (2) failure to thrive may be an early marker of families providing suboptimal developmental stimulation. PMID:8869197

  4. Evaluation of micronutrient in soil treated with organic fertilizer

    Directory of Open Access Journals (Sweden)

    Alexandre Antonio Pasqualini

    2012-12-01

    Full Text Available Taking advantage of organic fertilizer for use in agriculture, may have beneficial effects for supplying organic matter and nutrients to the soil. The tested organic fertilizer is produced in a system of thermophilic composting of sewage sludge, the process by which it is mixed with chopped pruning urban, the crushed sugar cane and eucalyptus bark, and the mixture is subjected to aeration process revolving mechanical and oxidation promoted by an intense activity of microorganisms. The same is also additived with gypsum (Ca2SO4 in order to reduce the losses of ammonia from the process, helping to prevent odors and also attraction of vectors, besides enriching the material with calcium and sulfur, two macronutrients in plants. On the other hand the application of such compounds should be carefully monitored in order to prevent environmental risks from its use. This work aimed to evaluate the effect of rates of organic fertilizer (OF, in the Instituto de Zootecnia (IZ, in a Typic Acrudox soil, pHCaCl2= 4.9, cultivated with Aries grass (Panicum maximum, Jacq., without liming and focused in soil micronutrients contents. Treatments involved four rates of OF application: 0, 1.5, 3.0 and 4.5 t ha-1, mixed with soil before sowing the grass. The experimental design was a randomized blocks, with five replications, in pots (3.34 dm3. Soil samples were collected prior to the experiment (original soil and after cultivation of the Aries grass. Were air dried and passed through sieves with mesh size of 2 mm and analyzed chemically. The micronutrients (B, Cu, Fe and Zn – mg dm-3 were determined by atomic absorption, after extraction with a solution of DTPA, pH 7.3 (RAIJ et al., 2001. Data were analyzed by the mixed procedure of SAS V. 9.2; average qualitative treatments were compared by Tukey test at 5% probability. The degrees of freedom related to N rates (quantitative treatment were decomposed into orthogonal polynomials; to obtain the best equation fits

  5. ERICA: intake of macro and micronutrients of Brazilian adolescents

    Directory of Open Access Journals (Sweden)

    Amanda de Moura Souza

    2016-02-01

    Full Text Available ABSTRACT OBJECTIVE To describe food and macronutrient intake profile and estimate the prevalence of inadequate micronutrient intake of Brazilian adolescents. METHODS Data from 71,791 adolescents aged from 12 to 17 years were evaluated in the 2013-2014 Brazilian Study of Cardiovascular Risks in Adolescents (ERICA. Food intake was estimated using 24-hour dietary recall (24-HDR. A second 24-HDR was collected in a subsample of the adolescents to estimate within-person variability and calculate the usual individual intake. The prevalence of food/food group intake reported by the adolescents was also estimated. For sodium, the prevalence of inadequate intake was estimated based on the Tolerable Upper Intake Level (UL. The Estimated Average Requirement (EAR method used as cutoff was applied to estimate the prevalence of inadequate nutrient intake. All the analyses were stratified according to sex, age group and Brazilian macro-regions. All statistical analyses accounted for the sample weight and the complex sampling design. RESULTS Rice, beans and other legume, juice and fruit drinks, breads and meat were the most consumed foods among the adolescents. The average energy intake ranged from 2,036 kcal (girls aged from 12 to 13 years to 2,582 kcal (boy aged from14 to 17 years. Saturated fat and free sugar intake were above the maximum limit recommended ( 50.0%. Sodium intake was above the UL for more than 80.0% of the adolescents. CONCLUSIONS The diets of Brazilian adolescents were characterized by the intake of traditional Brazilian food, such as rice and beans, as well as by high intake of sugar through sweetened beverages and processed foods. This food pattern was associated with an excessive intake of sodium, saturated fatty acids and free sugar.

  6. Effect of local cultural context on the success of community-based conservation interventions.

    Science.gov (United States)

    Waylen, Kerry A; Fischer, Anke; McGowan, Philip J K; Thirgood, Simon J; Milner-Gulland, E J

    2010-08-01

    Conservation interventions require evaluation to understand what factors predict success or failure. To date, there has been little systematic investigation of the effect of social and cultural context on conservation success, although a large body of literature argues it is important. We investigated whether local cultural context, particularly local institutions and the efforts of interventions to engage with this culture significantly influence conservation outcomes. We also tested the effects of community participation, conservation education, benefit provision, and market integration. We systematically reviewed the literature on community-based conservation and identified 68 interventions suitable for inclusion. We used a protocol to extract and code information and evaluated a range of measures of outcome success (attitudinal, behavioral, ecological, and economic). We also examined the association of each predictor with each outcome measure and the structure of predictor covariance. Local institutional context influenced intervention outcomes, and interventions that engaged with local institutions were more likely to succeed. Nevertheless, there was limited support for the role of community participation, conservation education, benefit provision, and market integration on intervention success. We recommend that conservation interventions seek to understand the societies they work with and tailor their activities accordingly. Systematic reviews are a valuable approach for assessing conservation evidence, although sensitive to the continuing lack of high-quality reporting on conservation interventions.

  7. Community-based surveillance of zoonotic parasites in a 'One Health' world: A systematic review.

    Science.gov (United States)

    Schurer, J M; Mosites, E; Li, C; Meschke, S; Rabinowitz, P

    2016-12-01

    The One Health (OH) concept provides an integrated framework for observing and improving health issues involving human, animal, and environmental factors, and has been applied in particular to zoonotic disease problems. We conducted a systematic review of English and Chinese language peer-reviewed and grey literature databases to identify zoonotic endoparasite research utilizing an OH approach in community-based settings. Our review identified 32 articles where specimens collected simultaneously from all three OH domains (people, animals, and the environment) were assessed for endoparasite infection or exposure. Study sites spanned 23 countries, and research teams brought together an average of seven authors from two countries. Surveillance of blood-borne and gastrointestinal protozoa were most frequently reported (19 of 32; 59%), followed by trematodes, nematodes, and cestodes. Laboratory techniques varied greatly between studies, and only 16 identified parasites using Polymerase Chain Reaction (PCR) in all three OH domains. Our review identified important gaps in parasitology research operating under an OH framework. We recommend that investigators working in the realm of zoonotic disease strive to evaluate all three OH domains by integrating modern molecular tools as well as techniques provided by economists and social scientists.

  8. Poor micronutrient intake and status is a public health problem among adolescent Mozambican girls.

    Science.gov (United States)

    Korkalo, Liisa; Freese, Riitta; Alfthan, Georg; Fidalgo, Lourdes; Mutanen, Marja

    2015-08-01

    Micronutrient deficiencies can damage the health of adolescent girls and their offspring. There is a lack of population-based data on the micronutrient status of adolescents in Sub-Saharan Africa. We conducted a cross-sectional, population-based study to examine the biochemical status, prevalence of deficiency, dietary intake, and food sources of selected micronutrients among adolescent girls in Central Mozambique. Separate groups of study participants were recruited in 2 seasons in 2010. The participants were girls between 14 and 19 years of age (n = 551) from 1 urban area and 2 rural districts. Micronutrient status indicators were analyzed from blood and urine samples. Twenty-four-hour dietary recalls were also carried out. The overall prevalence with 95% confidence interval (calculated using sampling weights) among nonpregnant girls was 42.4% (37.2%-47.8%; n = 466) for anemia, 27.4% (23.1%-32.2%; n = 427) for low serum ferritin, 32.7% (27.7%-38.1%; n = 423) for low serum zinc, 14.7% (11.2%-19.0%; n = 426) for low plasma retinol, and 4.1% (2.9%-5.8%; n = 448) for low serum folate. The selenium status was considered sufficient. Mild to moderate iodine deficiency was found in the rural districts, whereas the iodine status of urban girls was adequate. Significantly lower serum folate concentrations were found in the urban area compared to the rural districts. The seasonal differences in vitamin A intake were significant. The intakes of micronutrients from animal source foods were small. In summary, adolescent Mozambican girls are at risk of several micronutrient deficiencies. This raises concern especially because adolescent motherhood is common in the region. Actions need to be taken to prevent and control micronutrient deficiencies. Copyright © 2015 Elsevier Inc. All rights reserved.

  9. Micronutrient recommendations and policies in Spain: the cases of iodine, folic acid and vitamin D.

    Science.gov (United States)

    Brito Garcia, N; Serra Majem, L

    2012-01-01

    INTRODUCCIÓN: As part of the work carried out within the EURopean micronutrient RECommendations Aligned (EURRECA) Network of Excellence in Spain, we conducted a series of semi-structured interviews with decision makers and relevant scientific institutions in the field of nutrition and public health. The information gathered was collated with national relevant official and unofficial documents and subsequently analysed. To describe the current situation about nutrition policy in Spain, with special focus on the process of setting micronutrient recommendations and the development of subsequent policies. 3 cases will be detailed: iodine, folic acid and vitamin D. Information from 9 interviews was contrasted with the available official and unofficial documents on micronutrients recommendations setting and subsequent policy applications to help the population to achieve their requirements. Common topics and themes were identified in the interviews and desk research. They describe a heterogenic picture of isolated initiatives and timid measures regarding micronutrients recommendations and subsequent policy instruments. Several recommendations coexist but none of them is the result of an official request by the government or competent authority. Iodine, folic acid and vitamin D represent the past, the present and the future of public health policy measures on micronutrients in Spain. Despite of some examples, there exist a need for action. Current nutrition strategies are focused on obesity, with little room for micronutrients national measures despite of the opinion of many experts. Regardless of the several nutrients recommendations coexisting nowadays in Spain, there exist the need for a coordinated action in the field of micronutrients recommendations, fostered by the health and nutrition official authorities with financial support and clear terms of reference.

  10. Addressing the risk of inadequate and excessive micronutrient intakes: traditional versus new approaches to setting adequate and safe micronutrient levels in foods

    Directory of Open Access Journals (Sweden)

    Maaike J. Bruins

    2015-01-01

    Full Text Available Fortification of foods consumed by the general population or specific food products or supplements designed to be consumed by vulnerable target groups is amongst the strategies in developing countries to address micronutrient deficiencies. Any strategy aimed at dietary change needs careful consideration, ensuring the needs of at-risk subgroups are met whilst ensuring safety within the general population. This paper reviews the key principles of two main assessment approaches that may assist developing countries in deciding on effective and safe micronutrient levels in foods or special products designed to address micronutrient deficiencies, that is, the cut-point method and the stepwise approach to risk–benefit assessment. In the first approach, the goal is to shift population intake distributions such that intake prevalences below the Estimated Average Requirement (EAR and above the Tolerable Upper Intake Level (UL are both minimized. However, for some micronutrients like vitamin A and zinc, a narrow margin between the EAR and UL exists. Increasing their intakes through mass fortification may pose a dilemma; not permitting the UL to be exceeded provides assurance about the safety within the population but can potentially leave a proportion of the target population with unmet needs, or vice versa. Risk–benefit approaches assist in decision making at different micronutrient intake scenarios by balancing the magnitude of potential health benefits of reducing inadequate intakes against health risks of excessive intakes. Risk–benefit approaches consider different aspects of health risk including severity and number of people affected. This approach reduces the uncertainty for policy makers as compared to classic cut-point methods.

  11. Effect of a micronutrient-fortified beverage on cognition and nutritional status of primary school children / C. Taljaard.

    OpenAIRE

    Taljaard, Christine

    2012-01-01

    Childhood micronutrient deficiencies have negative effects on cognition. Little is known about the effects of combined consumption of micronutrients and sugar on growth and cognitive function. The aim of this thesis was to 1) investigate the effects of micronutrients and sugar, alone and in combination, in a beverage, on growth and cognition in South African children and 2) review recent evidence on iron status and anaemia prevalence in South African children since the National Food Consu...

  12. Micronutrient malnutrition, obesity, and chronic disease in countries undergoing the nutrition transition: potential links and program/policy implications

    OpenAIRE

    Eckhardt, Cara L.

    2006-01-01

    This paper discusses the potential long-term effects of micronutrient malnutrition in early childhood on obesity and related disease outcomes. The links between early micronutrient malnutrition, stunting, and subsequent short adult stature — emerging risk factors for obesity and associated chronic diseases—are reviewed. This paper also explores recent literature linking micronutrient malnutrition in adults to increased risk and severity of chronic disease. Finally, this paper discusses the pr...

  13. Using community-based interventions to improve disease ...

    African Journals Online (AJOL)

    Department of Community Health and Primary Care, College of Medicine, University ..... Gove S. Integrated management of childhood illness by outpatient ... management guidelines for asthma and chronic heart failure, other common chronic.

  14. The Girlfriends Project: Evaluating a Promising Community-Based Intervention from a Bottom-Up Perspective

    Science.gov (United States)

    Hawk, Mary

    2015-01-01

    Randomized controlled trials are the gold standard in research but may not fully explain or predict outcome variations in community-based interventions. Demonstrating efficacy of externally driven programs in well-controlled environments may not translate to community-based implementation where resources and priorities vary. A bottom-up evaluation…

  15. Community-Based Research: From Practice to Theory and Back Again.

    Science.gov (United States)

    Stoecker, Randy

    2003-01-01

    Explores the theoretical strands being combined in community-based research--charity service learning, social justice service learning, action research, and participatory research. Shows how different models of community-based research, based in different theories of society and different approaches to community work, may combine or conflict. (EV)

  16. Community-Based Programming: An Opportunity and Imperative for the Community College.

    Science.gov (United States)

    Boone, Edgar J.

    1992-01-01

    Defines community-based programing as a cooperative process in which the community college serves as leader and catalyst in effecting collaboration among community members, leaders, and groups. Recommends 15 tasks for community college leaders involved in community-based programing, including environmental scanning and coalition building. (DMM)

  17. Community-Based Field Experiences in Teacher Education: Possibilities for a Pedagogical Third Space

    Science.gov (United States)

    Hallman, Heidi L.

    2012-01-01

    The present article discusses the importance of community-based field experiences as a feature of teacher education programs. Through a qualitative case study, prospective teachers' work with homeless youth in an after-school initiative is presented. Framing community-based field experiences in teacher education through "third space" theory, the…

  18. The science and practice of micronutrient supplementations in nutritional anemia: an evidence-based review.

    Science.gov (United States)

    Chan, Lingtak-Neander; Mike, Leigh Ann

    2014-08-01

    Nutritional anemia is the most common type of anemia, affecting millions of people in all age groups worldwide. While inadequate access to food and nutrients can lead to anemia, patients with certain health status or medical conditions are also at increased risk of developing nutritional anemia. Iron, cobalamin, and folate are the most recognized micronutrients that are vital for the generation of erythrocytes. Iron deficiency is associated with insufficient production of hemoglobin. Deficiency of cobalamin or folate leads to impaired synthesis of deoxyribonucleic acid, proteins, and cell division. Recent research has demonstrated that the status of copper and zinc in the body can significantly affect iron absorption and utilization. With an increasing number of patients undergoing bariatric surgical procedures, more cases of anemia associated with copper and zinc deficiencies have also emerged. The intestinal absorption of these 5 critical micronutrients are highly regulated and mediated by specific apical transport mechanisms in the enterocytes. Health conditions that persistently alter the histology of the upper intestinal architecture, expression, or function of these substrate-specific transporters, or the normal digestion and flow of these key micronutrients, can lead to nutritional anemia. The focus of this article is to review the science of intestinal micronutrient absorption, discuss the clinical assessment of micronutrient deficiencies in relation to anemia, and suggest an effective treatment plan and monitoring strategies using an evidence-based approach. © 2014 American Society for Parenteral and Enteral Nutrition.

  19. Phytotoxicity of carbon nanotubes in soybean as determined by interactions with micronutrients

    Energy Technology Data Exchange (ETDEWEB)

    Zaytseva, Olga, E-mail: olga.zaytseva@uni-hohenheim.de [University of Hohenheim, Institute of Crop Science (340h), Faculty of Agriculture (Germany); Wang, Zhengrui [Academia Sinica, Agricultural Biotechnology Research Center (China); Neumann, Günter [University of Hohenheim, Institute of Crop Science (340h), Faculty of Agriculture (Germany)

    2017-02-15

    Carbon nanomaterials released into the environment exert extremely variable effects on living organisms. In this study, we used soybean (Glycine max) to investigate early responses to seed exposure to multi-walled carbon nanotubes (MWCNTs, outer diameter 20–70 nm, inner diameter 5–10 nm, length of >2 μm). Soybean seeds were imbibed with deionised water (control) or MWCNT suspension (1000 mg L{sup −1}) and were analysed for MWCNT contamination using light microscopy. The seedlings vitality status was evaluated by staining with triphenyltetrazolium chloride and measurement of oxidative stress indicators in the root tissue. Micronutrient (Zn, Mn, Cu) availability in different seedling organs was assessed and the effects of antioxidants, and micronutrient supplementation was investigated. Oxidative stress induction by MWCNTs was detectable in radicle tips, coincided with MWCNTs accumulation and was reverted by external application of proline as antioxidant and micronutrients (Zn, Cu, Mn) as cofactors for various enzymes involved in oxidative stress defence. Accordingly, SOD activity increased after Zn supplementation. During germination, the MWCNT treatments reduced Zn translocation from the cotyledons to the seedling and MWCNTs exhibited adsorption potential for Zn and Cu, which may be involved in internal micronutrients immobilisation. This study demonstrates for the first time that MWCNT phytotoxicity is linked with oxidative stress-related disturbances of micronutrient homeostasis.

  20. Utilizing Dietary Micronutrient Ratios in Nutritional Research May be More Informative than Focusing on Single Nutrients

    Directory of Open Access Journals (Sweden)

    Owen J. Kelly

    2018-01-01

    Full Text Available The 2015 US dietary guidelines advise the importance of good dietary patterns for health, which includes all nutrients. Micronutrients are rarely, if ever, consumed separately, they are not tissue specific in their actions and at the molecular level they are multitaskers. Metabolism functions within a seemingly random cellular milieu however ratios are important, for example, the ratio of adenosine triphosphate to adenosine monophosphate, or oxidized to reduced glutathione. Health status is determined by simple ratios, such as the waist hip ratio, or ratio of fat mass to lean mass. Some nutrient ratios exist and remain controversial such as the omega-6/omega-3 fatty acid ratio and the sodium/potassium ratio. Therefore, examining ratios of micronutrients may convey more information about how diet and health outcomes are related. Summarized micronutrient intake data, from food only, from the National Health and Nutrition Examination Survey, were used to generate initial ratios. Overall, in this preliminary analysis dietary ratios of micronutrients showed some differences between intakes and recommendations. Principles outlined here could be used in nutritional epidemiology and in basic nutritional research, rather than focusing on individual nutrient intakes. This paper presents the concept of micronutrient ratios to encourage change in the way nutrients are regarded.

  1. Characterization of nutrient deficiency in Hancornia speciosa Gomes seedlings by omitting micronutrients from the nutrient solution

    Directory of Open Access Journals (Sweden)

    Layara Alexandre Bessa

    2013-06-01

    Full Text Available Hancornia speciosa Gomes (Mangaba tree is a fruit tree belonging to the Apocynaceae family and is native to Brazil. The production of seedlings of this species is limited by a lack of technical and nutritional expertise. To address this deficiency, this study aimed to characterize the visual symptoms of micronutrient deficiency and to assess growth and leaf nutrient accumulation in H. speciosa seedlings supplied with nutrient solutions that lack individual micronutrients. H. speciosa plants were grown in nutrient solution in a greenhouse according to a randomized block design, with four replicates. The treatments consisted of a group receiving complete nutrient solution and groups treated with a nutrient solution lacking one of the following micronutrients: boron (B, copper (Cu, iron (Fe, manganese (Mn, zinc (Zn, and molybdenum (Mo. The visual symptoms of nutrient deficiency were generally easy to characterize. Dry matter production was affected by the omission of micronutrients, and the treatment lacking Fe most limited the stem length, stem diameter, root length, and number of leaves in H. speciosa seedlings as well as the dry weight of leaves, the total dry weight, and the relative growth in H. speciosa plants. The micronutrient contents of H. speciosa leaves from plants receiving the complete nutrient solution treatment were, in decreasing order, Fe>Mn>Cu>Zn>B.

