Full text: Dhaka, Bangladesh - Malnutrition remains the world's most serious health problem and the single biggest contributor to child deaths in the developing world, according to the World Bank. Now, the International Atomic Energy Agency (IAEA) is using its Nobel Peace Prize earnings to promote the use of nuclear techniques to combat malnutrition during the earliest years of life. 'One out of every ten children born in developing countries will die before his or her fifth birthday,' explains IAEA nutrition expert Lena Davidsson. 'That's more than 10 million dead children each year. And the vast majority of these child deaths in developing countries are preventable with a combination of good care, adequate nutrition and appropriate medical treatment,' explains Dr. Davidsson. 'This brings us hope that unacceptably high childhood mortality can be substantially reduced with effective and well-targeted nutritional interventions.' Undernutrition is an important factor in more than half of all child deaths worldwide. The high prevalence of infants born with low birth weight and undernutrition among Asian children, especially in South Asia, emphasizes the urgent need to develop effective nutrition interventions within 'the window of opportunity', i.e., to target young women before pregnancy as well as infants and young children during the first 2 years of life. The IAEA Nobel Peace Prize Fund School for Nutrition for Asia will be held in Dhaka, Bangladesh, April 22-26, 2007. It will focus on Interventions to combat undernutrition during early life and seeks to disseminate information about the usefulness of stable isotope techniques in intervention programs that reduce malnutrition, in particular in infants and children. The event is hosted by the Government of Bangladesh through the International Centre for Health and Population Research (ICDDR, B) and the Bangladesh Atomic Energy Commission (BAEC). The IAEA is assisting some of the world's poorest countries in their
Simon, Paul A; Chiang, Choiyuk; Lightstone, Amy S; Shih, Margaret
We assessed public opinion on nutrition-related policies to address child obesity: a soda tax, restrictions on advertising unhealthy foods and beverages to children, and restrictions on siting fast food restaurants and convenience stores near schools. We analyzed data from 998 adults (aged ≥18 years) in the 2011 Los Angeles County Health Survey. Support was highest for advertising restrictions (74%), intermediate for a soda tax (60%), and lowest for siting restrictions on fast food restaurants and convenience stores (44% and 37%, respectively). Support for food and beverage advertising restrictions and soda taxation is promising for future policy efforts to address child obesity.
Simon, Paul A.; Chiang, Choiyuk; Lightstone, Amy S.; Shih, Margaret
We assessed public opinion on nutrition-related policies to address child obesity: a soda tax, restrictions on advertising unhealthy foods and beverages to children, and restrictions on siting fast food restaurants and convenience stores near schools. We analyzed data from 998 adults (aged ≥18 years) in the 2011 Los Angeles County Health Survey. Support was highest for advertising restrictions (74%), intermediate for a soda tax (60%), and lowest for siting restrictions on fast food restaurant...
Malnutrition stunts physical growth and/or limits mental development in one child out of three in developing countries and is a factor in one-third of the 13 million child deaths which occur annually in developing countries. The Department of Technical Co-operation is sponsoring a programme, with technical support from the Human Health Division, to evaluate the effectiveness of a Government food supplement intervention to combat malnutrition in Peru. (IAEA)
... page: //medlineplus.gov/ency/patientinstructions/000164.htm Enteral nutrition - child - managing problems To use the sharing features ... trouble breathing, call 911. References Mcclave SA. Enteral nutrition. In: Goldman L, Schafer AI, eds. Goldman-Cecil ...
There are preventive pre-marriage measures to protect children threatened with forced marriages. An application may be made for an Emergency Protection Order. (EPO). Where the EPO is granted, but the parents are the threat to the child, the court could be asked for a presumption of non-contract for the duration of EPO to ...
Utah State Office of Education, Salt Lake City.
Recognizing the importance of efficient and effective program administration for the success of Utah's Child Nutrition Programs, the State Office of Education developed a manual to assist local program administrators in using the U.S. Department of Agriculture's (USDA's) programs. This document contains Part 1 of the manual's four interrelated…
... Health Topic - English Nutrición del niño: Tema de salud de MedlinePlus - español (Spanish) ... PDF Office of Oral Health Maryland Department of Health and Mental Hygiene A Healthy Smile for Your Young Child: ...
Efforts to reduce malnutrition, particularly in densely populated, peri-urban areas, is considered a priority among governments around the world. The problem is especially acute in Africa due to the high prevalence of malnutrition and micronutrient deficiency. The International Atomic Energy Agency is providing technical support to a community nutrition programme in Senegal where nuclear techniques help to monitor the programme's effectiveness in order to ensure that it produces maximum benefits on vulnerable groups (women and children). (IAEA)
Full Text Available The presentation/paper focuses on the challenges and necessity of building capacity at local, national, and international levels with a focus of how to more effectively combat trafficking in human beings (THB. Insight from several of initiatives are shared with the aim of illustrating how to capitalize on the vast number of opportunities that already exist at these levels and how they might be coordinated to enable collaborative work in an informed and dynamic manner to combat human trafficking. Information from several recent research projects that focus on some of these same issues is also incorporated into this paper. El artículo se centra en los desafíos de la lucha contra el tráfico de personas y en la necesidad de aumentar la capacidad para ser más eficaces en ese sentido, local, nacional e internacionalmente. Nos hacemos eco de la visión de varias iniciativas, con el fin de ilustrar cómo capitalizar el gran número de oportunidades que ya existen en los ámbitos citados, y la forma en que se podrían coordinar para posibilitar la colaboración de una manera informada y dinámica para combatir la trata de personas. También se incluye en el artículo información emanada de diversos proyectos recientes de investigación sobre el tema que nos ocupa. DOWNLOAD THIS PAPER FROM SSRN: http://ssrn.com/abstract=3086067
... 45 Public Welfare 4 2010-10-01 2010-10-01 false Child nutrition. 1304.23 Section 1304.23 Public... AGENCIES Early Childhood Development and Health Services § 1304.23 Child nutrition. (a) Identification of... into account staff and family discussions concerning: (1) Any relevant nutrition-related assessment...
Mathur, Shivani; Chopra, Rahul
Child abuse has serious physical and psychosocial consequences which adversely affect the health and overall well-being of a child. However, in a developing country like India there has been no knowledge of the extent, magnitude and trends of the problem. This study reviews the overall scenario of child abuse in India as well as the role of the dentist in recognising and thereby combating this problem. Among health professionals, dentists are probably in the most favourable position to recognise child abuse, with opportunities to observe and assess not only the physical and the psychological condition of the children, but also the family environment. The high frequency of facial injuries associated with physical abuse places the dentist at the forefront of professionals to detect and treat an abused child. Screening for maltreatment should be an integral part of any clinical examination performed on a child. Although many injuries are not caused by abuse, dentists should always be suspicious of traumatic injuries. The dental professional's role in child abuse and neglect is to know the current state law regarding reporting child abuse and to follow the law. Awareness, identification, documentation and notification should be carried out by the dentist. Paediatric dentists can provide valuable information and assistance to physicians about oral and dental aspects of child abuse and neglect. Such efforts will strengthen the ability to prevent and detect child abuse and neglect and enhance care and protection for the children.
Kimenju, Simon; Qaim, Matin
We analyze how the nutrition transition affects child malnutrition in developing countries. It is often assumed that the nutrition transition affects child weight but not child growth, which could be one reason why child underweight decreases faster than child stunting. But these effects have hardly been analyzed empirically. Our cross-country panel regressions show that the nutrition transition reduces child underweight, while no consistent effect on child overweight is found. Against common...
Grantham-McGregor, Sally M; Fernald, Lia C H; Kagawa, Rose M C; Walker, Susan
We conducted a systematic review of studies that examined the effect of interventions combining a child development component with a nutrition one; in some cases the nutrition interventions also included health-promotion components. Only papers with both child development and nutrition outcomes and rated as moderate-to-good quality were included. Eleven efficacy and two nonrandomized trials, and eight program evaluations were identified. Only six trials examined interventions separately and combined. The trials showed nutritional interventions usually benefited nutritional status and sometimes benefited child development. Stimulation consistently benefited child development. There was no significant loss of any effect when interventions were combined, but there was little evidence of synergistic interaction between nutrition and stimulation on child development. Only three trials followed up the children after intervention. All at-scale program evaluations were combined interventions. Five benefited child development, but one did not, and two showed deficits. There was generally little benefit of at-scale programs to nutritional status. We found no rigorous evaluations of adding stimulation to health and nutrition services at scale and there is an urgent need for them. There is also a need to establish quality-control mechanisms for existing scaled-up programs and to determine their long-term effects. There is also a need to determine if there are any sustained benefits for the children after programs finish. © 2013 New York Academy of Sciences.
The aim of the research in this thesis was to assess, through cross-sectional school child health surveys, the health and nutrition of primary school children (5-11 years) in Merseyside, England, in relation to their mother’s history of pregnancy smoking. Childhood health outcomes assessed included
Hoorweg, J.C.; Niemeijer, R.
In this monograph three major types of intervention in child nutrition are examined: nutrition education, food supplementation and nutrition rehabilitation. Detailed evaluations were carried out, between 1976 and 1979, of programmes in Central Kenya operating under different ecological
Sobkoviak, Rudina M; Yount, Kathryn M; Halim, Nafisa
Domestic violence against women is endemic globally and is an important social problem in its own right. A compounding concern is the impact of domestic violence against mothers on the nutritional status of their children. Liberia is an apt setting to examine this understudied topic, given the poor nutritional status of young children, high rate of domestic violence against women, and prolonged period of conflict that included systematic sexual violence against women. We expected that maternal exposure to domestic violence would predict lower anthropometric z-scores and higher odds of stunting, wasting, and underweight in children less than five years. Using data from 2467 mother-child dyads in the 2007 Liberia Demographic and Health Survey (LDHS) undertaken between December 24, 2006 and April 19, 2007, we conducted descriptive and multivariate analyses to examine the total, unadjusted and adjusted associations of maternal exposure to domestic violence with these anthropometric measures in children. Maternal reports of sexual domestic violence in the prior year predicted lower adjusted z-scores for height-for-age and weight-for-height as well as higher odds of stunting and underweight. The findings underscore the needs to (1) enhance and enforce conventional and customary laws to prevent the occurrence of domestic violence; (2) treat maternal survivors of domestic violence and screen their children for nutritional deficits; (3) heighten awareness of the intergenerational implications especially of recent sexual domestic violence; and (4) clarify the biological and behavior pathways by which domestic violence may influence child growth, thereby mitigating early growth failure and its adverse implications into adulthood. Copyright © 2011 Elsevier Ltd. All rights reserved.
Boudreaux, Monique C.; Lord, Wayne D.
High-profile media coverage of crimes against children has heightened public awareness of critical child safety needs and issues. However, numerous research studies in the area of child homicide have illustrated the importance of the power of science to correct false perceptions and misinformation, improving how to best serve and protect our…
Examines mainly practical activities of trade unions to fight child labor. Argues that trade unions can give the most significant contribution to the struggle against child labor by focusing on methods that are typical for, or even exclusive to, the trade union movement, in particular negotiations and collective bargaining. (Author)
Wade, Cheryl; And Others
Prepared for food manufacturers, this publication contains instructions for calculating the contribution that a meat or poultry product makes toward the meal pattern requirements of child nutrition programs. It also contains instructions on how to apply for and obtain the approval for a label containing a child nutrition statement. These…
Review of current practices and recent developments in impact evaluation of nutrition programmes for preschool children in developing countries. A survey of the major types of nutrition programmes for young children - nutrition education, food supplementation, and nutrition rehabilitation - is
The upbringing of children relies heavily on shared responsibilities between parents and society. The Council of Europe Recommendation (2006) 19 on Policy to Support Positive Parenting and the European Commission Recommendation (2013) Investing in Children: Breaking the Cycle of Disadvantage, both aim at supporting parents to care and provide for their children in accordance with the UN Convention on the Rights of the Child. By means of a document analysis this article examines what kind of parental practices and provision to parents the recommendations suggest to safeguard children's rights in the family. Three findings are highlighted: first, both recommendations reflect a commitment to respecting children's rights while at the same time acknowledging parents as children's primary caregivers. Second, both recognize parents' rights to work, while also recognizing the necessity of adequate income support if work is not available or income too low. Third, adequate resources are defined as a combination of universal policies and services, which guarantee a minimum level for all, and targeted measures reaching out to the most disadvantaged. The recommendations' emphasis on children and parents as partners and on the families' economic situations are valuable for future development of family and child policy and support programs.
Martin, M. Josephine
The role of health educators in integrating child nutrition programs into school health education is discussed and issues attending such programs are considered. The importance of breakfast and lunch programs in the school is stressed with particular emphasis on using these programs to instruct children in sound nutritional practices. It is…
Review of current practices and recent developments in impact evaluation of nutrition programmes for preschool children in developing countries. A survey of the major types of nutrition programmes for young children - nutrition education, food supplementation, and nutrition rehabilitation - is followed by a discussion of the problems confronting impact evaluation. Firstly, methodological difficulties often weaken the power of the evaluation or restrict its scope. Secondly, the effects of most...
Oliveira, Fabiana de Cássia Carvalho; Cotta, Rosângela Minardi Mitre; Sant'Ana, Luciana Ferreira da Rocha; Priore, Silvia Eloíza; Franceschini, Sylvia do Carmo Castro
The main nutritional deficiencies during childhood, namely anemia and malnutrition, are predominantly related to socio-economic factors. Thus, as the Bolsa Família Program (BFP) is the main policy to combat poverty, it is expected that it will have an impact on child nutrition. The aim was to analyze the differences in the nutritional situation of children registered with the BFP of a municipality located in Zona da Mata of Minas Gerais state. 446 children aged between 6 and 84 months were evaluated, of which 262 were non-beneficiaries and 184 were beneficiaries. Nutritional evaluation included analysis of weight and height parameters through weight/age, weight/height, height/age and Body Mass Index/age indexes and hemoglobin levels, using the Hemocue. The prevalence of anemia, short stature and obesity were 22.6, 6.3 and 5.2%, respectively, and there were no statistical differences between beneficiaries and non-beneficiaries. The beneficiary group initially had worse socio-economic conditions, but with the BFP it managed to financially match the non-beneficiary group. It is possible that the similarity between the two groups, also in the nutritional status, can be attributed to the program benefits, due to the financial funding as well as to the nutritional monitoring required as a condition of the program.
Skillman, Heather E; Mehta, Nilesh M
Malnutrition and obesity are prevalent in children admitted to the pediatric intensive care unit. Nutritional deterioration secondary to suboptimal nutrient delivery can adversely affect outcomes during pediatric critical illness. This review highlights the recent investigations of nutrition assessment, energy balance, indirect calorimetry, nutrition therapy, barriers to nutrient delivery, monitoring during enteral feeding, and the role of nutrition guidelines in critically ill children. Critically ill children are at high risk for energy and protein imbalance. Indirect calorimetry remains the only accurate method to assess energy requirements in this population. Intensive insulin therapy to achieve glycemic control may reduce morbidity and mortality in adults, but risks hypoglycemia in critically ill children. Early enteral nutrition improves nutrition outcomes and adherence to nutrition guidelines can overcome barriers to optimal nutrition therapy. Timely and adequate nutrition therapy is essential to improve nutrition outcomes in critically ill children. Further research is required to determine clinical outcome benefits with indirect calorimetry and enteral nutrition guidelines, and to identify optimal glucose targets.
Full Text Available Abstract Background Adequate infant and young child nutrition demands high rates of breastfeeding and good access to nutrient rich complementary foods, requiring public sector action to promote breastfeeding and home based complementary feeding, and private sector action to refrain from undermining breastfeeding and to provide affordable, nutrient rich complementary foods. Unfortunately, due to a lack of trust, the public and private sectors, from both the North and the South, do not work well together in achieving optimal infant and young child nutrition. Discussion As the current debate in infant and young child nutrition is reminiscent of the "sweatshop" debate fifteen years ago, we argue that lessons from the sweatshops debate regarding cooperation between public and private sectors - and specific organizational experiences such as the Ethical Trading Initiative in which companies, trade unions, and civil society organizations work together to enhance implementation of labour standards and address alleged allegations - could serve as a model for improving cooperation and trust between public, civil society and private groups, and ultimately health, in infant and young child nutrition. Summary Lessons from the sweatshops debate could serve as a model to promote cooperation and trust between public and private groups, such that they learn to work together towards their common goal of improving infant and young child nutrition.
Singer, Peter A; Ansett, Sean; Sagoe-Moses, Isabella
Adequate infant and young child nutrition demands high rates of breastfeeding and good access to nutrient rich complementary foods, requiring public sector action to promote breastfeeding and home based complementary feeding, and private sector action to refrain from undermining breastfeeding and to provide affordable, nutrient rich complementary foods. Unfortunately, due to a lack of trust, the public and private sectors, from both the North and the South, do not work well together in achieving optimal infant and young child nutrition. As the current debate in infant and young child nutrition is reminiscent of the "sweatshop" debate fifteen years ago, we argue that lessons from the sweatshops debate regarding cooperation between public and private sectors - and specific organizational experiences such as the Ethical Trading Initiative in which companies, trade unions, and civil society organizations work together to enhance implementation of labour standards and address alleged allegations - could serve as a model for improving cooperation and trust between public, civil society and private groups, and ultimately health, in infant and young child nutrition. Lessons from the sweatshops debate could serve as a model to promote cooperation and trust between public and private groups, such that they learn to work together towards their common goal of improving infant and young child nutrition.
Background Adequate infant and young child nutrition demands high rates of breastfeeding and good access to nutrient rich complementary foods, requiring public sector action to promote breastfeeding and home based complementary feeding, and private sector action to refrain from undermining breastfeeding and to provide affordable, nutrient rich complementary foods. Unfortunately, due to a lack of trust, the public and private sectors, from both the North and the South, do not work well together in achieving optimal infant and young child nutrition. Discussion As the current debate in infant and young child nutrition is reminiscent of the "sweatshop" debate fifteen years ago, we argue that lessons from the sweatshops debate regarding cooperation between public and private sectors - and specific organizational experiences such as the Ethical Trading Initiative in which companies, trade unions, and civil society organizations work together to enhance implementation of labour standards and address alleged allegations - could serve as a model for improving cooperation and trust between public, civil society and private groups, and ultimately health, in infant and young child nutrition. Summary Lessons from the sweatshops debate could serve as a model to promote cooperation and trust between public and private groups, such that they learn to work together towards their common goal of improving infant and young child nutrition. PMID:21545745
Engle, Patrice; Huffman, Sandra L
For their optimal growth, and for greater long-term human capital development, children profit not only from improved nutrition but also from improved learning opportunities in the earliest years of life. This paper describes how actions to enhance optimal infant and young child nutrition can be linked with child development interventions for children under 3 years of age. In countries with high rates of malnutrition, linking these two components will result in synergies of program activities, and will bring about a greater impact at reduced cost than either activity conducted separately. New understanding of social marketing and communication strategies can increase effectiveness of linked interventions. Public-private partnerships to improve both child development and nutrition offer promise for sustainable interventions.
Barbiero, Victor K; Kathuria, Ashi
This paper presents the views of the United States Agency for International Development, India (USAID/India) on priorities for nutrition research in 2001-2005. Indices of nutrition status in India have been stagnant for 30 years. Although severe malnutrition has declined significantly, there has been little improvement since the 1970s in the percentage of children and/or mothers who are moderately undernourished. USAID views nutrition as a maternal and child survival intervention and focuses programmatic priorities on micronutrient nutrition (specifically vitamin A and iron/folate), integrated community nutrition (MinPak), and improved nutrition status through USAID's Title II program. Major areas of research interest for USAID include the prevalence and etiology of nutrition deficiencies, operations research to improve service delivery, the application of new tools and technologies to improve nutrition, and increasing the role of the private sector (including nongovernmental organizations) in nutrition service delivery. It is concluded that nutrition research must be prioritized to drive programmatic action; research must focus on the key questions; known tools must be widely applied; and elegance should be pursued in all research endeavors.
Lapierre, Matthew A; Brown, Autumn M; Houtzer, Hunter V; Thomas, Tyler J
We tested whether the presence of both child-targeted and nutrition-focused (i.e. parent-targeted) marketing cues on food packaging was associated with the nutritional content of these products. We conducted a quantitative content analysis of 403 food packages chosen randomly from the supermarket's online portal along with all products (n 312) from the cereal aisle in a supermarket from the Southeastern USA. We examined main and interaction effects for cues on nutritional content (e.g. energy density, sugar, sodium, fibre). A regional supermarket chain in the Southeastern USA. Tests of main effects indicated that increased presence of nutritional cues was linked to more nutritious content (e.g. less sugar, less saturated fat, more fibre) while the increased presence of child-targeted cues was uniformly associated with less nutritious content (e.g. more sugar, less protein, less fibre). Among the interaction effects, results revealed that products with increased nutrition-focused and child-targeted cues were likely to contain significantly more sugar and less protein than other products. Products that seek to engage children with their packaging in the supermarket are significantly less nutritious than foods that do not, while product packages that suggest nutritional benefits have more nutritious content. More importantly, the study provides evidence that those products which try to engage both child and parent consumers are significantly less healthy in crucial ways (e.g. more sugar, less fibre) than products that do not.
Nielsen, Annemette; Michaelsen, Kim F.; Holm, Lotte
of the child and the interest and focus of the mother. The aim of this qualitative study was to explore mothers’ concerns and feeding practices in the context of everyday life. A total of 45 mothers with children either seven months old or 13 months old participated. The results showed that the need to find......Researchers question the implications of the way in which “motherhood” is constructed in public health discourse. Current nutritional guidelines for Danish parents of young children are part of this discourse. They are shaped by an assumed symbiotic relationship between the nutritional needs...... practical solutions for the whole family in a busy everyday life, to socialise the child into the family and society at large, and to create personal relief from the strain small children put on time and energy all served as socially acceptable reasons for knowingly departing from nutritional...
Rondó, P H C; Rezende, G; Lemos, J O; Pereira, J A
To assess the relationship between maternal stress and distress in pregnancy and 5-8 years postpartum and child nutritional status. Longitudinal cohort study carried out in Jundiai city, Southeast Brazil, involving 409 women followed throughout pregnancy to 5-8 years postpartum, and respective children. Measures of stress and distress were obtained three times in pregnancy (at gestational ages lower than 16 weeks, from 20 to 26 weeks and from 30 to 36 weeks) and 5-8 years postpartum by the Perceived Stress Scale (PSS), General Health Questionnaire (GHQ) and the State-Trait Anxiety Inventories (STAI). The nutritional status of the children was assessed by the World Health Organization body mass index (BMI) z-score for age. The relationship between child BMI z-score for age and scores of the PSS, GHQ and STAI was evaluated by multivariate linear regression, controlling for confounding variables. BMI z-score for age of the children was negatively associated with maternal scores of the PSS 5-8 years postpartum and scores of the GHQ in the second trimester of pregnancy. BMI of the children was positively associated with maternal BMI and birthweight (R(2)=0.13). There was -0.04 (confidence interval -0.07 to -0.9 × 10(-2)) decrease in child BMI per score unit of the PSS increase, and -0.09 (confidence interval -0.18 to -0.6 × 10(-3)) decrease in child BMI per score unit of the GHQ increase. This study detected a relationship between maternal mental and nutritional status and child nutritional status, implying that if the mother is not physically or mentally well, her capacity for caring for her child may be impaired.
Four of the eight Millennium Development Goals highlight the importance of adequate nutrition for human health and development. The IAEA is assisting Member States in their efforts to achieve these goals by providing technical support for strategies to combat undernutrition. In particular, the IAEA contributes technical expertise in the use of stable isotope techniques in the development and evaluation of nutrition interventions. Stable isotope techniques have been used as research tools in nutrition for many years. However, the application of stable isotope techniques in programme development and evaluation is a relatively new approach, where the IAEA has a unique opportunity to contribute. As only stable (non-radioactive) isotopes are used, the techniques can be applied in the most vulnerable population groups, i.e., infants and children. The use of stable isotope techniques adds value by increasing the sensitivity and specificity of measurements as compared to conventional techniques. This brief overview highlights selected activities in infant nutrition where stable isotope techniques have been used. They include projects to measure human milk intake in breast-fed infants, lean body mass (muscle mass) in lactating mothers, and bioavailability of iron in infants and young children
Nugyen, Anh Vu
Full text: Objective: To establish a scalable and sustainable, community led approach to prevent and manage child malnutrition, and increase vulnerable families’ access to food security. Methods: The establishment of the nutrition club is a participatory community mobilization process involving local leaders including the Women’s Union, Farmers Union and Youth Union, local health workers and caregivers of young children. The first step in the process is the formation of district and commune management boards and community development boards. This is followed by a training needs assessment and capacity strengthening of local partners. Nutrition club facilitators are selected by the community and are widely respected and committed to community service. Monthly nutrition club meetings are attended by pregnant women and caregivers of children under five years old. Activities during the nutrition club meeting includes: care and nutrition during pregnancy and the post partum period, complementary feeding, child care practices, development of home gardens and hygiene and sanitation; using interactive facilitation methods such as games, skills practice, role plays and competitions. Follow up home visits are conducted to reinforce positive practices and support vulnerable families. Caregivers who attend the nutrition club have access to community led interest groups such as: chicken raising, livelihoods, agriculture and micro-credit schemes. Nutrition club members pay a small monthly fee that covers cost of refreshments and utilities. Monitoring and supervision is conducted by a team of government district and health center staff. Sustainability of the approach is promoted by mobilizing and utilizing existing resources. An agreement is made between the community development board and World Vision that support for running costs will gradually be reduced and discontinued after four years. The alignment of the nutrition club approach with government policy and priorities
Wuehler, Sara E; Nadjilem, Djasndibye
Progress towards reducing mortality and malnutrition among children Sahel', starting with an analysis of current activities related to infant and young child nutrition (IYCN). The main objectives of the situational analysis are to compile, analyse, and interpret available information on infant and child feeding, and the nutrition situation of children security, and promotion of good hygienic practices. Chad is not on track to reaching the MDGs of reducing mortality by two-thirds and malnutrition by half among children <5 years of age between 1990 and 2015. Most of the key IYCN topics were addressed in a national policy to combat malnutrition and micronutrient deficiencies. No national nutrition policy was yet ratified in Chad, so the target of many documents reviewed was the malnourished child. Researchers have identified some barriers to optimal feeding practices. However, the majority of these surveys were small scale, so they do not necessarily provide information relevant to the general population. Expanded surveys would be needed for developing evidence-based educational messages targeted to local needs. Reviewed training materials and related programmes being implemented in Chad provide specific guidance for nearly all of the key IYCN topics, except for appropriate feeding choices for the prevention of mother-to-child transmission of HIV. Some of the programmes were intended for national coverage, but we could not confirm whether these programmes were actually implemented nationally. Monitoring and evaluation reports were available for some small-scale programmes, but few of these evaluated whether IYCN-specific programme components were implemented as designed and none evaluated whether participants adopted the promoted feeding practices. Establishment of the policy and programme framework has commenced for improving IYCN practices. Formative research is needed to guide the development of evidence-based training materials and programmes to address the
Alderman, Harold; Headey, Derek D
Existing evidence on the impacts of parental education on child nutrition is plagued by both internal and external validity concerns. In this paper we try to address these concerns through a novel econometric analysis of 376,992 preschool children from 56 developing countries. We compare a naïve least square model to specifications that include cluster fixed effects and cohort-based educational rankings to reduce biases from omitted variables before gauging sensitivity to sub-samples and exploring potential explanations of education-nutrition linkages. We find that the estimated nutritional returns to parental education are: (a) substantially reduced in models that include fixed effects and cohort rankings; (b) larger for mothers than for fathers; (c) generally increasing, and minimal for primary education; (d) increasing with household wealth; (e) larger in countries/regions with higher burdens of undernutrition; (f) larger in countries/regions with higher schooling quality; and (g) highly variable across country sub-samples. These results imply substantial uncertainty and variability in the returns to education, but results from the more stringent models imply that even the achievement of very ambitious education targets would only lead to modest reductions in stunting rates in high-burden countries. We speculate that education might have more impact on the nutritional status of the next generation if school curricula focused on directly improving health and nutritional knowledge of future parents.