  2. Effect of micronutrient supplement on health and nutritional status of schoolchildren: mental function.

    Science.gov (United States)

    Vazir, Shahnaz; Nagalla, Balakrishna; Thangiah, Vijayapushpam; Kamasamudram, Vijayaraghavan; Bhattiprolu, Sivakumar

    2006-01-01

    We evaluated the effect of a micronutrient-fortified beverage on mental function in schoolchildren. This double-blind, placebo-controlled, matched-pair, cluster, randomized feeding trial assessed baseline before supplementation and after 14 mo in a cohort of 608 children aged 6 to 15 y who received a micronutrient-fortified beverage or placebo. Children in two classes (clusters) in each of nine grades were assessed for intelligence, attention and concentration, memory, and school achievement. Mean intelligence quotient scores of the micronutrient-fortified beverage group and the placebo group at baseline and final follow-up were not significantly different. Mean verbal and performance scores and increments were also not different. After supplementation, attention-concentration increment scores of the micronutrient group were significantly higher (P < 0.05) than those of the placebo group. Mean and incremental scores of the supplemented group on the memory scale were not significantly different from those of the placebo group. Supplementation with a beverage fortified with a range of micronutrients significantly improved attention-concentration over 14 mo, but not intelligence quotient, memory, or school achievement among middle-income schoolchildren.

  3. Phytotoxicity of carbon nanotubes in soybean as determined by interactions with micronutrients

    International Nuclear Information System (INIS)

    Zaytseva, Olga; Wang, Zhengrui; Neumann, Günter

    2017-01-01

    Carbon nanomaterials released into the environment exert extremely variable effects on living organisms. In this study, we used soybean (Glycine max) to investigate early responses to seed exposure to multi-walled carbon nanotubes (MWCNTs, outer diameter 20–70 nm, inner diameter 5–10 nm, length of >2 μm). Soybean seeds were imbibed with deionised water (control) or MWCNT suspension (1000 mg L"−"1) and were analysed for MWCNT contamination using light microscopy. The seedlings vitality status was evaluated by staining with triphenyltetrazolium chloride and measurement of oxidative stress indicators in the root tissue. Micronutrient (Zn, Mn, Cu) availability in different seedling organs was assessed and the effects of antioxidants, and micronutrient supplementation was investigated. Oxidative stress induction by MWCNTs was detectable in radicle tips, coincided with MWCNTs accumulation and was reverted by external application of proline as antioxidant and micronutrients (Zn, Cu, Mn) as cofactors for various enzymes involved in oxidative stress defence. Accordingly, SOD activity increased after Zn supplementation. During germination, the MWCNT treatments reduced Zn translocation from the cotyledons to the seedling and MWCNTs exhibited adsorption potential for Zn and Cu, which may be involved in internal micronutrients immobilisation. This study demonstrates for the first time that MWCNT phytotoxicity is linked with oxidative stress-related disturbances of micronutrient homeostasis.

  4. Micronutrient Composition of 35 Food Fishes from India and Their Significance in Human Nutrition.

    Science.gov (United States)

    Mohanty, Bimal P; Sankar, T V; Ganguly, Satabdi; Mahanty, Arabinda; Anandan, R; Chakraborty, Kajal; Paul, B N; Sarma, Debajit; Dayal, J Syama; Mathew, Suseela; Asha, K K; Mitra, Tandrima; Karunakaran, D; Chanda, Soumen; Shahi, Neetu; Das, Puspita; Das, Partha; Akhtar, Md Shahbaz; Vijayagopal, P; Sridhar, N

    2016-12-01

    The micronutrients (vitamins and minerals) are required in small amounts but are essential for health, development, and growth. Micronutrient deficiencies, which affect over two billion people around the globe, are the leading cause of many ailments including mental retardation, preventable blindness, and death during childbirth. Fish is an important dietary source of micronutrients and plays important role in human nutrition. In the present investigation, micronutrient composition of 35 food fishes (includes both finfishes and shellfishes) was investigated from varying aquatic habitats. Macrominerals (Na, K, Ca, Mg) and trace elements (Fe, Cu, Zn, Mn, Se) were determined by either atomic absorption spectroscopy (AAS) or inductively coupled plasma mass spectrometry (ICP-MS)/atomic emission spectrometry (ICP-AES). Phosphorus content was determined either spectrophotometrically or by ICP-AES. Fat-soluble vitamins (A, D, E, K) were analyzed by high-performance liquid chromatography (HPLC). The analysis showed that, in general, the marine fishes were rich in sodium and potassium; small indigenous fishes (SIFs) in calcium, iron, and manganese; coldwater fishes in selenium; and the brackishwater fishes in phosphorous. The marine fishes Sardinella longiceps and Epinephelus spp. and the SIFs were rich in all fat-soluble vitamins. All these recommendations were made according to the potential contribution (daily value %) of the species to the recommended daily allowance (RDA). Information on the micronutrients generated would enhance the utility of fish in both community and clinical nutrition.

  5. Dietary modifications to improve micronutrient status of Indian children and adolescents with type 1 diabetes.

    Science.gov (United States)

    Parthasarathy, Lavanya S; Chiplonkar, Shashi A; Khadilkar, Anuradha V; Khadilkar, Vaman V

    2015-01-01

    Diet plays a crucial role for maintaining normal growth and development while optimizing glycemic control in children with diabetes. Dietary restrictions, in a diabetic child's diet may lead to micronutrient deficiencies. To examine dietary nutritional deficiencies of Asian Indian children with Type 1 diabetes mellitus and develop micronutrient-rich recipes suitable for them. Anthropometry, diet (3-day recall) of 70 children with diabetes (24 boys) was recorded. Daily nutrient intakes and nutrient content of recipes were estimated using CDIET version 2.0. Mean intake amongst children for energy was 79% of Indian Recommended Dietary Allowance (RDA), protein was 105% RDA, but fat intakes were high (143% RDA). Mean intakes of riboflavin, β carotene, zinc, iron were less than 50%, and thiamin and calcium were around 60% RDA suggesting a possible multiple micronutrient deficiency. Based on popularly consumed snacks, 20 healthy recipes were devised that can be incorporated in children's diet. Mean energy content of new recipes was similar to routine snacks (281±28 kcal/100 g vs 306±27 kcal/100 g cooked weight). However, the mean vitamin and mineral content of new recipes was significantly higher (pcontent (zinc, calcium and iron) and twofold increase in total vitamin content (β carotene, vitamin C, vitamin B-1, B-2, and B-3) in new recipes compared with the routine snacks. Multiple dietary micronutrient deficiencies are observed in diabetic children. Addition of newly developed recipes in their everyday diet may help to enhance micronutrient intakes without increasing their energy load.

  6. Wiisokotaatiwin: development and evaluation of a community-based palliative care program in Naotkamegwanning First Nation.

    Science.gov (United States)

    Nadin, Shevaun; Crow, Maxine; Prince, Holly; Kelley, Mary Lou

    2018-04-01

    summarized using descriptive statistics. An inductive approach was used to identify themes in the qualitative data related to the evaluation questions. The findings demonstrated the program was implemented as intended, and that there was a need for the program, with six clients on the 10-month pilot. The findings also indicated achievement of program-level outcomes and progress toward system-level outcomes. Clients/families and healthcare providers were satisfied with the program and perceived it to be meeting its objectives. The program model was also perceived to be transferrable to other First Nations communities. The results demonstrate how a rural First Nations community can build capacity and develop a palliative care program tailored to their unique culture and context that builds upon and is integrated into existing services. The Wiisokotaatiwin Program allowed community members to receive their palliative care at home, improved client experience and enhanced service integration. This article provides a First Nations specific model for a palliative care program that overcomes jurisdictional issues at the local level, and a methodology for developing and evaluating community-based palliative care programs in rural First Nations communities. The article demonstrates how local, federal and provincial healthcare providers and organizations collaborated to build capacity, fund and deliver community-based palliative care. The described process of developing the program has applicability in other First Nations (Indigenous) communities and for healthcare decisionmakers.

  7. The effects of regular consumption of a multiple micronutrient fortified milk beverage on the micronutrient status of school children and on their mental and physical performance.

    Science.gov (United States)

    Kuriyan, Rebecca; Thankachan, Prashanth; Selvam, Sumithra; Pauline, Maria; Srinivasan, K; Kamath-Jha, Shilpa; Vinoy, Sophie; Misra, Situn; Finnegan, Yvonne; Kurpad, Anura V

    2016-02-01

    Multiple micronutrient deficiencies exist in school going children in India and bridging the gap between nutrient intake and requirements is an effective way to combat the deficiencies. This study aimed to test the effect of a multi-micronutrient fortified malt and cocoa based milk beverage on the micronutrient status, cognition, physical performance and nutritional deficiencies of 7-10 years old south Indian children. A randomized, double blind placebo controlled study design was used with normal healthy children from low to middle income families, aged 7-10 years randomly assigned to receive either a multi-micronutrient fortified or an unfortified milk based control drink. The drinks were provided 6 days/week for 5 months. Assessments included anthropometry, blood biochemistry, physical performance and cognition at baseline and endline. The baseline characteristics of the study groups were similar. The changes in body weight and height were similar between the groups at the end of the study. Levels of vitamin B12, red cell folate and vitamin B2 significantly improved in the intervention group, while vitamin D, selenium and body iron showed no difference. The Hemoglobin (Hb) and serum ferritin levels of the control group decreased at endline, while those in the intervention group maintained their levels. The serum transferrin receptor levels increased in both the groups. The prevalence of iron deficiency and Vitamin B2 deficiency were significantly lower in the intervention group at endline. Overall improvement in cognitive and physical performance was seen in both the groups at endline, with no significant differences between the groups. The micronutrient fortified milk based drink was efficacious in improving the micronutrient status of Vitamin B2, Vitamin B12 and red cell folate and in preventing a decline in Hb level compared to an unfortified milk based drink. It also reduced anemia and the risk of deficiencies of iron, and B12, in apparently healthy children

  8. A Community-Based Approach to Leading the Nation in Smart Energy Use

    Energy Technology Data Exchange (ETDEWEB)

    None, None

    2013-12-31

    Project Objectives The AEP Ohio gridSMART® Demonstration Project (Project) achieved the following objectives: • Built a secure, interoperable, and integrated smart grid infrastructure in northeast central Ohio that demonstrated the ability to maximize distribution system efficiency and reliability and consumer use of demand response programs that reduced energy consumption, peak demand, and fossil fuel emissions. • Actively attracted, educated, enlisted, and retained consumers in innovative business models that provided tools and information reducing consumption and peak demand. • Provided the U.S. Department of Energy (DOE) information to evaluate technologies and preferred smart grid business models to be extended nationally. Project Description Ohio Power Company (the surviving company of a merger with Columbus Southern Power Company), doing business as AEP Ohio (AEP Ohio), took a community-based approach and incorporated a full suite of advanced smart grid technologies for 110,000 consumers in an area selected for its concentration and diversity of distribution infrastructure and consumers. It was organized and aligned around: • Technology, implementation, and operations • Consumer and stakeholder acceptance • Data management and benefit assessment Combined, these functional areas served as the foundation of the Project to integrate commercially available products, innovative technologies, and new consumer products and services within a secure two-way communication network between the utility and consumers. The Project included Advanced Metering Infrastructure (AMI), Distribution Management System (DMS), Distribution Automation Circuit Reconfiguration (DACR), Volt VAR Optimization (VVO), and Consumer Programs (CP). These technologies were combined with two-way consumer communication and information sharing, demand response, dynamic pricing, and consumer products, such as plug-in electric vehicles and smart appliances. In addition, the Project

  9. Developing a community-based flood resilience measurement standard

    Science.gov (United States)

    Keating, Adriana; Szoenyi, Michael; Chaplowe, Scott; McQuistan, Colin; Campbell, Karen

    2015-04-01

    Given the increased attention to resilience-strengthening in international humanitarian and development work, there has been concurrent interest in its measurement and the overall accountability of "resilience strengthening" initiatives. The literature is reaching beyond the polemic of defining resilience to its measurement. Similarly, donors are increasingly expecting organizations to go beyond claiming resilience programing to measuring and showing it. However, key questions must be asked, in particular "Resilience of whom and to what?". There is no one-size-fits-all solution. The approach to measuring resilience is dependent on the audience and the purpose of the measurement exercise. Deriving a resilience measurement system needs to be based on the question it seeks to answer and needs to be specific. This session highlights key lessons from the Zurich Flood Resilience Alliance approach to develop a flood resilience measurement standard to measure and assess the impact of community based flood resilience interventions, and to inform decision-making to enhance the effectiveness of these interventions. We draw on experience in methodology development to-date, together with lessons from application in two case study sites in Latin America. Attention will be given to the use of a consistent measurement methodology for community resilience to floods over time and place; challenges to measuring a complex and dynamic phenomenon such as community resilience; methodological implications of measuring community resilience versus impact on and contribution to this goal; and using measurement and tools such as cost-benefit analysis to prioritize and inform strategic decision making for resilience interventions. The measurement tool follows the five categories of the Sustainable Livelihoods Framework and the 4Rs of complex adaptive systems - robustness, rapidity, redundancy and resourcefulness -5C-4R. A recent white paper by the Zurich Flood Resilience Alliance traces the

  10. Adsorption and release of micronutrients by humin extracted from peat samples

    Energy Technology Data Exchange (ETDEWEB)

    Goveia, Danielle; Melo, Camila de A.; Oliveira, Lilian K. de; Rocha, Julio Cesar [Universidade Estadual Paulista Julio de Mesquita Filho (UNESP), Araraquara, SP (Brazil). Instituto de Quimica; Fraceto, Leonardo F.; Rosa, Andre Henrique, E-mail: ahrosa@sorocaba.unesp.br [Universidade Estadual Paulista Julio de Mesquita Filho (UNESP), Sorocaba, SP (Brazil). Departamento de Engenharia Ambiental; Dias Filho, Newton Luiz [Universidade Estadual Paulista Julio de Mesquita Filho (UNESP), Ilha Solteira, SP (Brazil). Departamento de Fisica e Quimica

    2013-05-15

    The objective of this work was to investigate the adsorption of micronutrients in humin and to verify the ability to release these elements in water. The first step was to determine the adsorption capacity of humin for several essential plant micronutrients and check the kinetic parameters. The order of adsorption was Zn < Ni < Co < Mn < Mo < Cu < Fe, whereas Zn showed maximum values of ca. 2.5 mg g-1 and Fe values of ca. 0.5 mg g-1 for systems containing 1 g of humin. Iron presented higher percentages of release (ca. 100%) and Co the lowest percentages (0.14%). The findings suggested that the use of humin enriched with micronutrients can be a promising alternative for the fertilization of agricultural soils, with the additional benefit of incorporating organic matter present in the form of humic substances into the soil and improving the agricultural productivity. (author)

  11. Micronutrient deficiencies in early childhood can lower a country's GDP: The Myanmar example.

    Science.gov (United States)

    Win, Aung Zaw

    2016-01-01

    Myanmar (Burma) is a developing country in South East Asia. While Myanmar is among the 20 countries where 80% of the world's malnourished children live, its military consumes the majority of the national budget. Children who are malnourished between conception and age two are at high risk for impaired physical and mental development, which adversely affects the country's productivity and growth. Myanmar is facing three major micronutrient deficiencies which are iodine, iron and vitamin A deficiencies. The three micronutrient deficiencies can cost about 2.4% of the country's GDP. Children are the future of Myanmar and persistent micronutrient deficiencies will hamper its economic growth and lower its GDP. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Modifiers of the effect of maternal multiple micronutrient supplementation on stillbirth, birth outcomes, and infant mortality

    DEFF Research Database (Denmark)

    Smith, Emily R; Shankar, Anuraj H; Wu, Lee S-F

    2017-01-01

    -analysis of individual patient included data from 17 randomised controlled trials done in 14 low-income and middle-income countries, which compared multiple micronutrient supplements containing iron-folic acid versus iron-folic acid alone in 112 953 pregnant women. We generated study-specific estimates and pooled...... subgroup estimates using fixed-effects models and assessed heterogeneity between subgroups with the χ(2) test for heterogeneity. We did sensitivity analyses using random-effects models, stratifying by iron-folic acid dose, and exploring individual study effect. FINDINGS: Multiple micronutrient supplements...... containing iron-folic acid provided significantly greater reductions in neonatal mortality for female neonates compared with male neonates than did iron-folic acid supplementation alone (RR 0·85, 95% CI 0·75-0·96 vs 1·06, 0·95-1·17; p value for interaction 0·007). Multiple micronutrient supplements resulted...

  13. Multivitamin/mineral supplement contribution to micronutrient intakes in the United States, 2007-2010.

    Science.gov (United States)

    Wallace, Taylor C; McBurney, Michael; Fulgoni, Victor L

    2014-01-01

    Multivitamin/mineral (MVMM) supplements are the most common dietary supplements consumed in the United States; however, intake data specific to how MVMM use contributes to micronutrient intakes among Americans are absent from the current scientific literature. This analysis aimed to assess contributions of micronutrients to usual intakes derived from MVMM supplements and to compare those intakes to the dietary reference intakes for US residents aged ≥ 4 years according to the National Health and Nutrition Examination Survey (NHANES) 2007-2010 (n = 16,444). We used the National Cancer Institute method to assess usual intakes of 21 micronutrients. Our results showed that 51% of Americans consumed MVMM supplements containing ≥ 9 micronutrients. Large portions of the population had total usual intakes (food and MVMM supplement use) below the estimated average requirement for vitamins A (35%), C (31%), D (74%), and E (67%) as well as calcium (39%) and magnesium (46%). Only 0%, 8%, and 33% of the population had total usual intakes of potassium, choline, and vitamin K above the adequate intake when food and MVMM use was considered. The percentage of the population with total intakes greater than the tolerable upper intake level (UL) was very low for all nutrients; excess intakes of zinc were the highest (3.5%) across the population of all of the nutrients assessed in NHANES. In large proportions of the population, micronutrient sufficiency is currently not being achieved through food solutions for several essential vitamins and minerals. Use of age- and gender-specific MVMM supplements may serve as a practical means to increase the micronutrient status in subpopulations of Americans while not increasing intakes above the UL.

  14. Food Group and Micronutrient Intake Adequacy among Children, Adults and Elderly Women in Greece

    Directory of Open Access Journals (Sweden)

    Yannis Manios

    2015-03-01

    Full Text Available The aim of the present study was to record the percentage of children, adults and elderly women in Greece meeting food and micronutrient intake recommendations. Additionally, the present study was aiming to identify the main food contributors of micronutrient intakes and assess the degree up to which meeting food intake recommendations also ensures micronutrient intake adequacy. Dietary intake data from three studies conducted in Greece (on 9–13-year-old children; 40–60-year-old adults; and 50–75-year-old women were used to estimate mean intakes, the percentages of subjects meeting food and nutrient intake recommendations and the contribution of six core food groups to nutrient intake adequacy. The present study showed that more than 50% of children, adults and elderly women were failing to consume the recommended portions of vegetables, dairy and grains. Furthermore, children and adults consuming the recommended portions of individual core food groups had significantly lower percentages of inadequate micronutrient intakes compared to their counterparts not meeting food intake recommendations (p < 0.05. Nevertheless, even among those consuming the recommended portions from a specific core food group, the recommended intake of the corresponding micronutrient (for which this food group is the main contributor was not always met. Indicatively, 18.2%–44.1% and 4.2%–7.0% of the populations under study were not meeting calcium and vitamin C intake recommendations, although they were consuming the recommended portions of dairy and fruits, respectively. In conclusion, these findings highlight the importance for public health policy makers to take all necessary initiatives to support the population in achieving the recommended intakes from all core food groups, but also emphasize on food variety to ensure adequate intake for all micronutrients.

  15. A virtue ethics guide to best practices for community-based participatory research.

    Science.gov (United States)

    Schaffer, Marjorie A

    2009-01-01

    Rule ethics, or principled thinking, is important in the analysis of risks and benefits of research and informed consent, but is not completely adequate for guiding ethical responses to communities as research participants and collaborators. Virtue ethics theory can be used to guide actions in relationships, which are foundational to the implementation of community-based participatory research (CBPR). Virtues are strengths of character that contribute to a life of flourishing or well-being for individuals and communities. This article provides an overview of virtue ethics theory, identifies common ethical problems in CBPR, and discusses how professional virtues can be used to guide ethical research practice. The virtues of compassion, courage, honesty, humility, justice, and practical reasoning are defined and applied to ethical practice in the development, implementation, and dissemination of CBPR. Best practices for CBPR that consider the well-being of communities are identified. The virtues of compassion and humility foster inclusiveness and integration of community perspectives in research collaboration. Courage requires researchers to step out of the research safety-net to listen to community member voices and wisdom and share power in research decisions. Honesty requires researchers to communicate realistic expectations for research outcomes, share all findings with the community, and consider community perspectives in research dissemination. Systematic involvement of the community in all steps of the research process represents the virtue of practical reasoning. From a justice perspective, CBPR aims to restore communities rather than take from them.

  16. Community based adaptation options for climate change impacts on water resources: The case of Jordan

    Directory of Open Access Journals (Sweden)

    Hammouri Nezar

    2015-09-01

    Full Text Available A strategic vision to ensure an adequate, safe and secure drinking water supply presents a challenge, particularly for such a small country as Jordan, faced with a critical supply-demand imbalance and a high risk of water quality deterioration. In order to provide sustainable and equitable long-term water management plans for the future, current and future demands, along with available adaptation options should be assessed through community engagement. An analysis of available water resources, existing demands and use per sector served to assess the nation’s historic water status. Taking into account the effect of both population growth and rainfall reduction, future per sector demands were predicted by linear temporal trend analysis. Water sector vulnerability and adaptation options were assessed by engaging thirty five stakeholders. A set of weighed-criterions were selected, adopted, modified, and then framed into comprehensive guidelines. A quantitative ratio-level approach was used to quantify the magnitude and likelihood of risks and opportunities associated with each proposed adaptation measure using the level of effectiveness and severity status. Prioritization indicated that public awareness and training programs were the most feasible and effective adaptation measures, while building new infrastructure was of low priority. Associated barriers were related to a lack of financial resources, institutional arrangements, and data collection, sharing, availability, consistency and transparency, as well as willingness to adapt. Independent community-based watershed-vulnerability analyses to address water integrity at watershed scale are recommended.

  17. Enhancing community based health programs in Iran: a multi-objective location-allocation model.

    Science.gov (United States)

    Khodaparasti, S; Maleki, H R; Jahedi, S; Bruni, M E; Beraldi, P

    2017-12-01

    Community Based Organizations (CBOs) are important health system stakeholders with the mission of addressing the social and economic needs of individuals and groups in a defined geographic area, usually no larger than a county. The access and success efforts of CBOs vary, depending on the integration between health care providers and CBOs but also in relation to the community participation level. To achieve widespread results, it is important to carefully design an efficient network which can serve as a bridge between the community and the health care system. This study addresses this challenge through a location-allocation model that deals with the hierarchical nature of the system explicitly. To reflect social welfare concerns of equity, local accessibility, and efficiency, we develop the model in a multi-objective framework, capturing the ambiguity in the decision makers' aspiration levels through a fuzzy goal programming approach. This study reports the findings for the real case of Shiraz city, Fars province, Iran, obtained by a thorough analysis of the results.

  18. Community-based counselors' interventions for elementary school-age children coping with trauma.

    Science.gov (United States)

    Nabors, Laura; Baker-Phibbs, Christina; Woodson, Kenneth

    2016-01-01

    Child trauma is a mental health concern and more information is needed about treatment in community mental health settings. This article presents results of a focus group and member checking sessions held with counselors who provided therapy for children experiencing posttraumatic stress disorder in a community-based setting. Results indicated that play and art techniques were commonly used during individual child therapy sessions. Sessions were child-directed and allowed children to review trauma experiences in a "safe" setting with an "expert" guide. Several themes were commonly addressed in sessions including opportunities to re-experience, release, and reorganize the trauma, building resilience or self-esteem for the child, promoting safety, and helping the child to regulate emotional reactions and behavior problems. Counselors focused on discussing ways to interact with the child to promote healing and there was a belief that children would return to a positive developmental trajectory after coping with traumatic experiences. Future research needs to address what works for whom, in terms of what interventions are useful in child-directed counseling sessions for children who have experienced specific types of trauma, such as sexual and physical abuse or witnessing domestic violence. Integration of knowledge from evidence-based treatments will also further inform clinical practice with children who have experienced traumatic events.

  19. Community-Based Research (CBR in the Education Doctorate: Lessons Learned and Promising Practices

    Directory of Open Access Journals (Sweden)

    Laurie Stevahn

    2016-12-01

    Full Text Available Community-based research (CBR is an advanced form of academic service-learning through which university students, faculty, and community organizations collaborate to conduct inquiry projects aimed at producing social change. Despite its potential for advancing learning in graduate studies, little research exists on CBR implementations or outcomes in doctoral programs. This study examined the effectiveness of integrating CBR into an educational leadership doctorate across three consecutive cohorts in which students worked in teams to conduct CBR projects, each in partnership with a community organization pursuing a social justice initiative. A mixed-methods developmental case study design produced quantitative and qualitative data on students’ perceived effectiveness of cooperative/collaborative interaction and team decision making in CBR, experience with and learning from CBR in the education doctorate, and development of CBR competencies. Triangulated results overall revealed students’ (a positive attitudes toward CBR, (b enhanced understanding of and commitment to CBR and how to conduct it, (c expanded understanding and application of technical research skills, (d growth in coopera-tive/collaborative and conflict resolution skills, and (e development of leadership project management skills. These findings may assist faculty in planning innovative, authentic, applied, professional training in the education doctorate capable of advancing students’ graduate inquiry skills while also enhancing competencies for successful leadership in the field.

  20. An adaptive community-based participatory approach to formative assessment with high schools for obesity intervention*.

    Science.gov (United States)

    Kong, Alberta S; Farnsworth, Seth; Canaca, Jose A; Harris, Amanda; Palley, Gabriel; Sussman, Andrew L

    2012-03-01

    In the emerging debate around obesity intervention in schools, recent calls have been made for researchers to include local community opinions in the design of interventions. Community-based participatory research (CBPR) is an effective approach for forming community partnerships and integrating local opinions. We used CBPR principles to conduct formative research in identifying acceptable and potentially sustainable obesity intervention strategies in 8 New Mexico school communities. We collected formative data from 8 high schools on areas of community interest for school health improvement through collaboration with local School Health Advisory Councils (SHACs) and interviews with students and parents. A survey based on formative results was created to assess acceptability of specific intervention strategies and was provided to SHACs. Quantitative data were analyzed using descriptive statistics while qualitative data were evaluated using an iterative analytic process for thematic identification. Key themes identified through the formative process included lack of healthy food options, infrequent curricular/extracurricular physical activity opportunities, and inadequate exposure to health/nutritional information. Key strategies identified as most acceptable by SHAC members included healthier food options and preparation, a healthy foods marketing campaign, yearly taste tests, an after-school noncompetitive physical activity program, and community linkages to physical activity opportunities. An adaptive CBPR approach for formative assessment can be used to identify obesity intervention strategies that address community school health concerns. Eight high school SHACs identified 6 school-based strategies to address parental and student concerns related to obesity. © 2012, American School Health Association.

  1. Place-power-prognosis: Community-based conservation, partnerships, and ecotourism enterprises in Namibia

    Directory of Open Access Journals (Sweden)

    Arthur Frederick Hoole

    2009-08-01

    Full Text Available Namibia’s community-based natural resource management program (CBRNM and communal conservancies have gained international acclaim for rural poverty alleviation and wildlife conservation on the commons. Community-based ecotourism enterprise development has played a central role in the generation of community revenues, employment and additional benefits. The place of community-based ecotourism enterprises in the evolution of Namibia’s conservancies is examined. A participatory rural appraisal (PRA approach was conducted in Namibia as part of recent doctoral research in 2006 and 2007, featuring participant observation, semi-structured key informant interviews and structured communal villager interviews. Findings demonstrate some tangible successes of community-based ecotourism enterprise development, as well as emerging issues in related benefits distribution and power brokering. The case of the Torra Conservancy is profiled as a leading model for success in partnerships between conservancies, as community-based conservation institutions, and tourism enterprises. The experience of Ehi-rovipuka Conservancy is also detailed, to illuminate challenges and prospects for replicating the Torra model. Power relationships between and among private enterprise, community, and the state are elucidated. Ecotourism enterprise development can contribute successfully to community-based conservation. But, issues of power sharing, governance and competition necessitate the further evolution of commons institutions to capture future, sustainable benefits from community-based conservation premised on wildlife and related ecotourism development.

  2. Role of Macronutrients and Micronutrients in DNA Damage: Results From a Food Frequency Questionnaire.

    Science.gov (United States)

    Ladeira, Carina; Carolino, Elisabete; Gomes, Manuel C; Brito, Miguel

    2017-01-01

    The links between diet and genomic instability have been under investigation for several decades, and evidence suggests a significant causal or preventive role for various dietary factors. This study investigates the influence of macronutrients (calories, protein, and glucides) and micronutrients, such as vitamins and minerals, as assessed by a food frequency questionnaire, on genotoxicity biomarkers measured by cytokinesis-blocked micronucleus assay and comet assay. The results found significant positive and negative correlations. Micronucleus frequency tends to increase with higher intake of caffeine, calcium, magnesium, zinc, and protein ( P macronutrients and micronutrients.

  3. Effects of soil applications of micro-nutrients and chelating agent citric acid on mineral nutrients in soybean seeds

    Science.gov (United States)

    Micro-nutrients deficiency in soil result in crop yield loss and poor seed quality. Correcting this deficiency is normally conducted by foliar or soil application. The objective of this research was to determine the effects of soil applications of five micro-nutrients (Mn, Cu, Zn, Mo, and B) with a ...

  4. Impact of multi-micronutrient supplementation on growth and morbidity of HIV-infected South African children

    NARCIS (Netherlands)

    Raaij, van J.M.A.; Villiers, de F.P.R.; Kok, F.J.

    2013-01-01

    Poor growth, micronutrient deficiencies and episodes of diarrhea and respiratory infections occur frequently in HIV-infected children. We investigated whether multi-micronutrient supplementation would improve the growth performance and reduce the number of episodes of diarrhea and/or of respiratory

  5. Reflections from a Creative Community-Based Participatory Research Project Exploring Health and Body Image with First Nations Girls

    Directory of Open Access Journals (Sweden)

    Jennifer M. Shea PhD

    2013-02-01

    Full Text Available In Canada, Aboriginal peoples often experience a multitude of inequalities when compared with the general population, particularly in relation to health (e.g., increased incidence of diabetes. These inequalities are rooted in a negative history of colonization. Decolonizing methodologies recognize these realities and aim to shift the focus from communities being researched to being collaborative partners in the research process. This article describes a qualitative community-based participatory research project focused on health and body image with First Nations girls in a Tribal Council region in Western Canada. We discuss our project design and the incorporation of creative methods (e.g., photovoice to foster integration and collaboration as related to decolonizing methodology principles. This article is both descriptive and reflective as it summarizes our project and discusses lessons learned from the process, integrating evaluations from the participating girls as well as our reflections as researchers.

  6. Community-based health care for indigenous women in Mexico: a qualitative evaluation.

    Science.gov (United States)

    Pelcastre-Villafuerte, Blanca; Ruiz, Myriam; Meneses, Sergio; Amaya, Claudia; Márquez, Margarita; Taboada, Arianna; Careaga, Katherine

    2014-01-06

    Indigenous women in Mexico represent a vulnerable population in which three kinds of discrimination converge (ethnicity, gender and class), having direct repercussions on health status. The discrimination and inequity in health care settings brought this population to the fore as a priority group for institutional action. The objective of this study was to evaluate the processes and performance of the "Casa de la Mujer Indígena", a community based project for culturally and linguistically appropriate service delivery for indigenous women. The evaluation summarizes perspectives from diverse stakeholders involved in the implementation of the model, including users, local authorities, and institutional representatives. The study covered five Casas implementation sites located in four Mexican states. A qualitative process evaluation focused on systematically analyzing the Casas project processes and performance was conducted using archival information and semi-structured interviews. Sixty-two interviews were conducted, and grounded theory approach was applied for data analysis. Few similarities were observed between the proposed model of service delivery and its implementation in diverse locations, signaling discordant operating processes. Evidence gathered from Casas personnel highlighted their ability to detect obstetric emergencies and domestic violence cases, as well as contribute to the empowerment of women in the indigenous communities served by the project. These themes directly translated to increases in the reporting of abuse and referrals for obstetric emergencies. The model's cultural and linguistic competency, and contributions to increased referrals for obstetric emergencies and abuse are notable successes. The flexibility and community-based nature of the model has allowed it to be adapted to the particularities of diverse indigenous contexts. Local, culturally appropriate implementation has been facilitated by the fact that the Casas have been

  7. Evaluation of community-based oral health promotion and oral disease prevention--WHO recommendations for improved evidence in public health practice

    DEFF Research Database (Denmark)

    Petersen, Poul Erik; Kwan, Stella

    2004-01-01

    Systematic evaluation is an integral part of the organisation and delivery of community oral health care programmes, ensuring the effectiveness of these community-based interventions. As for general health promotion programmes the common problems from effectiveness reviews of oral health...... a challenge to oral health professionals to integrate community oral health programmes into a wider health agenda. Public health research focusing on the development of evaluation methodologies has identified a variety of issues including the importance of using pluralistic evaluation approaches (quantitative...... of the evaluation of oral health promotion and oral disease prevention programmes. The aims of the workshop were to: (1) identify common problems and challenges in evaluating community-based oral health interventions; (2) explore developments in the evaluation approaches in public health; (3) share experiences...

  8. Collaborating while competing? The substainability of community-based integrated care initiatives through a health partnership.

    NARCIS (Netherlands)

    Plochg, T.; Delnoij, D.M.J.; Hoogedoorn, N.P.C.; Klazinga, N.S.

    2006-01-01

    BACKGROUND: To improve health-care delivery, care providers must base their services on community health needs and create a seamless continuum of care in which these needs can be met. Though, it is not obvious that providers apply this vision. Experiments with regulated competition in the health

  9. Collaborating while competing? The sustainability of community-based integrated care initiatives through a health partnership

    NARCIS (Netherlands)

    Plochg, Thomas; Delnoij, Diana M. J.; Hoogedoorn, Nelleke P. C.; Klazinga, Niek S.

    2006-01-01

    BACKGROUND: To improve health-care delivery, care providers must base their services on community health needs and create a seamless continuum of care in which these needs can be met. Though, it is not obvious that providers apply this vision. Experiments with regulated competition in the health

  10. Collaborating while competing? The sustainability of community-based integrated care initiatives through a health partnership

    NARCIS (Netherlands)

    Plochg, T.; Delnoij, D.M.J.; Hoogedoorn, N.P.C.; Klazinga, N.S.

    2006-01-01

    Background: To improve health-care delivery, care providers must base their services on community health needs and create a seamless continuum of care in which these needs can be met. Though, it is not obvious that providers apply this vision. Experiments with regulated competition in the health

  11. Contribution made by biomarkers of status to an FP6 Network of Excellence, EURopean micronutrient RECommendations Aligned (EURRECA).

    Science.gov (United States)

    Fairweather-Tait, Susan J

    2011-08-01

    Dietary reference values for micronutrients vary considerably among countries, and harmonization is needed to facilitate nutrition policy and public health strategies at the European and global levels. The EURopean micronutrient RECommendations Aligned (EURRECA) Network of Excellence is developing generic instruments for systematically deriving and updating micronutrient reference values and dietary recommendations. These include best practice guidelines, interlinked web pages, online databases, and decision trees. Journal supplements have been published on micronutrient intakes and status, and an ongoing activity of EURRECA is the completion of systematic reviews on associations between intakes, status, and various health outcomes for priority micronutrients (ie, iron, zinc, folate, vitamin B-12, and iodine), which were selected by using a triage technique. Future activities include meta-analyses to identify dose-response relations and the variability, factorial estimates of requirements, bioavailability from whole diets, effects of genotype, and modeling techniques for addressing dietary recommendations for combinations of nutrients with common health endpoints.

  12. How do Policy and Institutional Settings Shape Opportunities for Community-Based Primary Health Care? A Comparison of Ontario, Québec and New Zealand

    Directory of Open Access Journals (Sweden)

    Tim Tenbensel

    2017-06-01

    Full Text Available Community-based primary health care describes a model of service provision that is oriented to the population health needs and wants of service users and communities, and has particular relevance to supporting the growing proportion of the population with multiple chronic conditions. Internationally, aspirations for community-based primary health care have stimulated local initiatives and influenced the design of policy solutions. However, the ways in which these ideas and influences find their way into policy and practice is strongly mediated by policy settings and institutional legacies of particular jurisdictions. This paper seeks to compare the key institutional and policy features of Ontario, Québec and New Zealand that shape the ‘space available’ for models of community-based primary health care to take root and develop. Our analysis suggests that two key conditions are the integration of relevant health and social sector organisations, and the range of policy levers that are available and used by governments. New Zealand has the most favourable conditions, and Ontario the least favourable. All jurisdictions, however, share a crucial barrier, namely the ‘barbed-wire fence’ that separates funding of medical and ‘non-medical’ primary care services, and the clear interests primary care doctors have in maintaining this fence. Moves in the direction of system-wide community-based primary health care require a gradual dismantling of this fence.

  13. Effects of a parenting intervention to address maternal psychological wellbeing and child development and growth in rural Uganda: a community-based, cluster-randomised trial

    OpenAIRE

    Dr. Daisy R Singla, PhD; Elias Kumbakumba, MMed; Prof. Frances E Aboud, PhD

    2015-01-01

    Background: Parenting interventions have been implemented to improve the compromised developmental potential among 39% of children younger than 5 years living in low-income and middle-income countries. Maternal wellbeing is important for child development, especially in children younger than 3 years who are vulnerable and dependent on their mothers for nutrition and stimulation. We assessed an integrated, community-based parenting intervention that targeted both child development and maternal...

  14. Evolving hunting practices in Gabon: lessons for community-based conservation interventions

    Directory of Open Access Journals (Sweden)

    Gretchen Walters

    2015-12-01

    Full Text Available Addressing today's environmental challenges is intimately linked to understanding and improving natural resource governance institutions. As a result conservation initiatives are increasingly realizing the importance of integrating local perspectives of land tenure arrangements, natural resource rights, and local beliefs into conservation approaches. However, current work has not sufficiently considered the dynamic nature of natural resource governance institutions over time and the potential implications for current conservation interventions. We therefore explored how and why hunting governance has changed since the precolonial period in two ethnic hunting communities in Gabon, Central Africa, integrating various ethnographic methods with resource-use mapping, and a historic literature review. In both communities, hunting governance has undergone significant changes since the precolonial period. A closed-access, lineage-based system of resource use with strict penalties for trespassing, has evolved into a more open-access system, in which the influence of customary governance systems, including magico-political aspects, has declined. These changes have occurred mainly in response to policies and governance structures put in place by the colonial government and postindependence, early state laws. This included a policy of merging villages, the introduction of more modern hunting techniques such as guns and wire cables, and a shift from community to government ownership of the land. Current governance structures are thus the product of a complex mixture of customary, colonial and state influences. These findings suggest that a historical perspective of resource governance, gained through in-depth and long-term engagement with local communities, can provide important insights for community-based conservation approaches, such as helping to identify potential causes and perceptions of environmental change and to design more suitable conservation

  15. Expert meeting on Child Growth and Micronutrient Deficiencies--New Initiatives for Developing Countries to Achieve Millennium Development Goals: executive summary report.

    Science.gov (United States)

    Usfar, Avita A; Achadi, Endang L; Martorell, Reynaldo; Hadi, Hamam; Thaha, Razak; Jus'at, Idrus; Atmarita; Martianto, Drajat; Ridwan, Hardinsyah; Soekirman

    2009-01-01

    Undernutrition in early childhood has long-term physical and intellectual consequences. Improving child growth should start before the age of two years and be an integrated effort between all sectors, covering all aspects such as diet and nutrient intake, disease reduction, optimum child care, and improved environmental sanitation. To discuss these issues, the Indonesian Danone Institute Foundation organized an expert meeting on Child Growth and Micronutrient Deficiencies: New Initiatives for Developing Countries to Achieve Millennium Development Goals. The objective of the meeting was to have a retrospective view on child growth: lessons learned from programs to overcome under-nutrition in the developed countries and to relate the situation to the Indonesian context, as well as to discuss implications for future programs. Recommendations derived from the meeting include focus intervention on the window of opportunity group, re-activation of the Integrated Health Post at the village level, improvement of infant and young child feeding, expand food fortification intervention programs, strengthen supplementation programs with multi-micronutrient, and strengthening public and private partnership on food related programs.