Ruel, Marie T; Alderman, Harold
Acceleration of progress in nutrition will require effective, large-scale nutrition-sensitive programmes that address key underlying determinants of nutrition and enhance the coverage and effectiveness of nutrition-specific interventions. We reviewed evidence of nutritional effects of programmes in four sectors--agriculture, social safety nets, early child development, and schooling. The need for investments to boost agricultural production, keep prices low, and increase incomes is undisputable; targeted agricultural programmes can complement these investments by supporting livelihoods, enhancing access to diverse diets in poor populations, and fostering women's empowerment. However, evidence of the nutritional effect of agricultural programmes is inconclusive--except for vitamin A from biofortification of orange sweet potatoes--largely because of poor quality evaluations. Social safety nets currently provide cash or food transfers to a billion poor people and victims of shocks (eg, natural disasters). Individual studies show some effects on younger children exposed for longer durations, but weaknesses in nutrition goals and actions, and poor service quality probably explain the scarcity of overall nutritional benefits. Combined early child development and nutrition interventions show promising additive or synergistic effects on child development--and in some cases nutrition--and could lead to substantial gains in cost, efficiency, and effectiveness, but these programmes have yet to be tested at scale. Parental schooling is strongly associated with child nutrition, and the effectiveness of emerging school nutrition education programmes needs to be tested. Many of the programmes reviewed were not originally designed to improve nutrition yet have great potential to do so. Ways to enhance programme nutrition-sensitivity include: improve targeting; use conditions to stimulate participation; strengthen nutrition goals and actions; and optimise women's nutrition, time
Shamah, Teresa; Villalpando, Salvador
Since the last century, fortified and enriched foods are products whose original composition has been modified-through addition of essential nutrients-to satisfy specific population needs. For the fortification of foods to have a positive impact on nutritional status, the micronutrients added must be well absorbed and utilized by the organism (bioavailability). Diverse factors affect bioavailability, such as the nutritional status of individuals, the presence in the diet of substances which facilitate or inhibit its absorption, interactions among micronutrients, illnesses, and chemical characteristics of the compound used for fortification. In countries such as Chile, Venezuela and Mexico, important effects have been demonstrated in reducing iron deficiency anaemia in children under 5 years of age. In less than a decade, the salt iodization programme has also proven its effectiveness. Other programmes have fortified foods with Zn, vitamin A and folic acid, which are deficient in infants and children of many populations. In summary, food fortification is a low-cost, relatively simple strategy that may reach a wide range of people, and contribute to reducing the high prevalence of micronutrient deficiencies affecting children, especially in poor countries. The costs due to losses of human capital and their repercussions on health and future development are very high. Building links among academic researchers, politicians, food manufacturers and consumers is essential in order for food fortification to be efficacious and effective, and therefore should be considered as part of an integral strategy to combat micronutrient deficiencies.
A cross-sectional study was conducted between July and December 1992 to assess the nutritional status, cognitive development, and mother-child interactions in a group of 153 Nicaraguan refugee children living in Costa Rica. Nutritional status was assessed using anthropometric indices. Cognitive development was assessed with the Bayley Scale of Mental Development. Mother-child interaction was assessed with the Nursing Child Assessment Teaching Scale and Caldwell's Home Observation and Measurem...
Dev, Dipti A; McBride, Brent A
The Academy of Nutrition and Dietetics (Academy) recommends feeding practices for child-care providers to establish nutrition habits in early childhood to prevent obesity. With >12 million US children in child care, little is known about child-care providers' feeding practices. The purpose of this study was to examine child-care providers' feeding practices to assess whether providers met the Academy's benchmarks and whether attainment of benchmarks varied across child-care contexts (Head Start, Child and Adult Care Food Program [CACFP], and non-CACFP). Cross-sectional data was collected in 2011 and 2012 from 118 child-care providers who completed self-administered surveys regarding their feeding practices for 2- to 5-year-old children. χ(2) tests and analysis of variance were used to determine variation across contexts. Head Start providers sat more frequently with children during meals (P=0.01), ate the same foods as children (P=0.001), and served meals family style (Pchildren (P=0.01) received more nutrition-education opportunities compared with CACFP and non-CACFP. Head Start providers encouraged more balance and variety of foods (Pchildren about nutrition (PAcademy's benchmarks compared with CACFP and non-CACFP providers. Possible reasons for this compliance might be attributed to Head Start nutrition performance standards and increased nutrition-training opportunities for Head Start staff. Head Start programs can serve as a model in implementing the Academy's benchmarks. Copyright © 2013 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.
Alessandro Tarozzi; Aprajit Mahajan
We establish some new interesting stylized facts on the changes in boy versus girl nutritional status in India during the nineties, a period of rapid economic growth. Our analysis is based on the comparison, over time and across genders, of the distribution of z-scores calculated for height and weight measures. Overall, we find that child nutrition improved substantially, but we also find that gender differences in nutritional status increased as well, with nutritional status improving substa...
Reale, Reid; Slater, Gary; Burke, Louise M
Olympic combat sports separate athletes into weight divisions, in an attempt to reduce size, strength, range and/or leverage disparities between competitors. Official weigh-ins are conducted anywhere from 3 and up to 24 h prior to competition ensuring athletes meet weight requirements (i.e. have 'made weight'). Fighters commonly aim to compete in weight divisions lower than their day-to-day weight, achieved via chronic and acute manipulations of body mass (BM). Although these manipulations may impair health and absolute performance, their strategic use can improve competitive success. Key considerations are the acute manipulations around weigh-in, which differ in importance, magnitude and methods depending on the requirements of the individual combat sport and the weigh-in regulations. In particular, the time available for recovery following weigh-in/before competition will determine what degree of acute BM loss can be implemented and reversed. Increased exercise and restricted food and fluid intake are undertaken to decrease body water and gut contents reducing BM. When taken to the extreme, severe weight-making practices can be hazardous, and efforts have been made to reduce their prevalence. Indeed some have called for the abolition of these practices altogether. In lieu of adequate strategies to achieve this, and the pragmatic recognition of the likely continuation of these practices as long as regulations allow, this review summarises guidelines for athletes and coaches for manipulating BM and optimising post weigh-in recovery, to achieve better health and performance outcomes across the different Olympic combat sports.
... SERVICE, DEPARTMENT OF AGRICULTURE CHILD NUTRITION PROGRAMS SCHOOL BREAKFAST PROGRAM Pt. 220, App. C....21, and 226.20. The statement shall identify the contribution of a specific portion of a meat/meat...
... Order 13563 emphasizes the importance of quantifying both costs and benefits, of reducing costs, of... 12988 This rule has been reviewed under Executive Order 12988, Civil Justice Reform. This rule is... donations, Grant programs--Social programs, Indians, Nutrition education, Public assistance programs, WIC...
US Department of Agriculture, 2009
The McGovern-Dole International Food for Education and Child Nutrition Program (McGovern-Dole program) helps support education, child development, and food security for some of the world's poorest children. It provides for donations of U.S. agricultural products, as well as financial and technical assistance, for school feeding and maternal and…
Davis, Jennie N; Brown, Helen; Ramsay, Samantha A
To examine the nutrition and young child feeding (YCF) education and training of nurses in public health clinics of Ghana's Komenda-Edina-Eguafo-Abrem region (KEEA) in relation to global health guidelines, and how nurses served as educators for caregivers with children aged 0-5 years. A qualitative study of semi-structured one-on-one and group interviews (n 21) following a questionnaire of closed- and open-ended questions addressing child feeding, nutrition and global health recommendations. Interviews were conducted in English, audio-recorded, transcribed and coded. Descriptive data were tabulated. Content analysis identified themes from open-ended questions. KEEA public health clinics (n 12). Nurses (n 41) purposefully recruited from KEEA clinics. A model capturing nurses' nutrition and YCF education emerged with five major themes: (i) adequacy of nurses' basic knowledge in breast-feeding, complementary feeding, iron-deficiency anaemia, YCF and hygiene; (ii) nurses' delivery of nutrition and YCF information; (iii) nurses' evaluation of children's health status to measure education effectiveness; (iv) nurses' perceived barriers of caregivers' ability to implement nutrition and YCF education; and (v) a gap in global health recommendations on YCF practices for children aged 2-5 years. Nurses demonstrated adequate nutrition and YCF knowledge, but reported a lack of in-depth nutrition knowledge and YCF education for children 2-5 years of age, specifically education and knowledge of YCF beyond complementary feeding. To optimize child health outcomes, a greater depth of nutrition and YCF education is needed in international health guidelines.
Negash, Canaan; Whiting, Susan J; Henry, Carol J; Belachew, Tefera; Hailemariam, Tewodros G
Maternal and child under nutrition is highly prevalent in low-income and middle-income countries, resulting in substantial increases in mortality and overall disease burden. The aim of this baseline survey was to determine the association between selected maternal characteristics, maternal nutritional status and children's nutritional status. A survey with a cross sectional design was conducted between September and October 2012 in Hula, Ethiopia. The study subjects were 197 mothers of children between the ages of 6 and 23 months. Weight and height (mothers) or recumbent length (children) were measured using calibrated, standardized techniques. Seven percent of children were below -2 weight for height Z score (WHZ), 11.5% were below -2 height for age Z score (HAZ) and 9.9% were below -2 weight for age Z score (WAZ). Maternal anthropometrics were associated with child nutritional status in the bivariate analysis. Maternal BMI (r = 0.16 P = 0.02) and educational status (r = 0.25 P = 0.001) were correlated with WHZ of children while maternal height (r = 0.2 P = 0.007) was correlated with HAZ of children. After multivariate analysis, children whose mothers had salary from employment had a better WHZ score (P = 0.001) and WAZ score (Pmaternal BMI and maternal height were associated with WHZ (P = 0.04) and HAZ (P = 0.01) score of children. Having a mother with better nutritional status and salaried employment is a benefit for the nutritional status of the child. The interrelationship between maternal and child nutritional status stresses the value of improving maternal nutritional status as this should improve both maternal and child health outcomes. Therefore strategies to improve nutritional status of children should also include improving the nutritional status of the mother and empowering her financially.
Full Text Available A cross-sectional study was conducted between July and December 1992 to assess the nutritional status, cognitive development, and mother-child interactions in a group of 153 Nicaraguan refugee children living in Costa Rica. Nutritional status was assessed using anthropometric indices. Cognitive development was assessed with the Bayley Scale of Mental Development. Mother-child interaction was assessed with the Nursing Child Assessment Teaching Scale and Caldwell's Home Observation and Measurement of the Environment Inventory. Correlational analysis was performed to examine the relationship between child cognitive development scores and mother-child interaction measures and also between anthropometric measures and child cognitive development scores. Multiple regression analysis was performed to evaluate the relationship between the mother-child interaction measures and cognitive development scores, after adjusting by anthropometric measures. Thirty-three percent of the children were below the 10th percentile for height-for-age. There was no significant correlation between the total amount of mother-child interaction and child cognitive development. However, certain aspects of the home environment correlated with cognitive development, specifically the manner in which the mother responded emotionally and verbally to her child, and the organization of the child's physical and temporal environment. Multiple regression analysis revealed that the manner in which the mother responded and the child's weight-for-height were important in predicting child cognitive development. The child's weight-for-height and certain aspects of the home environment played an important role in the cognitive development of this refugee population. The findings indicate the importance of assessing nutritional status in this refugee population.
99. 69. SH Lee and Labuza, TP (1975) Destruction of ascorbic acid as a function of water activity. Journal of Food Science 40 370-377...e.g. biscuits and noodles. - fortification of instant noodle spice sachet. Vitamin B12 Main meals, tuna and dairy foods Defence-specific...University. Bianka has been employed at DSTO-Scottsdale since 1999 working in the fields of food technology, microbiology, biochemistry and nutrition
Dry season nutritional stress is a major constraint to ruminant livestock production in semi-arid areas. After the rains finish, quantity and quality of grazing fall rapidly, leaving cereal crop residues as the major feed resource. These residues are low in N and high in crude fibre, characteristics which restrict intake and digestibility, so that underfeeding results. Improved handling and storage procedures as well as chemical and physical treatments can all improve their quality. Other strategies include: rate of offer of stover; compensatory growth; conservation of fodder. Farmer-selection should also consider multiple use of the options available. (author)
Aguayo, Víctor M; Menon, Purnima
The latest available data indicate that 38% of South Asia's children aged 0-59 months are stunted. Such high prevalence combined with the region's large child population explain why South Asia bears about 40% of the global burden of stunting. Recent analyses indicate that the poor diets of children in the first years of life, the poor nutrition of women before and during pregnancy and the prevailing poor sanitation practices in households and communities are important drivers of stunting, most likely because of underlying conditions of women's status, food insecurity, poverty, and social inequalities. With this evidence in mind, UNICEF Regional Office for South Asia convened the Regional Conference: Stop Stunting: Improving Child Feeding, Women's Nutrition, and Household Sanitation in South Asia (New Delhi, November 10-12, 2014). The Conference provided a knowledge-for-action platform with three objectives: (1) share state-of-the-art research findings on the causes of child stunting and its consequences for child growth and development and the sustainable growth and development of nations; (2) discuss better practices and the cost and benefits of scaling up programmes to improve child feeding, women's nutrition, and household sanitation in South Asia; and (3) identify implications for sectoral and cross-sectoral policy, programme, advocacy and research to accelerate progress in reducing child stunting in South Asia. This overview paper summarizes the rationale for the focus on improving child feeding, women's nutrition, and household sanitation as priority areas for investment to prevent child stunting in South Asia. It builds on the invited papers presented at or developed as a follow on to the Stop Stunting Conference. © 2016 The Authors. Maternal & Child Nutrition published by John Wiley & Sons Ltd.
Ekvall, Shirley M.; Wheby, Elizabeth A.
The following papers were presented at a symposium on clinical nutrition for the child who is chronically ill or handicapped: (1) "Food Allergy"; (2) "Anemia and the Chronically Ill or Handicapped Child"; (3) "Nutrition and Neurotransmitters--Clinical Implications"; (4) "The Importance of Lipid Type in the Diet after Burn Injury"; (5) "Advances of…
Sofer, Sigal; Stark, Aliza H; Madar, Zecharia
Effective nutritional guidelines for reducing abdominal obesity and metabolic syndrome are urgently needed. Over the years, many different dietary regimens have been studied as possible treatment alternatives. The efficacy of low-calorie diets, diets with different proportions of fat, protein, and carbohydrates, traditional healthy eating patterns, and evidence-based dietary approaches were evaluated. Reviewing literature published in the last 5 y reveals that these diets may improve risk factors associated with obesity and metabolic syndrome. However, each diet has limitations ranging from high dropout rates to maintenance difficulties. In addition, most of these dietary regimens have the ability to attenuate some, but not all, of the components involved in this complicated multifactorial condition. Recently, interest has arisen in the time of day foods are consumed (food timing). Studies have examined the implications of eating at the right or wrong time, restricting eating hours, time allocation for meals, and timing of macronutrient consumption during the day. In this paper we review new insights into well-known dietary therapies as well as innovative time-associated dietary approaches for treating obesity and metabolic syndrome. We discuss results from systematic meta-analyses, clinical interventions, and animal models. © 2015 American Society for Nutrition.
Dev, Dipti A; Carraway-Stage, Virginia; Schober, Daniel J; McBride, Brent A; Kok, Car Mun; Ramsay, Samantha
National childhood obesity prevention policies recommend that child-care providers educate young children about nutrition to improve their nutrition knowledge and eating habits. Yet, the provision of nutrition education (NE) to children in child-care settings is limited. Using the 2011 Academy of Nutrition and Dietetics benchmarks for NE in child care as a guiding framework, researchers assessed child-care providers' perspectives regarding delivery of NE through books, posters, mealtime conversations, hands-on learning, and sensory exploration of foods to young children (aged 2 to 5 years). Using a qualitative design (realist method), individual, semistructured interviews were conducted until saturation was reached. The study was conducted during 2012-2013 and used purposive sampling to select providers. Final sample included 18 providers employed full-time in Head Start or state-licensed center-based child-care programs in Central Illinois. Child-care providers' perspectives regarding implementation of NE. Thematic analysis to derive themes using NVivo software. Three overarching themes emerged, including providers' motivators, barriers, and facilitators for delivering NE to children. Motivators for delivering NE included that NE encourages children to try new foods, NE improves children's knowledge of healthy and unhealthy foods, and NE is consistent with children's tendency for exploration. Barriers for delivering NE included that limited funding and resources for hands-on experiences and restrictive policies. Facilitators for delivering NE included providers obtain access to feasible, low-cost resources and community partners, providers work around restrictive policies to accommodate NE, and mealtime conversations are a feasible avenue to deliver NE. Providers integrated mealtime conversations with NE concepts such as food-based sensory exploration and health benefits of foods. Present study findings offer insights regarding providers' perspectives on
Berge, A C; Wierup, M
Nutritional strategies to minimize Salmonella in food animal production are one of the key components in producing safer food. The current European approach is to use a farm-to-fork strategy, where each sector must implement measures to minimize and reduce Salmonella contamination. In the pre-harvest phase, this means that all available tools need to be used such as implementation of biosecurity measures, control of Salmonella infections in animals at the farm as well as in transport and trade, optimal housing and management including cleaning, disinfection procedures as well as efforts to achieve Salmonella-free feed production. This paper describes some nutritional strategies that could be used in farm control programmes in the major mono-gastric food production animals: poultry and pigs. Initially, it is important to prevent the introduction of Salmonella onto the farm through Salmonella-contaminated feed and this risk is reduced through heat treatment and the use of organic acids and their salts and formaldehyde. Microbiological sampling and monitoring for Salmonella in the feed mills is required to minimize the introduction of Salmonella via feed onto the farm. In addition, feed withdrawal may create a stressful situation in animals, resulting in an increase in Salmonella shedding. Physical feed characteristics such as coarse-ground meal to pigs can delay gastric emptying, thereby increasing the acidity of the gut and thus reducing the possible prevalence of Salmonella. Coarse-ground grains and access to litter have also been shown to decrease Salmonella shedding in poultry. The feed can also modify the gastro-intestinal tract microflora and influence the immune system, which can minimize Salmonella colonization and shedding. Feed additives, such as organic acids, short- and medium-chain fatty acids, probiotics, including competitive exclusion cultures, prebiotics and certain specific carbohydrates, such as mannan-based compounds, egg proteins, essential oils
Foster, Jaime S; Contreras, Dawn; Gold, Abby; Keim, Ann; Oscarson, Renee; Peters, Paula; Procter, Sandra; Remig, Valentina; Smathers, Carol; Mobley, Amy R
Although some researchers have examined nutrition and physical activity policies within urban child care centers, little is known about the potentially unique needs of rural communities. Child care centers serving preschool children located within low-income rural communities (n = 29) from seven states (Indiana, Kansas, Michigan, North Dakota, Ohio, South Dakota, and Wisconsin) were assessed to determine current nutrition and physical activity (PA) practices and policies. As part of a large-scale childhood obesity prevention project, the Community Healthy Living Index's previously validated Early Childhood Program Assessment Tool was used to collect data. Descriptive statistical analysis was conducted to identify high-priority areas. Healthy People 2020 and the Academy of Nutrition and Dietetics' recommendations for nutrition and PA policies in child care centers were used as benchmarks. Reports of not fully implementing (nutrition-related policies or practices within rural early child care centers were identified. Centers not consistently serving a variety of fruits (48%), vegetables (45%), whole grains (41%), limiting saturated fat intake (31%), implementing healthy celebration guidelines (41%), involving children in mealtime (62%), and referring families to nutrition assistance programs (24%) were identified. More than one third of centers also had limited structured PA opportunities. Although eligible, only 48% of the centers participated in the Child and Adult Care Food Program. Overall, centers lacked parental outreach, staff training, and funding/resources to support nutrition and PA. These results provide insight into where child care centers within low-income, rural communities may need assistance to help prevent childhood obesity.
Gakidou, Emmanuela; Oza, Shefali; Vidal Fuertes, Cecilia; Li, Amy Y; Lee, Diana K; Sousa, Angelica; Hogan, Margaret C; Vander Hoorn, Stephen; Ezzati, Majid
The United Nations Millennium Development Goals (MDGs) set targets related to important global poverty, health, and sustainability issues. A critical but underinvestigated question for planning and allocating resources toward the MDGs is how interventions related to one MDG might affect progress toward other goals. To estimate the reduction in child mortality as a result of interventions related to the environmental and nutritional MDGs (improving child nutrition and providing clean water, sanitation, and fuels) and to estimate how the magnitude and distribution of the effects of interventions vary based on the economic status of intervention recipients. Population-level comparative risk assessment modeling the mortality effects of interventions on child nutrition and environmental risk factors, stratified by economic status. Data on economic status, child underweight, water and sanitation, and household fuels were from the nationally representative Demographic and Health Surveys for 42 countries in Latin America and the Caribbean, South Asia, and sub-Saharan Africa. Data on disease-specific child mortality were from the World Health Organization. Data on the hazardous effects of each MDG-related risk factor were from systematic reviews and meta-analyses of epidemiological studies. Child mortality, stratified by comparable international quintiles of economic status. Implementing interventions that improve child nutrition and provide clean water and sanitation and clean household fuels to all children younger than 5 years would result in an estimated annual reduction in child deaths of 49,700 (14%) in Latin America and the Caribbean, 0.80 million (24%) in South Asia, and 1.47 million (31%) in sub-Saharan Africa. These benefits are equivalent to 30% to 48% of the current regional gaps toward the MDG target on reducing child mortality. Fifty percent coverage of the same environmental and nutritional interventions, as envisioned by the MDGs, would reduce child
Daar Abdallah S
Full Text Available Abstract Background The defining event in the area of infant feeding is the aggressive marketing of infant formula in the developing world by transnational companies in the 1970s. This practice shattered the trust of the global health community in the private sector, culminated in a global boycott of Nestle products and has extended to distrust of all commercial efforts to improve infant and young child nutrition. The lack of trust is a key barrier along the critical path to optimal infant and young child nutrition in the developing world. Discussion To begin to bridge this gap in trust, we developed a set of shared principles based on the following ideals: Integrity; Solidarity; Justice; Equality; Partnership, cooperation, coordination, and communication; Responsible Activity; Sustainability; Transparency; Private enterprise and scale-up; and Fair trading and consumer choice. We hope these principles can serve as a platform on which various parties in the in the infant and young child nutrition arena, can begin a process of authentic trust-building that will ultimately result in coordinated efforts amongst parties. Summary A set of shared principles of ethics for infant and young child nutrition in the developing world could catalyze the scale-up of low cost, high quality, complementary foods for infants and young children, and eventually contribute to the eradication of infant and child malnutrition in the developing world.
Gunter, Katherine B.; Rice, Kelly R.; Trost, Stewart G.
Baseline findings from the Healthy Home Child Care Project include data from Family Child Care Providers (FCCPs) in Oregon (n=53) who completed assessments of nutrition and physical activity policies and practices and BMI data for children in the care of FCCPs (n=205). Results show that a significant percentage of FCCPs failed to meet child care…
Cortés Moreno, Assol; Universidad Nacional Autónoma de México-FES Iztacala; Avilés Flores, Ana Laura; Universidad Nacional Autónoma de México-FES Iztacala
Effects of undernourishment on psychological development vary according psychosocial factors. This study assessed the impact of demographic, familiar, and rearing variables on nourishment and psychological development in children aged complementary feeding. A sample of 124 child-caregiver dyads from four different socioeconomic and nutritional index communities from México participated. Anthropometrics and child development were measured. Prediction power of demographics, rearing practices, a...
Cunningham, K; Ploubidis, GB; Menon, P; Ruel, M; Kadiyala, S; Uauy, R; Ferguson, E
OBJECTIVE: To examine the association between women's empowerment in agriculture and nutritional status among children under 2 years of age in rural Nepal. DESIGN: Cross-sectional survey of 4080 households conducted in 2012. Data collected included: child and maternal anthropometric measurements; child age and sex; maternal age, education, occupation and empowerment in agriculture; and household size, number of children, religion, caste and agro-ecological zone. Associations between the Women...
Cunningham, Kenda; Ploubidis, George B; Menon, Purnima; Ruel, Marie; Kadiyala, Suneetha; Uauy, Ricardo; Ferguson, Elaine
To examine the association between women's empowerment in agriculture and nutritional status among children under 2 years of age in rural Nepal. Cross-sectional survey of 4080 households conducted in 2012. Data collected included: child and maternal anthropometric measurements; child age and sex; maternal age, education, occupation and empowerment in agriculture; and household size, number of children, religion, caste and agro-ecological zone. Associations between the Women's Empowerment in Agriculture Index (WEAI)'s Five Domains of Empowerment (5DE) sub-index and its ten component indicators and child length-for-age Z-scores (LAZ) and weight-for-length Z-scores (WLZ) were estimated, using ordinary least-squares regression models, with and without adjustments for key child, maternal and household level covariates. Two hundred and forty rural communities across sixteen districts of Nepal. Children under 24 months of age and their mothers (n 1787). The overall WEAI 5DE was positively associated with LAZ (β=0·20, P=0·04). Three component indicators were also positively associated with LAZ: satisfaction with leisure time (β=0·27, Pempowerment in agriculture was associated with WLZ. Women's empowerment in agriculture, as measured by the WEAI 5DE and three of its ten component indicators, was significantly associated with LAZ, highlighting the potential role of women's empowerment in improving child nutrition in Nepal. Additional studies are needed to determine whether interventions to improve women's empowerment will improve child nutrition.
Liu, Hong; Fang, Hai; Zhao, Zhong
This paper analyzes urban–rural disparities of China’s child health and nutritional status using the China Health and Nutrition Survey data from 1989 to 2006. We investigate degrees of health and nutritional disparities between urban and rural children in China as well as how such disparities have changed during the period 1989–2006. The results show that on average urban children have 0.29 higher height-for-age z-scores and 0.19 greater weight-for-age z-scores than rural children. Urban chil...