  16. A student-facilitated community-based support group initiative for ...

    African Journals Online (AJOL)

    A student-facilitated community-based support group initiative for Mental Health ... was a collaborative partnership between a local University Psychology Department ... users, Rehabilitation, Primary Health Care, Social support, Stigmatisation ...

  17. Community Based Social Audit of Health Services in Two Districts of ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Community Based Social Audit of Health Services in Two Districts of ... The health system in Afghanistan has been chronically neglected during decades of war ... Organization for Women in Science for the Developing World (OWSD), IDRC is ...

  18. Indonesia - Green Prosperity: Community-Based Off-Grid Renewable Energy Grant Portfolio

    Data.gov (United States)

    Millennium Challenge Corporation — Taken as a whole, this evaluation aims, to the extent possible, to validate the program logic underlying the portfolio of community-based off-grid renewable energy...

  19. Effectiveness of community-based mangrove management for sustainable resource use and livelihood support

    NARCIS (Netherlands)

    Damastuti, Ekaningrum; Groot, de Dolf

    2017-01-01

    Community-Based Mangrove Management (CBMM) is implemented with different approaches and outcomes. This study examined the effectiveness of various CBMM practices to achieve sustainable management of mangrove resources. We analyzed local mangrove resource management strategies in four coastal

  20. Community-based organizations in the health sector: A scoping review

    Directory of Open Access Journals (Sweden)

    Wilson Michael G

    2012-11-01

    Full Text Available Abstract Community-based organizations are important health system stakeholders as they provide numerous, often highly valued programs and services to the members of their community. However, community-based organizations are described using diverse terminology and concepts from across a range of disciplines. To better understand the literature related to community-based organizations in the health sector (i.e., those working in health systems or more broadly to address population or public health issues, we conducted a scoping review by using an iterative process to identify existing literature, conceptually map it, and identify gaps and areas for future inquiry. We searched 18 databases and conducted citation searches using 15 articles to identify relevant literature. All search results were reviewed in duplicate and were included if they addressed the key characteristics of community-based organizations or networks of community-based organizations. We then coded all included articles based on the country focus, type of literature, source of literature, academic discipline, disease sector, terminology used to describe organizations and topics discussed. We identified 186 articles addressing topics related to the key characteristics of community-based organizations and/or networks of community-based organizations. The literature is largely focused on high-income countries and on mental health and addictions, HIV/AIDS or general/unspecified populations. A large number of different terms have been used in the literature to describe community-based organizations and the literature addresses a range of topics about them (mandate, structure, revenue sources and type and skills or skill mix of staff, the involvement of community members in organizations, how organizations contribute to community organizing and development and how they function in networks with each other and with government (e.g., in policy networks. Given the range of terms used to

  1. Intake of micronutrients among Danish adult users and non-users of dietary supplements

    DEFF Research Database (Denmark)

    Tetens, Inge; Biltoft-Jensen, Anja Pia; Spagner, Camilla

    2011-01-01

    Objectives: To evaluate the intake of micronutrients from the diet and from supplements in users and non-users of dietary supplements, respectively, in a representative sample of the Danish adult population. A specific objective was to identify the determinants of supplement use. Design: A cross-...

  2. Optimizing nitrification in biological rapid sand filters: Diagnosing and supplementing micronutrients needed for proper filter performance

    DEFF Research Database (Denmark)

    Lee, Carson Odell; Wagner, Florian Benedikt; Boe-Hansen, Rasmus

    Nitrification is an important biological process commonly used in biological drinking water filters to remove ammonium from drinking water. Recent research has shown that a lack of micronutrients could be limiting the performance of these filters. Because nitrification is a biological process, ca...... to be an important diagnostic tool that could decrease regulatory hurdles, and save time and money....

  3. Micronutrients, omega-3 fatty acids and cognitive performance in Indian schoolchildren

    NARCIS (Netherlands)

    Eilander, J.H.C.

    2009-01-01

    In developing countries, approximately 30-40% of school-age children suffer from iodine and iron deficiencies. Poverty and consumption of monotonous diets are underlying causes of inadequate intakes of micronutrients and omega-3 fatty acids and may have severe consequences for children’s cognitive

  4. Effects of Micronutrients during Pregnancy and Early Infancy on Mental and Psychomotor Development

    NARCIS (Netherlands)

    Verhoef, H.; West, C.E.; Bleichrodt, N.; Dekker, P.H.; Born, M.P.

    2003-01-01

    The questions that are addressed in this chapter concern the extent to which a shortage of iodine and iron during fetal and infant development impairs mental development and the extent to which this impairment can be redressed by increasing the intake of these micronutrients

  5. Effects of macro and micronutrients on neutral lipid accumulation in oleaginous microalgae

    NARCIS (Netherlands)

    Ghafari, Mohsen; Rashidi, Behzad; Haznedaroglu, Berat Zeki

    2018-01-01

    In this study, effects of key macro and micronutrients on neutral lipid accumulation of six oleaginous microalgae species were investigated. For each nutrient, three different concentrations (0.5×, 1×, and 2×) were tested individually and compared to the most commonly utilized growth medium recipes.

  6. Prenatal micronutrient supplementation and postpartum depressive symptoms in a pregnancy cohort

    NARCIS (Netherlands)

    Leung, B.M.; Kaplan, B.J.; Field, C.J.; Tough, S.; Eliasziw, M.; Gomez, M.F.; McCargar, L.J.; Gagnon, L.; APrON Study Team, the; Pop, V.J.M.

    2013-01-01

    Background Postpartum depression is a serious problem for women and their offspring. Micronutrient supplements are recommended for pregnant women because of their documented protective effects for the offspring, but their potential beneficial effects on maternal mental health are unknown. This study

  7. Socio-economic determinants of micronutrient intake and status in Europe: a systematic review

    NARCIS (Netherlands)

    Novakovic, R.N.; Cavelaars, A.J.E.M.; Geelen, A.; Nikolic, M.; Altaba, I.I.; Vinas, B.R.; Ngo, J.; Golsorkhi, M.; Medina, M.; Brzozowska, A.; Szczecinkska, A.; Cock, de D.; Vansant, G.; Renkema, J.M.S.; Serra Majem, L.; Moreno, L.A.; Glibetic, M.; Gurinovic, M.; Veer, van 't P.; Groot, de C.P.G.M.

    2014-01-01

    OBJECTIVE: To provide the evidence base for targeted nutrition policies to reduce the risk of micronutrient/diet-related diseases among disadvantaged populations in Europe, by focusing on: folate, vitamin B12, Fe, Zn and iodine for intake and status; and vitamin C, vitamin D, Ca, Se and Cu for

  8. Transcriptomic profiling of Arabidopsis gene expression in response to varying micronutrient zinc supply

    NARCIS (Netherlands)

    Azevedo, Herlânder; Azinheiro, Sarah Gaspar; Muñoz-Mérida, Antonio; Castro, Pedro Humberto; Huettel, Bruno; Aarts, Mark M.G.; Assunção, Ana G.L.

    2016-01-01

    Deficiency of the micronutrient zinc is a widespread condition in agricultural soils, causing a negative impact on crop quality and yield. Nevertheless, there is an insufficient knowledge on the regulatory and molecular mechanisms underlying the plant response to inadequate zinc nutrition [1].

  9. The role of micronutrients in child health: A review of the literature ...

    African Journals Online (AJOL)

    The health and well being of children depend upon the interaction between their genetic potential and exogenous factors like adequacy of nutrition, safety of the environment, social interaction and stimulation. Micronutrients which are nutrients that are only needed by the body in minute amounts play leading roles in the ...

  10. Micronutrient supplementation of young stunted Beninese children: effects on appetite and growth performance

    NARCIS (Netherlands)

    Dossa, R.A.M.

    2001-01-01

    Linear growth retardation (stunting) still has a high prevalence rate in developing countries (ACC/SCN, 2000). In the republic of Benin reported prevalence rates range from 25% to 40%. In malnourished children it is quite common to observe a combination of multiple micronutrient deficiency,

  11. Macro- and micronutrient disposition in an ex vivo model of extracorporeal membrane oxygenation.

    Science.gov (United States)

    Estensen, Kristine; Shekar, Kiran; Robins, Elissa; McDonald, Charles; Barnett, Adrian G; Fraser, John F

    2014-12-01

    Extracorporeal membrane oxygenation (ECMO) circuits have been shown to sequester circulating blood compounds such as drugs based on their physicochemical properties. This study aimed to describe the disposition of macro- and micronutrients in simulated ECMO circuits. Following baseline sampling, known quantities of macro- and micronutrients were injected post oxygenator into ex vivo ECMO circuits primed with the fresh human whole blood and maintained under standard physiologic conditions. Serial blood samples were then obtained at 1, 30 and 60 min and at 6, 12 and 24 h after the addition of nutrients, to measure the concentrations of study compounds using validated assays. Twenty-one samples were tested for thirty-one nutrient compounds. There were significant reductions (p single-dose ex vivo circuit study. Most significantly, there is potential for circuit loss of essential amino acid isoleucine and lipid soluble vitamins (A and E) in the ECMO circuit, and the mechanisms for this need further exploration. While the reductions in glucose concentrations and an increase in other macro- and micronutrient concentrations probably reflect cellular metabolism and breakdown, the decrement in arginine and glutamine concentrations may be attributed to their enzymatic conversion to ornithine and glutamate, respectively. While the results are generally reassuring from a macronutrient perspective, prospective studies in clinical subjects are indicated to further evaluate the influence of ECMO circuit on micronutrient concentrations and clinical outcomes.

  12. Reduced dietary intake of micronutrients with antioxidant properties negatively impacts muscle health in aged mice

    NARCIS (Netherlands)

    Dijk, Van Miriam; Dijk, Francina J.; Hartog, Anita; Norren, Van Klaske; Verlaan, Sjors; Helvoort, Van Ardy; Jaspers, Richard T.; Luiking, Yvette

    2018-01-01

    Background. Inadequate intake of micronutrients with antioxidant properties is common among older adults and has been associated with higher risk of frailty, adverse functional outcome, and impaired muscle health. However, a causal relationship is less well known. The aim was to determine in old

  13. Reduced dietary intake of micronutrients with antioxidant properties negatively impacts muscle health in aged mice

    NARCIS (Netherlands)

    van Dijk, Miriam; Dijk, Francina J.; Hartog, Anita; van Norren, Klaske; Verlaan, Sjors; van Helvoort, Ardy; Jaspers, Richard T.; Luiking, Yvette

    2018-01-01

    Background: Inadequate intake of micronutrients with antioxidant properties is common among older adults and has been associated with higher risk of frailty, adverse functional outcome, and impaired muscle health. However, a causal relationship is less well known. The aim was to determine in old

  14. Micronutrient Intake and the Contribution of Dietary Supplements in Hispanic Infants.

    Science.gov (United States)

    Amaro-Rivera, Kiara; López-Cepero, Andrea; Diaz, Beatriz; Lee, Jae Eun; Palacios, Cristina

    2018-03-04

    To calculate micronutrient adequacy among infants and toddlers and to determine the contribution of dietary supplements to this adequacy, micronutrient intake was assessed using two nonconsecutive 24-hour recalls in a sample of 296 infants aged 0-24 months. Micronutrient intake was calculated from foods and beverages and from supplements and compared between nonusers and users of supplements. Percentages of children below the Dietary Reference Intake (DRI) and above the tolerable upper limit intake (UL) were also compared between groups. A total of 241 participants had complete data. The prevalence of dietary supplement use among the sample was 15%. Mean intake of all micronutrients from foods and beverages was similar between nonusers and users of supplements (p > .05) but significantly higher for the following vitamins when supplements were included: D, E, B1, B2, B3, and B6 (p supplements were included, this percentage significantly decreased among users compared to nonusers (p supplements were added. Supplements significantly increased the intake of some vitamins. Vitamins D and E had the highest percentage of children below the DRI, which was partly corrected with the use of supplements. The UL was exceeded for magnesium, zinc, and vitamin B3 in many children. It is important to understand these patterns as they may be indicative of future nutritional deficiencies and excesses.

  15. Micronutrient intake and risk of colon and rectal cancer in a Danish cohort.

    Science.gov (United States)

    Roswall, Nina; Olsen, Anja; Christensen, Jane; Dragsted, Lars O; Overvad, Kim; Tjønneland, Anne

    2010-02-01

    Micronutrients may protect against colorectal cancer. Especially folate has been considered potentially preventive. However, studies on folate and colorectal cancer have found contradicting results; dietary folate seems preventive, whereas folic acid in supplements and fortification may increase the risk. To evaluate the association between intake of vitamins C, E, folate and beta-carotene and colorectal cancer risk, focusing on possibly different effects of dietary, supplemental and total intake, and on potential effect modification by lifestyle factors. In a prospective cohort study of 56,332 participants aged 50-64 years, information on diet, supplements and lifestyle was collected through questionnaires. 465 Colon and 283 rectal cancer cases were identified during follow-up. Incidence rate ratios of colon and rectal cancers related to micronutrient intake were calculated using Cox proportional hazard analyses. The present study found a protective effect of dietary but not supplemental folate on colon cancer. No association with any other micronutrient was found. Rectal cancer did not seem associated with any micronutrient. For both colon and rectal cancer, we found an interaction between dietary folate and alcohol intake, with a significant, preventive effect among those consuming above 10g alcohol/day only. This study adds further weight to the evidence that dietary folate protects against colon cancer, and specifies that there is a source-specific effect, with no preventive effect of supplemental folic acid. Further studies should thus take source into account. Vitamins C, E and beta-carotene showed no relation with colorectal cancer.

  16. Vitamin A, iron and zinc deficiency in Indonesia : micronutrient interactions and effects of supplementation

    NARCIS (Netherlands)

    Dijkhuizen, M.A.; Wieringa, F.T.

    2001-01-01

    The research described in this thesis was concerned with vitamin A, iron and zinc deficiency in pregnant and lactating women and in infants. The effects of supplementation withβ-carotene, iron and zinc on micronutrient status, growth, pregnancy outcome and immune function, and interactions

  17. Mind the Gap - Building Profitable Community Based Businesses on the Internet

    OpenAIRE

    Krieger,Bernhard; Müller,Philipp

    2001-01-01

    Building Internet communities will become a strategic tool both as a stand-alone model and as a supplement to sustain competitive advantage for "normal" businesses. Community based business models aim to profit from the value, which is created when Internet communities solve problems of collective action, by controlling access, aggregating data, or realizing side-payments. The current literature on community based business models refers to rational choices by individuals to explain why member...

  18. Learning from disaster: Community-based marine protected areas in Fiji

    OpenAIRE

    Yoshito Takasaki

    2013-01-01

    This paper empirically examines whether and how experiencing climate-related disasters can improve the rural poor fs adaptation to climate change through community-based resource management. Original household survey data in Fiji capture the unique sequence of a tropical cyclone and the establishment of community-based marine protected areas as a natural experiment. The analysis reveals that household disaster victimization increases its support for establishing marine protected areas for fut...

  19. Formation of community-based hypertension practice networks: success, obstacles, and lessons learned.

    Science.gov (United States)

    Dart, Richard A; Egan, Brent M

    2014-06-01

    Community-based practice networks for research and improving the quality of care are growing in size and number but have variable success rates. In this paper, the authors review recent efforts to initiate a community-based hypertension network modeled after the successful Outpatient Quality Improvement Network (O'QUIN) project, located at the Medical University of South Carolina. Key lessons learned and new directions to be explored are highlighted. ©2014 Wiley Periodicals, Inc.

  20. Community-based population-level interventions for promoting child oral health.

    OpenAIRE

    de Silva, AM; Hegde, S; Akudo Nwagbara, B; Calache, H; Gussy, MG; Nasser, M; Morrice, HR; Riggs, E; Leong, PM; Meyenn, LK; Yousefi-Nooraie, R

    2016-01-01

    BACKGROUND: Dental caries and gingival and periodontal disease are commonly occurring, preventable chronic conditions. Even though much is known about how to treat oral disease, currently we do not know which community-based population-level interventions are most effective and equitable in preventing poor oral health. OBJECTIVES: Primary • To determine the effectiveness of community-based population-level oral health promotion interventions in preventing dental caries and gingival and period...

  1. Improved Information and Educational Messages on Outer Packaging of Micronutrient Powders Distributed in Indonesia Increase Caregiver Knowledge and Adherence to Recommended Use.

    Science.gov (United States)

    Sutrisna, Aang; Vossenaar, Marieke; Poonawala, Alia; Mallipu, Agnes; Izwardy, Doddy; Menon, Ravi; Tumilowicz, Alison

    2018-06-08

    The objective of this study was to examine the influence of improved information and educational messages on outer packaging of a micronutrient powder (MNP), locally known as “ Taburia ”, on knowledge and adherence to recommended use. A community-based cluster randomized controlled trial was conducted among 1149 caregivers and their children aged 6⁻36 months. Caregiver⁻child dyads were randomized by their villages to receive 30 sachets of Taburia with the: (i) original outer packaging; (ii) improved outer packaging; or (iii) improved outer packaging combined with cooking demonstrations. Adherence to Taburia use was assessed through caregiver interviews and observation of unused sachets during home visits; “high” adherence was defined as consuming 13⁻17 sachets in the previous month. Data collection included surveys and focus groups discussions. The majority of caregivers (>80%) preferred the improved packaging because it was more attractive and contained more comprehensive information. Caregivers who received the improved packaging had better knowledge regarding the recommended use of Taburia ( p influencers of recommended MNP use by caregivers.

  2. 'Integration'

    DEFF Research Database (Denmark)

    Olwig, Karen Fog

    2011-01-01

    , while the countries have adopted disparate policies and ideologies, differences in the actual treatment and attitudes towards immigrants and refugees in everyday life are less clear, due to parallel integration programmes based on strong similarities in the welfare systems and in cultural notions...... of equality in the three societies. Finally, it shows that family relations play a central role in immigrants’ and refugees’ establishment of a new life in the receiving societies, even though the welfare society takes on many of the social and economic functions of the family....

  3. A Community-Based Randomized Trial of Hepatitis B Screening Among High-Risk Vietnamese Americans.

    Science.gov (United States)

    Ma, Grace X; Fang, Carolyn Y; Seals, Brenda; Feng, Ziding; Tan, Yin; Siu, Philip; Yeh, Ming Chin; Golub, Sarit A; Nguyen, Minhhuyen T; Tran, Tam; Wang, Minqi

    2017-03-01

    To evaluate the effectiveness of a community-based liver cancer prevention program on hepatitis B virus (HBV) screening among low-income, underserved Vietnamese Americans at high risk. We conducted a cluster randomized trial involving 36 Vietnamese community-based organizations and 2337 participants in Pennsylvania, New Jersey, and New York City between 2009 and 2014. We randomly assigned 18 community-based organizations to a community-based multilevel HBV screening intervention (n = 1131). We randomly assigned the remaining 18 community-based organizations to a general cancer education program (n = 1206), which included information about HBV-related liver cancer prevention. We assessed HBV screening rates at 6-month follow-up. Intervention participants were significantly more likely to have undergone HBV screening (88.1%) than were control group participants (4.6%). In a Cochran-Mantel-Haenszel analysis, the intervention effect on screening outcomes remained statistically significant after adjustment for demographic and health care access variables, including income, having health insurance, having a regular health provider, and English proficiency. A community-based, culturally appropriate, multilevel HBV screening intervention effectively increases screening rates in a high-risk, hard-to-reach Vietnamese American population.