Full Text Available Abstract Background Undernutrition is a leading cause of child mortality in developing countries, especially in sub-Saharan Africa. We examine the household and community level socioeconomic and environmental factors associated with child nutritional status in Cameroon, and changes in the effects of these factors during the 1990s economic crisis. We further consider age-specific effects of household economic status on child nutrition. Methods Child nutritional status was measured by weight-for-age (WAZ and height-for-age (HAZ z-scores. Data were from Demographic and Health Surveys conducted in 1991 and 1998. We used analysis of variance to assess the bivariate association between the explanatory factors and nutritional status. Multivariate, multilevel analyses were undertaken to estimate the net effects of both household and community factors. Results Average WAZ and HAZ declined respectively from -0.70 standard deviations (SD, i.e. 0.70 SD below the reference median, to -0.83 SD (p = 0.006 and from -1.03 SD to -1.14 SD (p = 0.026 between 1991 and 1998. These declines occurred mostly among boys, children over 12 months of age, and those of low socioeconomic status. Maternal education and maternal health seeking behavior were associated with better child nutrition. Household economic status had an overall positive effect that increased during the crisis, but it had little effect in children under 6 months of age. Improved household (water, sanitation and cooking fuel and community environment had positive effects. Children living in the driest regions of the country were consistently worst off, and those in the largest cities were best off. Conclusion Both household and community factors have significant impact on child health in Cameroon. Understanding these relationships can facilitate design of age- and community-specific intervention programs.
In the absence of variables used for measuring household expenditure proxy variables are used. The proxy variables (type of dwelling, household size, water source, and toilet location) for economic status of households seem to influence nutritional status more directly while the person related variables seem to indirectly ...
Past research indicates a significantly higher prevalence of early sexual maturation in African American (AA) girls, which is associated with a number of psychological and behavioral problems as well as with health problems such as childhood obesity and diabetes. Both nutrition and body image perceptions have never before been empirically…
CCWs (N = 40) employed permanently or part-time were included. Convenience purposive sampling of the CCWs was undertaken. A structured self-administered questionnaire, developed and tested for this purpose, was used to gather information on the profile, nutrition knowledge, food safety and hygiene practices.
Abuya, Benta A; Ciera, James; Kimani-Murage, Elizabeth
Malnutrition continues to be a critical public health problem in sub-Saharan Africa. For example, in East Africa, 48 % of children under-five are stunted while 36 % are underweight. Poor health and poor nutrition are now more a characteristic of children living in the urban areas than of children in the rural areas. This is because the protective mechanism offered by the urban advantage in the past; that is, the health benefits that historically accrued to residents of cities as compared to residents in rural settings is being eroded due to increasing proportion of urban residents living in slum settings. This study sought to determine effect of mother's education on child nutritional status of children living in slum settings. Data are from a maternal and child health project nested within the Nairobi Urban Health and Demographic Surveillance System (NUHDSS). The study involves 5156 children aged 0-42 months. Data on nutritional status used were collected between October 2009 and January 2010. We used binomial and multiple logistic regression to estimate the effect of education in the univariable and multivariable models respectively. Results show that close to 40 % of children in the study are stunted. Maternal education is a strong predictor of child stunting with some minimal attenuation of the association by other factors at maternal, household and community level. Other factors including at child level: child birth weight and gender; maternal level: marital status, parity, pregnancy intentions, and health seeking behaviour; and household level: social economic status are also independently significantly associated with stunting. Overall, mothers' education persists as a strong predictor of child's nutritional status in urban slum settings, even after controlling for other factors. Given that stunting is a strong predictor of human capital, emphasis on girl-child education may contribute to breaking the poverty cycle in urban poor settings.
Liu, Hong; Rizzo, John A.; Fang, Hai
Background Hukou is the household registration system in China that determines eligibility for various welfare benefits, such as health care, education, housing, and employment. The hukou system may lead to nutritional and health disparities in China. We aim at examining the role of the hukou system in affecting urban-rural disparities in child nutrition, and disentangling the institutional effect of hukou from the effect of urban/rural residence on child nutrition-related health outcomes. Me...
Method: A cross sectional study was carried out to assess infant feeding practices of mothers and its effect on child nutritional status. A multistage random sampling procedure was used to select 450 mothers of children between the ages of 0-24 months. Breastfeeding and complementary feeding practices were examined ...
Nutritional care of the elite child and adolescent athlete: Part I - Energy and nutrient needs. ... assessed with skin folds or body fat percentages. Anthropometric measurements should be limited to twice yearly and too much ... 1300 mg calcium per day which can be achieved by having ~3 milk and/or dairy servings per day.
...;Prices of new books are listed in the first FEDERAL REGISTER issue of each #0;week. #0; #0; #0; #0;#0... 245 RIN 0584-AE14 Child Nutrition Programs: Nondiscretionary Amendments Related to the Healthy, Hunger... rule implements several nondiscretionary provisions of the Healthy, Hunger-Free Kids Act of 2010...
As a result of ongoing research and better supportive care, the treatment of childhood malignancies has dramatically improved survival in developed countries. The same cannot be said about the all important nutritional care of the child with cancer as much still needs to be done to reach the ultimate goal, namely to provide ...
Manda, Julius; Gardebroek, Koos; Khonje, Makaiko G.; Alene, Arega D.; Mutenje, Munyaradzi; Kassie, Menale
Using household survey data from a sample of 810 households, this paper analyses the determinants of children’s nutritional status and evaluates the impacts of improved maize varieties on child malnutrition in eastern Zambia. The paper uses an endogenous switching regression technique, combined
Lee, Yee Ming; Kwon, Junehee; Sauer, Kevin
Purpose/Objectives: The purpose of this study was to explore child nutrition professionals' (CNPs) attitudes about food allergies, current practices of food allergy training, and operational issues related to food allergy training in school foodservice operations. Methods: Three focus groups were conducted with 21 CNPs with managerial…
Fox, Kiira; Heaton, Tim B.
Purpose: Rural children in developing countries have poor health outcomes in comparison with urban children. This paper considers 4 questions regarding the rural/urban difference, namely: (1) do individual-level characteristics account for rural/urban differences in child nutritional status; (2) do community-level characteristics account for…
Larsen, Anna Folke; Lilleør, Helene Bie
Severely reduced height-for-age due to undernutrition is widespread in young African children, with serious implications for their health and later economic productivity. It is primarily caused by growth faltering due to hunger spells in critical periods of early child development. We assess...
The current economic crisis and food price increase may have a widespread impact on the nutritional and health status of populations, especially in the developing world. Gains in child survival over the past few decades are likely to be threatened and millennium development goals will be harder to achieve. Beyond starvation, which is one of the causes of death in famine situations, there are numerous nutritional pathways by which childhood mortality can increase. These include increases in childhood wasting and stunting, intrauterine growth restriction, and micronutrient deficiencies such as that of vitamin A, iron, and zinc when faced with a food crisis and decreased food availability. These pathways are elucidated and described. Although estimates of the impact of the current crisis on child mortality are yet to be made, data from previous economic crises provide evidence of an increase in childhood mortality that we review. The current situation also emphasizes that there are vast segments of the world's population living in a situation of chronic food insecurity that are likely to be disproportionately affected by an economic crisis. Nutritional and health surveillance data are urgently needed in such populations to monitor both the impacts of a crisis and of interventions. Addressing the nutritional needs of children and women in response to the present crisis is urgent. But, ensuring that vulnerable populations are also targeted with known nutritional interventions at all times is likely to have a substantial impact on child mortality.
Wuehler, Sara E; Ly Wane, Coudy Thierno
Progress towards reducing mortality and malnutrition among children Sahel', starting with an analysis of current activities related to infant and young child nutrition (IYCN). The main objectives of the situational analysis are to compile, analyse and interpret available information on infant and child feeding and the nutrition situation of children security and hygienic practices. Nearly all of the key IYCN topics were addressed, specifically or generally, in national policy documents. Senegal reported substantial improvements since the 1990s towards reducing infant and young child mortality and underweight, and increasing exclusive breastfeeding among infants <6 months of age (34%). Senegal is one of the few countries in the region that is nearly on track for reaching related MDGs. Notable activities that may have played a role include: (1) vitamin A supplementation was expanded to nearly semi-annual national campaigns starting in 1994; (2) the Ministry of Health partnered with several national and international agencies to scale up child survival activities under the umbrella of the Basic Support for Institutionalizing Child Survival (1994-2006); (3) a national nutrition division was developed to support a national nutrition strengthening programme; (4) the national nutrition counsel was organized to coordinate nutritional activities across various organizations and governmental sectors, involving representatives from health, agriculture and surveillance; and (5) an integrated communications programme was developed to support harmonized behaviour change communication tools for the health and nutrition sectors. Along with these activities, a number of programme evaluations were conducted to ensure that programmes obtain desired results. Although useful, these evaluations were not rigorous enough to identify effective programmes that contributed to the mentioned reductions in the prevalence of underweight and mortality, and increases in exclusive breastfeeding
Full Text Available This work questions the premise that the nutritional status of children under six years of age is a reliable indicator of family health. To do so, a research strategy based in case studies was carried out, following a qualitative design (participant observation and semistructured interviews using intentional sampling and framed within the interpretivist paradigm. The anthropometric measurements of 20 children under six years of age attending the local Child Care Center in Villa La Tela, Córdoba were evaluated. Nutritional status was understood as an object that includes socially determined biological processes, and was therefore posited analytically as a cross between statistical data and its social determination. As a statistic, child nutritional status is merely descriptive; to assist in the understanding of its social determination, it must be placed in dialectical relationship with the spheres of sociability proposed to analyze the reproduction of health problems.
Empirical studies of social capital rarely take into account the socioeconomic context of the region in which it operates, indeed as most of this research has been located in high income countries. It is imperative to investigate how development may influence the impact of social capital, especially in developing countries. This paper examines the relationship between social capital and child nutrition using the India Human Development Survey, 2005-2006. Using a multilevel framework and a sample of 6770 rural children under the age of five, it finds that household based bridging social capital, expressed as connections with development based organizations, is positively associated with child nutrition. Bonding social capital, expressed as ties with caste and religious based organizations, has the opposite impact. At the village level, contextual measures of social capital are associated with nutritional status of children, but their influence is conditional on local development. Copyright © 2018 Elsevier Ltd. All rights reserved.
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.
Maalouf, Joyce; Evers, Sarah Connell; Griffin, Monica; Lyn, Rodney
The amount of time children spend in child care each week has increased in recent years. The aim of this cross-sectional study was to describe the nutritional quality of foods served and the mealtime environment in 24 child care centers in Georgia. Data were collected between April 2010 and September 2010. Each child care center provided a sample 5-day menu (breakfast, lunch, and an afternoon snack) at baseline. Energy and nutrient contents of the menus were analyzed using NutriKids Menu Planning & Nutritional Analysis software (LunchByte Systems, Inc., Rochester, NY). Foods and beverages on the menus were compared to MyPlate food group standards for preschoolers. The child care environment was assessed in each center over 1 full day using the Environment and Policy Assessment and Observation instrument. Menus met one half to two thirds of the recommended levels for energy, carbohydrate, protein, and vitamins A and C. However, the menus were high in saturated fat and sodium content and did not meet the recommendations for iron or fiber. The majority of the centers did not meet the recommendations for MyPlate food group standards for preschoolers. On the day of the observation, seven centers did not serve a vegetable and more than half of the centers (n=13) did not serve any whole grains. Nineteen centers served high-sugar and/or high-fat foods and 11 did not have visible water indoors. This study identified determinants of the child care environment and nutritional characteristics of the combined meals and snacks offered to children. Findings from this study could inform child care centers how to provide healthier nutrition environments to preschool children.
Nandi, Arindam; Ashok, Ashvin; Kinra, Sanjay; Behrman, Jere R; Laxminarayan, Ramanan
India's Integrated Child Development Scheme, which provides supplementary nutrition and other public health services to >91 million women and children aged nutrition provided under the Integrated Child Development Scheme with educational outcomes when the children became adolescents. We used longitudinal data from a controlled nutrition trial conducted near the city of Hyderabad, India. From 1987 to 1990, a balanced protein-energy supplement (corn-soya meal, called upma) was offered to pregnant women and children aged nutrition with school enrollment, schooling grades completed, and academic test performance of these adolescents. Children born in intervention villages were 7.8% (95% CI: 0.1%, 15.4%; P nutrition and academic performance, as measured by school test scores. Offering a nutritional supplement to pregnant women and children Nutrition Trial was associated with improved school enrollment and completion of more schooling grades when the children became adolescents. © 2016 American Society for Nutrition.
Kwon, Sooyoun; Yeoh, Yoonjae; Abe, Satoko
This study aimed to investigate the nutritional quality and patterns of lunch menus provided by child care centers in South Korea and Japan. The weekly lunch menus from Monday to Saturday that child care centers provided in November 2014 in South Korea and Japan were analyzed. For Korea, a total of 72 meals provided by 12 centers in Seoul were analyzed by referring to the homepage of the Center for Children's Foodservice Management, which serviced menus for child care centers. For Japan, a total of 30 meals provided by 5 child care centers in Tokyo were analyzed. Nutrient content and pattern in lunch menus were evaluated. The lunch menus in Korea and Japan provided 359.5 kcal (25.7% of the estimated energy requirement) and 376.3 kcal (29.5% of the estimated energy requirement), respectively. 'Rice + Soup + Main dish + Side dish I + Side dish II' were provided in 66.7% of meals in Korea, while various patterns with rice and soup as their bases were provided in Japan. The lunch menus of child care centers in Korea and Japan provide similar amounts of energy, protein, carbohydrate, vitamin A, calcium, and other nutrients. However, there were significant differences in the lunch menu patterns in Korea and Japan. This study provides information about the nutritional content and pattern of lunch menus at child care centers in Asian countries with rice as a staple food.
This paper examines the determinants of child nutritional status in China, focusing specifically on those determinants related to health system reform and only-child status. Data are drawn from four waves of the China Health and Nutrition Survey (1991-2000). The empirical relationship between nutritional status, on the one hand, and income, access to quality healthcare and being an only-child, on the other hand, is investigated using ordinary least squares (OLS), random effects (RE), fixed effects (FE) and instrumental variables (IV) models. In the preferred model - a fixed effects model where income is instrumented - we find that being an only-child increases height-for-age z-scores by 0.12 of a standard deviation. By contrast, measures of access to quality healthcare are not found to be significantly associated with improved nutritional status.
Palakshappa, Deepak; Fiks, Alexander G; Faerber, Jennifer A; Feudtner, Chris
Many states have enacted laws to improve school nutrition. We tested whether stronger state nutrition laws are associated with subsequently decreased obesity. We conducted a retrospective national multi-year panel data study (analyzed 2014-2016 at the Children's Hospital of Philadelphia). The predictors were 2010 laws regarding 9 nutrition categories from the Classification of Laws Associated with School Students, which grades the strength of state laws (none, weak, or strong). The outcome was weight status (healthy weight, overweight, or obese) in elementary, middle, and high school from the 2011/2012 National Survey of Children's Health. We tested the association between the strength of laws and weight using multinomial logistic regression. To further evaluate our main results, we conducted state-level longitudinal analyses testing the association between competitive food and beverage laws on the change in obesity from 2003-2011. In main analyses of 40,177 children ages 10-17years, we found strong state laws restricting the sale of competitive food and beverages in elementary school (OR: 0.68; 95% CI: 0.48, 0.96) and strong advertising laws across all grades (OR: 0.63; 95% CI: 0.46, 0.86) were associated with reduced odds of obesity. In longitudinal analyses, states with strong competitive food and beverage laws from 2003-2010 had small but significant decreases in obesity, compared to states with no laws. Although further research is needed to determine the causal effect of these laws, this study suggests that strong state laws limiting the sale and advertising of unhealthy foods and beverages in schools are associated with decreased obesity rates. Copyright © 2016 Elsevier Inc. All rights reserved.
Onyango, Adelheid W
Many infants in sub-Saharan Africa (SSA) begin to receive cereal-based supplemental feeds well before the age (6 months) recommended for the introduction of 'safe and nutritionally adequate' complementary foods, or in rarer instances, do not receive these until the second year. The diets offered are monotonous and bulky, and rarely cover the shortfall left by breast milk in providing the energy and nutrients required to support rapid growth, build nutrient stores and assure resistance to infection. The pattern of growth and prevalence of malnutrition observed from birth through the first 5 years in SSA are suggestive of the nutrient inadequacies of the diet and the experience of infection. However, it is difficult to link poor growth and specific nutrient deficiencies in epidemiological studies because multiple nutrients are required for growth and deficiencies usually involve several nutrients. Moreover, accurate measurement of nutrient intakes is no small challenge. In this regard, qualitative and easier-to-measure characteristics of diet which are associated with nutrient adequacy could serve as alternative determinant factors in studies looking at causes of malnutrition. Dietary diversity is proposed as a candidate indicator of food security and predictor of nutritional status, but there is need for further research to standardize definitions and methodology before it can be applied widely.
Black, Maureen M; Pérez-Escamilla, Rafael; Rao, Sylvia Fernandez
The Millennium Development Goals (MDGs) have contributed to unprecedented reductions in poverty and improvement in the lives of millions of men, women, and children in low- and middle-income countries. Yet, hundreds of millions of children under 5 y of age are not reaching their developmental potential. This article reviews the scientific basis for early childhood nutrition and child development interventions, the impact of integrated interventions on children's linear growth and cognitive development, and implementation strategies for integrated nutrition and child development programs. Advances in brain science have documented that the origins of adult health and well-being are grounded in early childhood, from conception through age 24 mo (first 1000 d) and extending to age 5 y (second 1000 d). Young children with adequate nutrition, nurturant caregiving, and opportunities for early learning have the best chances of thriving. Evidence from adoption, experimental, and quasi-experimental studies has shown that stunting prevention is sensitive during the first 1000 d, and sensitivity to child development interventions extends through the second 1000 d. Cognitive development responds to interventions post–1000 d with effect sizes that are inversely associated with initial age and length of program exposure. Integrated interventions need governance structures that support integrated policies and programming, with attention to training, supervision, and monitoring. The MDGs have been replaced by the Sustainable Development Goals (SDGs), with targets for the next 15 y. Achievement of the SDGs depends on children receiving adequate nutrition, nurturant caregiving, and learning opportunities from conception through age 5.
Dumas, Sarah E; Kassa, Lea; Young, Sera L; Travis, Alexander J
To investigate the association between livestock ownership and dietary diversity, animal-source food consumption, height-for-age z-score, and stunting among children living in wildlife "buffer zones" of Zambia's Luangwa Valley using a novel livestock typology approach. We conducted a cross-sectional study of 838 children aged 6-36 months. Households were categorized into typologies based on the types and numbers of animals owned, ranging from no livestock to large numbers of mixed livestock. We used multilevel mixed-effects linear and logistic regression to examine the association between livestock typologies and four nutrition-related outcomes of interest. Results were compared with analyses using more common binary and count measures of livestock ownership. No measure of livestock ownership was significantly associated with children's odds of animal-source food consumption, child height-for-age z-score, or stunting odds. Livestock ownership Type 2 (having a small number of poultry) was surprisingly associated with decreased child dietary diversity (β = -0.477; powning no livestock. Similarly, in comparison models, chicken ownership was negatively associated with dietary diversity (β = -0.320; p<0.01), but increasing numbers of chickens were positively associated with dietary diversity (β = 0.022; p<0.01). Notably, neither child dietary diversity nor animal-source food consumption was significantly associated with height, perhaps due to unusually high prevalences of morbidities. Our novel typologies methodology allowed for an efficient and a more in-depth examination of the differential impact of livestock ownership patterns compared to typical binary or count measures of livestock ownership. We found that these patterns were not positively associated with child nutrition outcomes in this context. Development and conservation programs focusing on livestock must carefully consider the complex, context-specific relationship between livestock ownership and
Benjamin, Sara E; Haines, Jess; Ball, Sarah C; Ward, Dianne S
A large percentage of children in the United States spend part of their day in out-of-home child care. As rates of obesity continue to rise, especially among young children, child care has become a focus for nutrition and physical activity intervention. Parental involvement is an important component of these efforts. During summer 2006, parents of children in child care were surveyed to better understand their perceived quality of meals, snacks, and physical activity at the child-care center, and their recommendations for improvement. Parents of children who attended 94 licensed child-care centers in North Carolina were invited to complete a brief survey of perceived quality of meals, snacks, and physical activity at their centers using close-ended questions. Open-ended questions were used to identify suggestions for improvement. Five hundred eight parents from 91 child-care centers completed the questionnaire. The majority of parents reported quality of meals and snacks at the center as either excellent (30% meals, 27% snacks) or good (42% meals, 46% snacks). The main recommendations for improving meals and snacks were to increase fruits and vegetables and provide a variety of healthful foods. The majority of parents categorized the quality of physical activity at the center as excellent (36%) or good (46%), and suggested more structured, outdoor activities for children. Findings from this study provide insight into key areas of concern for parents regarding the nutrition and activity environment of child-care centers. This information may be used to create or modify interventions or policies and to help motivate parents to become advocates for change in child care.
Using data from the Young Lives younger cohort, we examine the effect of economic shocks on nutritional achievement, schooling and child work of index children (at age 5), controlling for various individual and household characteristics. Shocks that occurred both before and after the child was born
Petrie, Heather J; Stover, Elizabeth A; Horswill, Craig A
With exercise for sports competition in children and adolescents, acute nutrient needs will change. Fluid intake to ensure the replacement of water and minerals (electrolytes) lost in sweat is important. Energy needs also increase because of the elevated energy expenditure with physical activity. Arguably carbohydrate is the recommended source of training needs, although research has yet to be done to show performance benefits in young athletes on a high-carbohydrate diet. In the majority of sports, an increased intake of food naturally occurs to accommodate the day-to-day nutrient needs of young athletes, and unlike non-athlete, young competitors typically come closer to meeting their requirements for micronutrients. Nonetheless, certain athletic groups may be at risk for shortfalls in their diet. Compared to athletes in team sports, participants in weight-control sports may be at greater risk of failing to meet requirements for energy, protein, and some micronutrients. Endurance athletes, particularly female distance runners, may have intake deficits for the minerals iron and calcium. Acute issues such as heat illness and chronic concerns that include impaired growth and development, and the risk of injuries that include stress fractures may be an outcome of inadequate nutrition during physical training.
Cunningham, Kenda; Ruel, Marie; Ferguson, Elaine; Uauy, Ricardo
Women's disempowerment is hypothesised to contribute to high rates of undernutrition among South Asian children. However, evidence for this relationship has not been systematically reviewed. This review of empirical studies aims to: (1) synthesise the evidence linking women's empowerment and child nutritional status in South Asia and (2) suggest directions for future research. We systematically searched Global Health, Embase (classic and Ovid), MEDLINE, Campbell Collaboration, Popline, Eldis, Web of Science, EconLit and Scopus. We generated 1661 studies for abstract and title screening. We full-text screened 44 of these, plus 10 additional studies the authors were aware of. Only 12 studies fulfilled our inclusion criteria. We included English materials published between 1990 and 2012 that examined the relationship(s) of at least one women's empowerment domain and nutritional status among South Asian children. Data were extracted and synthesised within three domains of empowerment: control of resources and autonomy, workload and time, and social support. The results showed women's empowerment to be generally associated with child anthropometry, but the findings are mixed. Inter-study differences in population characteristics, settings or methods/conceptualisations of women's empowerment, and the specific domains studied, likely contributed to these inconsistencies. This review also highlights that different women's empowerment domains may relate differently to child nutritional status. Future research should aim to harmonise definitions of women's empowerment, which key domains it should include, and how it is measured. Rigorous evaluation work is also needed to establish which policies and programmes facilitate women's empowerment and in turn, foster child nutritional well-being. © 2014 John Wiley & Sons Ltd.
Kassa, Lea; Young, Sera L.; Travis, Alexander J.
Objective To investigate the association between livestock ownership and dietary diversity, animal-source food consumption, height-for-age z-score, and stunting among children living in wildlife “buffer zones” of Zambia’s Luangwa Valley using a novel livestock typology approach. Methods We conducted a cross-sectional study of 838 children aged 6–36 months. Households were categorized into typologies based on the types and numbers of animals owned, ranging from no livestock to large numbers of mixed livestock. We used multilevel mixed-effects linear and logistic regression to examine the association between livestock typologies and four nutrition-related outcomes of interest. Results were compared with analyses using more common binary and count measures of livestock ownership. Results No measure of livestock ownership was significantly associated with children’s odds of animal-source food consumption, child height-for-age z-score, or stunting odds. Livestock ownership Type 2 (having a small number of poultry) was surprisingly associated with decreased child dietary diversity (β = -0.477; plivestock. Similarly, in comparison models, chicken ownership was negatively associated with dietary diversity (β = -0.320; plivestock ownership patterns compared to typical binary or count measures of livestock ownership. We found that these patterns were not positively associated with child nutrition outcomes in this context. Development and conservation programs focusing on livestock must carefully consider the complex, context-specific relationship between livestock ownership and nutrition outcomes–including how livestock are utilized by the target population–when attempting to use livestock as a means of improving child nutrition. PMID:29408920
Yount, Kathryn M; DiGirolamo, Ann M; Ramakrishnan, Usha
Domestic violence against women is a global problem, and young children are disproportionate witnesses. Children's exposure to domestic violence (CEDV) predicts poorer health and development, but its effects on nutrition and growth are understudied. We propose a conceptual framework for the pathways by which domestic violence against mothers may impair child growth and nutrition, prenatally and during the first 36 months of life. We synthesize literatures from multiple disciplines and critically review the evidence for each pathway. Our review exposes gaps in knowledge and opportunities for research. The framework also identifies interim strategies to mitigate the effects of CEDV on child growth and nutrition. Given the global burden of child malnutrition and its long-term effects on human-capital formation, improving child growth and nutrition may be another reason to prevent domestic violence and its cascading after-effects. Copyright © 2011 Elsevier Ltd. All rights reserved.
Kabunga, Nassul S; Ghosh, Shibani; Webb, Patrick
The promotion of livestock production is widely believed to support enhanced diet quality and child nutrition, but the empirical evidence for this causal linkage remains narrow and ambiguous. This study examines whether adoption of improved dairy cow breeds is linked to farm-level outcomes that translate into household-level benefits including improved child nutrition outcomes in Uganda. Using nationwide data from Uganda's National Panel Survey, propensity score matching is used to create an unbiased counterfactual, based on observed characteristics, to assess the net impacts of improved dairy cow adoption. All estimates were tested for robustness and sensitivity to variations in observable and unobservable confounders. Results based on the matched samples showed that households adopting improved dairy cows significantly increased milk yield-by over 200% on average. This resulted in higher milk sales and milk intakes, demonstrating the potential of this agricultural technology to both integrate households into modern value chains and increase households' access to animal source foods. Use of improved dairy cows increased household food expenditures by about 16%. Although undernutrition was widely prevalent in the study sample and in matched households, the adoption of improved dairy cows was associated with lower child stunting in adopter household. In scale terms, results also showed that holding larger farms tends to support adoption, but that this also stimulates the household's ability to achieve gains from adoption, which can translate into enhanced nutrition.
Soo, J; Letona, P; Chacon, V; Barnoya, J; Roberto, C A
Food marketing has been implicated as an important driver of obesity. However, few studies have examined food marketing in low- and middle-income countries (LMICs). This study documents the prevalence of advertising on cereal boxes in Guatemala and examines associations between various marketing strategies and nutritional quality. One box from all available cereals was purchased from a supermarket located in an urban area in Guatemala City, Guatemala. A content analysis was performed to document child-oriented marketing practices, product claims and health-evoking images. The Nutrient Profile Model (NPM) was used to calculate an overall nutrition score for each cereal (the higher the score, the lower the nutritional quality). In all, 106 cereals were purchased, and half of the cereals featured child-oriented marketing (54, 50.9%). Cereals had a mean (±s.d.) of 5.10±2.83 product claims per cereal, and most cereals (102, 96.2%) contained health-evoking images. Child-oriented cereals had, on average, higher NPM scores (13.0±0.55 versus 7.90±0.74, Pmarketing and health claims for certain products.
Nassul S Kabunga
Full Text Available The promotion of livestock production is widely believed to support enhanced diet quality and child nutrition, but the empirical evidence for this causal linkage remains narrow and ambiguous. This study examines whether adoption of improved dairy cow breeds is linked to farm-level outcomes that translate into household-level benefits including improved child nutrition outcomes in Uganda. Using nationwide data from Uganda's National Panel Survey, propensity score matching is used to create an unbiased counterfactual, based on observed characteristics, to assess the net impacts of improved dairy cow adoption. All estimates were tested for robustness and sensitivity to variations in observable and unobservable confounders. Results based on the matched samples showed that households adopting improved dairy cows significantly increased milk yield-by over 200% on average. This resulted in higher milk sales and milk intakes, demonstrating the potential of this agricultural technology to both integrate households into modern value chains and increase households' access to animal source foods. Use of improved dairy cows increased household food expenditures by about 16%. Although undernutrition was widely prevalent in the study sample and in matched households, the adoption of improved dairy cows was associated with lower child stunting in adopter household. In scale terms, results also showed that holding larger farms tends to support adoption, but that this also stimulates the household's ability to achieve gains from adoption, which can translate into enhanced nutrition.
Lohia, Neha; Udipi, Shobha A
Infant and child feeding index (ICFI) an age-specific index, can be used to assess child feeding practices. We used the ICFI to assess feeding practices for urban slum children and the association between ICFI and child nutritional status. 446 children aged 6 to 24 months from urban slums of Mumbai, India were studied. We used the 24-hour diet recall to study dietary diversity and a food frequency questionnaire for consumption of food groups during the preceding week. ICFI was computed using five components, namely, breastfeeding, use of bottle, dietary diversity score (DDS), food group frequency score (FGFS) and feeding frequency scores (FFS). Weight, height and Mid-Upper Arm Circumference (MUAC) were measured, and z scores were calculated. Association between ICFI scores and nutritional status was examined. The mean total ICFI score for all was 5.9 ± 1.9. Among the five components, FGFS and FFS differed between children 12 months and by breast feeding status. In contrast, there were no differences vis-à-vis dietary diversity scores (DDS), breast feeding, and use of bottle. Non-breastfed children had significantly higher DDS scores than did breastfed children. The mean feeding frequency score (FFS) for children children >12 months of age. Mother's age and child's age were significant determinants of ICFI. Multivariate analysis indicated that ICFI was significantly associated with Length-for-Age z scores (LAZ) and BMI-for-Age z scores (BAZ). Sensitivity of ICFI was lower than its specificity. The results of the present study confirmed that the ICFI can be used to collect information on key components of young child feeding practices and be incorporated into public-health programmes. Further, it could be used to determine the influence of complementary feeding practices on nutritional status of children.
Vaivada, Tyler; Gaffey, Michelle F; Bhutta, Zulfiqar A
Although effective health and nutrition interventions for reducing child mortality and morbidity exist, direct evidence of effects on cognitive, motor, and psychosocial development is lacking. To review existing evidence for health and nutrition interventions affecting direct measures of (and pathways to) early child development. Reviews and recent overviews of interventions across the continuum of care and component studies. We selected systematic reviews detailing the effectiveness of health or nutrition interventions that have plausible links to child development and/or contain direct measures of cognitive, motor, and psychosocial development. A team of reviewers independently extracted data and assessed their quality. Sixty systematic reviews contained the outcomes of interest. Various interventions reduced morbidity and improved child growth, but few had direct measures of child development. Of particular benefit were food and micronutrient supplementation for mothers to reduce the risk of small for gestational age and iodine deficiency, strategies to reduce iron deficiency anemia in infancy, and early neonatal care (appropriate resuscitation, delayed cord clamping, and Kangaroo Mother Care). Neuroprotective interventions for imminent preterm birth showed the largest effect sizes (antenatal corticosteroids for developmental delay: risk ratio 0.49, 95% confidence interval 0.24 to 1.00; magnesium sulfate for gross motor dysfunction: risk ratio 0.61, 95% confidence interval 0.44 to 0.85). Given the focus on high-quality studies captured in leading systematic reviews, only effects reported within studies included in systematic reviews were captured. These findings should guide the prioritization and scale-up of interventions within critical periods of early infancy and childhood, and encourage research into their implementation at scale. Copyright © 2017 by the American Academy of Pediatrics.
Liu, Hong; Fang, Hai; Zhao, Zhong
This paper analyzes urban–rural disparities of China’s child health and nutritional status using the China Health and Nutrition Survey data from 1989 to 2006. We investigate degrees of health and nutritional disparities between urban and rural children in China as well as how such disparities have changed during the period 1989–2006. The results show that on average urban children have 0.29 higher height-for-age z-scores and 0.19 greater weight-for-age z-scores than rural children. Urban children are approximately 40% less likely to be stunted (OR = 0.62; p urban–rural health and nutritional disparities have been declining significantly from 1989 to 2006. Both urban and rural children have increased consumption of high protein and fat foods from 1989 to 2006, but the urban–rural difference decreased over time. Moreover, the urban–rural gap in child preventive health care access was also reduced during this period. PMID:22608863
Liu, Hong; Fang, Hai; Zhao, Zhong
This paper analyzes urban-rural disparities of China's child health and nutritional status using the China Health and Nutrition Survey data from 1989 to 2006. We investigate degrees of health and nutritional disparities between urban and rural children in China as well as how such disparities have changed during the period 1989-2006. The results show that on average urban children have 0.29 higher height-for-age z-scores and 0.19 greater weight-for-age z-scores than rural children. Urban children are approximately 40% less likely to be stunted (OR=0.62; purban-rural health and nutritional disparities have been declining significantly from 1989 to 2006. Both urban and rural children have increased consumption of high protein and fat foods from 1989 to 2006, but the urban-rural difference decreased over time. Moreover, the urban-rural gap in child preventive health care access was also reduced during this period. Copyright © 2012 Elsevier B.V. All rights reserved.
Watterworth, Jessica C; Hutchinson, Joy M; Buchholz, Andrea C; Darlington, Gerarda; Randall Simpson, Janis A; Ma, David W L; Haines, Jess
In Canada, little is known about how food parenting practices are associated with young children's dietary intakes and no studies have examined food parenting practices of Canadian fathers. This study aimed to examine associations between food parenting practices and preschool-age children's nutrition risk. We conducted a cross-sectional analysis of thirty-one 2-parent families; 31 mothers, 31 fathers, and 40 preschool-age children. Parents completed an adapted version of the Comprehensive Feeding Practices Questionnaire. We calculated children's nutrition risk using their NutriSTEP score. To account for sibling association, we used generalized estimating equations, adjusting for child age, sex, household income, and parental body mass index. Both mothers' and fathers' involvement of children in meal preparation were associated with lower child nutrition risk (mother [Formula: see text] = -3.45, p = 0.02; father [Formula: see text] = -1.74, p = 0.01), as were their healthy home environment scores (mother [Formula: see text] = -8.36, p parental emotion regulation, control, monitoring, or restriction for weight. In conclusion, both mothers' and fathers' food parenting practices are associated with their children's nutrition status. Fathers should be included in food parenting practices interventions.
Gowani, Saima; Yousafzai, Aisha K; Armstrong, Robert; Bhutta, Zulfiqar A
Early childhood programs are heralded as a way to improve children's health and educational outcomes. However, few studies in developing countries calculate the effectiveness of quality early childhood interventions. Even fewer estimate the associated costs of such interventions. The study here looks at the costs and effectiveness of a cluster-randomized effectiveness trial on children from birth to 24 months in rural Sindh, Pakistan. Responsive stimulation and/or enhanced nutrition interventions were integrated in the Lady Health Worker program in Pakistan. Outcomes suggest that children who receive responsive stimulation had significantly better development outcomes at 24 months than those who only received enhanced nutrition intervention. A cost-effectiveness analysis of the results verifies that early childhood interventions that include responsive stimulation are more cost effective than a nutrition intervention alone in promoting children's early development. Costs of a responsive stimulation intervention integrated in an existing community-based service providing basic health and nutrition care is approximately US$4 per month per child. We discuss these findings and make recommendations about scaling up and costs for future early child development programs. © 2014 New York Academy of Sciences.
Pust, R E; Binns, C W; Weinhold, D W; Martin, J R
Two mass interventions in the local low energy-density diet were evaluated for safety, acceptability and nutritional efficacy in a four-group matched study of 896 Papua New Guinea children aged 12-54 months. A single dose of 125 mg of pyrantel pamoate and an 800 mg supply of red palm oil were given monthly at the regular child health clinics. Both were safe and highly accepted. Children given palm oil gained more weight than controls (P less than .05) in the first three study months, confirming a pilot study. However, weight gain after one year was 94% of standard, with no differences in anthropometry, morbidity or mortality between groups. The lack of demonstrable differences at one year is attributed to secular improvement in control group nutrition and to diffusion of palm oil supplies within the family. While pyrantel was an effective antihelminthic, further study is needed to define the nutritional role of mass worm treatment. Palm oil was economical and culturally popular; thus it should be an ideal import substitution. It is clinically useful where diets are of low energy-density. However, any simultaneous demonstration of its nutritional safety, acceptability as a sustained mass intervention must be carried out in an area where major child growth deficits remain and expropriation of the oil by other household members can be controlled.
Andreyeva, Tatiana; Kenney, Erica L; O'Connell, Meghan; Sun, Xiaohan; Henderson, Kathryn E
This study assessed the dietary quality of lunches and feeding practices (family-style service, teacher role modeling) in Connecticut child care centers and made comparisons by center participation in the federal Child and Adult Care Food Program (CACFP). Plate waste methods and visual observation of lunches served and consumed. A total of 97 randomly selected licensed Connecticut child care centers (53 CACFP and 44 non-CACFP). A total of 838 preschool-aged children. Total energy intake, macronutrient intake, and intake by CACFP meal component as well as use of family-style dining, management of additional helpings, and whether and what teachers consumed in view of children. Child dietary intake at lunch was compared with dietary and CACFP recommendations using a mixed linear regression model. The CACFP centers were more likely to offer family-style service and have staff eat the same foods as the children. Children in non-CACFP centers consumed more saturated fat (4.1 vs 2.7 g; P advantages in terms of provider behavior during meals, characteristics of food offerings, and child intake. Current feeding practices in child care settings require further exploration in the context of serving children at risk for food insecurity and in light of recent work on responsive feeding. Copyright © 2018 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.
Felisbino-Mendes, Mariana Santos; Villamor, Eduardo; Velasquez-Melendez, Gustavo
Although child undernutrition and stunting has been decreasing worldwide while obesity rates increase, these extreme conditions might coexist in families from low- and middle-income countries. We examined the association between maternal and child anthropometric indicators using a population representative sample. 4,258 non-pregnant women and their children nutritional indexes of children, height-for-age (HAZ) and body mass index-for age (BAZ) z-scores, by categories of maternal height, body mass index (BMI), and waist circumference (WC). Adjusted mean differences and 95% confidence intervals (95% CI) were estimated from linear regression, taking into account the complex survey design. We also examined the associations of maternal anthropometry with the prevalence of child stunting (HAZ2). HAZ was positively associated with maternal height and WC in a linear fashion. After adjustment, for sociodemographic characteristics, children whose mothers' height wasmaternal height and maternal BMI, children of mothers with a waist circumference ≥88 cm had 0.3 higher HAZ than those of mothers with WCmaternal height (maternal BMI and WC. We observed a strong, positive association of maternal and child nutritional status. Mothers of low stature had children with lower stature, mothers with central obesity had taller children, and mothers with overall or abdominal obesity had children with higher BAZ.
Larson, Leila M; Martorell, Reynaldo; Bauer, Patricia J
Nutrition plays an important role in the development of a child, particularly in low- and middle-income countries where malnutrition is often widespread. The relation between diet, hemoglobin, nutritional status, motor development, stimulation and mental development was examined in a cross-sectional sample of 1,079 children 12-18 months of age living in rural Bihar, India. Path analysis revealed associations between (a) length-for-age z-scores and motor development, standardized β (β) = .285, p < .001, and (b) motor and all mental development outcomes (language: β = .422; personal-social: β = .490; memory: β = .139; and executive function: β = .072, all p < .001). Additionally, stimulation was significantly associated with language scores and hemoglobin concentration with memory. These findings inform interventions aimed at improving child development in Northern India. © 2018 The Authors Child Development published by Wiley Periodicals, Inc. on behalf of Society for Research in Child Development.
Thurber, Melanie D; Fahey, Jed W
Moringa oleifera, an edible tree found worldwide in the dry tropics, is increasingly being used for nutritional supplementation. Its nutrient-dense leaves are high in protein quality, leading to its widespread use by doctors, healers, nutritionists and community leaders, to treat under-nutrition and a variety of illnesses. Despite the fact that no rigorous clinical trial has tested its efficacy for treating under-nutrition, the adoption of M. oleifera continues to increase. The "Diffusion of innovations theory" describes well, the evidence for growth and adoption of dietary M. oleifera leaves, and it highlights the need for a scientific consensus on the nutritional benefits. Copyright © Taylor & Francis Group, LLC
Black, Maureen M; Pérez-Escamilla, Rafael; Fernandez Rao, Sylvia
The Millennium Development Goals (MDGs) have contributed to unprecedented reductions in poverty and improvement in the lives of millions of men, women, and children in low- and middle-income countries. Yet, hundreds of millions of children under 5 y of age are not reaching their developmental potential. This article reviews the scientific basis for early childhood nutrition and child development interventions, the impact of integrated interventions on children’s linear growth and cognitive development, and implementation strategies for integrated nutrition and child development programs. Advances in brain science have documented that the origins of adult health and well-being are grounded in early childhood, from conception through age 24 mo (first 1000 d) and extending to age 5 y (second 1000 d). Young children with adequate nutrition, nurturant caregiving, and opportunities for early learning have the best chances of thriving. Evidence from adoption, experimental, and quasi-experimental studies has shown that stunting prevention is sensitive during the first 1000 d, and sensitivity to child development interventions extends through the second 1000 d. Cognitive development responds to interventions post–1000 d with effect sizes that are inversely associated with initial age and length of program exposure. Integrated interventions need governance structures that support integrated policies and programming, with attention to training, supervision, and monitoring. The MDGs have been replaced by the Sustainable Development Goals (SDGs), with targets for the next 15 y. Achievement of the SDGs depends on children receiving adequate nutrition, nurturant caregiving, and learning opportunities from conception through age 5. PMID:26875208
Gerritsen, Sarah; Wall, Clare; Morton, Susan
To describe nutrition environments in formal child care for 3- and 4-year-olds. Cross-sectional online survey of nutrition-related child-care policy and practice. Written nutrition policies were analysed using the Wellness Child Care Assessment Tool. Licensed child-care services in the Auckland, Counties Manukau and Waikato regions of New Zealand. Eight hundred and forty-seven services (private and community day care, kindergartens and playcentres). Managers/head teachers of 257 child-care services completed the survey. Of services, 82·4 % had a written food, nutrition or wellness policy. Most policies did not refer to the national Food and Nutrition Guidelines and lacked directives for staff regarding recommended behaviours to promote healthy eating. Food was provided daily to children in 56·4 % of child-care services, including 33·5 % that provided lunch and at least two other meals/snacks every day. Teachers talked to children about food, and cooked with children, at least weekly in 60 % of child-care services. Nearly all services had an edible garden (89·5 %). Foods/beverages were sold for fundraising in the past 12 months by 37·2 % of services. The most commonly reported barrier to promoting nutrition was a lack of support from families (20·6 %). Although the majority of child-care services had a written nutrition policy, these were not comprehensive and contained weak statements that could be difficult to action. Foods served at celebrations and for fundraising were largely high in sugar, salt and/or saturated fat. Most services promoted some healthy eating behaviours but other widespread practices encouraged children to overeat or form unhealthy food preferences.
Lessard, Laura; Williams Leng, Sarah; Brennan, Robin
As more calls are made in the literature for nutrition interventions to be delivered in child care settings, research on the implementation of these interventions becomes more important. This study examined compliance with Delaware's regulations related to nutrition in child care settings, which are designed to improve the nutrition-related environment in these settings. A stratified random sample of licensed child care centers (n=233) was created from the total population of eligible centers in Delaware (N=450). Study staff visited each center and distributed self-administered surveys to the director and two randomly selected teachers. Surveys contained items about classroom-level compliance with the regulations along with center-level characteristics. Bivariate analyses were conducted to explore relationships between consistent compliance with each regulation component and center-level characteristics. A total of 179 of the 233 centers in the selected sample participated in the study. Compliance with the regulations varied within centers and across components; the highest levels of consistent compliance were reported for juice type (88.3%) and the lowest levels for whole grains (18.6%). Center characteristics, such as participation in the Child and Adult Care Food Program, were associated with consistent compliance for certain regulations components. Our results suggest that these types of regulations can be implemented across a diversity of centers, but that certain components (e.g., those relating to whole grains and water) may need further clarification. Our results also suggest that there are certain types of centers on which to focus training efforts to maximize compliance.
Phuong H. Nguyen
Full Text Available Background: Alive & Thrive Vietnam, a 6-year initiative (2009–2014, has developed and incorporated elements of social franchising into government health services to provide high-quality nutrition counseling services to improve infant and young child feeding practices. One element of franchising that has not yet been implemented is fee for service, which is a potential financing mechanism for sustaining services in the long run. Objective: This research aims to estimate maternal willingness to pay (WTP for nutrition counseling services and to examine potential factors associated with their WTP. Design and methods: Data were drawn from an impact evaluation survey of 2,511 women with a child <2 years old from four provinces in Vietnam. An iterative bidding technique was employed to explore individual WTP. The first bid was defined as VND 20,000 (~US$ 1, which was approximately the level of the actual service cost. Depending on the participant response, the bid increased or decreased. Finally, the respondents were asked about the highest price they would be willing to pay for the service. Results: Overall, 92.6% of clients reported a need for nutrition counseling services for children <2 years. The WTP rates at bid levels of VND 5,000, 10,000, 20,000, 40,000, and 100,000 were 95.2, 94.4, 90.7, 68.9, and 33.4%, respectively. The mean and median of the maximum WTP were VND 58,500 and 50,000, respectively. In multiple regression models, WTP rates were higher among younger women, the Kinh majority group, and better educated and wealthier women. Conclusion: A high demand for nutrition counseling coupled with a WTP by almost all segments of society would potentially cover costs of delivery for nutrition counseling services in Vietnam.
Paul, Vinod Kumar; Sachdev, Harshpal Singh; Mavalankar, Dileep; Ramachandran, Prema; Sankar, Mari Jeeva; Bhandari, Nita; Sreenivas, Vishnubhatla; Sundararaman, Thiagarajan; Govil, Dipti; Osrin, David; Kirkwood, Betty
India, with a population of more than 1 billion people, has many challenges in improving the health and nutrition of its citizens. Steady declines have been noted in fertility, maternal, infant and child mortalities, and the prevalence of severe manifestations of nutritional deficiencies, but the pace has been slow and falls short of national and Millennium Development Goal targets. The likely explanations include social inequities, disparities in health systems between and within states, and consequences of urbanisation and demographic transition. In 2005, India embarked on the National Rural Health Mission, an extraordinary effort to strengthen the health systems. However, coverage of priority interventions remains insufficient, and the content and quality of existing interventions are suboptimum. Substantial unmet need for contraception remains, adolescent pregnancies are common, and access to safe abortion is inadequate. Increases in the numbers of deliveries in institutions have not been matched by improvements in the quality of intrapartum and neonatal care. Infants and young children do not get the health care they need; access to effective treatment for neonatal illness, diarrhoea, and pneumonia shows little improvement; and the coverage of nutrition programmes is inadequate. Absence of well functioning health systems is indicated by the inadequacies related to planning, financing, human resources, infrastructure, supply systems, governance, information, and monitoring. We provide a case for transformation of health systems through effective stewardship, decentralised planning in districts, a reasoned approach to financing that affects demand for health care, a campaign to create awareness and change health and nutrition behaviour, and revision of programmes for child nutrition on the basis of evidence. This agenda needs political commitment of the highest order and the development of a people’s movement. PMID:21227494
Wuehler, Sara E; Biga Hassoumi, Abdoulazize
Due to limited progress towards reducing mortality and malnutrition among children Sahel,' starting with a situational analysis of current activities related to infant and young child nutrition (IYCN). The main objectives of this analysis are to compile, analyse, and interpret available information on infant and child feeding and the nutrition situation of children security, and hygienic practices. The results reported are limited by the availability of documents for review. Mortality rates are on track to reaching the Millennium Development Goal to reduce mortality among young children by two-thirds by 2015, but there has been no change in undernutrition, and total mortality rates are still high among young children. Nearly all of the key IYCN topics were addressed, specifically or generally, in national policy documents, training materials, and programmes. A national nutrition council meets regularly to coordinate programme activities nationally. Many of the IYCN-related programmes are intended for national coverage, but few reach this coverage. Monitoring and impact evaluations were conducted on some programmes, but few of these reported on whether the specific IYCN components of the programme were implemented as designed or compared outcomes with non-intervention sites. Human resources have been identified as inadequate to fully carry out nutrition programmes in Niger. Due to these limitations, we could not confirm whether the lack of progress in reducing malnutrition was due to ineffective or inadequately implemented programmes, though both of these were likely contributors. The policy framework is well established for the promotion of optimal IYCN practices, but greater resources and capacity building are needed to: (i) increase human capacities to carry out nutrition programmes; (ii) expand and track the implementation of evidence-based programmes nationally; (iii) improve and carry out monitoring and evaluation that identify effective and ineffective
Ngure, Francis M; Reid, Brianna M; Humphrey, Jean H; Mbuya, Mduduzi N; Pelto, Gretel; Stoltzfus, Rebecca J
There is scarce research and programmatic evidence on the effect of poor water, sanitation, and hygiene (WASH) conditions of the physical environment on early child cognitive, sensorimotor, and socioemotional development. Furthermore, many common WASH interventions are not specifically designed to protect babies in the first 3 years of life, when gut health and linear growth are established. We review evidence linking WASH, anemia, and child growth, and highlight pathways through which WASH may affect early child development, primarily through inflammation, stunting, and anemia. Environmental enteropathy, a prevalent subclinical condition of the gut, may be a key mediating pathway linking poor hygiene to developmental deficits. Current early child development research and programs lack evidence-based interventions to provide a clean play and infant feeding environment in addition to established priorities of nutrition, stimulation, and child protection. Solutions to this problem will require appropriate behavior change and technologies that are adapted to the social and physical context and conducive to infant play and socialization. We propose the concept of baby WASH as an additional component of early childhood development programs. © 2014 New York Academy of Sciences.
Alkon, Abbey; Crowley, Angela A; Neelon, Sara E Benjamin; Hill, Sherika; Pan, Yi; Nguyen, Viet; Rose, Roberta; Savage, Eric; Forestieri, Nina; Shipman, Linda; Kotch, Jonathan B
To address the public health crisis of overweight and obese preschool-age children, the Nutrition And Physical Activity Self Assessment for Child Care (NAP SACC) intervention was delivered by nurse child care health consultants with the objective of improving child care provider and parent nutrition and physical activity knowledge, center-level nutrition and physical activity policies and practices, and children's body mass index (BMI). A seven-month randomized control trial was conducted in 17 licensed child care centers serving predominantly low income families in California, Connecticut, and North Carolina, including 137 child care providers and 552 families with racially and ethnically diverse children three to five years old. The NAP SACC intervention included educational workshops for child care providers and parents on nutrition and physical activity and consultation visits provided by trained nurse child care health consultants. Demographic characteristics and pre - and post-workshop knowledge surveys were completed by providers and parents. Blinded research assistants reviewed each center's written health and safety policies, observed nutrition and physical activity practices, and measured randomly selected children's nutritional intake, physical activity, and height and weight pre- and post-intervention. Hierarchical linear models and multiple regression models assessed individual- and center-level changes in knowledge, policies, practices and age- and sex-specific standardized body mass index (zBMI), controlling for state, parent education, and poverty level. Results showed significant increases in providers' and parents' knowledge of nutrition and physical activity, center-level improvements in policies, and child-level changes in children's zBMI based on 209 children in the intervention and control centers at both pre- and post-intervention time points. The NAP SACC intervention, as delivered by trained child health professionals such as child care
Zembe-Mkabile, Wanga; Ramokolo, Vundli; Sanders, David; Jackson, Debra; Doherty, Tanya
Cash transfer programmes targeting children are considered an effective strategy for addressing child poverty and for improving child health outcomes in developing countries. In South Africa, the Child Support Grant (CSG) is the largest cash transfer programme targeting children from poor households. The present paper investigates the association of the duration of CSG receipt with child growth at 2 years in three diverse areas of South Africa. The study analysed data on CSG receipt and anthropometric measurements from children. Predictors of stunting were assessed using a backward regression model. Paarl (peri-urban), Rietvlei (rural) and Umlazi (urban township), South Africa, 2008. Children (n 746), median age 22 months. High rates of stunting were observed in Umlazi (28 %), Rietvlei (20 %) and Paarl (17 %). Duration of CSG receipt had no effect on stunting. HIV exposure (adjusted OR=2·30; 95 % CI 1·31, 4·03) and low birth weight (adjusted=OR 2·01, 95 % CI 1·02, 3·96) were associated with stunting, and maternal education had a protective effect on stunting. Our findings suggest that, despite the presence of the CSG, high rates of stunting among poor children continue unabated in South Africa. We argue that the effect of the CSG on nutritional status may have been eroded by food price inflation and limited progress in the provision of other important interventions and social services.