  4. Embracing a competency-based specialty curriculum for community-based nursing roles.

    Science.gov (United States)

    Levin, Pamela F; Swider, Susan M; Breakwell, Susan; Cowell, Julia M; Reising, Virginia

    2013-01-01

    The Quad Council competencies for public health nursing (PHN) provide guidance in developing curricula at both the generalist and specialist level. However, these competencies are based on nursing roles in traditional public health agencies and community/public health is defined more broadly than official agency practice. The question arises as to whether community-based specialties require largely the same knowledge and skill set as PHN. The purpose of the competency cross-mapping project reported here was to (a) assess the intersection of the Quad Council competencies with four community-based specialties and (b) ensure the appropriateness of a Quad Council-based curriculum to prepare graduates across these four specialties (home health, occupational health, environmental health, and school nursing). This article details the multistep cross-mapping process, including validation with practice leaders. Results indicate strong alignment of community-based specialty competencies with Quad Council competencies. Community-based specialty-specific content that did not align well is identified, along with examples of didactic and clinical strategies to address gaps. This work indicates that a Quad Council-based curriculum is appropriate to prepare graduates in community-based specialties when attention to the specialty-specific competencies in the clinical setting is included. This work guides the development of a doctorate of nursing practice curriculum in PHN, encompassing the four additional community-based specialties. © 2013 Wiley Periodicals, Inc.

  5. Validation of a community-based survey assessing non-obstetric surgical conditions in Burera District, Rwanda.

    Science.gov (United States)

    Linden, Allison F; Maine, Rebecca; Hedt-Gauthier, Bethany L; Kamanzi, Emmanual; Mody, Gita; Ntakiyiruta, Georges; Kansayisa, Grace; Ntaganda, Edmond; Niyonkuru, Francine; Mubiligi, Joel; Mpunga, Tharcisse; Meara, John G; Riviello, Robert

    2015-04-27

    98·9%), and hypospadias (50% and 100%). Injuries or wounds and hernias or hydroceles were the conditions most frequently identified on examination that were not reported during the interview (appendix). To the best of our knowledge, this study provides the first attempt to validate a community-based surgical surveillance tool. The finding of low sensitivity limits the use of the tool, which will require further revision, and calls into question previously published unvalidated community surgical survey data. To improve validation of community-based surveys, community education efforts on common surgically treatable conditions are needed in conjunction with increased access to surgical care. Accurate community-based surveys are crucial to integrated health system planning that includes surgical care as a core component. The Harvard Sheldon Traveling Fellowship. Copyright © 2015 Elsevier Ltd. All rights reserved.

  6. Implementing Climate-Compatible Development in the Context of Power: Lessons for Encouraging Procedural Justice through Community-Based Projects

    Directory of Open Access Journals (Sweden)

    Benjamin T. Wood

    2018-05-01

    Full Text Available Climate-compatible development (CCD is being operationalised across the developing world through projects that integrate development, adaptation and mitigation using community-based approaches—community-based CCD (CB-CCD. By incorporating and considering local people’s concerns, these projects are positioned as more effective, efficient and sustainable than ‘top-down’ climate and development solutions. However, the literature pays little attention to whether and how these projects achieve procedural justice by recognising local people’s identities, cultures and values; and providing local people with meaningful participatory opportunities. We address this gap through an analysis of two donor-funded CB-CCD projects in Malawi, drawing on household surveys, semi-structured interviews and documentary materials. Our findings show that the projects had only limited success in facilitating procedural justice for the target populations. Households’ meaningful engagement in project activities and decision-making was often curtailed because power asymmetries went unchallenged. While many households were well engaged in projects, the recognition and participation of others—including many of the most vulnerable households—was limited. Building on our findings, we present a six-step approach to help CB-CCD project staff understand, manage and challenge power asymmetries; and create widespread recognition of, and meaningful participatory opportunities for, local people.

  7. Community-based interventions for building social inclusion of refugees and asylum seekers in Australia: A systematic review

    Directory of Open Access Journals (Sweden)

    Di Mahoney

    2017-12-01

    Full Text Available As refugee and asylum seeker numbers increase in Australia, their effective integration into society is facilitated by inclusion in social, economic and community life. This systematic review of the literature explored community-based programs that contribute to inclusion and social participation of refugees and asylum seekers in Australia. Four scholarly databases were searched for articles published between 2007 and 2017 resulting in five articles which met inclusion criteria. Although the studies identified were of variable quality, the findings suggest a number of factors that facilitate program effectiveness. These included where: (a English language and communications skills were considered; (b programs built on refugees’ own skills and experience prior to resettlement; (c volunteers and mentors were involved; and (d participants engaged in diverse projects that enabled new connections. The review highlights the paucity of well-researched interventions that build social inclusion of refugees and asylum seekers in Australia. Emerging evidence suggests that community-based programs can positively increase social inclusion and connectedness amongst refugees and asylum seekers. Additional well-designed programs and evaluation of such programs are needed to better understand and identify effective interventions targeting social inclusion of refugees and asylum seekers.

  8. 45 CFR 2517.600 - How are funds for community-based service-learning programs distributed?

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false How are funds for community-based service-learning... (Continued) CORPORATION FOR NATIONAL AND COMMUNITY SERVICE COMMUNITY-BASED SERVICE-LEARNING PROGRAMS Distribution of Funds § 2517.600 How are funds for community-based service-learning programs distributed? All...

  9. Antioxidant Micronutrients and Cardiovascular Risk in Patients with Diabetes: A Systematic Review

    Energy Technology Data Exchange (ETDEWEB)

    Sarmento, Roberta Aguiar [Instituto de Cardiologia do Rio Grande do Sul - Fundação Universitária de Cardiologia, Porto Alegre, RS (Brazil); Serviço de Endocrinologia do Hospital de Clínicas de Porto Alegre - Universidade Federal do Rio Grande do Sul, Porto Alegre, RS (Brazil); Silva, Flávia Moraes [Serviço de Endocrinologia do Hospital de Clínicas de Porto Alegre - Universidade Federal do Rio Grande do Sul, Porto Alegre, RS (Brazil); Sbruzzi, Graciele [Instituto de Cardiologia do Rio Grande do Sul - Fundação Universitária de Cardiologia, Porto Alegre, RS (Brazil); Schaan, Beatriz D' Agord [Instituto de Cardiologia do Rio Grande do Sul - Fundação Universitária de Cardiologia, Porto Alegre, RS (Brazil); Serviço de Endocrinologia do Hospital de Clínicas de Porto Alegre - Universidade Federal do Rio Grande do Sul, Porto Alegre, RS (Brazil); Departamento de Medicina Interna - Faculdade de Medicina da Universidade Federal do Rio Grande do Sul, Porto Alegre, RS (Brazil); Almeida, Jussara Carnevale de, E-mail: jussara.carnevale@gmail.com [Serviço de Endocrinologia do Hospital de Clínicas de Porto Alegre - Universidade Federal do Rio Grande do Sul, Porto Alegre, RS (Brazil); Departamento de Medicina Interna - Faculdade de Medicina da Universidade Federal do Rio Grande do Sul, Porto Alegre, RS (Brazil)

    2013-09-15

    Inverse associations between micronutrient intake and cardiovascular outcomes have been previously shown, but did not focus on diabetic patients. To systematically review the role of micronutrients in the development/presence of cardiovascular outcomes in patients with diabetes. We searched Medline, Embase, and Scopus (January/1949-March/2012) for observational studies that evaluated micronutrients and cardiovascular outcomes in patients with diabetes, and then selected and extracted the data (two independent reviewers). From the 15 658 studies identified, five were included, comprising three case-control and two cohorts, with a follow-up of 7-15 years. A meta-analysis was not performed due to the different antioxidant micronutrients (types and measurement methods) and outcomes evaluated. The micronutrients assessed were vitamin C intake in diet and/ or supplementation, chromium and selenium in toenail samples, and α-tocopherol and zinc in serum levels. Intake of > 300 mg of vitamin C through supplementation was associated with increased risk of cardiovascular disease, coronary artery disease (CAD), and stroke (RR 1.69-2.37). High levels of α-tocopherol in serum were associated with 30% lower CAD risk in another study (HR 0.71; 95%CI 0.53-0.94). Among minerals (zinc, selenium, and chromium), an inverse association between zinc and CAD was observed; levels lower than 14.1 μmol/L were associated with an increased risk for CAD (RR 1.70; 95%CI 1.21-2.38). The information available on this issue is scarce. Further prospective studies are needed to elucidate the role of these nutrients in the cardiovascular risk of patients with diabetes.

  10. Micronutrient Intake in the Etiology, Prevention and Treatment of Osteosarcopenic Obesity.

    Science.gov (United States)

    Kelly, Owen J; Gilman, Jennifer C; Kim, Youjin; Ilich, Jasminka Z

    2016-01-01

    Aging, chronic inflammation and/or many chronic conditions may result in loss of bone, loss of muscle and increased adiposity, manifested either overtly (overweight) or furtively as fat infiltration into bone and muscle. This combined condition has been identified as osteosarcopenic obesity. Micronutrients are required, not just to prevent deficiency diseases, but for optimal health and metabolic homeostasis. Further, micronutrients have multifunctional roles in the body. However, it is unknown if the micronutrient intake of the Western diet contributes to bone and muscle loss, increased adiposity, and ultimately osteosarcopenic obesity. The aim of this review is to examine the micronutrient intake using US National Health and Nutrition Examination Survey (NHANES) data, and explore if the insufficiencies, or excesses present contribute to the development of osteosarcopenic obesity in aging. First NHANES food intake data from 2002-2012 were obtained and transposed to Microsoft Excel for analysis. A literature search of PubMed and Medline for human data using combinations and synonyms of osteoporosis, sarcopenia and obesity, and each mineral and vitamin indicated as insufficient by NHANES. NHANES data suggested phosphorus, calcium, magnesium, potassium, iron, and vitamins B6/B12/C/A/D/E and K were candidates for further evaluation. 170 articles were included. While chronic single/multiple micronutrient insufficiency/excess is not studied in clinical trials, NHANES data suggest that they have existed for at least a decade. Examining the status and roles of those nutrients may be important to understanding the health issues associated with Western-type diets, including development of osteosarcopenic obesity.

  11. Antioxidant Micronutrients and Cardiovascular Risk in Patients with Diabetes: A Systematic Review

    International Nuclear Information System (INIS)

    Sarmento, Roberta Aguiar; Silva, Flávia Moraes; Sbruzzi, Graciele; Schaan, Beatriz D'Agord; Almeida, Jussara Carnevale de

    2013-01-01

    Inverse associations between micronutrient intake and cardiovascular outcomes have been previously shown, but did not focus on diabetic patients. To systematically review the role of micronutrients in the development/presence of cardiovascular outcomes in patients with diabetes. We searched Medline, Embase, and Scopus (January/1949-March/2012) for observational studies that evaluated micronutrients and cardiovascular outcomes in patients with diabetes, and then selected and extracted the data (two independent reviewers). From the 15 658 studies identified, five were included, comprising three case-control and two cohorts, with a follow-up of 7-15 years. A meta-analysis was not performed due to the different antioxidant micronutrients (types and measurement methods) and outcomes evaluated. The micronutrients assessed were vitamin C intake in diet and/ or supplementation, chromium and selenium in toenail samples, and α-tocopherol and zinc in serum levels. Intake of > 300 mg of vitamin C through supplementation was associated with increased risk of cardiovascular disease, coronary artery disease (CAD), and stroke (RR 1.69-2.37). High levels of α-tocopherol in serum were associated with 30% lower CAD risk in another study (HR 0.71; 95%CI 0.53-0.94). Among minerals (zinc, selenium, and chromium), an inverse association between zinc and CAD was observed; levels lower than 14.1 μmol/L were associated with an increased risk for CAD (RR 1.70; 95%CI 1.21-2.38). The information available on this issue is scarce. Further prospective studies are needed to elucidate the role of these nutrients in the cardiovascular risk of patients with diabetes

  12. Vitamin K and other markers of micronutrient status in morbidly obese patients before bariatric surgery.

    Science.gov (United States)

    Ewang-Emukowhate, M; Harrington, D J; Botha, A; McGowan, B; Wierzbicki, A S

    2015-06-01

    Micronutrient deficiencies occur in morbidly obese patients. The aim of this study was to assess vitamin deficiencies prior to bariatric surgery including vitamin K about which there is little data in this population. A prospective assessment of 118 consecutive patients was performed. Clinical allied with haematological and biochemical variables were measured. Micronutrients measured included vitamins K1 , PIVKA-II (protein-induced in vitamin K absence factor II), vitamin D, vitamin B12 (holotranscobalamin), iron, transferrin and folate. Patients were aged 49 ± 11 [mean (SD, standard deviation)] years, body mass index (BMI) 50 ± 8 kg/m(2), 66% female and 78% Caucasian. Hypertension was present in 47% and type 2 diabetes in 32%. Vitamin D supplements had been prescribed in 8%. Micronutrient insufficiencies were found for vitamin K (40%), vitamin D (92%) and vitamin B12 (25%), and also iron (44%) and folate (18%). Normocalcaemic vitamin D insufficiency with secondary hyperparathyroidism was present in 18%. Iron and transferrin levels were associated with age, sex and estimated glomerular filtration rate. Vitamin K levels were associated with age, and inversely with BMI and diabetes mellitus; and PIVKA-II with smoking, triglycerides and liver function markers. Vitamin D levels were associated with statin use and prescription of supplements and inversely with BMI. Vitamin B12 levels were associated with ethnicity and HbA1c. Micronutrient status shows differing relationships with age, gender and BMI. Vitamin K insufficiency was present in 40% and not related to deficiencies in other vitamins or micronutrients. Vitamin D and vitamin K supplementation should be considered prebariatric surgery in patients with diabetes or severe insulin resistance. © 2014 John Wiley & Sons Ltd.

  13. Community-based grain banks using local foods for improved infant and young child feeding in Ethiopia.

    Science.gov (United States)

    Roche, Marion L; Sako, Binta; Osendarp, Saskia J M; Adish, Abdul A; Tolossa, Azeb L

    2017-04-01

    The first thousand days of a child's life are critical for ensuring adequate nutrition to enable optimal health, development and growth. Inadequate infant and young child feeding (IYCF) practices likely contribute to Ethiopia's concerning malnutrition situation. Development partners in four regions of Ethiopia implemented community production of complementary food with women's groups processing local grains and legumes at grain banks to improve availability, accessibility, dietary diversity and timely introduction of complementary foods. The objective of this study was to establish the acceptability, perceived impact, feasibility and required inputs to sustain local grain bank interventions to improve IYCF. A subsidized barter system was used by mothers in the rural communities, and flour was sold in the semi-urban context. Purposive sampling guided the qualitative study design and selection of project stakeholders. A total of 51 key informant interviews and 33 focus group discussions (n = 237) were conducted. The grain bank flour was valued for its perceived diverse local ingredients; while the project was perceived as creating labour savings for women. The grain bank flour offered the potential to contribute to improved IYCF; however, further dietary modification or fortification is needed to improve the micronutrient content. Dependence upon external inputs to subsidize the barter model and the reliance on volunteer labour from women's groups in the rural context are the greatest risks to sustainability. This intervention illustrates how integrated agricultural and health interventions leveraging local production can appeal to diverse stakeholders as an acceptable approach to improve IYCF. © 2015 John Wiley & Sons Ltd.

  14. Using Spent Mushroom Substrate as the Base for Organic-Mineral Micronutrient Fertilizer – Field Tests on Maize

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    Łukasz Tuhy

    2015-07-01

    Full Text Available Spent mushroom substrate (SMS is a noxious byproduct of the mushroom industry. The aim of this work was to convert SMS into organic-mineral micronutrient (Zn(II, Mn(II, and Cu(II fertilizer via biosorption and examine the effect of its application in field tests on maize compared to commercial reference micronutrient fertilizer. Crop yield and crop quality were assessed, and multielemental analysis of grains was conducted for the evaluation of the fertilization effect on maize grains and to assess bioavailability of nutrients from fertilizers. Grain yield for maize treated with micronutrients delivered with SMS was noticeably higher (11.5% than the untreated group and the NPK (nitrogen, phosphorus, potassium fertilizer treated only group (2.8%. Bioavailability (TF of micronutrients from SMS were comparable with reference micronutrient fertilizer (7% Zn, 4% Mn, and 2.3% Cu. The new product has the potential to be used as a micronutrient fertilizer. Satisfactory results of grain yield (6.4 Mg ha-1, high content of micronutrients (Zn 1.6%, Mn 1.2%, and Cu 1.8%, and macronutrients (P 1.0%, S 3.1%, Ca 8.2%, and K 0.2% were observed. The bioavailability suggests that enriched SMS could be a good alternative to fertilizers in the present market.

  15. Micronutrient Daily Intake of Elementary School Children in Bandung as Determined by Using NAA and AAS Methods

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    E. Damastuti

    2011-08-01

    Full Text Available Micronutrients in human diet are known to be among the most essential sources of nutrition, that required by the human body in small amount to maintain normal physiological function. Micronutrient malnutrition (MNM is widespread all over the world, mostly in the developing country, where young children tend to be the most at risk of developing micronutrient deficiencies. In Indonesia, data of micronutrient status of children is limited. Therefore, the assessment of micronutrient intake of young children is needed to carry out. Food samples were taken by duplicate diet method of 19 elementary school children in Bandung and were analyzed using neutron activation analysis and atomic absorption spectrophotometry. Quality control of data analysis was assessed using SRM NIST 1548a Typical Diet. The result was giving the average daily intake of Ca, Cr, Cu, Fe, K, Mg, Mn, Na, Se and Zn were 228, 0.15, 0.57, 9.3, 929, 106, 2,1, 2314, 0.022 and 4.6 mg/day respectively and gives 22, 527, 86, 111, 17, 54, 116, 49 and 63% of Recommended Dietary Allowance (RDA values. Its generally concluded that these children are still lack of micronutrient intake, and many of them were below their recommended dietary allowances. These result were expected could be used as baseline data and reference to encourage government and related institution in making policies for public health improvement and micronutrient malnutrition solution as well.

  16. Monitoring the marketing, distribution, and use of Sprinkles micronutrient powders in rural western Kenya.

    Science.gov (United States)

    Suchdev, Parminder S; Ruth, Laird; Obure, Alfredo; Were, Vincent; Ochieng, Cliff; Ogange, Lorraine; Owuor, Mercy; Ngure, Frances; Quick, Robert; Juliao, Patricia; Jung, Christina; Teates, Kathryn; Cruz, Kari; Jefferds, Maria Elena D

    2010-06-01

    In 2007, the US Centers for Disease Control and Prevention partnered with local Kenyan institutions to implement the Nyando Integrated Child Health and Education Project, an effectiveness study that used social marketing and a community-based distribution program to promote the sale of Sprinkles and other health products. To describe monitoring of wholesale sales, household demand, promotional strategies, and perceived factors influencing Sprinkles sales among vendors. Ongoing quantitative and qualitative monitoring of Sprinkles sales began in May 2007 in 30 intervention villages. Data sources included baseline and follow-up cross-sectional surveys; office records of Sprinkles sales to vendors; biweekly household monitoring of Sprinkles use; and qualitative data collection, including vendor focus groups and key informant interviews. A total of 550 children aged 6 to 35 months were enrolled at baseline, and 451 were available at 12-month follow-up. During this period, nearly 160,000 sachets were sold wholesale to vendors, with variability in sales influenced by the social, political, and economic context. Vendors living closer to the wholesale office purchased more Sprinkles, so a second office was opened closer to remote vendors. On average, 33% of households purchased Sprinkles during household monitoring visits. Training sessions and community launches were important for community support and raising awareness about Sprinkles. Vendor incentives motivated vendors to sell Sprinkles, and consumer incentives promoted purchases. Sprinkles program monitoring in Kenya was critically important for understanding sales and distribution trends and vendor perceptions. Understanding these trends led to strategic changes to the intervention over time.