Sarah E Dumas
Full Text Available To investigate the association between livestock ownership and dietary diversity, animal-source food consumption, height-for-age z-score, and stunting among children living in wildlife "buffer zones" of Zambia's Luangwa Valley using a novel livestock typology approach.We conducted a cross-sectional study of 838 children aged 6-36 months. Households were categorized into typologies based on the types and numbers of animals owned, ranging from no livestock to large numbers of mixed livestock. We used multilevel mixed-effects linear and logistic regression to examine the association between livestock typologies and four nutrition-related outcomes of interest. Results were compared with analyses using more common binary and count measures of livestock ownership.No measure of livestock ownership was significantly associated with children's odds of animal-source food consumption, child height-for-age z-score, or stunting odds. Livestock ownership Type 2 (having a small number of poultry was surprisingly associated with decreased child dietary diversity (β = -0.477; p<0.01 relative to owning no livestock. Similarly, in comparison models, chicken ownership was negatively associated with dietary diversity (β = -0.320; p<0.01, but increasing numbers of chickens were positively associated with dietary diversity (β = 0.022; p<0.01. Notably, neither child dietary diversity nor animal-source food consumption was significantly associated with height, perhaps due to unusually high prevalences of morbidities.Our novel typologies methodology allowed for an efficient and a more in-depth examination of the differential impact of livestock ownership patterns compared to typical binary or count measures of livestock ownership. We found that these patterns were not positively associated with child nutrition outcomes in this context. Development and conservation programs focusing on livestock must carefully consider the complex, context-specific relationship between
Full Text Available BackgroundChild healthcare practices in China over the last 60 yearshave extensively improved children’s health and growth, yetnew challenges lie ahead. This review aims to summarisethe successful experiences and the newly identifiedproblems in child healthcare in China.MethodInformation, available to the public, was obtained fromChinese databases and Chinese Government websites,chiefly the Chinese National Knowledge Infrastructuredatabase, the Chinese Biomedical Literature database, theMinistry of Health website and the National WorkingCommittee on Children and Women website.ResultsDuring its poverty-stricken 1950s–1970s, China protectedchildren’s health mainly through prevention and control ofcommon infectious diseases and severe malnutrition withina comprehensive healthcare system. After the subsequent30 years of rapid socio-economic development, China hasachieved great success in reducing childhood mortality ratesand promoting child growth, meeting the MillenniumDevelopment Goal 4 targets and the WHO child growthstandards. Meanwhile, new challenges for children’shealthcare emerged, including: large disparities in thehealth, growth and nutritional status of children, and in theaccessibility and quality of child healthcare, between urbanand rural areas and across different regions of China; thenutritional and healthcare concerns of the fast-expandingpopulation of migrant children and rural left-behindchildren; the burgeoning epidemic of childhood obesity inurban and economically developed areas; micronutrientdeficiencies such as calcium, iron, zinc and vitamin A; andincreasing prevalence of mental and behavioural disorders.ConclusionUnder poor economic conditions, healthcare plays a keyrole in protecting children against diseases. With thedevelopment of social economy, new challenges present tohealthcare services, specifically, to comprehensivelypromote and optimise childrens’ health and nutrition.
Robert E Black
Full Text Available Under the Global Forum for Health Research, the Child Health and Nutrition Research Initiative (CHNRI began its operations in 1999 and became a Swiss foundation in 2006. The vision of CHNRI was to improve child health and nutrition of all children in low– and middle–income countries (LMIC through research that informs health policy and practice. Specific objectives included expanding global knowledge on childhood disease burden and cost-effectiveness of interventions, promoting priority setting in research, ensuring inclusion of institutions and scientists in LMIC in setting priorities, promoting capacity development in LMIC and stimulating donors and countries to increase resources for research. CHNRI created a knowledge network, funded research through multiple rounds of a global competitive process and published research papers and policy briefs. A signature effort was to develop a systematic methodology for prioritizing health and nutrition research investments. The “CHNRI method” has been extensively applied to global health problems and is now the most commonly used method for prioritizing health research questions.
Nguyen, Phuong H; Hoang, Minh V; Hajeebhoy, Nemat; Tran, Lan M; Le, Chung H; Menon, Purnima; Rawat, Rahul
Alive & Thrive Vietnam, a 6-year initiative (2009-2014), has developed and incorporated elements of social franchising into government health services to provide high-quality nutrition counseling services to improve infant and young child feeding practices. One element of franchising that has not yet been implemented is fee for service, which is a potential financing mechanism for sustaining services in the long run. This research aims to estimate maternal willingness to pay (WTP) for nutrition counseling services and to examine potential factors associated with their WTP. Data were drawn from an impact evaluation survey of 2,511 women with a child Vietnam. An iterative bidding technique was employed to explore individual WTP. The first bid was defined as VND 20,000 (~US$ 1), which was approximately the level of the actual service cost. Depending on the participant response, the bid increased or decreased. Finally, the respondents were asked about the highest price they would be willing to pay for the service. Overall, 92.6% of clients reported a need for nutrition counseling services for children Vietnam.
Chang-Martinez, Catherina; Ahmed, Nasar U; Natale, Ruby A; Messiah, Sarah E
The child care center (CCC) environment presents opportunities for healthy weight promotion in preschoolers. Our study examined the current state of CCC adherence to nutrition, physical activity, and screen time legislative regulations and the differences in their adherence by center socioeconomic position (SEP: low, middle, high) in Miami-Dade County. In 34 CCC, we used the Environment and Policy Assessment and Observation tool to evaluate nutrition, physical activity, and screen time practices during 1-school day. Twenty-five of the centers (73.5%) were participants of the Child and Adult Care Food Program. Almost 80% of the centers adhered to serving low-fat/fat-free milk to children older than 2 years. Only 34.5% served vegetables and 75.9% served whole fruits during meals/snacks. Ninety-four percent of the centers had quiet and active play incorporated into their daily routines. All centers adhered to the 2-hour screen time limit for children older than 2 years. Low- and middle-SEP centers fared better in the serving of fruits, vegetables, and low-fat/fat-free milk. The centers averaged 1 hour in outdoor play regardless of SEP. High-SEP centers had no TV or screen time during day of observation. CCC practices highlight opportunities for improvement in nutrition, physical activity, and screen time practices in the prevention of overweight in early childhood.
Benjamin Neelon, Sara E; Vaughn, Amber; Ball, Sarah C; McWilliams, Christina; Ward, Dianne S
The majority of children in the United States attend out-of-home child care. However, little is known about the nutritional quality of foods served and the mealtime environments. We assessed 96 child care centers over one full day using a researcher-administered structured observation and document review. We focused on eight nutrition domains: (1) fruits and vegetables, (2) whole grains, (3) high-sugar, high-salt, and high-fat foods, (4) beverages, (5) food availability and service, (6) staff behaviors, (7) training and education, and (8) policies. We computed daily means and frequencies for each domain. Seventy-five percent of centers participated in the Child and Adult Care Food Program, indicating they served low-income children. Centers enrolled 66 children on average; 60% were white, 28% were black, 4% were Native American, and 8% identified as mixed race. On the day of observation, seven centers did not serve a fruit and 15 did not serve a vegetable. Eighty centers served a high-sugar or high-salt food and 84 did not serve any whole grains. Five centers did not provide water indoors to children, 22 served juice twice, and 50 served whole milk. Seventeen centers had a vending machine on site visible to parents and children. Overall, children were served excessive juice, high-sugar and high-salt snack foods, and too much whole milk. Centers had room for improvement and could strive to serve more nutritious foods and create healthier mealtime environments for children.
Background Poor nutritional status of mothers has a direct and indirect consequence on their own health and that of their children. The objective of this study was to determine the relationship between nutritional status of mothers and their children and the risk factors for under-nutrition among mothers and children in rural and urban communities of Lagos State, Nigeria. Methods This was a cross sectional survey conducted using the multistage random sampling technique. A total of 300 mother-child pairs were studied, consisting of 150 each from rural and urban communities. Under-nutrition in mothers and children was determined using standard criteria. Results The prevalence of under-nutrition among mothers was significantly higher in rural than urban communities (10.7% vs. 2.7%, p = 0.014). The prevalences of underweight and stunted children were also significantly higher in rural than urban communities (19.4% vs. 9.3%, p maternal and child under nutrition differs across rural and urban communities. Conclusions The prevalence of maternal and child under-nutrition is high in both communities although higher in rural communities. Efforts at reducing the vicious cycle of under-nutrition among mothers and children should concentrate on addressing risk factors specific for each community. PMID:23880121
Paes-Sousa, Rômulo; Miazaki, Édina Shisue
Abstract Objective To examine the association between Brazil’s Bolsa Familia programme (BFP), which is the world's largest conditional cash transfer programme, and the anthropometric indicators of nutritional status in children. Methods Using the opportunity provided by vaccination campaigns, the Brazilian government promotes Health and Nutrition Days to estimate the prevalence of anthropometric deficits in children. Data collected in 2005–2006 for 22 375 impoverished children under 5 years of age were employed to estimate nutritional outcomes among recipients of Bolsa Família. All variables under study, namely child birth weight, lack of birth certificate, educational level and gender of family head, access to piped water and electricity, height for age, weight for age and weight for height, were converted into binary variables for regression analysis. Findings Children from families exposed to the BFP were 26% more likely to have normal height for age than those from non-exposed families; this difference also applied to weight for age. No statistically significant deficit in weight for height was found. Stratification by age group revealed 19% and 41% higher odds of having normal height for age at 12–35 and 36–59 months of age, respectively, in children receiving Bolsa Familia, and no difference at 0–11 months of age. Conclusion The BFP can lead to better nutritional outcomes in children 12 to 59 months of age. Longitudinal studies are needed to confirm these findings. PMID:21734763
Wuehler, Sara E; Coulibaly, Mouctar
Progress towards reducing mortality and malnutrition among children Sahel', starting with a situational analysis of current activities related to infant and young child nutrition (IYCN). The main objectives of the situational analysis are to compile, analyse and interpret available information on infant and young child feeding, and the nutrition situation of children security, and hygienic practices. Most of the key IYCN topics were addressed in national policies, training materials, and programme documents. Information on the national coverage and impact of these programmes is generally not available. Exclusive breastfeeding (<6 months) has increased in Mali, but no studies identified the contributors to this increase. Despite improvements in breastfeeding practices, optimal infant, and young child feeding is still practiced among too few young children in Mali. Several research articles were identified, but few of these were linked to programme development. Some programme monitoring and evaluation reports were available, but few of these were rigorous enough to identify whether IYCN-specific programme components were implemented as designed or were achieving desired outcomes. Therefore, we could not confirm which programmes contributed to reported improvements. Monitoring of programmes managing malnutrition identified gaps in human and institutional capacities to fully carry out intended interventions and the government has recognized the overall lack of adequate numbers of health care providers to carry out necessary programmes in Mali, of which nutrition programmes are a part. The policy and programme framework is well established for support of optimal IYCN practices, but greater resources and capacity building are needed to: (i) conduct necessary research to adapt training materials and programme protocols to programmatic needs; (ii) implement rigorous monitoring and evaluation that identify effective programme components; and (iii) apply these findings in
Erinosho, Temitope; Dixon, L Beth; Young, Candace; Brotman, Laurie Miller; Hayman, Laura L
Early childhood is a critical time to establish nutrition habits to prevent obesity. At least half of US children spend time in care outside of the home, where little is known about their dietary intakes and nutrition environment. The purpose of this study was to evaluate nutrition practices of group child-care centers in New York City and to assess whether dietary intakes of children at these centers meet nutrition recommendations. In 2005 and 2006, student research assistants administered surveys to directors of 40 child-care centers in three underserved communities (Central Brooklyn, East/Central Harlem, South Bronx) and in Manhattan, gathered menus, and observed beverages and foods consumed by 240 3- and 4-year-old children. Almost all centers provided beverages and foods recommended by national guidelines, including reduced-fat milk, 100% fruit juice, and whole grains. Some centers also provided higher-fat milk and sugar-sweetened beverages, but no centers provided soda. Drinking water was available in classrooms at only half of the centers. From observations at meal and snack times between 8 AM to 2 PM, <50% of children ate at least half of the daily recommended intake for each of five main food groups, with only 17% of children eating at least half of the daily recommended intake for vegetables and only 5% of children eating at least half of the daily recommended intake for vitamin E. Although many centers provided healthful beverages and foods to children, further efforts are needed to make water available as a beverage throughout the day and to improve dietary intakes, especially of vegetables and vitamin E-containing foods. Copyright © 2011 American Dietetic Association. Published by Elsevier Inc. All rights reserved.
Watanabe, Toshihiko; Arai, Katsuhiro; Takahashi, Masataka; Ohno, Michinobu; Sato, Kaori; Fuchimoto, Yasushi; Wada, Takahiko; Ida, Shinobu; Kawahara, Hisayoshi; Kanamori, Yutaka
X-linked alpha thalassemia mental retardation (ATR-X) syndrome is an X-linked recessive disorder that often involves gastrointestinal symptoms. Aspiration pneumonia related to gastroesophageal reflux has been reported as the major cause of death, but gastrointestinal function has not been well investigated. The present report describes a child with ATR-X syndrome who suffered from periodical episodes of refractory vomiting. We investigated the function of upper alimentary tract and found that esophago-gastric dysmotility and severe gastric volvulus were the major causes of gastrointestinal symptoms. This child was surgically treated with anterior gastropexy and jejunal alimentation through gastrostomy, and the symptoms were relieved with good weight gain. This report may provide insight into the gastrointestinal function and nutritional management in children with ATR-X syndrome. © 2014 Japan Pediatric Society.
Trost, Stewart G; Messner, Lana; Fitzgerald, Karen; Roths, Barbara
Family child care homes (FCCHs) provide child care to 1.9 million children in the U.S., but many do not meet established child care standards for healthy eating and physical activity. To determine the effects of a community-based train-the-trainer intervention on FCCHs policies and practices related to healthy eating and physical activity. Quasi-experimental design with replication in three independent cohorts of FCCHs. Registered FCCHs from 15 counties across Kansas participated in the Healthy Kansas Kids (HKK) program. Resource and referral agencies (RRAs) in each county recruited and enrolled between five and 15 child care providers in their service delivery area to participate in the program. The number of registered FCCHs participating in HKK in Years 1 (2006-2007); 2 (2007-2008); and 3 (2008-2009) of the program were 85, 64, and 87, respectively. A stratified random sample of registered FCCHs operating in Kansas (n=297) served as a normative comparison group. Child care trainers from each RRA completed a series of train-the-trainer workshops related to promotion of healthy eating and physical activity. FCCHs were subsequently guided through a four-step iterative process consisting of (1) self-evaluation; (2) goal setting; (3) developing an action plan; and (4) evaluating progress toward meeting goals. FCCHs also received U.S. Department of Agriculture resources related to healthy eating and physical activity. Nutrition and Physical Activity Self-Assessment for Child Care (NAP SACC) self-assessment instrument (NAP SACC-SA). Analyses of outcome measures were conducted between 2008 and 2010. Healthy Kansas Kids FCCHs exhibited significant improvements in healthy eating (Δ=6.9%-7.1%) and physical activity (Δ=15.4%-19.2%) scores (phealthy eating and physical activity in FCCHs are feasible, sustainable, and effective. Copyright © 2011 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
Fayez, Merfat; Takash, Hanan Mahmoud; Al-Zboon, Eman Khleif
Early childhood teachers play major roles in defying child abuse and neglect and alleviating its detrimental effects on young children. Therefore, this study aimed at exploring how Jordanian pre-service early childhood teachers define and perceive violence against children and their role in child abuse detection and prevention. Furthermore, the…
Parent-child relationship quality and family transmission of parent posttraumatic stress disorder symptoms and child externalizing and internalizing symptoms following fathers' exposure to combat trauma.
Snyder, James; Gewirtz, Abigail; Schrepferman, Lynn; Gird, Suzanne R; Quattlebaum, Jamie; Pauldine, Michael R; Elish, Katie; Zamir, Osnat; Hayes, Charles
Transactional cascades among child internalizing and externalizing symptoms, and fathers' and mothers' posttraumatic stress disorder (PTSD) symptoms were examined in a sample of families with a male parent who had been deployed to recent military conflicts in the Middle East. The role of parents' positive engagement and coercive interaction with their child, and family members' emotion regulation were tested as processes linking cascades of parent and child symptoms. A subsample of 183 families with deployed fathers and nondeployed mothers and their 4- to 13-year-old children who participated in a randomized control trial intervention (After Deployment: Adaptive Parenting Tools) were assessed at baseline prior to intervention, and at 12 and 24 months after baseline, using parent reports of their own and their child's symptoms. Parents' observed behavior during interaction with their children was coded using a multimethod approach at each assessment point. Reciprocal cascades among fathers' and mothers' PTSD symptoms, and child internalizing and externalizing symptoms, were observed. Fathers' and mothers' positive engagement during parent-child interaction linked their PTSD symptoms and their child's internalizing symptoms. Fathers' and mothers' coercive behavior toward their child linked their PTSD symptoms and their child's externalizing symptoms. Each family member's capacity for emotion regulation was associated with his or her adjustment problems at baseline. Implications for intervention, and for research using longitudinal models and a family-systems perspective of co-occurrence and cascades of symptoms across family members are described.
Hurley, Kristen M; Yousafzai, Aisha K; Lopez-Boo, Florencia
Poor nutrition (substandard diet quantity and/or quality resulting in under- or overnutrition) and the lack of early learning opportunities contribute to the loss of developmental potential and life-long health and economic disparities among millions of children aged child development (ECD) or nutrition have been linked to positive child development and/or nutritional status, and recommendations currently advocate for the development and testing of integrated interventions. We reviewed the theoretical and practical benefits and challenges of implementing integrated nutrition and ECD interventions along with the evidence for best practice and benefit-cost and concluded that the strong theoretical rationale for integration is more nuanced than the questions that the published empirical evidence have addressed. For example, further research is needed to 1) answer questions related to how integrated messaging influences caregiver characteristics such as well-being, knowledge, and behavior and how these influence early child nutrition and development outcomes; 2) understand population and nutritional contexts in which integrated interventions are beneficial; and 3) explore how varying implementation processes influence the efficacy, uptake, and cost-benefit of integrated nutrition and ECD interventions. PMID:26980819
This study is based on an evaluation of the Maternal and Child Health and Nutrition Program (PROMIN) targeting pregnant women and their children under five years of age. The objective was to identify the conditioning factors for the Program's implementation in Rosario, Argentina. There were three levels of analysis: the organizational environment as perceived by the Executive Directors of the Health and Child Development Centers; management of interventions by the health teams; and the community's perception of the program's accessibility and acceptability. Two centers were chosen for the year 1998. Empirical evidence was obtained through quantitative and qualitative procedures. The results suggest that the two centers' respective organizational environments influenced the intervention strategies. The goal for coverage had been set at 80%. Documentation of the interventions by the two teams shows a partial and heterogeneous implementation. In terms of accessibility, mothers recognize the institutions by their reputation, quality of services, and extra services beyond the PROMIN basics. Acceptability is expressed as the provision of supplementary nutrition.
Ansari, T.; Ali, L.; Aziz, T.; Ara, J.; Liaquat, N.; Tahir, H.
Background: Iron deficiency is the most common aetiology of anaemia worldwide and has several risk factors. Although iron deficiency anaemia (IDA) can occur at any age, women from reproductive age group are particularly vulnerable to develop IDA due to increased nutritional demand during pregnancy. Objective was to determine the frequency and nutritional risk factor of iron deficiency anaemia in women of child bearing age. This descriptive, cross sectional study was conducted from October 2005 to March 2006 at the Department of Medicine, Ward-5, and out-patients department of Jinnah Postgraduate Medical Centre, Karachi. Method: Two hundred non-pregnant females of child bearing age were included in the study; 100 with no previous pregnancy and remaining 100 with at least one prior history of pregnancy. All the relevant information, i.e., demographic and socioeconomic was collected through a questionnaire. Results: Two hundred patients with signs and symptoms of anaemia were recruited. Out of them 89 patients were found to be having iron deficiency anaemia in various age groups. Results also showed that dietary habit of patients was one of the causative factors leading to iron deficiency anaemia. Conclusion: To overcome iron deficiency anaemia a thorough and comprehensive strategy is required, i.e., educating the subjects to consume food rich in iron, community based program, monitoring severely anaemic cases and their treatment. (author)
Ford, N D; Stein, A D
An estimated 200 million children worldwide fail to meet their development potential due to poverty, poor health and unstimulating environments. Missing developmental milestones has lasting effects on adult human capital. Africa has a large burden of risk factors for poor child development. The objective of this paper is to identify scope for improvement at the country level in three domains--nutrition, environment, and mother-child interactions. We used nationally representative data from large-scale surveys, data repositories and country reports from 2000 to 2014. Overall, there was heterogeneity in performance across domains, suggesting that each country faces distinct challenges in addressing risk factors for poor child development. Data were lacking for many indicators, especially in the mother-child interaction domain. There is a clear need to improve routine collection of high-quality, country-level indicators relevant to child development to assess risk and track progress.
Reinsma, Kate; Nkuoh, Godlove; Nshom, Emmanuel
Despite the recent international focus on maternal and child nutrition, little attention is paid to nutrition capacity development. Although infant feeding counselling by health workers increases caregivers' knowledge, and improves breastfeeding, complementary feeding, and children's linear growth, most of the counselling in sub-Saharan Africa is primarily conducted by nurses or volunteers, and little is done to develop capacity for nutrition at the professional, organizational, or systemic levels. The Cameroon Baptist Convention Health Services Nutrition Improvement Program (NIP) has integrated a cadre of nutrition counselors into prevention of mother-to-child transmission of HIV programs, infant welfare clinics, and antenatal clinics to improve infant and young child feeding practices (IYCF). The study objective was to evaluate the effects of NIP's infant feeding counselors on exclusive breastfeeding (EBF), complementary feeding (CF), and children's linear growth. A cross-sectional evaluation design was used. Using systematic random sampling, caregivers were recruited from NIP sites (n = 359) and non-NIP sites (n = 415) from Infant Welfare Clinics (IWCs) in the Northwest (NWR) and Southwest Regions (SWR) of Cameroon between October 2014 and April 2015. Differences in EBF and CF practices and children's linear growth between NIP and non-NIP sites were determined using chi-square and multiple logistic regression. After adjusting for differences in religion, occupation, and number of months planning to breastfeed, children were almost seven times (Odds Ratio [OR]: 6.9; 95% Confidence Interval [CI]: 2.30, 21.09; β = 1.94) more likely to be exclusively breastfed at NIP sites compared to non-NIP sites. After adjusting for differences in occupation, religion, number of months planning to breastfeed, rural environment, economic status, attending other Infant Welfare Clinics, and non-biological caregiver, children were five times more likely to be stunted at
Full Text Available Abstract Background Despite the recent international focus on maternal and child nutrition, little attention is paid to nutrition capacity development. Although infant feeding counselling by health workers increases caregivers’ knowledge, and improves breastfeeding, complementary feeding, and children’s linear growth, most of the counselling in sub-Saharan Africa is primarily conducted by nurses or volunteers, and little is done to develop capacity for nutrition at the professional, organizational, or systemic levels. The Cameroon Baptist Convention Health Services Nutrition Improvement Program (NIP has integrated a cadre of nutrition counselors into prevention of mother-to-child transmission of HIV programs, infant welfare clinics, and antenatal clinics to improve infant and young child feeding practices (IYCF. The study objective was to evaluate the effects of NIP’s infant feeding counselors on exclusive breastfeeding (EBF, complementary feeding (CF, and children’s linear growth. Methods A cross-sectional evaluation design was used. Using systematic random sampling, caregivers were recruited from NIP sites (n = 359 and non-NIP sites (n = 415 from Infant Welfare Clinics (IWCs in the Northwest (NWR and Southwest Regions (SWR of Cameroon between October 2014 and April 2015. Differences in EBF and CF practices and children’s linear growth between NIP and non-NIP sites were determined using chi-square and multiple logistic regression. Results After adjusting for differences in religion, occupation, and number of months planning to breastfeed, children were almost seven times (Odds Ratio [OR]: 6.9; 95% Confidence Interval [CI]: 2.30, 21.09; β = 1.94 more likely to be exclusively breastfed at NIP sites compared to non-NIP sites. After adjusting for differences in occupation, religion, number of months planning to breastfeed, rural environment, economic status, attending other Infant Welfare Clinics, and non-biological caregiver
Benjamin Neelon, Sara E; Mayhew, Meghan; O'Neill, Jennifer R; Neelon, Brian; Li, Fan; Pate, Russell R
Policies to promote healthy eating in young children appear promising, but are largely untested. Recently, South Carolina implemented mandatory nutrition standards governing child-care centers serving low-income children. This study evaluated consistency with the standards before and after the policy took effect. This study evaluated consistency with the nutrition standards in South Carolina, using North Carolina-a state not making policy changes-as the comparison. The research team conducted assessments in a longitudinal sample of centers and a cross-sectional sample of children before and approximately 9 months after the standards took effect. Trained observers recorded foods and beverages served to 102 children from 34 centers in South Carolina and 90 children from 30 centers in North Carolina at baseline. At follow-up, the research team observed 99 children from 33 centers in South Carolina and 78 children from 26 centers in North Carolina. The policy was implemented in April 2012 and included 13 standards governing the nutritional quality of foods and beverages served to children, and staff behaviors related to feeding children in care. The outcome was consistency with each standard at follow-up in South Carolina compared with North Carolina, controlling for baseline consistency and other covariates. Logistic regressions were conducted to evaluate consistency with each standard, adjusting for baseline and potential confounders. Compared with North Carolina, centers in South Carolina were more likely to be consistent with the standard prohibiting the use of food as a reward or punishment (odds ratio=1.22; 95% CI 1.11 to 1.61; P=0.03). Two centers in South Carolina met all 13 standards at follow-up compared with none in North Carolina. No other differences were observed. New standards modestly improved nutrition practices in South Carolina child-care centers, but additional support is needed to bring all centers into compliance with the current policies
This article reviews the maternal and child nutrition situation in Asia in transition and its public health implications. Countries in Asia are facing a double burden of malnutrition. Accessibility to high energy, less nutrient-dense foods or processed foods affects current dietary patterns, whereas industrialization is leading to more sedentary lifestyles both in rural and urban areas. Stunting and wasting among young children persist but have declined in severity, whereas overweight and obesity have risen rapidly. Growth faltering in height during the first 2 years of life has affected muscle mass accretion, but rapid weight gain after 2 years of age has led to more fat accretion, imposing risks of childhood obesity and consequent metabolic disorders. The number of women entering pregnancy with low BMI has decreased, but increasing BMI is noticeable. Prepregnancy BMI and gestational weight gain are important determinants of maternal nutrition during pregnancy, the risk of gestational diabetes and postpartum weight retention, as well as obesity and diet-related noncommunicable diseases in later adulthood. Asia in transition is faced with persistent undernutrition and increasing trends of obesity and metabolic disorders among children and women. The first 1000 days from conception is a critical period, but it is also a window of opportunity for preventing double burden of malnutrition in Asian countries characterized by a nutrition transition.
The prenatal period encompasses a critical window for future health and functioning of mother and child. Attention previously focused on undernutrition risk (i.e., in developing countries and famine conditions) shifted to mismatch between prenatal 'programming' by undernutrition and postnatal overconsumption (i.e., low birthweight vs rapid postnatal growth), now to overconsumption/overweight throughout the reproductive cycle and short- and long-term health risks, including obesity, diabetes, dyslipidemia and cardiovascular disease. Moreover, overconsumption/overweight do not guarantee adequacy of critical nutrients (i.e., against birth defects or for brain development). Multinutrient supplementation - including zinc, iodine, choline and long-chain polyunsaturated fatty acids, especially n-3 - may have advantages over single-nutrient supplements, for example, iron or folate. Future nutritional care for healthy in utero programming may necessitate individual assessment and follow-up, including preconception nutritional preparation, appropriate weight gain, metabolic balance and food-based regimens enhanced by key nutrient fortification and/or supplementation, warranting further research into nutritional optimization of pregnancy outcomes.
Benjamin Neelon, Sara E.; Reyes-Morales, Hortensia; Haines, Jess; Gillman, Matthew W.; Taveras, Elsie M.