  17. BioPortal: An Open-Source Community-Based Ontology Repository

    Science.gov (United States)

    Noy, N.; NCBO Team

    2011-12-01

    Advances in computing power and new computational techniques have changed the way researchers approach science. In many fields, one of the most fruitful approaches has been to use semantically aware software to break down the barriers among disparate domains, systems, data sources, and technologies. Such software facilitates data aggregation, improves search, and ultimately allows the detection of new associations that were previously not detectable. Achieving these analyses requires software systems that take advantage of the semantics and that can intelligently negotiate domains and knowledge sources, identifying commonality across systems that use different and conflicting vocabularies, while understanding apparent differences that may be concealed by the use of superficially similar terms. An ontology, a semantically rich vocabulary for a domain of interest, is the cornerstone of software for bridging systems, domains, and resources. However, as ontologies become the foundation of all semantic technologies in e-science, we must develop an infrastructure for sharing ontologies, finding and evaluating them, integrating and mapping among them, and using ontologies in applications that help scientists process their data. BioPortal [1] is an open-source on-line community-based ontology repository that has been used as a critical component of semantic infrastructure in several domains, including biomedicine and bio-geochemical data. BioPortal, uses the social approaches in the Web 2.0 style to bring structure and order to the collection of biomedical ontologies. It enables users to provide and discuss a wide array of knowledge components, from submitting the ontologies themselves, to commenting on and discussing classes in the ontologies, to reviewing ontologies in the context of their own ontology-based projects, to creating mappings between overlapping ontologies and discussing and critiquing the mappings. Critically, it provides web-service access to all its

  18. Marginal Micronutrient Intake in High-Performance Male Wheelchair Basketball Players: A Dietary Evaluation and the Effects of Nutritional Advice.

    Science.gov (United States)

    Grams, Lena; Garrido, Guadalupe; Villacieros, Jorge; Ferro, Amelia

    2016-01-01

    Wheelchair basketball has evolved into a high-performance sport over several years, and small variations in player performance can determine the difference between winning and losing. Therefore, adequate micronutrient intake may influence this difference if performance-promoting macronutrient intake and physical fitness are equal between teams. Seventeen elite male wheelchair basketball players belonging to the Spanish National Team participated in this study. Macro- and micronutrient intake were determined using a food-weighing diary over three consecutive days during three training camps in two consecutive years. Current Dietary Reference Intake levels were used to determine the adequacy of intake of seventeen micronutrients of particular interest for athletes. After categorizing the consumed foods into fourteen food groups according to the National Nutrient Database for Standard References (USDA) these groups were used to identify the best predictors of the adequacy of intake for each micronutrient. Total energy intake correlated positively with the adequacy of all micronutrient intake levels, except for vitamins A and E. Five B vitamins and phosphorus, selenium, and iron showed 100% adequacy. All other micronutrient intake levels were found to be inadequate, e.g., vitamin E (51% adequacy) and calcium (73%). The fruit, fish and cereal food groups were found to be predictors of adequate intake of most micronutrients. Together with energy intake (p = .009, η2 = 0.49), the intake of the fruit (p = .032, η2 = 0.39) and egg (p = .036, Kendall's W = 0.42) food groups increased significantly over time, along with improved iodine (p = .008, W = 0.61) and magnesium (p = .030, W = 0.44) adequacy levels. Because the adequacy of micronutrient intake correlates positively with energy intake (R = 0.64, p nutritional knowledge of the athletes and assure adequate micronutrient intake.

  19. Depression among patients with diabetes: A community-based study in South India

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    Abdullahi S Aminu

    2017-01-01

    Full Text Available Background: Depression is one of the more common mental health conditions found among people suffering from chronic diseases. Its presence in patients with type 2 diabetes could hinder the adherence to and effectiveness of treatment. Most studies on depression among patients with diabetes are hospital-based suggesting the need for a community-based study to assess the correlates of depression among patients with diabetes. Aim: This study aimed to estimate the prevalence and to identify the factors influencing depression among patients with type 2 diabetes in Udupi taluk situated in southern India. Subjects and Methods: This study recruited 200 patients with type 2 diabetes from both rural and urban areas. Demographic, clinical, and diabetes-related information were collected using a semi-structured questionnaire. Depression was assessed using Patient Health Questionnaire-9; a standardized questionnaire developed in the United States of America and validated in the Indian population. Results: The prevalence of depression among patients with diabetes in the community was found to be 37.5%. Most frequently, depression was mild (42, 21% in nature with severe depression (9, 4.5% seen the least. Several factors were found to be positively associated with depression including female gender, rural residence, unemployment, and the status of being unmarried. The presence of diabetic complications and other chronic diseases such as hypertension and obesity also were found to be associated with depression. Conclusion: Depression was found to be particularly high among the study population. Since depression could significantly hinder patient's adherence to treatment, there is an urgent need for early diagnosis and treatment. This calls for the integration of mental health care into the management of diabetes.

  20. Community-based measures for mitigating the 2009 H1N1 pandemic in China.

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    Sanyi Tang

    Full Text Available Since the emergence of influenza A/H1N1 pandemic virus in March-April 2009, very stringent interventions including Fengxiao were implemented to prevent importation of infected cases and decelerate the disease spread in mainland China. The extent to which these measures have been effective remains elusive. We sought to investigate the effectiveness of Fengxiao that may inform policy decisions on improving community-based interventions for management of on-going outbreaks in China, in particular during the Spring Festival in mid-February 2010 when nationwide traveling will be substantially increased. We obtained data on initial laboratory-confirmed cases of H1N1 in the province of Shaanxi and used Markov-chain Monte-Carlo (MCMC simulations to estimate the reproduction number. Given the estimates for the exposed and infectious periods of the novel H1N1 virus, we estimated a mean reproduction number of 1.68 (95% CI 1.45-1.92 and other A/H1N1 epidemiological parameters. Our results based on a spatially stratified population dynamical model show that the early implementation of Fengxiao can delay the epidemic peak significantly and prevent the disease spread to the general population but may also, if not implemented appropriately, cause more severe outbreak within universities/colleges, while late implementation of Fengxiao can achieve nothing more than no implementation. Strengthening local control strategies (quarantine and hygiene precaution is much more effective in mitigating outbreaks and inhibiting the successive waves than implementing Fengxiao. Either strong mobility or high transport-related transmission rate during the Spring Festival holiday will not reverse the ongoing outbreak, but both will result in a large new wave. The findings suggest that Fengxiao and travel precautions should not be relaxed unless strict measures of quarantine, isolation, and hygiene precaution practices are put in place. Integration and prompt implementation of

  1. Community-Based Global Health Program for Maltreated Children and Adolescents in Brazil: The Equilibrium Program

    Science.gov (United States)

    Marques, Andrea Horvath; Oliveira, Paula Approbato; Scomparini, Luciana Burim; Silva, Uiara Maria Rêgo e; Silva, Angelica Cristine; Doretto, Victoria; de Medeiros Filho, Mauro Victor; Scivoletto, Sandra

    2015-01-01

    The maltreatment of children and adolescents is a global public health problem that affects high- and low-middle income countries (“LMICs”). In the United States, around 1.2 million children suffer from abuse, while in LMICs, such as Brazil, these rates are much higher (an estimated 28 million children). Exposition to early environmental stress has been associated with suboptimal physical and brain development, persistent cognitive impairment, and behavioral problems. Studies have reported that children exposed to maltreatment are at high risk of behavioral problems, learning disabilities, communication and psychiatric disorders, and general clinical conditions, such as obesity and systemic inflammation later in life. The aim of this paper is to describe The Equilibrium Program (“TEP”), a community-based global health program implemented in São Paulo, Brazil to serve traumatized and neglected children and adolescents. We will describe and discuss TEP’s implementation, highlighting its innovation aspects, research projects developed within the program as well as its population profile. Finally, we will discuss TEP’s social impact, challenges, and limitations. The program’s goal is to promote the social and family reintegration of maltreated children and adolescents through an interdisciplinary intervention program that provides multi-dimensional bio-psycho-social treatment integrated with the diverse services needed to meet the unique demands of this population. The program’s cost effectiveness is being evaluated to support the development of more effective treatments and to expand similar programs in other areas of Brazil. Policy makers should encourage early evidence-based interventions for disadvantaged children to promote healthier psychosocial environments and provide them opportunities to become healthy and productive adults. This approach has already shown itself to be a cost-effective strategy to prevent disease and promote health. PMID

  2. Innovative partnerships to advance public health training in community-based academic residency programs

    Directory of Open Access Journals (Sweden)

    Lo JC

    2017-10-01

    Full Text Available Joan C Lo,1–3 Thomas E Baudendistel,2,3 Abhay Dandekar,3,4 Phuoc V Le,5 Stanton Siu,2,3 Bruce Blumberg6 1Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA; 2Department of Medicine, Kaiser Permanente Oakland Medical Center, Oakland, CA, USA; 3Graduate Medical Education, Kaiser Permanente East Bay, Oakland, CA, USA; 4Department of Pediatrics, Kaiser Permanente Oakland Medical Center, Oakland, CA, USA; 5School of Public Health, University of California Berkeley, Berkeley, CA, USA; 6Graduate Medical Education, Kaiser Permanente Northern California, Oakland, CA, USA Abstract: Collaborative partnerships between community-based academic residency ­training programs and schools of public health, represent an innovative approach to training future physician leaders in population management and public health. In Kaiser Permanente Northern California, development of residency-Masters in Public Health (MPH tracks in the Internal Medicine Residency and the Pediatrics Residency programs, with MPH graduate studies completed at the University of California Berkeley School of Public Health, enables physicians to integrate clinical training with formal education in epidemiology, biostatistics, health policy, and disease prevention. These residency-MPH programs draw on more than 50 years of clinical education, public health training, and health services research – creating an environment that sparks inquiry and added value by developing skills in patient-centered care through the lens of population-based outcomes. Keywords: graduate medical education, public health, master’s degree, internal medicine, pediatrics, residency training

  3. Community-Based Global Health Program for Maltreated Children and Adolescents in Brazil: The Equilibrium Program.

    Science.gov (United States)

    Marques, Andrea Horvath; Oliveira, Paula Approbato; Scomparini, Luciana Burim; Silva, Uiara Maria Rêgo E; Silva, Angelica Cristine; Doretto, Victoria; de Medeiros Filho, Mauro Victor; Scivoletto, Sandra

    2015-01-01

    The maltreatment of children and adolescents is a global public health problem that affects high- and low-middle income countries ("LMICs"). In the United States, around 1.2 million children suffer from abuse, while in LMICs, such as Brazil, these rates are much higher (an estimated 28 million children). Exposition to early environmental stress has been associated with suboptimal physical and brain development, persistent cognitive impairment, and behavioral problems. Studies have reported that children exposed to maltreatment are at high risk of behavioral problems, learning disabilities, communication and psychiatric disorders, and general clinical conditions, such as obesity and systemic inflammation later in life. The aim of this paper is to describe The Equilibrium Program ("TEP"), a community-based global health program implemented in São Paulo, Brazil to serve traumatized and neglected children and adolescents. We will describe and discuss TEP's implementation, highlighting its innovation aspects, research projects developed within the program as well as its population profile. Finally, we will discuss TEP's social impact, challenges, and limitations. The program's goal is to promote the social and family reintegration of maltreated children and adolescents through an interdisciplinary intervention program that provides multi-dimensional bio-psycho-social treatment integrated with the diverse services needed to meet the unique demands of this population. The program's cost effectiveness is being evaluated to support the development of more effective treatments and to expand similar programs in other areas of Brazil. Policy makers should encourage early evidence-based interventions for disadvantaged children to promote healthier psychosocial environments and provide them opportunities to become healthy and productive adults. This approach has already shown itself to be a cost-effective strategy to prevent disease and promote health.

  4. Developing a vision and strategic action plan for future community-based residency training.

    Science.gov (United States)

    Skelton, Jann B; Owen, James A

    2016-01-01

    The Community Pharmacy Residency Program (CPRP) Planning Committee convened to develop a vision and a strategic action plan for the advancement of community pharmacy residency training. Aligned with the profession's efforts to achieve provider status and expand access to care, the Future Vision and Action Plan for Community-based Residency Training will provide guidance, direction, and a strategic action plan for community-based residency training to ensure that the future needs of community-based pharmacist practitioners are met. National thought leaders, selected because of their leadership in pharmacy practice, academia, and residency training, served on the planning committee. The committee conducted a series of conference calls and an in-person strategic planning meeting held on January 13-14, 2015. Outcomes from the discussions were supplemented with related information from the literature. Results of a survey of CPRP directors and preceptors also informed the planning process. The vision and strategic action plan for community-based residency training is intended to advance training to meet the emerging needs of patients in communities that are served by the pharmacy profession. The group anticipated the advanced skills required of pharmacists serving as community-based pharmacist practitioners and the likely education, training and competencies required by future residency graduates in order to deliver these services. The vision reflects a transformation of community residency training, from CPRPs to community-based residency training, and embodies the concept that residency training should be primarily focused on training the individual pharmacist practitioner based on the needs of patients served within the community, and not on the physical location where pharmacy services are provided. The development of a vision statement, core values statements, and strategic action plan will provide support, guidance, and direction to the profession of pharmacy to

  5. Functional outcomes in community-based adults with borderline personality disorder.

    Science.gov (United States)

    Javaras, Kristin N; Zanarini, Mary C; Hudson, James I; Greenfield, Shelly F; Gunderson, John G

    2017-06-01

    Many individuals in clinical samples with borderline personality disorder (BPD) experience high levels of functional impairment. However, little is known about the levels of functional impairment experienced by individuals with BPD in the general community. To address this issue, we compared overall and domain-specific (educational/occupational; social; recreational) functioning in a sample of community-based individuals with BPD (n = 164); community-based individuals without BPD (n = 901); and clinically-ascertained individuals with BPD (n = 61). BPD diagnoses and functional outcomes were based on well-accepted, semi-structured interviews. Community-based individuals with BPD were significantly less likely to experience good overall functioning (steady, consistent employment and ≥1 good relationship) compared to community-based individuals without BPD (BPD: 47.4%; Non- BPD: 74.5%; risk difference -27.1%; p < 0.001), even when compared directly to their own non-BPD siblings (risk difference -35.5%; p < 0.001). Community-based individuals with BPD versus those without BPD did not differ significantly on most domain-specific outcomes, but the former group experienced poorer educational/occupational performance and lower quality relationships with parents, partners, and friends. However, community-based individuals with BPD were significantly more likely to experience good overall functioning than clinically-based individuals with BPD (risk difference -35.2%; p < 0.001), with the latter group more likely to experience reduced employment status, very poor quality relationships with partners, and social isolation. In conclusion, community-based individuals with BPD experienced marked functional impairment, especially in the social domain, but were less likely to experience the more extreme occupational and social impairments seen among patients with BPD. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. Current micronutrient recommendations in Europe: towards understanding their differences and similarities.

    Science.gov (United States)

    Doets, Esmée L; de Wit, Liesbeth S; Dhonukshe-Rutten, Rosalie A M; Cavelaars, Adriënne E J M; Raats, Monique M; Timotijevic, Lada; Brzozowska, Anna; Wijnhoven, Trudy M A; Pavlovic, Mirjana; Totland, Torunn Holm; Andersen, Lene F; Ruprich, Jiri; Pijls, Loek T J; Ashwell, Margaret; Lambert, Janet P; van 't Veer, Pieter; de Groot, Lisette C P G M

    2008-04-01

    Nowadays most countries in Europe have established their own nutrient recommendations to assess the adequacy of dietary intakes and to plan desirable dietary intakes. As yet there is no standard approach for deriving nutrient recommendations, they may vary from country to country. This results in different national recommendations causing confusion for policy-makers, health professionals, industry, and consumers within Europe. EURRECA (EURopean micronutrient RECommendations Aligned) is a network of excellence funded by the European Commission (EC), and established to identify and address the problem of differences between countries in micronutrient recommendations. The objective of this paper is to give an overview of the available micronutrient recommendations in Europe, and to provide information on their origin, concepts and definitions. Furthermore this paper aims to illustrate the diversity in European recommendations on vitamin A and vitamin D, and to explore differences and commonalities in approaches that could possibly explain variations observed. A questionnaire was developed to get information on the process of establishing micronutrient recommendations. These questionnaires were sent to key informants in the field of micronutrient recommendations to cover all European countries/regions. Also the latest reports on nutrient recommendations in Europe were collected. Standardisation procedures were defined to enable comparison of the recommendations. Recommendations for vitamin A and vitamin D were compared per sex at the ages 3, 9 months and 5, 10, 15, 25, 50 and 70 years. Information extracted from the questionnaires and reports was compared focusing on: (1) The concept of recommendation (recommended daily allowance (RDA), adequate intake (AI) or acceptable range), (2) The year of publication of the report (proxy for available evidence), (3) Population groups defined, (4) Other methodological issues such as selected criteria of adequacy, the type of

  7. Effect of multi-micronutrient-fortified rice on cognitive performance depends on premix composition and cognitive function tested

    DEFF Research Database (Denmark)

    Fiorentino, Marion; Perignon, Marlène; Khov, Kuong

    2018-01-01

    OBJECTIVE: Even though current policy is strongly focused on the crucial first '1000 days', it might be still possible to enhance cognitive function during the pre-adolescent and adolescent years by improving micronutrient status. In Cambodia, nutritional status is poor. Provision of rice fortified...... with micronutrients through a school meal programme (SMP) could be a cost-effective strategy to help improve health and school performance. The present study aimed to evaluate the effect of three different micronutrient-fortified rice formulations on cognitive function in Cambodian children. SETTING: Sixteen...

  8. Reflections on Researcher Identity and Power: The Impact of Positionality on Community Based Participatory Research (CBPR) Processes and Outcomes.

    Science.gov (United States)

    Muhammad, Michael; Wallerstein, Nina; Sussman, Andrew L; Avila, Magdalena; Belone, Lorenda; Duran, Bonnie

    2015-11-01

    The practice of community based participatory research (CBPR) has evolved over the past 20 years with the recognition that health equity is best achieved when academic researchers form collaborative partnerships with communities. This article theorizes the possibility that core principles of CBPR cannot be realistically applied unless unequal power relations are identified and addressed. It provides theoretical and empirical perspectives for understanding power, privilege, researcher identity and academic research team composition, and their effects on partnering processes and health disparity outcomes. The team's processes of conducting seven case studies of diverse partnerships in a national cross-site CBPR study are analyzed; the multi-disciplinary research team's self-reflections on identity and positionality are analyzed, privileging its combined racial, ethnic, and gendered life experiences, and integrating feminist and post-colonial theory into these reflections. Findings from the inquiry are shared, and incorporating academic researcher team identity is recommended as a core component of equalizing power distribution within CBPR.

  9. Enabling and sustaining the activities of lay health influencers: lessons from a community-based tobacco cessation intervention study.

    Science.gov (United States)

    Castañeda, Heide; Nichter, Mark; Nichter, Mimi; Muramoto, Myra

    2010-07-01

    The authors present findings from a community-based tobacco cessation project that trained lay health influencers to conduct brief interventions. They outline four major lessons regarding sustainability. First, participants were concerned about the impact that promoting cessation might have on social relationships. "Social risk" must be addressed during training to ensure long-term sustainability. Second, formal training provided participants with an increased sense of self-efficacy, allowed them to embrace a health influencer identity, and aided in further reducing social risk. Third, material resources functioned to mediate social tensions during health intervention conversations. A variety of resources should be made available to health influencers to accommodate type of relationship, timing, and location of the interaction. Finally, project design must be attentive to the creation of a "community of practice" among health influencers as an integral part of project sustainability. These lessons have broad implications for successful health promotion beyond tobacco cessation.

  10. Prospecting plant growth promoting bacteria and cyanobacteria as options for enrichment of macro- and micronutrients in grains in rice–wheat cropping sequence

    Directory of Open Access Journals (Sweden)

    Anuj Rana

    2015-12-01

    Full Text Available The influence of plant growth promoting bacteria (PGPB and cyanobacteria, alone and in combination, was investigated on micronutrient enrichment and yield in rice–wheat sequence, over a period of two years. Analysis of variance (ANOVA in both crops indicated significant differences in soil dehydrogenase activity and micronutrient enrichment in grains (Fe, Zn in rice, and Cu, Mn in wheat. The combined inoculation of Anabaena oscillarioides CR3, Brevundimonas diminuta PR7, and Ochrobactrum anthropi PR10 (T6 significantly increased nitrogen, phosphorus, and potassium (NPK content and improved rice yield by 21.2%, as compared to the application of recommended dose of NPK fertilizers (T2. The treatment T5 (Providencia sp. PR3 + B. diminuta PR7 + O. anthropi PR10 recorded an enhancement of 13–16% in Fe, Zn, Cu, and Mn concentrations, respectively, in rice grains. In wheat, Providencia sp. PW5 (T6 recorded the highest yield (5.23 Mg ha−1 and significantly higher enrichment of Fe and Cu (44–45% in the grains. This study highlighted the promise of combinations of cyanobacteria/bacteria and their synergistic action in biofortification and providing savings of 40–60 kg N ha−1. Future focus needs to be towards integrating such promising environment-friendly and environmentally sustainable options in nutrient management strategies for this cropping sequence.

  11. Added Sugar, Macro- and Micronutrient Intakes and Anthropometry of Children in a Developing World Context.

    Directory of Open Access Journals (Sweden)

    Eleni M W Maunder

    Full Text Available The objective of this study was to determine the relationship between added sugar and dietary diversity, micronutrient intakes and anthropometric status in a nationally representative study of children, 1-8.9 years of age in South Africa.Secondary analysis of a national survey of children (weighted n = 2,200; non weighted n = 2818 was undertaken. Validated 24-hour recalls of children were collected from mothers/caregivers and stratified into quartiles of percentage energy from added sugar (% EAS. A dietary diversity score (DDS using 9 food groups, a food variety score (FVS of individual food items, and a mean adequacy ratio (MAR based on 11 micronutrients were calculated. The prevalence of stunting and overweight/obesity was also determined.Added sugar intake varied from 7.5-10.3% of energy intake for rural and urban areas, respectively. Mean added sugar intake ranged from 1.0% of energy intake in Quartile 1 (1-3 years (Q1 to 19.3% in Q4 (4-8 years. Main sources of added sugar were white sugar (60.1%, cool drinks (squash type (10.4% and carbonated cool drinks (6.0%. Added sugar intake, correlated positively with most micronutrient intakes, DDS, FVS, and MAR. Significant negative partial correlations, adjusted for energy intake, were found between added sugar intake and intakes of protein, fibre, thiamin, pantothenic acid, biotin, vitamin E, calcium (1-3 years, phosphorus, iron (4-8 years, magnesium and zinc. The prevalence of overweight/obesity was higher in children aged 4-8 years in Q4 of %EAS than in other quartiles [mean (95%CI % prevalence overweight 23.0 (16.2-29.8% in Q4 compared to 13.0 (8.7-17.3% in Q1, p = 0.0063].Although DDS, FVS, MAR and micronutrient intakes were positively correlated with added sugar intakes, overall negative associations between micronutrients and added sugar intakes, adjusted for dietary energy, indicate micronutrient dilution. Overweight/obesity was increased with higher added sugar intakes in the 4-8 year old

  12. Effect and mechanism of micronutrient compound on swimming endurance in mice with nutritional deficiency

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    Jian-quan WU

    2012-07-01

    Full Text Available Objective To investigate the anti-fatigue effect and possible mechanisms of micronutrient compound. Methods One hundred and twenty-five male Kunming mice (SPF were fed following different feeding stuffs: sufficient feed, i.e. AIN-93M feed (corn starch 46.6%, casein 14%, dextrinized corn starch 15.5%, sucrose 10%, soybean oil 4%, fiber 5%, mineral mix 3.5%, vitamin mix 1%, L-cystine 0.18%, choline chloride 0.138% and tert-butylhydroquinone 8 ppm; insufficient feed (composed the same ingredients as the AIN-93M diet, replacing 30%, 50% or 70% of the content of mineral and vitamin mix with corn starch; compound micronutrient-added feed (CMAF, replacing 30% of the content of mineral and vitamin mix of AIN-93M diet with micronutrient compound composed of (g/kg Vit A 0.25, Vit B1 0.3, Vit B2 0.3, Vit B6 0.35, nicotinic acid 1.5, Vit D 0.05, Vit C 50, Vit E 10, calcium carbonate 180, ferrous glycine 1, zinc lactate 1 and corn starch 755.25. The mice were fed for 14 or 28 d, and then subjected to forced swim test with a load on their tails to exhaustion. The maximal swimming time was recorded. In another experiment, the Kunming mice were fed with corresponding feed for 28 d, and then subjected to forced swim test for 60 min, thereafter the samples of blood and liver were collected immediately. The serum contents of glucose, lactate, nonprotein nitrogen, nonesterified fatty acids and hepatic glycogen were measured. Results The dietary intake of 30% nutritional insufficient group (30% group was significantly decreased compared with normal control group (fed with AIN-93M diet, (P 0.05. The serum glucose and hepatic glycogen decreased and serum lactate, nonprotein nitrogen and nonesterified fatty acids increased in the control group, which were aggravated in nutrient insufficient group and reversed in micronutrient supplementation group. Conclusions Insufficient intake of micronutrients has significant influence on swimming endurance in mice and compound

  13. Effects of micronutrient fortified milk and cereal food for infants and children: a systematic review

    Directory of Open Access Journals (Sweden)

    Eichler Klaus

    2012-07-01

    Full Text Available Abstract Background Micronutrient deficiency is a common public health problem in developing countries, especially for infants and children in the first two years of life. As this is an important time window for child development, micronutrient fortified complementary feeding after 6 months of age, for example with milk or cereals products, in combination with continued breastfeeding, is recommended. The overall effect of this approach is unclear. Methods We performed a Systematic Review and Meta-analysis to assess the impact of micronutrient fortified milk and cereal food on the health of infants and little children (aged 6 months to 5 years compared to non-fortified food. We reviewed randomized controlled trials using electronic databases (MEDLINE and Cochrane library searches through FEB 2011, reference list screening and hand searches. Three reviewers assessed 1153 studies for eligibility and extracted data. One reviewer assessed risk of bias using predefined forms. Results We included 18 trials in our analysis (n = 5’468 children; range of mean hemoglobin values: 9.0 to 12.6 g/dl. Iron plus multi micronutrient fortification is more effective than single iron fortification for hematologic outcomes. Compared to non-fortified food, iron multi micronutrient fortification increases hemoglobin levels by 0.87 g/dl (95%-CI: 0.57 to 1.16; 8 studies and reduces risk of anemia by 57% (relative risk 0.43; 95%-CI 0.26 to 0.71; absolute risk reduction 22%; number needed to treat 5 [95%-CI: 4 to 6]; 6 Studies. Compared to non-fortified food, fortification increases serum levels of vitamin A but not of zinc. Information about functional health outcomes (e.g. weight gain and morbidity was scarce and evidence is inconclusive. Risk of bias is unclear due to underreporting, but high quality studies lead to similar results in a sensitivity analysis. Conclusions Multi micronutrient fortified milk and cereal products can be an effective option to

  14. Moral Stress, Moral Practice, and Ethical Climate in Community-Based Drug-Use Research: Views From the Front Line.

    Science.gov (United States)

    Fisher, Celia B; True, Gala; Alexander, Leslie; Fried, Adam L

    2013-01-01

    The role of front-line researchers, those whose responsibilities include face-to-face contact with participants, is critical to ensuring the responsible conduct of community-based drug use research. To date, there has been little empirical examination of how front-line researchers perceive the effectiveness of ethical procedures in their real-world application and the moral stress they may experience when adherence to scientific procedures appears to conflict with participant protections. This study represents a first step in applying psychological science to examine the work-related attitudes, ethics climate, and moral dilemmas experienced by a national sample of 275 front-line staff members whose responsibilities include face-to-face interaction with participants in community-based drug-use research. Using an anonymous Web-based survey we psychometrically evaluated and examined relationships among six new scales tapping moral stress (frustration in response to perceived barriers to conducting research in a morally appropriate manner); organizational ethics climate; staff support; moral practice dilemmas (perceived conflicts between scientific integrity and participant welfare); research commitment; and research mistrust. As predicted, front-line researchers who evidence a strong commitment to their role in the research process and who perceive their organizations as committed to research ethics and staff support experienced lower levels of moral stress. Front-line researchers who were distrustful of the research enterprise and frequently grappled with moral practice dilemmas reported higher levels of moral stress. Applying psychometrically reliable scales to empirically examine research ethics challenges can illuminate specific threats to scientific integrity and human subjects protections encountered by front-line staff and suggest organizational strategies for reducing moral stress and enhancing the responsible conduct of research.

  15. Adaptive Management and Social Learning in Collaborative and Community-Based Monitoring: a Study of Five Community-Based Forestry Organizations in the western USA

    Directory of Open Access Journals (Sweden)

    Maria E. Fernandez-Gimenez

    2008-12-01

    Full Text Available Collaborative and community-based monitoring are becoming more frequent, yet few studies have examined the process and outcomes of these monitoring approaches. We studied 18 collaborative or community-based ecological assessment or monitoring projects undertaken by five community-based forestry organizations (CBFs, to investigate the objectives, process, and outcomes of collaborative ecological monitoring by CBF organizations. We found that collaborative monitoring can lead to shared ecological understanding among diverse participants, build trust internally and credibility externally, foster social learning and community-building, and advance adaptive management. The CBFs experienced challenges in recruiting and sustaining community participation in monitoring, building needed technical capacity for monitoring, and communicating monitoring results back to the broader community. Our results suggest that involving diverse and sometimes adversarial interests at key points in the monitoring process can help resolve conflicts and advance social learning, while also strengthening the link between social and ecological systems by improving the information base for management and increasing collective awareness of the interdependence of human and natural forest communities.

  16. Exploring the Position of Community-Based Nursing in Iran: A Qualitative Study

    Directory of Open Access Journals (Sweden)

    Heshmatolah Heydari

    2017-10-01

    Full Text Available Background: Community-based nursing focuses on providing health services to families and communities in the second and third levels of prevention and this can improve the individuals, families and communities’ quality of life, and reduce the healthcare costs. The aim of this study was to explore the status of community-based nursing in Iran. Methods: This qualitative study was conducted from March to November 2015, in Tehran, Iran, using the content analysis approach. The study setting consisted of Iran and Tehran Faculties of Nursing and Midwifery, Tehran, Iran. The purposive sampling method was used. Twenty faculty members and Master’s and PhD students were interviewed by using the face-to-face semi-structured interview method. Moreover, two focus groups were conducted for complementing and enriching the study data. The data were analyzed using the Graneheim and Lundman’s approach to content analysis. The trustworthiness of the study findings was maintained by employing the Lincoln and Guba’s criteria of credibility, dependability, and confirmability. Results: In total, 580 codes were generated and categorized into three main categories of conventional services, the necessity for creating infrastructures, and multidimensional outcomes of community-based nursing. Conclusion: Introducing community-based nursing into nursing education curricula and creating ample job opportunities for community-based nurses seem clearly essential.

  17. Exploring the Position of Community-Based Nursing in Iran: A Qualitative Study.

    Science.gov (United States)

    Heydari, Heshmatolah; Rahnavard, Zahra; Ghaffari, Fatemeh

    2017-10-01

    Community-based nursing focuses on providing health services to families and communities in the second and third levels of prevention and this can improve the individuals, families and communities' quality of life, and reduce the healthcare costs. The aim of this study was to explore the status of community-based nursing in Iran. This qualitative study was conducted from March to November 2015, in Tehran, Iran, using the content analysis approach. The study setting consisted of Iran and Tehran Faculties of Nursing and Midwifery, Tehran, Iran. The purposive sampling method was used. Twenty faculty members and Master's and PhD students were interviewed by using the face-to-face semi-structured interview method. Moreover, two focus groups were conducted for complementing and enriching the study data. The data were analyzed using the Graneheim and Lundman's approach to content analysis. The trustworthiness of the study findings was maintained by employing the Lincoln and Guba's criteria of credibility, dependability, and confirmability. In total, 580 codes were generated and categorized into three main categories of conventional services, the necessity for creating infrastructures, and multidimensional outcomes of community-based nursing. Introducing community-based nursing into nursing education curricula and creating ample job opportunities for community-based nurses seem clearly essential.

  18. Employing continuous quality improvement in community-based substance abuse programs.

    Science.gov (United States)

    Chinman, Matthew; Hunter, Sarah B; Ebener, Patricia

    2012-01-01

    This article aims to describe continuous quality improvement (CQI) for substance abuse prevention and treatment programs in a community-based organization setting. CQI (e.g., plan-do-study-act cycles (PDSA)) applied in healthcare and industry was adapted for substance abuse prevention and treatment programs in a community setting. The authors assessed the resources needed, acceptability and CQI feasibility for ten programs by evaluating CQI training workshops with program staff and a series of three qualitative interviews over a nine-month implementation period with program participants. The CQI activities, PDSA cycle progress, effort, enthusiasm, benefits and challenges were examined. Results indicated that CQI was feasible and acceptable for community-based substance abuse prevention and treatment programs; however, some notable resource challenges remain. Future studies should examine CQI impact on service quality and intended program outcomes. The study was conducted on a small number of programs. It did not assess CQI impact on service quality and intended program outcomes. Practical implications- This project shows that it is feasible to adapt CQI techniques and processes for community-based programs substance abuse prevention and treatment programs. These techniques may help community-based program managers to improve service quality and achieve program outcomes. This is one of the first studies to adapt traditional CQI techniques for community-based settings delivering substance abuse prevention and treatment programs.

  19. Implementing community-based education in basic nursing education programs in South Africa.

    Science.gov (United States)

    Mtshali, N G

    2009-03-01

    Education of health professionals using principles of community-based education is the recommended national policy in South Africa. A paradigm shift to community-based education is reported in a number of nursing education institutions in South Africa. Reviewed literature however revealed that in some educational institutions planning, implementation and evaluation of Community-based Educational (CBE) programmes tended to be haphazard, uncoordinated and ineffective, resulting in poor student motivation. Therefore the purpose of this study was to analyse the implementation of community-based education in basic nursing education programmes in South Africa. Strauss and Corbin's (1990) grounded theory approach guided the research process. Data were collected by means of observation, interviews and document analysis. The findings revealed that collaborative decision-making involving all stakeholders was crucial especially during the curriculum planning phase. Furthermore, special criteria should be used when selecting community learning sites to ensure that the selected sites are able to facilitate the development of required graduate competencies. Collaborative effort, true partnership between academic institutions and communities, as well as government support and involvement emerged as necessary conditions for the successful implementation of community-based education programmes.

  20. Implementing community-based education in basic nursing education programs in South Africa

    Directory of Open Access Journals (Sweden)

    N.G. Mtshali

    2009-09-01

    Full Text Available Education of health professionals using principles of community-based education is the recommended national policy in South Africa. A paradigm shift to community based education is reported in a number of nursing education institutions in South Africa. Reviewed literature however revealed that in some educational institutions planning, implementation and evaluation of Community-based Educational (CBE programmes tended to be haphazard, uncoordinated and ineffective, resulting in poor student motivation. Therefore the purpose of this study was to analyse the implementation of community-based education in basic nursing education programmes in South Africa. Strauss and Corbin’s (1990 grounded theory approach guided the research process. Data were collected by means of observation, interviews and document analysis. The findings revealed that collaborative decision-making involving all stakeholders was crucial especially during the curriculum planning phase. Furthermore, special criteria should be used when selecting community learning sites to ensure that the selected sites are able to facilitate the development of required graduate competencies. Collaborative effort, true partnership between academic institutions and communities, as well as government support and involvement emerged as necessary conditions for the successful implementation of community-based education programmes.

  1. Effects of a multi-micronutrient-fortified beverage, with and without sugar, on growth and cognition in South African schoolchildren: a randomised, double-blind, controlled intervention.

    Science.gov (United States)

    Taljaard, Christine; Covic, Namukolo M; van Graan, Averalda E; Kruger, Herculina S; Smuts, Cornelius M; Baumgartner, Jeannine; Kvalsvig, Jane D; Wright, Hattie H; van Stuijvenberg, Martha E; Jerling, Johann C

    2013-12-01

    Little is known about the effects of combined micronutrient and sugar consumption on growth and cognition. In the present study, we investigated the effects of micronutrients and sugar, alone and in combination, in a beverage on growth and cognition in schoolchildren. In a 2 × 2 factorial design, children (n 414, 6-11 years) were randomly allocated to consume beverages containing (1) micronutrients with sugar, (2) micronutrients with a non-nutritive sweetener, (3) no micronutrients with sugar or (4) no micronutrients with a non-nutritive sweetener for 8.5 months. Growth was assessed and cognition was tested using the Kaufman Assessment Battery for Children version II (KABC-II) subtests and the Hopkins Verbal Learning Test (HVLT). Micronutrients decreased the OR for Fe deficiency at the endpoint (OR 0.19; 95% CI 0.07, 0.53). Micronutrients increased KABC Atlantis (intervention effect: 0.76; 95% CI 0.10, 1.42) and HVLT Discrimination Index (1.00; 95% CI 0.01, 2.00) scores. Sugar increased KABC Atlantis (0.71; 95% CI 0.05, 1.37) and Rover (0.72; 95% CI 0.08, 1.35) scores and HVLT Recall 3 (0.94; 95% CI 0.15, 1.72). Significant micronutrient × sugar interaction effects on the Atlantis, Number recall, Rover and Discrimination Index scores indicated that micronutrients and sugar in combination attenuated the beneficial effects of micronutrients or sugar alone. Micronutrients or sugar alone had a lowering effect on weight-for-age z-scores relative to controls (micronutrients - 0.08; 95% CI - 0.15, - 0.01; sugar - 0.07; 95% CI - 0.14, - 0.002), but in combination, this effect was attenuated. The beverages with micronutrients or added sugar alone had a beneficial effect on cognition, which was attenuated when provided in combination.

  2. Developing community based rehabilitation for cancer survivors: Organizing for coordination and coherence in practice

    DEFF Research Database (Denmark)

    la Cour, Karen; Cutchin, Malcolm

    2013-01-01

    Background. Increasing incidence of cancer combined with prolonged survival have raised the need for developing community based rehabilitation. The objectives of the analysis were to describe and interpret the key issues related to coordination and coherence of community-based cancer rehabilitation......-based organization, and informal relationships were fundamental for developing coordination and coherence. Conclusions. Coordination and coherence in community-based rehabilitation relies on increased collaboration, which may best be optimized by use of shared frameworks within and across systems. Results highlight...... in Denmark and to provide insights relevant for other contexts. Methods. Twenty-seven rehabilitation managers across 15 municipalities in Denmark comprised the sample. The study was designed with a combination of data collection methods including questionnaires, individual interviews, and focus groups...

  3. Recommendations for scale-up of community-based misoprostol distribution programs.

    Science.gov (United States)

    Robinson, Nuriya; Kapungu, Chisina; Carnahan, Leslie; Geller, Stacie

    2014-06-01

    Community-based distribution of misoprostol for prevention of postpartum hemorrhage (PPH) in resource-poor settings has been shown to be safe and effective. However, global recommendations for prenatal distribution and monitoring within a community setting are not yet available. In order to successfully translate misoprostol and PPH research into policy and practice, several critical points must be considered. A focus on engaging the community, emphasizing the safe nature of community-based misoprostol distribution, supply chain management, effective distribution, coverage, and monitoring plans are essential elements to community-based misoprostol program introduction, expansion, or scale-up. Copyright © 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  4. [Extension of health coverage and community based health insurance schemes in Africa: Myths and realities].

    Science.gov (United States)

    Boidin, B

    2015-02-01

    This article tackles the perspectives and limits of the extension of health coverage based on community based health insurance schemes in Africa. Despite their strong potential contribution to the extension of health coverage, their weaknesses challenge their ability to play an important role in this extension. Three limits are distinguished: financial fragility; insufficient adaptation to characteristics and needs of poor people; organizational and institutional failures. Therefore lessons can be learnt from the limits of the institutionalization of community based health insurance schemes. At first, community based health insurance schemes are to be considered as a transitional but insufficient solution. There is also a stronger role to be played by public actors in improving financial support, strengthening health services and coordinating coverage programs.

  5. Reduction of phytic acid and enhancement of bioavailable micronutrients in food grains.

    Science.gov (United States)

    Gupta, Raj Kishor; Gangoliya, Shivraj Singh; Singh, Nand Kumar

    2015-02-01

    More than half of the world populations are affected by micronutrient malnutrition and one third of world's population suffers from anemia and zinc deficiency, particularly in developing countries. Iron and zinc deficiencies are the major health problems worldwide. Phytic acid is the major storage form of phosphorous in cereals, legumes, oil seeds and nuts. Phytic acid is known as a food inhibitor which chelates micronutrient and prevents it to be bioavailabe for monogastric animals, including humans, because they lack enzyme phytase in their digestive tract. Several methods have been developed to reduce the phytic acid content in food and improve the nutritional value of cereal which becomes poor due to such antinutrient. These include genetic improvement as well as several pre-treatment methods such as fermentation, soaking, germination and enzymatic treatment of grains with phytase enzyme. Biofortification of staple crops using modern biotechnological techniques can potentially help in alleviating malnutrition in developing countries.