Objective The purpose of the present study was to assess the nutritional quality of foods and beverages listed on menus serving children in government-sponsored child-care centres throughout Mexico. Design For this cross-sectional menu assessment, we compared (i) food groups and portion sizes of foods and beverages on the menus with MyPlate recommendations and (ii) macronutrients, sugar and fibre with Daily Reference Intake standards. Setting Menus reflected foods and beverages served to children attending one of 142 government-sponsored child-care centres throughout Mexico. Subjects There were fifty-four distinct menus for children aged 4–6 months, 7–9 months, 10–12 months, 13–23 months, 24–47 months and 48–72 months. Results Menus included a variety of foods meeting minimum MyPlate recommendations for each food category except whole grains for children aged 48–72 months. Menus listed excessive amounts of high-energy beverages, including full-fat milk, fruit juice and sugar-sweetened beverages for children of all ages. The mean daily energy content of menu items yielded an average of 2·76 MJ for infants, 4·77 MJ for children aged 13–23 months, 5·36 MJ for children aged 24–47 months and 5·87 MJ for children aged 48–72 months. Foods and beverages on menus provided sufficient grams of carbohydrate and fat, but excessive protein. Conclusions Menus provided a variety of foods but excessive energy. Whole grains were limited, and high-energy beverages were prevalent. Both may be appropriate targets for nutrition intervention. Future studies should move beyond menus and assess what children actually consume in child care. PMID:23036360
Golley, R K; McNaughton, S A; Collins, C E; Magarey, A; Garnett, S P; Campbell, K J; Mallan, K; Burrows, T
The Food and Nutrition stream of Australasian Child and Adolescent Obesity Research Network (ACAORN) aims to improve the quality of dietary methodologies and the reporting of dietary intake within Australasian child obesity research (http://www.acaorn.org.au/streams/nutrition/). With 2012 marking ACAORN's 10th anniversary, this commentary profiles a selection of child obesity nutrition research published over the last decade by Food and Nutrition Stream members. In addition, stream activities have included the development of an online selection guide to assist researchers in their selection of appropriate dietary intake methodologies (http://www.acaorn.org.au/streams/nutrition/dietary-intake/index.php). The quantity and quality of research to guide effective child obesity prevention and treatment has increased substantially over the last decade. ACAORN provides a successful case study of how research networks can provide a collegial atmosphere to foster and coordinate research efforts in an otherwise competitive environment. © 2014 The Authors. Pediatric Obesity © 2014 International Association for the Study of Obesity.
Full Text Available This article compares maternal child health and nutrition programmes in Argentina and Chile, focusing on long-term institutional features and the central neo-liberal trends organizing social reforms during the 1980s and the 1990s. Objective: To carry out a comparative study of the ransformations of Maternal Child Health and Nutrition Programmes, taking into account three intertwined issues: social policies, institutional capacity, and policy implementation. Methodology: The documentary analysis done in this article is framed in the structural force model of Carmelo Mesa-Lago and the polity-centred structure model of Theda Skocpol. Conclusions: Despite relatively similar policy lines implemented in both countries, the contrasting long-term institutional features (Chilean programmes addressed maternal and child health more efficiently than the Argentines account for most of the variation in the overall process of reform implementation and the performance of maternal and child health policies.
Jin, Minchao; Iannotti, Lora L
Animal source foods (ASF) provide critical micronutrients in highly bioavailable forms, with the potential to efficiently address undernutrition among young children living in developing countries. There is limited evidence for how livestock ownership might increase ASF intake in poor households either through own-consumption or income generation. Along with lack of nutrition knowledge, gender dimensions may affect the pathways leading from livestock ownership to child ASF intake and ultimately to young child growth. Using data from a large-scale impact evaluation conducted in Kenya, this study tested the hypothesis that co-owned/female-owned livestock would be associated with improved child growth, mediated by increases in ASF consumption. Data were collected from September 2010 to January 2011 from households in six provinces in Kenya on a broad range of agricultural, economic, social, health and nutrition factors. Children ages 6-60 months were included in this analysis (n = 183). In this sample, co-owned/female-owned livestock was valued at 18,861 Kenyan shillings in contrast with male-owned livestock valued at 66,343 Kenyan shillings. Multivariate linear regression models showed a positive association between co-owned/female-owned livestock with child weight-for-age z score (WAZ) after adjusting for caregiver education level, income, child age, and child sex. A mediating effect by child ASF intake was evident, explaining 25% of the relationship of livestock ownership with child WAZ, by Sobel-Goodman test (p livestock and height-for-age z score (HAZ), and no effect was apparent for weight-for-height z score (WHZ). The partial mediating effect may be indicative of other factors inherent in co-owned/female-owned livestock such as higher status of females in these households with greater influence over other child care practices promoting growth. Nonetheless, our study suggests targeting females in livestock production programming may better ensure improvements
Amarra, Sofia; Chan, Pauline
The Infant and Early Childhood Nutrition Task Force, International Life Sciences Institute Southeast Asia (ILSI SEA) Region, organised the 1st and 2nd Expert Consultation and Planning Meeting on Infant and Early Childhood Nutrition in 2009 and 2011, respectively. The goal of the consultations was "to generate and promote relevant science-based information that will help improve nutritional status, growth and development of infants and young children in Southeast Asia." An Expert Panel Core Group was created whose role is to provide advice and recommendations through a review of current scientific knowledge regarding issues related to early childhood growth and nutrition. The Panel is composed of experts representing 7 countries (China, Indonesia, Malaysia, Philippines, Singapore, Thailand, and Vietnam). In July 2012, the Panel convened the 3rd Expert Consultation and Planning Meeting on Infant and Young Child Nutrition in Singapore. This report presents the highlights of the meeting and recommendations made by the Panel on ways to improve infant and young child nutrition in Southeast Asia. The effective use of WHO indicators for assessing infant and young child feeding practices, mitigating the effects of maternal employment on breastfeeding, using behaviour change communication, updating the education of health personnel, and improving maternal health were considered important actions to be taken. Since current feeding practices in Southeast Asia fall short of WHO recommendations, studies are needed to develop strategies which take into consideration the diverse cultural settings that characterise the region.
Haidar, J; Abate, G; Kogi-Makau, W; Sorensen, P
To identify the factors associated with childhood under-nutrition in North Wollo, Ethiopia. A cross-sectional study. Four purposefully selected rural villages (kebeles) in North Wollo zone of the Amhara Region, Ethiopia. One hundred-forty four sampled households with under five year old children (n=200) comprising of 96 male-headed, 24 female-headed and 24 landless with children aged between six and 59 months. Determinations of anthropometric measurements and various socio-economic factors. The overall prevalence rate of under nutrition as determined by stunting, underweight and wasting was 44.5%, 25.0% and 9.0% respectively with more preponderance among the toddlers. The proportion of under nutrition was higher in female-headed households. Shortage of farmland, lack of irrigation, dispossession of livestock, shortage of non-farm employment options, parental illiteracy, high number of children, water inadequacy, food taboos and wrong eating habits of families, poor child feeding practices, deprivation of health nutrition education as well as maternal attributes such as young motherhood, low body mass index and short stature of mothers influenced the nutritional status of the children. The prominent risk factors for undernutrition among children were dispossession of livestock, child food taboos and wrong eating habits of families, deprivation of health/nutrition education, short stature and early marriage of mothers. This study led to the conclusion that improvement of household resources through promotion of irrigation and initiation of income generating livelihood options can reverse the nutrition situation for better. Health and nutrition education focusing on appropriate child feeding, eradication of harmful traditional practices such as early marriage and inequitable intra-household food distribution, encouragement of family planning and nutrition interventions including food diversification is recommended.
Bilukha, Oleg O; Jayasekaran, Douglas; Burton, Ann; Faender, Gabriele; King'ori, James; Amiri, Mohammad; Jessen, Dorte; Leidman, Eva
As a result of civil war, an estimated 2.8 million refugees have fled Syria and reside in neighboring countries, mainly Lebanon, Turkey, Jordan, and Iraq. The largest Syrian refugee camp in the region is Zaatari camp in Jordan, with approximately 79,000 refugees; another estimated 500,000 Syrian refugees live in Jordanian cities, towns, and villages, mostly in the capital (Amman) and in four northern governorates (Irbid, Mafraq, Jarash, and Zarqa). Although all registered refugees in Jordan receive food vouchers from the World Food Programme (WFP) and vulnerable refugees receive cash assistance from the United Nations High Commissioner for Refugees (UNHCR) and nongovernmental organizations, the nutritional status of some refugees might be compromised because of dislocation, lack of income, and limited access to nutritious foods. To assess the nutritional status of Syrian refugees, UNHCR, WFP, the United Nations Children's Fund (UNICEF), Medair International (a nongovernmental organization), and CDC, in collaboration with the United Nations Population Fund and the World Health Organization (WHO), conducted cross-sectional, population-representative cluster surveys in Zaatari camp and among refugees residing in the host community. The surveys were conducted during April-May 2014 with the principal objective of assessing nutritional status of refugee children aged 6-59 months and nonpregnant women of reproductive age (15-49 years). Preliminary findings indicated a high prevalence of anemia in Zaatari camp among both children and women (48.4% and 44.8%, respectively). Nutrition policies aimed at ensuring optimal child and maternal micronutrient status and addressing the underlying risk factors for anemia are likely to result in improved health outcomes and a reduction in anemia.
Snyder, James; Gewirtz, Abigail; Schrepferman, Lynn; Gird, Suzanne R.; Quattlebaum, Jamie; Pauldine, Michael R.; Elish, Katie; Zamir, Osnat; Hayes, Charles
Transactional cascades among child internalizing and externalizing symptoms, and fathers’ and mothers’ post-traumatic stress disorder symptoms were examined in a sample of families with a male parent who had been deployed to recent military conflicts in the Middle East. The role of parents’ positive engagement and coercive interaction with their child, and family members’ emotion regulation were tested as processes linking cascades of parent and child symptoms. A subsample of 183 families with deployed fathers and non-deployed mothers and their 4 to 13 year old children who participated in a randomized control trial intervention (After Deployment: Adaptive Parenting Tools, or ADAPT) were assessed at baseline prior to intervention, and at 12 and 24 months after baseline, using parent reports of their own and their child’s symptoms. Parents’ observed behavior during interaction with their children was coded using a multi-method approach at each assessment point. Reciprocal cascades among fathers’ and mothers’ PTSD symptoms, and child internalizing and externalizing symptoms were observed. Fathers’ and mothers’ positive engagement during parent-child interaction linked their PTSD symptoms and their child’s internalizing symptoms. Fathers’ and mothers’ coercive behavior toward their child linked their PTSD symptoms and their child’s externalizing symptoms. Each family members’ capacity for emotion regulation was associated with their adjustment problems at baseline. Implications for intervention, and for research using longitudinal models and a family-systems perspective of co-occurrence and cascades of symptoms across family members are described. PMID:27739388
Wandner, Laura D.; Hair, Elizabeth
This brief discusses aspects of healthy diets for children in elementary and middle school. It summarizes the current guidelines and recommendations for child nutrition and provides information for schools and out-of-school time programs about how to measure child nutrition. (Contains 27 endnotes.)
Gorman, Lisa A; Fitzgerald, Hiram E; Blow, Adrian J
The injuries (physical and emotional) sustained by service members during combat influence all members of a family system. This review used a systemic framework to conceptualize the direct and indirect effects of a service member's injury on family functioning, with a specific focus on young children. Using a meta-ethnographic approach to synthesize the health research literature from a variety of disciplines, this review makes relevant linkages to health care professionals working with injured veterans. Studies were included that examined how family functioning (psychological and physical) is impacted by parental illness; parental injury; and posttraumatic stress disorder. The synthesis of literature led to the development of a heuristic model that illustrates both direct and indirect effects of parental injury on family functioning and the development of young children. It further illustrates the contextual factors or moderating variables that buffer detrimental effects and promote family resilience. This model can be a foundation for future research, intervention, and policy.
Liu, Hong; Rizzo, John A; Fang, Hai
Hukou is the household registration system in China that determines eligibility for various welfare benefits, such as health care, education, housing, and employment. The hukou system may lead to nutritional and health disparities in China. We aim at examining the role of the hukou system in affecting urban-rural disparities in child nutrition, and disentangling the institutional effect of hukou from the effect of urban/rural residence on child nutrition-related health outcomes. This study uses data from the China Health and Nutrition Survey 1993-2009 with a sample of 9616 children under the age of 18. We compute height-for-age z-score and weight-for-age z-score for children. We use both descriptive statistics and multiple regression techniques to study the levels and significance of the association between child nutrition-related health outcomes and hukou type. Children with urban hukou have 0.25 (P rural hukou, and this difference by urban vs. rural hukou status is larger than the difference in height and weight (0.23 and 0.09, respectively) by urban vs. rural residence. Controlling for place of residence, children with urban hukou had 0.18 higher height z-scores and 0.17 (P rural hukou. The hukou system exacerbates urban-rural disparities in child nutrition-related health outcomes independent of the well-known disparity stemming from urban-rural residence. Fortunately, however, child health disparities due to hukou have been declining since 2000.
Despite the importance of breakfast, summer, and after-school child nutrition programs, coverage in these programs in Massachusetts is low. This report describes the barriers facing the states School Breakfast, Summer Food Service, and After-School Snack Programs and suggests many innovative solutions and resources that program sponsors can use to…
... Agricultural Marketing Service's (AMS) intention to request approval, from the Office of Management and Budget... DEPARTMENT OF AGRICULTURE Agricultural Marketing Service [Doc. No. AMS-FV-11-0015] Child Nutrition... Collection AGENCY: Agricultural Marketing Service, USDA. ACTION: Request for comments. SUMMARY: In accordance...
Fabiana de Cássia Carvalho Oliveira
Full Text Available Anemia e desnutrição, principais carências nutricionais na infância, têm como principais determinantes os socioeconômicos. Assim, por se tratar da principal política de combate à pobreza, espera-se que o Programa Bolsa Família (PBF promova impacto no estado nutricional infantil. Objetivou-se analisar as diferenças na situação nutricional de crianças cadastradas no PBF de um município da Zona da Mata Mineira. Foram avaliadas 446 crianças com idade entre 6 e 84 meses, sendo que 262 eram beneficiárias e 184 não-beneficiárias. A avaliação nutricional constituiu-se da análise dos parâmetros peso e estatura, através dos índices peso/idade, peso/estatura, estatura/idade e Índice de Massa Corporal/idade, e dos níveis de hemoglobina, com uso do Hemocue. As prevalências de anemia, déficit estatural e obesidade foram 22,6, 6,3 e 5,2%, respectivamente, sendo que não houve diferença estatística entre os beneficiários e não-beneficiários. Inicialmente, o grupo beneficiário apresentava piores condições socioeconômicas, porém, com o recebimento do benefício, os grupos se igualaram financeiramente. É possível que a similaridade dos dois grupos também quanto ao estado nutricional possa ser atribuída ao recebimento do benefício, tanto devido ao incremento financeiro, quanto ao acompanhamento nutricional exigido como condicionalidade do programa.The main nutritional deficiencies during childhood, namely anemia and malnutrition, are predominantly related to socio-economic factors. Thus, as the Bolsa Família Program (BFP is the main policy to combat poverty, it is expected that it will have an impact on child nutrition. The aim was to analyze the differences in the nutritional situation of children registered with the BFP of a municipality located in Zona da Mata of Minas Gerais state. 446 children aged between 6 and 84 months were evaluated, of which 262 were non-beneficiaries and 184 were beneficiaries. Nutritional
Leung, Brenda M Y; Giesbrecht, Gerald F; Letourneau, Nicole; Field, Catherine J; Bell, Rhonda C; Dewey, Deborah
Mental disorders are one of the leading contributors to the global burden of disease. The Alberta Pregnancy Outcomes and Nutrition (APrON) study was initiated in 2008 to better understand perinatal environmental impacts on maternal mental health and child development. This pregnancy cohort was established to investigate the relationship between the maternal environment (e.g. nutritional status), maternal mental health status, birth outcomes, and child development. The purpose of this paper is to describe the creation of this longitudinal cohort, the data collection tools and procedures, and the background characteristics of the participants. Participants were pregnant women age 16 or older, their infants and the biological fathers. For the women, data were collected during each trimester of pregnancy and at 3, 6, 12, 24, and 36months after the birth of their infant. Maternal measures included diet, stress, current mental and physical health, health history, and lifestyle. In addition, maternal biological samples (DNA, blood, urine, and spot breast milk samples) were banked. Paternal data included current mental and physical health, health history, lifestyle, and banked DNA samples. For infants, DNA and blood were collected as well as information on health, development and feeding behavior. At the end of recruitment in 2012, the APrON cohort included 2140 women, 2172 infants, and 1417 biological fathers. Descriptive statistics of the cohort, and comparison of women who stayed in the study and those who dropped out are discussed. Findings from the longitudinal cohort may have important implications for health policy and clinical practice. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Sisson, Susan B; Campbell, Janis E; May, Kellie B; Brittain, Danielle R; Monroe, Lisa A; Guss, Shannon H; Ladner, Jennifer L
The purpose of the current study was to determine the obesogenic practices in all-day child-care centers caring for preschool-aged children. This study used a cross-sectional, self-reported survey mailed to centers across Oklahoma (n=314). Frequency of responses and χ(2) were calculated comparing region and star rating. Items where the majority of centers frequently report best practices include: daily fruits served (76%), daily nonfried vegetables served (71%), rarely/never served sugary drinks (92%), rarely/never used food to encourage good behaviors (88%), staff join children at table most of the time (81%), staff rarely eat different foods in view of children (69%), visible self-serve or request availability of water (93%), regular informal communication about healthy eating (86%), opportunities for outdoor play (95%), not withholding activity for punishment (91%), accessible play equipment (59% to 80% for different types of equipment), and minimization of extended sitting time (78%). Practices where centers can improve include increasing variety of vegetables (18%), reducing frequency of high-fat meats served (74% serve more than once per week), increasing high-fiber and whole-grain foods (35% offer daily), serving style of "seconds" (28% help kids determine whether they are still hungry), nonfood holiday celebrations (44% use nonfood treats), having toys and books that encourage healthy eating (27%) and physical activity (25%) in all rooms in the center, a standard nutrition (21%) and physical education (50%) curriculum, and following a written physical activity policy (43%). Practitioners can use these data to develop benchmarks and interventions, as this was the first study to assess statewide obesogenic practices in child care. Copyright © 2012 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.
Woodward-Lopez, Gail; Kao, Janice; Kuo, Elena S; James, Paula; Lenhart, Kitty; Becker, Christina; Boyle, Kathryn; Williamson, Dana; Rauzon, Suzanne
From 2012 to 2014, a total of 17 family child care homes participated in a multisector, community-wide initiative to prevent obesity. Strategies included staff workshops, materials, site visits, and technical assistance regarding development and implementation of nutrition policies. The purpose of the evaluation was to examine the impact of the initiative on family child care home nutrition-related policies and practices and child dietary intake. Pre- and post-intervention without control group. Measures taken at baseline and follow-up included structured observations and questionnaires regarding nutrition policies, practices, and environments; documentation of lunch foods served on 5 days; and lunch plate waste observations on 2 days. Paired t-tests were used to determine the significance of change over time. Seventeen family child care homes in a low-income diverse community in Northern California; children aged 2-5 years who attended the family child care homes. Change in nutrition-related policies and practices, lunch foods served and consumed. Data was collected at 17 sites for an average of 5.2 children aged 2-5 years per site per day at baseline and 4.6 at follow-up for a total of 333 plate waste observations. There were significant increases in staff training, parental involvement, and several of the targeted nutrition-related practices; prevalence of most other practices either improved or was maintained over time. There were significant increases in the number of sites meeting Child and Adult Care Food Program meal guidelines, variety of fruit and frequency of vegetables offered, and reductions in frequency of juice and high-fat processed meats offered. Adequate portions of all food groups were consumed at both time points with no significant change over time. A simple, policy-focused intervention by a child care resource and referral agency was successful at reinforcing and improving upon nutrition-related practices at family child care homes. Children
Vieux, Florent; Brouzes, Chloé M C; Maillot, Matthieu
consume YCFs and/or supplements and in those who do not. Dietary data from 1147 young children (aged 12–18 months) were used to identify, using linear programming models, the minimum changes needed to ensure nutritional adequacy: (i) by changing the quantities of foods initially consumed by each child...... (repertoire-foods); and (ii) by introducing new foods (non-repertoire-foods). Most of the children consumed neither YCFs, nor supplements (61.6%). Nutritional adequacy with repertoire-foods alone was ensured for only one child in this group, against 74.4% of the children consuming YCFs and supplement. When...... access to all foods was allowed, smaller food changes were required when YCFs and supplements were initially consumed than when they were not. In the total sample, the main dietary shifts needed to ensure nutritional adequacy were an increase in YCF and a decrease in cow’s milk (+226 g/day and –181 g...
This paper examines the barriers to educational achievement presented by child labour and the formal education systems of Latin America. Parents put pressure on children to work rather than study, and historically the formal education systems have had no safeguards to remedy the resulting knowledge gaps. Knowledge gaps lead to repeated failure in academic courses, which in turn prompts parents to view education as irrelevant. The paper examines the various economic-incentive programmes that h...
Full Text Available Antibiotic use on animals demonstrates improved growth regardless of whether or not there is clinical evidence of infectious disease. Antibiotics used for trachoma control may play an unintended benefit of improving child growth.In this sub-study of a larger randomized controlled trial, we assess anthropometry of pre-school children in a community-randomized trial of mass oral azithromycin distributions for trachoma in Niger. We measured height, weight, and mid-upper arm circumference (MUAC in 12 communities randomized to receive annual mass azithromycin treatment of everyone versus 12 communities randomized to receive biannual mass azithromycin treatments for children, 3 years after the initial mass treatment. We collected measurements in 1,034 children aged 6-60 months of age.We found no difference in the prevalence of wasting among children in the 12 annually treated communities that received three mass azithromycin distributions compared to the 12 biannually treated communities that received six mass azithromycin distributions (odds ratio = 0.88, 95% confidence interval = 0.53 to 1.49.We were unable to demonstrate a statistically significant difference in stunting, underweight, and low MUAC of pre-school children in communities randomized to annual mass azithromycin treatment or biannual mass azithromycin treatment. The role of antibiotics on child growth and nutrition remains unclear, but larger studies and longitudinal trials may help determine any association.
Kulwa, Kissa B M; Kinabo, Joyce L D; Modest, Beata
Care is increasingly being recognized as a crucial input to child health and nutrition, along with food security, availability of health services, and a healthy environment. Although significant gains have been made in the fight against malnutrition in Tanzania, the nutritional status of preschool children in urban areas is not improving. To assess child-care practices and the nutritional status of infants and young children with the aim of improvingfeeding practices and child nutritional status. A cross-sectional study was undertaken in urban Dar-es-Salaam, Tanzania. The study involved 100 randomly selected mothers of children 6 to 24 months old from households in Ilala Municipality, one of the three municipalities that constitute the Dar-es-Salaam City Council. Data were collected by a structured questionnaire, spot-check observations, and anthropometric measurements. The prevalence rates of stunting, underweight, wasting, and morbidity were 43%, 22%, 3%, and 80%, respectively. The prevalence of exclusive breastfeeding was very low (9%), and most stunted children (88%) were not exclusively breastfed for the first 6 months. The mean age at which complementary foods and fluids were introduced was 3.26 +/- 1.12 months (range, 1 to 5 months). The fluids given were mainly water and thin cereal-based porridge. More than half of the households practiced good hygiene. Most of the psychosocial practices (e.g., caregiver's attention, affection, and involvement in child feeding, hygiene, health care, and training) were performed by mothers, except for cooking and feeding the children and child training, which were done mostly by alternative caregivers. Nearly half of the mothers (44%) worked out of the home. The mean number of working hours per day was long (10.32 +/- 2.13), necessitating the use of alternative caregivers. A negative correlation was found between height-for-age z-scores and the number of hours mothers worked outside the home. The prevalence rates of chronic
Uauy, Ricardo; Kurpad, Anura; Tano-Debrah, Kwaku; Otoo, Gloria E; Aaron, Grant A; Toride, Yasuhiko; Ghosh, Shibani
Over a third of all deaths of children under the age of five are linked to undernutrition. At a 90% coverage level, a core group of ten interventions inclusive of infant and young child nutrition could save one million lives of children under 5 y of age (15% of all deaths) (Lancet 2013). The infant and young child nutrition package alone could save over 220,000 lives in children under 5 y of age. High quality proteins (e.g. milk) in complementary, supplementary and rehabilitation food products have been found to be effective for good growth. Individual amino acids such as lysine and arginine have been found to be factors linked to growth hormone release in young children via the somatotropic axis and high intakes are inversely associated with fat mass index in pre-pubertal lean girls. Protein intake in early life is positively associated with height and weight at 10 y of age. This paper will focus on examining the role of protein and amino acids in infant and young child nutrition by examining protein and amino acid needs in early life and the subsequent relationship with stunting.
Konstantyner, Tulio; Konstantyner, Thais Cláudia Roma de Oliveira; Toloni, Maysa Helena Aguiar; Longo-Silva, Giovana; Taddei, José Augusto de Aguiar Carrazedo
In Brazil, although many children from low income families attend day care centers with appropriate hygiene practices and food programs, they have nutritional disorders and communicable diseases. This quantitative and qualitative cross-sectional study identified staff challenges in child day care centers and suggested alternative activity management to prevent nutritional disorders and communicable diseases. The study included 71 nursery teachers and 270 children from public and philanthropic day care centers (teacher to child ratios of 1:2.57 and 1:6.40, respectively). Interviews and focus groups were conducted with teachers and parents, and anthropometry and blood samples were drawn from the children by digital puncture. Children in philanthropic child day care centers were more likely to be hospitalized due to communicable diseases. Teachers from philanthropic child day care centers had lower age, income and education and higher work responsibilities based on the number of children and working time. The focus groups characterized institutions with organized routines, standard food practices, difficulties with caretaking, and lack of training to provide healthcare to children. Strategies to improve children's health in day care settings should focus on training of teachers about healthcare and nutrition.
Full Text Available Despite an increasing trend in labour migration and economic dependence on foreign migrant workers in Sri Lanka, very little is known about the child care and nutritional status of “children left behind”. The aim of this study was to examine the factors influencing the nutritional status and care practices of children left behind. A sample of 321 children, 6–59 months old of international migrant workers from a cross-sectional nationally represented study were included. Care practices were assessed using ten caregiving behaviours on personal hygiene, feeding, and use of health services. Results revealed the prevalence of stunting, wasting and underweight to be 11.6, 18.2 and 24.0 percent, respectively. Father being a migrant worker has a positive effect on childcare practices and birthweight of the child. This study indicates that undernutrition remains a major concern, particularly in the poorest households where the mother is a migrant worker, also each additional 100 g increase in the birthweight of a child in a migrant household, decreases the probability of being wasted, stunted and underweight by 6%, 8% and 23% respectively. In depth study is needed to understand how labour migration affects household level outcomes related to child nutrition and childcare in order to build skills and capacities of migrant families.
Jayatissa, Renuka; Wickramage, Kolitha
Despite an increasing trend in labour migration and economic dependence on foreign migrant workers in Sri Lanka, very little is known about the child care and nutritional status of "children left behind". The aim of this study was to examine the factors influencing the nutritional status and care practices of children left behind. A sample of 321 children, 6-59 months old of international migrant workers from a cross-sectional nationally represented study were included. Care practices were assessed using ten caregiving behaviours on personal hygiene, feeding, and use of health services. Results revealed the prevalence of stunting, wasting and underweight to be 11.6, 18.2 and 24.0 percent, respectively. Father being a migrant worker has a positive effect on childcare practices and birthweight of the child. This study indicates that undernutrition remains a major concern, particularly in the poorest households where the mother is a migrant worker, also each additional 100 g increase in the birthweight of a child in a migrant household, decreases the probability of being wasted, stunted and underweight by 6%, 8% and 23% respectively. In depth study is needed to understand how labour migration affects household level outcomes related to child nutrition and childcare in order to build skills and capacities of migrant families.