  6. The coexistence of other micronutrient deficiencies in anaemic adolescent schoolgirls in rural Bangladesh.

    Science.gov (United States)

    Ahmed, F; Khan, M R; Banu, C P; Qazi, M R; Akhtaruzzaman, M

    2008-03-01

    To investigate the prevalence of selected micronutrient deficiencies amongst anaemic adolescent schoolgirls in rural Bangladesh and to examine their relationship with haemoglobin (Hb) levels. A cross-sectional study. Girls' high schools in rural areas of Dhaka District in Bangladesh. Three hundred and ten anaemic adolescent girls aged 14-18 years from eight schools participated in the study. Information on personal characteristics and food habits were collected by interview. Parents were asked about their socio-economic conditions. Anthropometric data and blood samples were collected following the interview. Twenty-eight per cent of the girls had depleted iron stores (serum ferritin or =1.4) and 7% had vitamin B(12) deficiencies (serum vitamin B(12) Bangladesh, although they do not suffer from energy deficiency. Of all micronutrients, only iron and vitamin B(2) concentrations were found to be related to the Hb concentration.

  7. Role of Macronutrients and Micronutrients in DNA Damage: Results From a Food Frequency Questionnaire

    Directory of Open Access Journals (Sweden)

    Carina Ladeira

    2017-02-01

    Full Text Available The links between diet and genomic instability have been under investigation for several decades, and evidence suggests a significant causal or preventive role for various dietary factors. This study investigates the influence of macronutrients (calories, protein, and glucides and micronutrients, such as vitamins and minerals, as assessed by a food frequency questionnaire, on genotoxicity biomarkers measured by cytokinesis-blocked micronucleus assay and comet assay. The results found significant positive and negative correlations. Micronucleus frequency tends to increase with higher intake of caffeine, calcium, magnesium, zinc, and protein ( P  < .05, Spearman correlation. Calorie and omega-6 intakes are negatively correlated with DNA damage measured by the comet assay. These results are somewhat controversial because some of the correlations found are contrary to dominant views in the literature; however, we suggest that unraveling the association between diet and genetic instability requires a much better understanding of the modulating role of macronutrients and micronutrients.

  8. New criteria for supplementation of selected micronutrients in the era of nutrigenetics and nutrigenomics.

    Science.gov (United States)

    Schwartz, Betty

    2014-08-01

    Advances in molecular biology, emergence of novel techniques and huge amount of information generated in the post-Human Genome Project era have fostered the emergence of new disciplines in the field of nutritional research: Nutrigenomics deals with the effect of diet on gene expression whereas nutrigenetics refers to the impact of inherited traits on the response to a specific dietary pattern, functional food or supplement. Understanding the role of micronutrient supplementation with specific genetic backgrounds may provide an important contribution to a new optimum health strategy based on individualized nutritional treatment and may provide the strategies for the development of safer and more effective dietary interventions. This overview of the various aspects of supplementation of micronutrients in the era of nutrigenetics and nutrigenomics may provide a better understanding of novel nutritional research approach and provide an additional insight that can be applied to the daily dietary practice.

  9. Reparative Osteogenesis in Normal Conditions and in Micronutrient Iodine and Selenium Deficiency

    Directory of Open Access Journals (Sweden)

    P.Ye. Kovalchuk

    2015-04-01

    Full Text Available Today, a number of unresolved issues remains without researchers’ attention and should be explored, among them: the impact of selenium and iodine deficiencies on bone tissue, healing of bone defects and morphological peculiarities of the process under micronutrient iodine and selenium deficiency. This paper presents the results of experimental study of physiological features and reparative osteogenesis in posttraumatic defects of femoral metadiaphysis under selenium and iodine deficiency. The data that we have shown testify the negative impact of micronutrient deficiency on reparative osteogenesis that is manifested by inhibition of this process and is accompanied by the formation of bone regenerate, deterioration of structural and functional state of bone tissue, development of degenerative and necrotic changes in bone tissue and epiphyseal cartilage.

  10. Using Analysis of Governance to Unpack Community-Based Conservation: A Case Study from Tanzania.

    Science.gov (United States)

    Robinson, Lance W; Makupa, Enock

    2015-11-01

    Community-based conservation policies and programs are often hollow with little real devolution. But to pass a judgment of community-based or not community-based on such initiatives and programs obscures what is actually a suite of attributes. In this paper, we analyze governance around a specific case of what is nominally community-based conservation-Ikona Wildlife Management Area (WMA) in Tanzania-using two complementary sets of criteria. The first relates to governance "powers": planning powers, regulatory powers, spending powers, revenue-generating powers, and the power to enter into agreements. The second set of criteria derive from the understanding of governance as a set of social functions: social coordination, shaping power, setting direction, and building community. The analysis helps to detail ways in which the Tanzanian state through policy and regulations has constrained the potential for Ikona WMA to empower communities and community actors. Although it has some features of community-based conservation, community input into how the governance social functions would be carried out in the WMA was constrained from the start and is now largely out of community hands. The two governance powers that have any significant community-based flavor-spending powers and revenue-generating powers-relate to the WMA's tourism activities, but even here the picture is equivocal at best. The unpacking of governance that we have done, however, reveals that community empowerment through the processes associated with creating and recognizing indigenous and community-conserved areas is something that can be pursued through multiple channels, some of which might be more strategic than others.

  11. Micronutrient mineral and folate content of Australian and imported dried fruit products.

    Science.gov (United States)

    Bennett, Louise E; Singh, Davinder P; Clingeleffer, Peter R

    2011-01-01

    A selection of Australian and imported fresh and dried fruit products, including sultanas, Sunmuscats, Carina currants, Zante currants, apricots, and prunes, were analyzed for selected minerals (Ca, Mg, Na, S, B, Al, Fe, Mn, Cu, Zn, Mo, and Se), folate and vitamin C, and the capacity of dried fruits for dietary provision of these micronutrients evaluated. Micro-nutrients were concentrated by a factor of 3-5 in dried fruits compared with their fresh fruit counterparts and were consequently present in nutritionally significant levels, in contrast to fresh fruit. Australian dried sultanas, Carina currant, Zante currant, apricots, and prunes contained Cu, Fe, K, and Mn at levels of >20% of daily Required Dietary Intake (RDI, taken as the average for adult men and women as nominated by the Australian National Health and Medical Research Council) and Sunmuscats contained Cu, Fe, and K at >20% of RDI. All dried fruits studied contained boron in the range of 1.5 to 5.4 mg per 100 g; however, the RDI for boron has not been defined by the NHMRC at the present time. All sultanas and currants studied contained folate at levels of 10-20% of RDI per 100 g. Experimental drying methods significantly affected folate levels with higher folate content in non-ground versus ground-based drying methods. Of the micro-nutrients supplying >20% of RDI, folate represents a particular nutrient for which the mean daily intake of adult Australians is typically inadequate. This study shows that dried fruit consumption, in contrast with fresh fruit, can provide significant proportions of daily requirements of several micronutrients, particularly folate.

  12. Long-term outcome of patients with chronic pancreatitis treated with micronutrient antioxidant therapy.

    Science.gov (United States)

    Rupasinghe, Sukitha Namal; Siriwardena, Ajith K

    2017-04-01

    Micronutrient antioxidant therapy did not relieve pain in a European randomized trial of patients with chronic pancreatitis without malnutrition. However, intervention was undertaken only for 6 months leaving unanswered the question of whether long-term antioxidant therapy may modulate chronic pancreatitis. The aim of this study is to assess the outcome of long-term use of micronutrient antioxidant therapy in patients with chronic pancreatitis. This is a single center clinical cohort report of patients with chronic pancreatitis prescribed micronutrient antioxidant therapy and followed for up to 10 years. Data were collected on demographic detail, clinic pain assessment, insulin requirements, interventions and outcome. A group of 30 patients with a diagnosis of chronic pancreatitis constitute the study population. Median age at time of diagnosis was 40 years (range 14-66); 19 (63%) were male and the median duration of symptoms was 2 years (range 0-18). Alcohol was the dominant cause in 22 (73%) patients and 16 (53%) patients were Cambridge stage 1. Twenty-four (80%) patients had pain at presentation. During antioxidant treatment of 4 years (range 1-10), pain decreased but the proportion with abdominal pain compared to those who were pain-free remained constant (P=0.16; two-way ANOVA with Bonferroni correction). There was a significant increase in requirement for insulin (P=0.028) with time together with use of both endoscopic and surgical interventions. This is the first study to report long-term disease-specific outcome in patients with chronic pancreatitis prescribed micronutrient antioxidant therapy. There appears to be no effect of intervention on outcome.

  13. Decrease in specific micronutrient intake in colorectal cancer patients with tumors presenting Ki-ras mutation

    OpenAIRE

    JORDI SALAS; NURIA LASO; SERGI MAS; M. JOSE LAFUENTE; XAVIER CASTERAD; MANUEL TRIAS; ANTONIO BALLESTA; RAFAEL MOLINA; CARLOS ASCASO; SHICHUN ZHENG; JOHN K. WIENCKE; AMALIA LAFUENTE

    2004-01-01

    Decrease in specific micronutrient intake in colorectal cancer patients with tumors presenting Ki-ras mutation BACKGROUND: The diversity of the Mediterranean diet and the heterogeneity of acquired genetic alterations in colorectal cancer (CRC) led us to examine the possible association between dietary factors and mutations, such as Ki-ras mutations, in genes implicated in the pathogenesis of these neoplasms. PATIENTS AND METHODS: The study was based on 246 cases and 296 controls. For th...

  14. Societal Costs of Micronutrient Deficiencies in 6- to 59-month-old Children in Pakistan.

    Science.gov (United States)

    Wieser, Simon; Brunner, Beatrice; Tzogiou, Christina; Plessow, Rafael; Zimmermann, Michael B; Farebrother, Jessica; Soofi, Sajid; Bhatti, Zaid; Ahmed, Imran; Bhutta, Zulfiqar A

    2017-12-01

    In Pakistan, nearly half of children younger than 5 years are stunted, and 1 in 3 is underweight. Micronutrient deficiencies, a less visible form of undernutrition, are also endemic. They may lead to increased morbidity and mortality as well as to impaired cognitive and physical development. To estimate the lifetime costs of micronutrient deficiencies in Pakistani children aged between 6 and 59 months. We develop a health economic model of the lifetime health and cost consequences of iodine, iron, vitamin A, and zinc deficiencies. We assess medical costs, production losses in terms of future incomes lost, and disability-adjusted life-years (DALYs). The estimation is based on large population surveys, information on the health consequences of micronutrient deficiencies extracted from randomized trials, and a variety of other sources. Total societal costs amount to US$46 million in medical costs, US$3,222 million in production losses, and 3.4 million DALYs. Costs are dominated by the impaired cognitive development induced by iron-deficiency anemia in 6- to 23-month-old children and the mortality caused by vitamin A deficiency. Costs are substantially higher in poorer households. Societal costs amounted to 1.44% of gross domestic product and 4.45% of DALYs in Pakistan in 2013. These costs hinder the country's development. They could be eliminated by improved nutrition of 6- to 59-month-old children and public health measures. Our results may contribute to the design of cost-effective interventions aiming to reduce micronutrient deficiencies in early childhood and their lifetime consequences.

  15. Stability and retention of micronutrients in fortified rice prepared using different cooking methods.

    Science.gov (United States)

    Wieringa, Frank T; Laillou, Arnaud; Guyondet, Christophe; Jallier, Vincent; Moench-Pfanner, Regina; Berger, Jacques

    2014-09-01

    Fortified rice holds great potential for bringing essential micronutrients to a large part of the world population. However, it is unknown whether differences in cooking methods or in production of rice premix affect the final amount of micronutrient consumed. This paper presents a study that quantified the losses of five different micronutrients (vitamin A, iron, zinc, folic acid, and vitamin B12) in fortified rice that was produced using three different techniques (hot extrusion, cold extrusion, and coating) during cooking and five different cooking methods (absorption method with or without soaking, washing before cooking, cooking in excess water, and frying rice before cooking). Fortified rice premix from six different producers (two for each technique) was mixed with normal rice in a 1:100 ratio. Each sample was prepared in triplicate, using the five different cooking methods, and retention of iron, zinc, vitamin A, vitamin B12, and folic acid was determined. It was found that the overall retention of iron, zinc, vitamin B12, and folic acid was between 75% and 100% and was unaffected by cooking method, while the retention of vitamin A was significantly affected by cooking method, with retention ranging from 0% (excess water) to 80% (soaking), depending on the cooking method and producer of the rice premix. No systematic differences between the different production methods were observed. We conclude that different cooking methods of rice as used in different regions of the world do not lead to a major loss of most micronutrients, with the exception of vitamin A. The factors involved in protecting vitamin A against losses during cooking need to be identified. All production techniques of rice premix yielded similar results, showing that coating is not inferior to extrusion techniques. Standard overages (50%) for vitamin B12 and folic acid are too high. © 2014 New York Academy of Sciences.

  16. HEAVY METALS AND MICRONUTRIENTS IN THE SOIL AND GRAPEVINE UNDER DIFFERENT IRRIGATION STRATEGIES

    Directory of Open Access Journals (Sweden)

    Vanessa de Souza Oliveira

    2015-02-01

    Full Text Available Soils under natural conditions have heavy metals in variable concentrations and there may be an increase in these elements as a result of the agricultural practices adopted. Transport of heavy metals in soil mainly occurs in forms dissolved in the soil solution or associated with solid particles, water being their main means of transport. In this context, the aim of this study was to evaluate the heavy metal and micronutrient content in the soil and in the grapevine plant and fruit under different irrigation strategies. The experiment was carried out in Petrolina, PE, Brazil. The treatments consisted of three irrigation strategies: full irrigation (FI, regulated deficit irrigation (RDI, and deficit irrigation (DI. During the period of grape maturation, soil samples were collected at the depths of 0-10, 10-20, 20-40, 40-60, and 60-80 cm. In addition, leaves were collected at the time of ripening of the bunches, and berries were collected at harvest. Thus, the heavy metal and micronutrient contents were determined in the soil, leaves, and berries. The heavy metal and micronutrient contents in the soil showed a stochastic pattern in relation to the different irrigation strategies. The different irrigation strategies did not affect the heavy metal and micronutrient contents in the vine leaves, and they were below the contents considered toxic to the plant. In contrast, the greater availability of water in the FI treatment favored a greater Cu content in the grape, which may be a risk to vines, causing instability and turbidity. Thus, adoption of deficit irrigation is recommended so as to avoid compromising the stability of tropical wines of the Brazilian Northeast.

  17. Micronutrients attenuate progression of prostate cancer by elevating the endogenous inhibitor of angiogenesis, Platelet Factor-4

    International Nuclear Information System (INIS)

    Cervi, David; Pak, Brian; Venier, Natalie A; Sugar, Linda M; Nam, Robert K; Fleshner, Neil E; Klotz, Laurence H; Venkateswaran, Vasundara

    2010-01-01

    Longstanding evidence implicates an inadequate diet as a key factor in the onset and progression of prostate cancer. The purpose herein was to discover, validate and characterize functional biomarkers of dietary supplementation capable of suppressing the course of prostate cancer in vivo. The Lady transgenic mouse model that spontaneously develops prostate cancer received a diet supplemented with a micronutrient cocktail of vitamin E, selenium and lycopene ad libitum. A proteomic analysis was conducted to screen for serum biomarkers of this dietary supplementation. Candidate peptides were validated and identified by sequencing and analyzed for their presence within the prostates of all mice by immunohistochemistry. Dietary supplementation with the combined micronutrients significantly induced the expression of the megakaryocyte-specific inhibitor of angiogenesis, platelet factor-4 (P = 0.0025). This observation was made predominantly in mice lacking tumors and any manifestations associated with progressive disease beyond 37 weeks of life, at which time no survivors remained in the control group (P < 0.0001). While prostates of mice receiving standard chow were enlarged and burdened with poorly differentiated carcinoma, those of mice on the supplemented diet appeared normal. Immunohistochemical analysis revealed marked amplifications of both platelet binding and platelet factor-4 within the blood vessels of prostates from mice receiving micronutrients only. We present unprecedented data whereby these combined micronutrients effectively promotes tumor dormancy in early prostate cancer, following initiation mutations that may drive the angiogenesis-dependent response of the tumor, by inducing platelet factor-4 expression and concentrating it at the tumor endothelium through enhanced platelet binding

  18. Prenatal Micronutrient Supplementation Is Not Associated with Intellectual Development of Young School-Aged Children.

    Science.gov (United States)

    Li, Chao; Zeng, Lingxia; Wang, Duolao; Yang, Wenfang; Dang, Shaonong; Zhou, Jing; Yan, Hong

    2015-08-01

    Micronutrient supplementation is often prescribed during pregnancy. The effects of prenatal iron and multimicronutrient supplementation on intellectual development in young school-aged children are less than clear. The aim of this study was to examine the long-term effects of prenatal iron plus folic acid or multiple micronutrient (including iron and folic acid) supplementation vs. folic acid supplementation on the intellectual development of young school-aged children in rural China. Young school-aged children (aged 7-10 y, n = 1744) of women who had participated in a trial of prenatal supplementation with various combinations of micronutrients and remained residents in 2 rural counties in China were followed. We measured their intellectual development by Wechsler Intelligence Scale for Children Fourth Edition (WISC-IV). The WISC-IV generated the Full-Scale Intelligence Quotient (FSIQ), Verbal Comprehension Index (VCI), Working Memory Index (WMI), Perceptual Reasoning Index (PRI), and Processing Speed Index (PSI). Multilevel analyses were used to assess the effect of prenatal micronutrient supplementation on the intellectual development of children. The mean differences in FSIQ, VCI, WMI, PRI, and PSI, respectively, were not significant between prenatal folic acid supplementation and either iron plus folic acid [-0.34 (P = 0.65), -0.06 (P = 0.95), -0.22 (P = 0.76), -0.01 (P = 0.99), and -1.26 (P = 0.11)] or multimicronutrient [-0.39 (P = 0.60), -0.64 (P = 0.48), 0.11 (P = 0.87), -0.43 (P = 0.59), and -0.34; (P = 0.65)] supplementation after adjusting for confounders. There is no evidence to suggest a different effect on intellectual development between prenatal iron plus folic acid, multimicronutrient supplementation, and prenatal folic acid supplementation in children aged 7-10 y. This trial was registered at www.isrctn.com as ISRCTN08850194. © 2015 American Society for Nutrition.

  19. Hidden hunger or knowledge hunger? Nutritional knowledge, diet diversity and micronutrient intake in Rwanda: The case of Vitamin A

    OpenAIRE

    Okello, Julius J.; Sindi, Kirimi; Low, Jan; Shikuku, Kelvin M.

    2013-01-01

    The problem of hidden hunger has emerged as one of the major development issues alongside food security. This problem highlights the likelihood of households having access to inadequate amount of key micronutrients in a diet despite having access to adequate quantities of food. , This paper uses a recent detailed household consumption data to investigate households’ nutritional knowledge, the diversity of diets consumed, and the micronutrient uptake, focusing specifically on Vitamin A. The st...

  20. IMPACT OF SOCIAL CAPITAL CHARACTERISTICS ON THE EFFECTIVENESS OF COMMUNITY-BASED APPROACH TO LOCAL DEVELOPMENT

    Directory of Open Access Journals (Sweden)

    N. Grazhevska

    2013-10-01

    Full Text Available The article examines the impact of social capital characteristics of local communities on the effectiveness of the community-based approach to economic development. The conclusion that such social capital characteristics as (antipaternalism, solidarity and cooperation have the greatest importance for the economic development is made based on the analysis of UNDP and the European Union project “Community-based approach to local development”. It was hypothesized that the creation of community organizations could be an effective mechanism to actualize the existing social capital of rural communities in Ukraine.