Cunha, Antonio Jose Ledo Alves da; Leite, Álvaro Jorge Madeiro; Almeida, Isabela Saraiva de
To describe the concept of the first 1000 days, its importance for health, and actions to be implemented, particularly by pediatricians, in order to attain healthy nutrition and development. A nonsystematic review was carried out in the SciELO, LILACS, MEDLINE, Scopus, and Web of Science databases, encompassing the last decade, using the terms 1000 days, child nutrition, child development, childhood, and child. A non-systematic search was performed online for organizations that use the 1000-day concept and give recommendations on children's health. The first 1000 days range from conception to the end of the second year of life. It represents an important period to implement interventions to ensure healthy nutrition and development, which will bring benefits throughout life. Children should receive adequate nutrition, through proper prenatal diet, exclusive breastfeeding for the first 6 months, addition of adequate complementary foods, and continued breastfeeding up to 2 years of life. Given the condition of absolute dependence on an adult's care, it is crucial to establish an enabling and friendly environment, necessary for the development of strong bonds with caregivers, laying the groundwork for a full and healthy development. The pediatrician, together with other professionals, can act by promoting actions emphasizing the concept of the first 1000 days to ensure healthy nutrition and development. Focusing on actions in this period may increase the child's chance of having a healthy and productive life in the future, strengthening family and community ties, helping to break the intergenerational cycle of poverty. Copyright © 2015 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.
Breck, Andrew; Goodman, Ken; Dunn, Lillian; Stephens, Robert L; Dawkins, Nicola; Dixon, Beth; Jernigan, Jan; Kakietek, Jakub; Lesesne, Catherine; Lessard, Laura; Nonas, Cathy; O'Dell, Sarah Abood; Osuji, Thearis A; Bronson, Bernice; Xu, Ye; Kettel Khan, Laura
This article describes the multi-method cross-sectional design used to evaluate New York City Department of Health and Mental Hygiene's regulations of nutrition, physical activity, and screen time for children aged 3 years or older in licensed group child care centers. The Center Evaluation Component collected data from a stratified random sample of 176 licensed group child care centers in New York City. Compliance with the regulations was measured through a review of center records, a facility inventory, and interviews of center directors, lead teachers, and food service staff. The Classroom Evaluation Component included an observational and biometric study of a sample of approximately 1,400 children aged 3 or 4 years attending 110 child care centers and was designed to complement the center component at the classroom and child level. The study methodology detailed in this paper may aid researchers in designing policy evaluation studies that can inform other jurisdictions considering similar policies.
Lu, J X; Liu, X B; Chen, J; Hu, Y C; Yun, C F; Li, W D; Wang, R; Yang, Y H; Mao, D Q; Piao, J H; Yang, X G; Yang, L C
Objective: To evaluate the vitamin D nutritional status in Chinese women of child-bearing age by analyzing serum 25-hydroxyvitamin D level in 2010-2012. Methods: Data were obtained from the China Nutrition and Health Survey in 2010-2012. Using cluster sampling and proportional stratified random sampling, 1 514 women of child-bearing age (18-44 years old) from 34 metropolis and 41 small and medium-sized cities were included in this study. Demographic information was collected by questionnaire and serum 25-hydroxyvitamin D concentration was determined by radioimmunoassay, in accordance with the 2010 Institute of Medicine of the National Academies standards. We compared differences in vitamin D levels, specifically serious deficiency, lack of deficiency, insufficiency, and excess. Results: The overall serum 25-hydroxyvitamin D level of Chinese urban women of child-bearing age ( P (50) ( P (25)- P (75))) was 20.1 (15.1-26.3) ng/ml; minorities had a significantly higher serum 25-hydroxyvitamin D level of 22.0 (15.9-27.5) ng/ml compared with women of Han nationality (19.8 (14.9-26.2) ng/ml) (χ(2)=7.02, P= 0.008). The proportions of women with serious deficiency, lack of deficiency, insufficiency, and excess vitamin D were 11.6% ( n= 175), 37.9% ( n= 574), 35.1% ( n= 531), and 0.3% ( n= 5), respectively. Only 15.1% ( n= 229) of women of child-bearing age had normal vitamin D nutritional status. No significant differences in vitamin D nutritional status were observed according to age, body mass index, city, nationality, educational level, marital status, or household income per capita ( P> 0.05). Conclusion: Most Chinese urban women of child-bearing age have poor vitamin D levels and require vitamin D supplementation.
Wuehler, Sara E; Ouedraogo, Albertine Wendpagnagdé
Progress towards reducing mortality and malnutrition among children Sahel', starting with an analysis of current activities related to infant and young child nutrition (IYCN). The objectives of the present paper are to compare relevant national policies, training materials, programmes, and monitoring and evaluation activities with internationally accepted IYCN recommendations. These findings are available to assist countries in identifying inconsistencies and filling gaps in current programming. Between August and November 2008, key informants responsible for conducting IYCN-related activities in Burkina Faso were interviewed, and 153 documents were examined on the following themes: optimal breastfeeding and complementary feeding practices, prevention of micronutrient deficiencies, screening and treatment of acute malnutrition, prevention of mother-to-child transmission of HIV, food security and hygienic practices. National policy documents addressed nearly all of the key IYCN topics, specifically or generally. Formative research has identified some local barriers and beliefs related to general breastfeeding and complementary feeding practices, and other formative research addressed about half of the IYCN topics included in this review. However, there was little evidence that this formative research was being utilized in developing training materials and designing programme interventions. Nevertheless, the training materials that were reviewed do provide specific guidance for nearly all of the key IYCN topics. Although many of the IYCN programmes are intended for national coverage, we could only confirm with available reports that programme coverage extended to certain regions. Some programme monitoring and evaluation were conducted, but few of these provided information on whether the specific IYCN programme components were implemented as designed. Most surveys that were identified reported on general nutrition status indicators, but did not provide the detail
Duarte, Luciane Simões; Fujimori, Elizabeth; Toriyama, Áurea Tamami Minagawa; Palombo, Claudia Nery Teixeira; Miranda, Patrícia Pereira Lima; Borges, Ana Luiza Vilela
Assessing maternal perception of their children's nutritional status and identifying associated factors. A cross-sectional study conducted in a small municipality with 342 children less than 3 years of age treated in Basic Health Units of São Paulo. Nutritional status was classified in percentiles of body mass index for age and maternal perception was assessed using the scale of verbal descriptors (very thin, thin, healthy weight, fat, very fat). Logistic regression was used to identify the associatedfactors. 44.7% of maternal perception was found to beinadequate. Mothers of overweight (OR = 11.8, 95% CI: 6.4-21.7) and underweight (OR = 5.5; 95% CI: 1.9-16.2) children had a higher chance of having inadequate perception, similar to mothers of children over 24 months of age (OR = 2.9; 95% CI: 1.4-6.0). For effective child care in primary care, healthcare professionals should consider maternal perception and helpmothers to identify the nutritional status of children in childcare consultations and growth monitoring. Avaliar a percepção materna do estado nutricional do filho e identificar os fatores associados. Estudo transversal realizado em município de pequeno porte com 342 crianças menores de 3anos atendidas em Unidades Básicas de Saúde do Estado de São Paulo. O estado nutricional foi classificado em percentis do Índice de Massa Corporalpara Idade e a percepção materna foi avaliada com escala de descritores verbais (muito magro, magro, peso adequado, gordo, muito gordo). Utilizou-se de regressão logística para identificar os fatores associados. Constatou-se 44,7% de percepção materna inadequada. Mães de crianças com excesso de peso (OR=11,8; IC95%:6,4-21,7) e com baixo peso (OR=5,5; IC95%:1,9-16,2) apresentaram mais chance de percepção inadequada, da mesma forma que mães de crianças com mais de 24 meses de idade (OR=2,9; IC95%:1,4-6,0). Para uma efetiva assistência à criança na atenção básica, profissionais de saúde devem considerar a
Full Text Available Abstract Background Human beings from time immemorial have eradicated neighbouring tribes, languages, religions, and cultures. In war and crisis, the cumulative exposure to traumatic stress constitutes a predictor of the development of post traumatic stress disorder (PTSD. However, homicide has evolved as a profitable strategy in man, leading to greater reproductive success. Thus, an evolutionary advantage of perpetrating violence would be eliminated if the exposure to aggressive acts would traumatize the perpetrator. We argue that perpetrating violence could actually ‘immunize’ a person against adverse effects of traumatic stressors, significantly reducing the risk of developing PTSD. Methods We surveyed 42 former child soldiers in Northern Uganda that have all been abducted by the Lord Resistance Army (LRA as well as 41 non-abducted controls. Results Linear regression analyses revealed a dose–response effect between the exposure to traumatic events and the Posttraumatic Diagnostic Scale (PDS sum score. However, the vulnerability to develop trauma related symptoms was reduced in those with higher scores on the Appetitive Aggression Scale (AAS. This effect was more pronounced in the formerly abducted group. Conclusions We conclude that attraction to aggression when being exposed to the victim’s struggling can lead to a substantial risk-reduction for developing PTSD.
Huicho, L.; Segura, E.R.; Huayanay-Espinoza, C.A.; Niño de Guzman, J.; Restrepo-Méndez, M.C.; Tam, Y.; Barros, A.J.D.; Victora, C.G.; Hernández-Peña, P.
Background Peru is an upper-middle-income country with wide social and regional disparities. In recent years, sustained multisectoral antipoverty programmes involving governments, political parties, and civil society have included explicit health and nutrition goals and spending increased sharply. We did a country case study with the aim of documenting Peru's progress in reproductive, maternal, neonatal, and child health from 2000–13, and explored the potential determinants. Methods We examin...
Jordan, Irmgard; Kuchenbecker, Judith; Reinbott, Anika; Krawinkel, Michael B; Muehlhoff, Ellen
Full text: Poor nutritional status in early infancy is associated with growth faltering and increased risk for morbidity. Main causes for undernutrition are a diet poor in quality and quantity, feeding practices, and hygiene. Programmes emphasize on affordable ways for improving diets for low-income families. Little is known about the period needed for behaviour changes. Longitudinal studies were conducted in Malawi and Cambodia looking at infant and young child feeding as well as growth of children below two years. At baseline 6-9 months old children and their caregivers participating in a nutrition education(NE) program of FAO were invited. The recruited children were matched by age (days) and sex with children living in an area without NE (control). Baseline data was collected prior the NE carried out by trained volunteers twice a month based on locally adopted teaching materials. The children and their caregivers were visited every three months for a total period of 12 months. At baseline the mean age of the children in Malawi was 227 days, all breastfed (n = 149). In Cambodia the mean age was 230 days and 90% of them were still breastfed (n = 96). The mean HAZ was -1.53 in Malawi and -0.87 in Cambodia. Minimum acceptable diet(MAD) was received by 42% and 34% of the children in the intervention areas of Malawi and Cambodia respectively. After three months MAD was achieved by 88% in Malawi and 45% in Cambodia. The rates in the control area in Malawi increased as well from 22% at baseline to 52% three months later. A similar change could be observed in Cambodia with 28% of the children receiving MAD at baseline and 38% three months later. Hygiene behaviour was one focus of the NE in both countries. In Malawi soap usage before feeding the child increased to 32% (p< 0.001), and before food preparation to 33% (both p < 0.001). Also washing before eating the food increased to 22%. In the control area no significant changes in terms of soap usage could be observed. In
Review and Reauthorization of Certain Child Nutrition Programs. Hearings before the Subcommittee on Nutrition of the Committee on Agriculture, Nutrition, and Forestry, United States Senate and the Committee on Agriculture, Nutrition, and Forestry, United States Senate. Ninety-Eighth Congress, Second Session (March 12 and April 4, 1984).
Congress of the U.S., Washington, DC. Senate Committee on Agriculture, Nutrition, and Forestry.
Testimony is given in this report from two hearings concerning reauthorization of the nonentitlement child nutrition programs: the Women, Infants, and Children Feeding Program; the Summer Food Service Program; Nutrition Education and Training (NET); State Administrative Expenses, and authority for section 32 commodities. At the March 12, 1984…
Jacobi, Sheila K; Boyd, R Dean; Bauman, Dale E; Anthony, Russell V; Bazer, Fuller W; Lock, Adam L; Serazin, Andrew C
High among the challenges facing mankind as the world population rapidly expands toward 9 billion people by 2050 is the technological development and implementation of sustainable agriculture and food systems to supply abundant and wholesome nutrition. In many low-income societies, women and children are the most vulnerable to food insecurity, and it is unequivocal that quality nutrition during the first 1000 d of life postconception can be transformative in establishing a robust, lifelong developmental trajectory. With the desire to catalyze disruptive advancements in global maternal and child health, this landscape review was commissioned by the Bill & Melinda Gates Foundation to examine the nutritional and managerial practices used within the food-animal agricultural system that may have relevance to the challenges faced by global human health. The landscape was categorized into a framework spanning 1) preconception, 2) gestation and pregnancy, 3) lactation and suckling, and 4) postweaning and toddler phases. Twelve key findings are outlined, wherein research within the discipline of animal sciences stands to inform the global health community and in some cases identifies gaps in knowledge in which further research is merited. Notable among the findings were 1) the quantitative importance of essential fatty acid and amino acid nutrition in reproductive health, 2) the suggested application of the ideal protein concept for improving the amino acid nutrition of mothers and children, 3) the prospect of using dietary phytase to improve the bioavailability of trace minerals in plant and vegetable-based diets, and 4) nutritional interventions to mitigate environmental enteropathy. The desired outcome of this review was to identify potential interventions that may be worthy of consideration. Better appreciation of the close linkage between human health, medicine, and agriculture will identify opportunities that will enable faster and more efficient innovations in global
Vyas, Sangita; Kov, Phyrum; Smets, Susanna; Spears, Dean
Child height is an important indicator of human capital and human development, in large part because early life health and net nutrition shape both child height and adult economic productivity and health. Between 2005 and 2010, the average height of children under 5 in Cambodia significantly increased. What contributed to this improvement? Recent evidence suggests that exposure to poor sanitation - and specifically to widespread open defecation - can pose a critical threat to child growth. We closely analyze the sanitation height gradient in Cambodia in these two years. Decomposition analysis, in the spirit of Blinder-Oaxaca, suggests that the reduction in children's exposure to open defecation can statistically account for much or all of the increase in average child height between 2005 and 2010. In particular, we see evidence of externalities, indicating an important role for public policy: it is the sanitation behavior of a child's neighbors that matters more for child height rather than the household's sanitation behavior by itself. Moving from an area in which 100% of households defecate in the open to an area in which no households defecate in the open is associated with an average increase in height-for-age z-score of between 0.3 and 0.5. Our estimates are quantitatively robust and comparable with other estimates in the literature. Copyright Â© 2016 The Authors. Published by Elsevier B.V. All rights reserved.
Stookey, Jodi D; Evans, Jane; Chan, Curtis; Tao-Lew, Lisa; Arana, Tito; Arthur, Susan
North Carolina Nutrition and Physical Activity Self-Assessment for Child Care (NAP SACC) resources improve child body mass index (BMI) when the resources are introduced by nurses to child care providers, and offered with workshops and incentives. In San Francisco, public health and child care agencies partnered to adapt NAP SACC resources into an annual "Healthy Apple" quality improvement program (HAP). This cluster randomized controlled trial pilot-tested integration of the HAP with bi-annual public health screenings by nurses. All child care centers that participated in Child Care Health Program (CCHP) screenings in San Francisco in 2011-2012 were offered routine services plus HAP in 2012-2013 (CCHP + HAP, n = 19) or routine services with delayed HAP in 2014-2015 (CCHP + HAP Delayed, n = 24). Intention-to-treat analyses (robust SE or mixed models) used 4 years of screening data from 12 to 17 CCHP + HAP and 17 to 20 CCHP + HAP Delayed centers, regarding 791 to 945 children ages 2 to 5y, annually. Year-specific, child level models tested if children in CCHP + HAP centers had greater relative odds of exposure to 3 index best practices and smaller Autumn-to-Spring changes in BMI percentile and z-score than children in CCHP + HAP Delayed centers, controlling for age, sex, and Autumn status. Multi-year, child care center level models tested if HAP support modified year-to-year changes (2013-2014 and 2014-2015 vs 2011-2012) in child care center annual mean Autumn-to-Spring BMI changes. In 2011-2012, the CCHP + HAP and CCHP + HAP Delayed centers had similar index practices (public health nursing services was associated with significantly more children exposed to best practices and improvement in child BMI change. The results warrant continued integration of HAP into local public health infrastructure. ISRCTN18857356 (24/04/2015) Retrospectively registered.
Dewey, Kathryn G
Meeting the high nutrient needs of pregnant and lactating women and their young children in regions such as South Asia is challenging because diets are dominated by staple foods with low nutrient density and poor mineral bioavailability. Gaps in nutritional adequacy in such populations probably date back to the agricultural revolution ~10 000 years ago. Options for improving diets during the first 1000 days include dietary diversification and increased intake of nutrient-rich foods, improved complementary feeding practices, micronutrient supplements and fortified foods or products specifically designed for these target groups. Evidence from intervention trials indicates that several of these strategies, both prenatal and post-natal, can have a positive impact on child growth, but results are mixed and a growth response is not always observed. Nutrition interventions, by themselves, may not result in the desired impact if the target population suffers from frequent infection, both clinical and subclinical. Further research is needed to understand the mechanisms underlying both prenatal and post-natal growth restriction. In the meantime, implementation and rigorous evaluation of integrated interventions that address the multiple causes of stunting is a high priority. These intervention packages should ideally include improved nutrition during both pregnancy and the post-natal period, prevention and control of prenatal and post-natal infection and subclinical conditions that restrict growth, care for women and children and stimulation of early child development. In regions such as South Asia, such strategies hold great promise for reducing stunting and enhancing human capital formation. © 2016 The Authors. Maternal & Child Nutrition published by John Wiley & Sons Ltd.
The International Atomic Energy Agency (IAEA) programme on nutrition enhances countries’ capabilities to combat malnutrition for better health throughout life. It complements the work of other United Nations (UN) agencies, non-governmental organizations (NGOs) and interested stakeholders in the field of nutrition and health, by encouraging the use of accurate nuclear techniques (including stable isotopes) to design and evaluate interventions aimed at addressing malnutrition in all its forms with specific focus on: infant and young child feeding; maternal and adolescent nutrition; diet quality; prevention and control of non-communicable diseases (NCDs); and healthy ageing.
The International Atomic Energy Agency (IAEA) programme on nutrition enhances countries’ capabilities to combat malnutrition for better health throughout life. It complements the work of other United Nations (UN) agencies, non-governmental organizations (NGOs) and interested stakeholders in the field of nutrition and health, by encouraging the use of accurate nuclear techniques (including stable isotopes) to design and evaluate interventions aimed at addressing malnutrition in all its forms with specific focus on: infant and young child feeding; maternal and adolescent nutrition; diet quality; prevention and control of non-communicable diseases (NCDs); and healthy ageing.
The International Atomic Energy Agency (IAEA) programme on nutrition enhances countries’ capabilities to combat malnutrition for better health throughout life. It complements the work of other United Nations (UN) agencies, non-governmental organizations (NGOs) and interested stakeholders in the field of nutrition and health, by encouraging the use of accurate nuclear techniques (including stable isotopes) to design and evaluate interventions aimed at addressing malnutrition in all its forms with specific focus on: infant and young child feeding; maternal and adolescent nutrition; diet quality; prevention and control of non-communicable diseases (NCDs); and healthy ageing.
Durnin, J V
Nutrition appeared somewhat late on the scene in the I.B.P. projects in the U.K., but eventually it occupied an integral part of many of the H.A. (human adaptability) investigations. The nutritional data obtained in the studies of isolated and nearisolated communities in Tristan da Cunha and in New Guinea provided information of wide nutritional significance. There were also detailed and extensive studies in Israel which, similarly to those in New Guinea, attempted to relate nutritional factors to enviroment, working conditions, and physical fitness. Some extraordinarily low energy intakes found in Ethiopians have induced much speculation on the extent which man can adequately adapt to restricted food supplies. Interesting nutritional observations, of general importance, have also arisen from results obtained on such disparate groups as Glasgow adolescents, Tanzanian and Sudanese students, children in Malawi and vegans in the U.K.
Lynch, Miranda L., E-mail: Miranda_Lynch@urmc.rochester.edu [University of Rochester School of Medicine and Dentistry, Rochester, NY 14642 (United States); Huang, Li-Shan [University of Rochester School of Medicine and Dentistry, Rochester, NY 14642 (United States); Cox, Christopher [Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (United States); Strain, J.J. [University of Ulster, Coleraine, Northern Ireland (United Kingdom); Myers, Gary J. [University of Rochester School of Medicine and Dentistry, Rochester, NY 14642 (United States); Bonham, Maxine P. [University of Ulster, Coleraine, Northern Ireland (United Kingdom); Shamlaye, Conrad F. [Ministry of Health, Republic of Seychelles (Seychelles); Stokes-Riner, Abbie [University of Rochester School of Medicine and Dentistry, Rochester, NY 14642 (United States); Wallace, Julie M.W.; Duffy, Emeir M. [University of Ulster, Coleraine, Northern Ireland (United Kingdom); Clarkson, Thomas W.; Davidson, Philip W. [University of Rochester School of Medicine and Dentistry, Rochester, NY 14642 (United States)
Maternal consumption of fish during the gestational period exposes the fetus to both nutrients, especially the long-chain polyunsaturated fatty acids (LCPUFAs), believed to be beneficial for fetal brain development, as well as to the neurotoxicant methylmercury (MeHg). We recently reported that nutrients present in fish may modify MeHg neurotoxicity. Understanding the apparent interaction of MeHg exposure and nutrients present in fish is complicated by the limitations of modeling methods. In this study we fit varying coefficient function models to data from the Seychelles Child Development Nutrition Study (SCDNS) cohort to assess the association of dietary nutrients and children's development. This cohort of mother-child pairs in the Republic of Seychelles had fish consumption averaging 9 meals per week. Maternal nutritional status was assessed for five different nutritional components known to be present in fish (n-3 LCPUFA, n-6 LCPUFA, iron status, iodine status, and choline) and associated with children's neurological development. We also included prenatal MeHg exposure (measured in maternal hair). We examined two child neurodevelopmental outcomes (Bayley Scales Infant Development-II (BSID-II) Mental Developmental Index (MDI) and Psychomotor Developmental Index (PDI)), each administered at 9 and at 30 months. The varying coefficient models allow the possible interactions between each nutritional component and MeHg to be modeled as a smoothly varying function of MeHg as an effect modifier. Iron, iodine, choline, and n-6 LCPUFA had little or no observable modulation at different MeHg exposures. In contrast the n-3 LCPUFA docosahexaenoic acid (DHA) had beneficial effects on the BSID-II PDI that were reduced or absent at higher MeHg exposures. This study presents a useful modeling method that can be brought to bear on questions involving interactions between covariates, and illustrates the continuing importance of viewing fish consumption during pregnancy
Lynch, Miranda L.; Huang, Li-Shan; Cox, Christopher; Strain, J.J.; Myers, Gary J.; Bonham, Maxine P.; Shamlaye, Conrad F.; Stokes-Riner, Abbie; Wallace, Julie M.W.; Duffy, Emeir M.; Clarkson, Thomas W.; Davidson, Philip W.
Maternal consumption of fish during the gestational period exposes the fetus to both nutrients, especially the long-chain polyunsaturated fatty acids (LCPUFAs), believed to be beneficial for fetal brain development, as well as to the neurotoxicant methylmercury (MeHg). We recently reported that nutrients present in fish may modify MeHg neurotoxicity. Understanding the apparent interaction of MeHg exposure and nutrients present in fish is complicated by the limitations of modeling methods. In this study we fit varying coefficient function models to data from the Seychelles Child Development Nutrition Study (SCDNS) cohort to assess the association of dietary nutrients and children's development. This cohort of mother-child pairs in the Republic of Seychelles had fish consumption averaging 9 meals per week. Maternal nutritional status was assessed for five different nutritional components known to be present in fish (n-3 LCPUFA, n-6 LCPUFA, iron status, iodine status, and choline) and associated with children's neurological development. We also included prenatal MeHg exposure (measured in maternal hair). We examined two child neurodevelopmental outcomes (Bayley Scales Infant Development-II (BSID-II) Mental Developmental Index (MDI) and Psychomotor Developmental Index (PDI)), each administered at 9 and at 30 months. The varying coefficient models allow the possible interactions between each nutritional component and MeHg to be modeled as a smoothly varying function of MeHg as an effect modifier. Iron, iodine, choline, and n-6 LCPUFA had little or no observable modulation at different MeHg exposures. In contrast the n-3 LCPUFA docosahexaenoic acid (DHA) had beneficial effects on the BSID-II PDI that were reduced or absent at higher MeHg exposures. This study presents a useful modeling method that can be brought to bear on questions involving interactions between covariates, and illustrates the continuing importance of viewing fish consumption during pregnancy as a case
Background To address the public health crisis of overweight and obese preschool-age children, the Nutrition And Physical Activity Self Assessment for Child Care (NAP SACC) intervention was delivered by nurse child care health consultants with the objective of improving child care provider and parent nutrition and physical activity knowledge, center-level nutrition and physical activity policies and practices, and children’s body mass index (BMI). Methods A seven-month randomized control trial was conducted in 17 licensed child care centers serving predominantly low income families in California, Connecticut, and North Carolina, including 137 child care providers and 552 families with racially and ethnically diverse children three to five years old. The NAP SACC intervention included educational workshops for child care providers and parents on nutrition and physical activity and consultation visits provided by trained nurse child care health consultants. Demographic characteristics and pre - and post-workshop knowledge surveys were completed by providers and parents. Blinded research assistants reviewed each center’s written health and safety policies, observed nutrition and physical activity practices, and measured randomly selected children’s nutritional intake, physical activity, and height and weight pre- and post-intervention. Results Hierarchical linear models and multiple regression models assessed individual- and center-level changes in knowledge, policies, practices and age- and sex-specific standardized body mass index (zBMI), controlling for state, parent education, and poverty level. Results showed significant increases in providers’ and parents’ knowledge of nutrition and physical activity, center-level improvements in policies, and child-level changes in children’s zBMI based on 209 children in the intervention and control centers at both pre- and post-intervention time points. Conclusions The NAP SACC intervention, as delivered by
Stephens, Samuel A.
Child care centers, Head Start programs, and family child care providers serving young children--as well as after school programs and homeless shelters that reach older children, adults, and families--are supported in providing healthy meals and snacks by reimbursements through the Child and Adult Care Food Program (CACFP). Administered by the…
Erinosho, Temitope O; Hales, Derek P; McWilliams, Christina P; Emunah, Josie; Ward, Dianne Stanton
Studies suggest that caregivers influence children's dietary behaviors through role modeling in child-care environments. However, few studies have examined role modeling by caregivers and child-care center policies. This cross-sectional study evaluated the associations between child-care center policies about staff eating practices and caregivers' eating behaviors during mealtime interactions with children. Data were collected in 2008-2009 at 50 North Carolina child-care centers. Caregivers (n=124) reported about modeling healthy eating behaviors to children, trained research staff observed caregivers' (n=112) eating behaviors in classrooms, and directors reported about the presence/absence of center policies on staff eating practices. About 90% of caregivers reported modeling healthy eating behaviors to children. At 80% of centers, caregivers were observed modeling healthy dietary behaviors (eg, sitting with or eating same foods as children), but at fewer centers they were observed consuming unhealthy foods (eg, fast foods, salty snacks: 25%; and sugar-sweetened beverages: 50%). Although no substantial associations were observed between caregiver behaviors and center policies, effect size estimates suggest differences that may be of clinical significance. For example, caregivers were observed modeling healthy dietary behaviors more frequently at centers that had written policies about staff discouraging unhealthy foods for meals/snacks and having informal nutrition talks with children at meals. However, caregivers were observed consuming unhealthy foods and sugar-sweetened beverages more often at centers with policies that promoted healthier foods for meals/snacks. Future research should build on this study by using larger samples to understand why healthy food policies in child-care centers may not translate to eating practices among caregivers. Copyright © 2012 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.
Richards, Esther; Theobald, Sally; George, Asha; Kim, Julia C; Rudert, Christiane; Jehan, Kate; Tolhurst, Rachel
A growing body of research highlights the importance of gendered social determinants of child health, such as maternal education and women's status, for mediating child survival. This narrative review of evidence from diverse low and middle-income contexts (covering the period 1970-May 2012) examines the significance of intra-household bargaining power and process as gendered dimensions of child health and nutrition. The findings focus on two main elements of bargaining: the role of women's decision-making power and access to and control over resources; and the importance of household headship, structure and composition. The paper discusses the implications of these findings in the light of lifecycle and intersectional approaches to gender and health. The relative lack of published intervention studies that explicitly consider gendered intra-household bargaining is highlighted. Given the complex mechanisms through which intra-household bargaining shapes child health and nutrition it is critical that efforts to address gender in health and nutrition programming are thoroughly documented and widely shared to promote further learning and action. There is scope to develop links between gender equity initiatives in areas of adult and adolescent health, and child health and nutrition programming. Child health and nutrition interventions will be more effective, equitable and sustainable if they are designed based on gender-sensitive information and continually evaluated from a gender perspective. Copyright © 2012 Elsevier Ltd. All rights reserved.
Battista, Rebecca A; Oakley, Hillary; Weddell, Melissa S; Mudd, Lanay M; Greene, J B; West, Stephanie T
To determine if child care centers in rural, Western North Carolina met recommendations for nutrition and physical activity, if focusing on nutrition and physical activity practices and policies was effective in improving the center environment, and if differences existed between centers affiliated or unaffiliated with schools. Of 33 child care centers in three counties, 29 submitted mini-grant requests and participated in a pre-post evaluation using Nutrition and Physical Activity Self-Assessment for Child Care (NAP SACC). NAP SACC assesses compliance for nutrition and physical activity recommendations and standards. Between October 2011 and April 2012, centers participated in workshops and goal setting specific to nutrition and physical activity. At baseline, over 95% of the centers met all recommendations. However, post-intervention, Wilcoxon Signed Ranks Test (pcenter types in five out of 37 nutrition and seven out of 17 physical activity standards following the intervention. Centers unaffiliated with schools made significant changes in ten nutrition standards, while those affiliated with schools improved in only two standards and decreased on one standard. Overall, rural child care centers in Western North Carolina were meeting standards, they were still able to strengthen policies and practices by following NAP SACC. This was especially true for centers unaffiliated with schools. Continued financial support may assist centers in sustaining increased physical activity in children. Copyright © 2014 The Authors. Published by Elsevier Inc. All rights reserved.
Slack, Kristen S; Font, Sarah; Maguire-Jack, Kathryn; Berger, Lawrence M
This exploratory study examines combinations of income-tested welfare benefits and earnings, as they relate to the likelihood of child maltreatment investigations among low-income families with young children participating in a nutritional assistance program in one U.S. state (Wisconsin). Using a sample of 1065 parents who received the Special Supplemental Nutrition Assistance Program for Women, Infants, and Children (WIC) benefits in late 2010 and early 2011, we find that relying on either work in the absence of other means-tested welfare benefits, or a combination of work and welfare benefits, reduces the likelihood of CPS involvement compared to parents who rely on welfare benefits in the absence of work. Additionally, we find that housing instability increases the risk of CPS involvement in this population. The findings from this investigation may be useful to programs serving low-income families with young children, as they attempt to identify safety net resources for their clientele.
Yakoob, Mohammad Yawar; Lo, Clifford W
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.
Longvah, Thingnganing; Khutsoh, Bewe; Meshram, Indrapal Ishwarji; Krishna, Sreerama; Kodali, Venkaiah; Roy, Phrang; Kuhnlein, Harriet V
Despite the importance of the nutritional status and food systems of Indigenous Peoples, the subject has received very little attention, especially in North-East India. Therefore, a community-based cross-sectional descriptive study was carried out among Chakhesang mothers with children under 5 years of age to evaluate their nutritional status and prevalence of chronic diseases in the context of their dietary habits. From 558 households (HHs), 661 children and 540 mothers were covered using standard anthropometric measurements as well as blood collection for haemoglobin and vitamin A. Data were collected from mothers on HH socio-demographic particulars and infant and young child feeding practices. The results showed that the prevalence of underweight, stunting, and wasting among children security among the Chakhesangs. © 2018 John Wiley & Sons Ltd.
Menon, Purnima; Thow, Anne Marie
Enabling policy environments for nutrition require require evidence to support best practice and engagement with political and policy contexts, as well as leadership, resourcing, advocacy, and technical support. However, research on nutrition policy contexts is limited. The papers in this special supplement on policy contexts for infant and young child feeding (IYCF) in South Asia makes a valuable contribution to understanding the policy landscape and political dynamics in the region and the global literature. Studies included in this special supplement analyzed policy content and stakeholder influence on IYCF in Bangladesh, India, Nepal, Pakistan and Sri Lanka, and assess the role of advocacy in addressing multiple elements of the policy environment. These analyses highlight opportunities to harmonize and manage the demands and interests of multiple actors while strengthening policy to strategically support optimal IYCF as the ultimate goal. They also provide robust examples of research on policy environments and policy change. Further investments in research on policy contexts for nutrition can help to understand and support continued progress towards improved actions for nutrition.
Jensen, Melissa L; Frongillo, Edward A; Leroy, Jef L; Blake, Christine E
Food assistance programs may alter food choices, but factors determining households' decisions regarding food acquisition, preparation, and consumption in the context of food aid are not well understood. This study aimed to understand how the Programa Comunitario Materno Infantil de Diversificación Alimentaria (Mother-Child Community Food Diversification Program; PROCOMIDA), a food-assisted maternal and child health and nutrition program in rural Alta Verapaz, Guatemala, altered household food choices. We conducted semistructured interviews and focus groups with 63 households in 3 participating (n = 32 households) and 3 control (n = 31) villages. A last-day food recall (without estimating quantities) and food-frequency questionnaire that used food cards assessed dietary choices. Qualitative analysis used thematic a priori and emergent coding; food group consumption frequencies were analyzed by using 2-level, logistic, mixed modeling, and chi-square testing while accounting for community clustering. Compared with control households, PROCOMIDA changed household food choices through a combination of providing food resources (with monthly food rations) and new knowledge and skills related to health and food (in the program's behavior change communication component) while reinforcing existing knowledge and beliefs. PROCOMIDA families consumed rice, red beans, and oil more frequently than did control families (differences of 2.20 (P foods were in the rations. PROCOMIDA families also ate chicken, local plants, and some vegetables more frequently. The importance of these foods was emphasized in the behavioral change communication component; these foods may have been more accessible because provision of food rations freed resources. Our findings suggest that if a program provides food free of cost to rural indigenous families in the context of a maternal and child nutrition and health program, it may be important to include a well-designed behavioral change communication
Moyes, Kasey; Friggens, Nic; Ingvartsen, Klaus Lønne
Thirty Danish Holstein cows were used to determine how cows in early lactation adapt to changes in protein to starch supply in order to manipulate metabolism to combat physiological imbalance. During weeks 4 through 6 of lactation, 10 cows were fed either a high protein to starch ratio (high) diet...
Cheikh Moussa, Kamila; Sanz-Valero, Javier; Wanden-Berghe, Carmina
to review the social determinants of health more characteristic of the child and adolescents of immigrants, by reviewing the literature and assess its effect on nutritional status. a systematic review was performed using Medical Subject Headings (MeSH) in PubMed (Medline) and The Cochrane Library, in order to identify undetected studies; articles bibliographic lists were examined. The final election was done according to inclusion and exclusion criteria. No restrictions on sex and ethnicity of the participants. STROBE checkpoints were used for an information and methodological quality control. As Social Determinants of Health (SDH); social, demographic and economic conditions were considered for the study of their effect on the nutritional status. from 31 identified articles 18 are included in this study, 17 (94.4%) had a good or excellent quality. Hispanic and African were the most studied ethnicities; birth place and parent's residence period were used for generational classification. Alimentary culture and linguistic isolation of the first generation have a protective effect preventing from overweight and obesity risk while it decrease in second and third generation due to the experienced acculturation process equalizing their weight gain to natives; which prevalence is higher among Hispanics. No relation was found for nutritional status differences between sexes neither alimentary aids protective effect hypothesis was confirmed. the SDH with greater influence on child-adolescent immigrants were the socio-demographic conditions; among them: residence period distinguish the three identified generations while linguistic barrier and ethnic background are truly influential on the biological response to the experimented change caused by the acculturation process, establishing differences in the nutritional status. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.
Shamah-Levy, Teresa; Mundo-Rosas, Verónica; Morales-Ruan, Carmen; Cuevas-Nasu, Lucia; Méndez-Gómez-Humarán, Ignacio; Pérez-Escamilla, Rafael
Objective To examine the association between household food insecurity (HFI) and risk of childhood stunting and to determine whether this association is modified by maternal–child overweight/obesity. Design Observational cross-sectional study. Setting Data come from the Mexican National Health and Nutrition Survey (ENSANUT 2012 by its initials in Spanish), representative of rural and urban areas. Participants Our study sample included 5087 mother–preschool child pairs and 7181 mother–schoolchild pairs. Main outcome measures Differences in the prevalence (95% CI) of each HFI category by socioeconomic characteristics and maternal–child nutritional status were estimated. A logistic regression model was conducted for stunting and overweight among preschool children and for stunting and overweight/obesity among schoolchildren, adjusting for pertinent covariates. HFI was measured according to the Latin American and Caribbean Food Security Scale (ELCSA by its initials in Spanish). Weight and recumbent lenght or height measures were obtained from children. Overweight and obesity in women were determined according to the WHO Growth Reference Charts. The following covariates were included: sex of the child. urbanicity (urban/rural), region of residence and maternal education. Benefiting from food assistance programmes and socioeconomic status index were also included. Results were expressed as adjusted ORs. Results Stunting proved more prevalent in preschool children with moderate or severe HFI (16.2% and 16.8%, respectively) (p=0.036 and p=0.007, respectively) than in their counterparts with mild or no HFI (13.2% and 10.7%, respectively). Furthermore, the interaction between HFI and maternal obesity had a significant impact on stunting in preschool children (p<0.05). Severe HFI increased risk of stunting in children with non-obese mothers but not in those with obese mothers. Conclusion We have discovered a new relationship between HFI and maternal obesity on the
Shamah-Levy, Teresa; Mundo-Rosas, Verónica; Morales-Ruan, Carmen; Cuevas-Nasu, Lucia; Méndez-Gómez-Humarán, Ignacio; Pérez-Escamilla, Rafael
To examine the association between household food insecurity (HFI) and risk of childhood stunting and to determine whether this association is modified by maternal-child overweight/obesity. Observational cross-sectional study. Data come from the Mexican National Health and Nutrition Survey ( ENSANUT 2012 by its initials in Spanish), representative of rural and urban areas. Our study sample included 5087 mother-preschool child pairs and 7181 mother-schoolchild pairs. Differences in the prevalence (95% CI) of each HFI category by socioeconomic characteristics and maternal-child nutritional status were estimated. A logistic regression model was conducted for stunting and overweight among preschool children and for stunting and overweight/obesity among schoolchildren, adjusting for pertinent covariates. HFI was measured according to the Latin American and Caribbean Food Security Scale (ELCSA by its initials in Spanish). Weight and recumbent lenght or height measures were obtained from children. Overweight and obesity in women were determined according to the WHO Growth Reference Charts. The following covariates were included: sex of the child. urbanicity (urban/rural), region of residence and maternal education. Benefiting from food assistance programmes and socioeconomic status index were also included. Results were expressed as adjusted ORs. Stunting proved more prevalent in preschool children with moderate or severe HFI (16.2% and 16.8%, respectively) (p=0.036 and p=0.007, respectively) than in their counterparts with mild or no HFI (13.2% and 10.7%, respectively). Furthermore, the interaction between HFI and maternal obesity had a significant impact on stunting in preschool children (p<0.05). Severe HFI increased risk of stunting in children with non-obese mothers but not in those with obese mothers. We have discovered a new relationship between HFI and maternal obesity on the one hand and risk of childhood stunting on the other hand. This may reflect a shared
Taylor, Maija B; Emley, Elizabeth; Pratt, Mercedes; Musher-Eizenman, Dara R
This study examined the relationship between structure, autonomy promotion, and control feeding strategies and parent-reported child diet. Participants (N = 497) were parents of children ages 2.5 to 7.5 recruited from Amazon Mechanical Turk. This sample was a Caucasian (79%), educated sample (61% college graduates) with most reports from mothers (76%). Online survey including measures of parent feeding strategies and child dietary intake. Use of structure-based feeding strategies explained 21% of the variance in child consumption of added sugar, 12% of the variance in child intake of added sugar from sugar-sweetened beverages, and 16% of the variance in child consumption of fruits and vegetables. Higher unhealthy food availability and permissive feeding uniquely predicted higher child added sugar intake and child consumption of added sugar from sugar-sweetened beverages. Greater healthy food availability uniquely predicted higher child fruit and vegetable intake. and Future Directions: In Caucasian educated families, structure-based feeding strategies appear to be a relatively stronger correlate of parent-reported child intake of added sugar and fruits and vegetables as compared to autonomy promotion and control feeding strategies. Longitudinal research may be needed in order to reveal the relationships between autonomy promotion and control feeding strategies with child diet. If future studies have similar findings to this study's results, researchers may want to focus more heavily on investigating the impact of teaching parents stimulus-control techniques and feeding-related assertiveness skills on child dietary intake. Copyright © 2017 Elsevier Ltd. All rights reserved.
The objective of this paper is to create awareness, and stimulate the need for proper evaluation and utilization of fish as a means of reducing the level of child malnutrition in Nigeria and other developing nations. The paper discussed thoroughly the trends in child malnutrition, causes of malnutrition in children which include ...
Results: Mother's knowledge about child care influences the amount and type of care that is given to children. Time taken to perform various activities was also found to vary with the mother's education level, her occupation, number of children less than five years in the house and the child's age and birth order.
Afghanistan has high rates of malnutrition and a high infant mortality rate of 77/1000 births. Infant and young child feeding practices are a key determinant of malnutrition in Afghanistan, and thus far, relatively little attention has been given to this issue. This report was prepared to inform the scaling up of infant and young child feeding through the Government of Afghanistan's Basic...
World Health Organization 2006 Child Growth Standards and 2007 Growth Reference Charts: A Discussion Paper by the Committee on Nutrition of the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition
Turck, Dominique; Michaelsen, Kim F.; Shamir, Raanan
for Paediatric Gastroenterology, Hepatology, and Nutrition Committee on Nutrition is to provide information on the background and rationale of the World Health Organization (WHO) 2006 child growth standards and WHO 2007 growth reference charts, describe their development, outline their main innovative aspects......Growth charts are essential for evaluating children’s health including their nutrition; however, the evaluation of child growth trajectories and consequently the decision to intervene are highly dependent on the growth charts used. The aim of this discussion paper of the European Society...... between different countries and ethnic groups. WHO 2007 growth reference charts (5–19 years) are based mainly on a re-analysis of National Centre for Health Statistics data from 1977, without information on feeding. European Society for Paediatric Gastroenterology, Hepatology, and Nutrition Committee...
Al-Zeidaneen Safaa A.
Full Text Available Background: Glycogen storage disease (GSD type IIIa is a rare inborn error of metabolism characterized by a deficiency in glycogen disbranching enzymes. Nutritional intervention is a cornerstone in the medical care plane.
The IAEA has received a grant of over US$ 1 million from the Bill and Melinda Gates Foundation to support its work on combating malnutrition in children. The funding, announced in late September 2016, will cover the cost of research using stable isotope and related techniques to collect data on healthy growth and body composition in infants, mainly in low and middle income countries. The results will contribute to Member States’ fight against both childhood obesity and undernutrition. The funding is the first major donation from a non-State donor to the IAEA in recent years. The IAEA is enhancing its efforts to promote partnerships and attract funding from private donors.
Huicho, Luis; Segura, Eddy R; Huayanay-Espinoza, Carlos A; de Guzman, Jessica Niño; Restrepo-Méndez, Maria Clara; Tam, Yvonne; Barros, Aluisio J D; Victora, Cesar G
Peru is an upper-middle-income country with wide social and regional disparities. In recent years, sustained multisectoral antipoverty programmes involving governments, political parties, and civil society have included explicit health and nutrition goals and spending increased sharply. We did a country case study with the aim of documenting Peru's progress in reproductive, maternal, neonatal, and child health from 2000-13, and explored the potential determinants. We examined the outcomes of health interventions coverage, under-5 mortality, neonatal mortality, and prevalence of under-5 stunting. We obtained data from interviews with key informants, a literature review of published and unpublished data, national censuses, and governmental reports. We obtained information on social determinants of health, including economic growth, poverty, unmet basic needs, urbanisation, women's education, water supply, fertility rates, and child nutrition from the annual national households surveys and the Peruvian Demographic and Health Surveys. We obtained national mortality data from the Interagency Group for Child Mortality Estimation, and calculated subnational rates from 11 surveys. Analyses were stratified by region, wealth quintiles, and urban or rural residence. We calculated coverage indicators for the years 2000-13, and we used the Lives Saved Tool (LiST) to estimate the effect of changes in intervention coverage and in nutritional status on mortality. From 2000 to 2013, under-5 mortality fell by 58% from 39·8 deaths per 1000 livebirths to 16·7. LiST, which was used to predict the decline in mortality arising from changes in fertility rates, water and sanitation, undernutrition, and coverage of indicators of reproductive, maternal, neonatal, and child health predicted that the under-5 mortality rate would fall from 39·8 to 28·4 per 1000 livebirths, accounting for 49·2% of the reported reduction. Neonatal mortality fell by 51% from 16·2 deaths per 1000 livebirths
Syed Sadat Ali
Conclusion: Breast feeding has a positive effect on the overall development of the child and should be promoted in the present generation. In India, child malnutrition is responsible for a higher percentage of the country′s burden of disease. Undernutrition also affects cognitive and motor development and undermines educational attainment; and ultimately impacts on productivity at work and at home, with adverse implications for income and economic growth.
Watson, Gene E.; van Wijngaarden, Edwin; Love, Tanzy M.T.; McSorley, Emeir M.; Bonham, Maxine P.; Mulhern, Maria S.; Yeates, Alison J.; Davidson, Philip W.; Shamlaye, Conrad F.; Strain, J.J.; Thurston, Sally W.; Harrington, Donald; Zareba, Grazyna; Wallace, Julie M.W.; Myers, Gary J.
Limited human data are available to assess the association between prenatal mercury vapor (Hg0) exposure from maternal dental amalgam restorations and neurodevelopment of children. We evaluated the association between maternal dental amalgam status during gestation and children’s neurodevelopmental outcomes at 5 years in the Seychelles Child Development Nutrition Study (SCDNS). Maternal amalgam status was determined prospectively in a longitudinal cohort study examining the associations of prenatal exposure to nutrients and methylmercury (MeHg) with neurodevelopment. A total of 236 mother-child pairs initially enrolled in the SCDNS in 2001 were eligible to participate. Maternal amalgam status was measured as number of amalgam surfaces (the primary metric) and number of occlusal points. The neurodevelopmental assessment battery was comprised of age-appropriate tests of cognitive, language, and perceptual functions, and scholastic achievement. Linear regression analysis controlled for MeHg exposure, maternal fatty acid status, and other covariates relevant to child development. Maternal amalgam status evaluation yielded an average of 7.0 surfaces (range 0–28) and 11.0 occlusal points (range 0–40) during pregnancy. Neither the number of maternal amalgam surfaces nor occlusal points were associated with any outcome. Our findings do not provide evidence to support a relationship between prenatal exposure to Hg0 from maternal dental amalgam and neurodevelopmental outcomes in children at 5 years of age. PMID:23856391
Watson, Gene E; van Wijngaarden, Edwin; Love, Tanzy M T; McSorley, Emeir M; Bonham, Maxine P; Mulhern, Maria S; Yeates, Alison J; Davidson, Philip W; Shamlaye, Conrad F; Strain, J J; Thurston, Sally W; Harrington, Donald; Zareba, Grazyna; Wallace, Julie M W; Myers, Gary J
Limited human data are available to assess the association between prenatal mercury vapor (Hg⁰)) exposure from maternal dental amalgam restorations and neurodevelopment of children. We evaluated the association between maternal dental amalgam status during gestation and children's neurodevelopmental outcomes at 5 years in the Seychelles Child Development Nutrition Study (SCDNS). Maternal amalgam status was determined prospectively in a longitudinal cohort study examining the associations of prenatal exposure to nutrients and methylmercury (MeHg) with neurodevelopment. A total of 236 mother-child pairs initially enrolled in the SCDNS in 2001 were eligible to participate. Maternal amalgam status was measured as number of amalgam surfaces (the primary metric) and number of occlusal points. The neurodevelopmental assessment battery was comprised of age-appropriate tests of cognitive, language, and perceptual functions, and scholastic achievement. Linear regression analysis controlled for MeHg exposure, maternal fatty acid status, and other covariates relevant to child development. Maternal amalgam status evaluation yielded an average of 7.0 surfaces (range 0-28) and 11.0 occlusal points (range 0-40) during pregnancy. Neither the number of maternal amalgam surfaces nor occlusal points were associated with any outcome. Our findings do not provide evidence to support a relationship between prenatal exposure to Hg⁰ from maternal dental amalgam and neurodevelopmental outcomes in children at 5 years of age. © 2013.
Kim, Sunny S.; Avula, Rasmi; Ved, Rajani; Kohli, Neha; Singh, Kavita; van den Bold, Mara; Kadiyala, Suneetha; Menon, Purnima
Background Convergence of sectoral programs is important for scaling up essential maternal and child health and nutrition interventions. In India, these interventions are implemented by two government programs ? Integrated Child Development Services (ICDS) and National Rural Health Mission (NRHM). These programs are designed to work together, but there is limited understanding of the nature and extent of coordination in place and needed at the various administrative levels. Our study examined...
Full Text Available A variety of feeding issues and concerns, including food aversion, food selectivity, and complete food refusal, are not uncommon among children with autism spectrum disorder (ASD. Other underlying issues are often comorbid with the concerns for feeding and ASD. These may include food allergies, gastrointestinal issues, oral motor issues, and swallowing disorders. The refusal to consume particular foods coupled with the inability to tolerate, digest, and absorb these foods can compromise an individual’s overall nutrition status. Therefore, a child’s behavior toward food and feeding activities has great impact on dietary intake, nutritional status, and growth. This case report is the first to document combined medical, behavioral, and nutritional intervention for a toddler with ASD and comorbid feeding disorder.
WHO has released prescriptive child growth standards for, among others, BMI-for-age (BMI-FA), mid-upper arm circumference-for-age, and weight velocity. The ability of these indices to predict child mortality remains understudied, although growth velocity prognostic value underlies current growth monitoring programs. The study aims were first to assess, in children under 2, the independent and combined ability of these indices and of stunting to predict all-cause mortality within 3 mo, and second, the comparative abilities of weight-for-length (WFL) and BMI-FA to predict short-term (<3 mo) mortality. We used anthropometry and survival data from 2402 children aged between 0 and 24 mo in a rural area of the Democratic Republic of Congo with high malnutrition and mortality rates and limited nutritional rehabilitation. Analyses used Cox proportional hazard models and receiver operating characteristic curves. Univariate analysis and age-adjusted analysis showed predictive ability of all indices. Multivariate analysis without age adjustment showed that only very low weight velocity [HR = 3.82 (95%CI = 1.91, 7.63); P < 0.001] was independently predictive. With age adjustment, very low weight velocity [HR = 3.61 (95%CI = 1.80, 7.25); P < 0.001] was again solely retained as an independent predictor. There was no evidence for a difference in predictive ability between WFL and BMI-FA. This paper shows the value of attained BMI-FA, a marker of wasting status, and recent weight velocity, a marker of the wasting process, in predicting child death using the WHO child growth standards. WFL and BMI-FA appear equivalent as predictors.
Sharma, Renee; Gaffey, Michelle F; Alderman, Harold; Bassani, Diego G; Bogard, Kimber; Darmstadt, Gary L; Das, Jai K; de Graft-Johnson, Joseph E; Hamadani, Jena D; Horton, Susan; Huicho, Luis; Hussein, Julia; Lye, Stephen; Pérez-Escamilla, Rafael; Proulx, Kerrie; Marfo, Kofi; Mathews-Hanna, Vanessa; Mclean, Mireille S; Rahman, Atif; Silver, Karlee L; Singla, Daisy R; Webb, Patrick; Bhutta, Zulfiqar A
Existing health and nutrition services present potential platforms for scaling up delivery of early childhood development (ECD) interventions within sensitive windows across the life course, especially in the first 1000 days from conception to age 2 years. However, there is insufficient knowledge on how to optimize implementation for such strategies in an integrated manner. In light of this knowledge gap, we aimed to systematically identify a set of integrated implementation research priorities for health, nutrition and early child development within the 2015 to 2030 timeframe of the Sustainable Development Goals (SDGs). We applied the Child Health and Nutrition Research Initiative method, and consulted a diverse group of global health experts to develop and score 57 research questions against five criteria: answerability, effectiveness, deliverability, impact, and effect on equity. These questions were ranked using a research priority score, and the average expert agreement score was calculated for each question. The research priority scores ranged from 61.01 to 93.52, with a median of 82.87. The average expert agreement scores ranged from 0.50 to 0.90, with a median of 0.75. The top-ranked research question were: i) "How can interventions and packages to reduce neonatal mortality be expanded to include ECD and stimulation interventions?"; ii) "How does the integration of ECD and MNCAH&N interventions affect human resource requirements and capacity development in resource-poor settings?"; and iii) "How can integrated interventions be tailored to vulnerable refugee and migrant populations to protect against poor ECD and MNCAH&N outcomes?". Most highly-ranked research priorities varied across the life course and highlighted key aspects of scaling up coverage of integrated interventions in resource-limited settings, including: workforce and capacity development, cost-effectiveness and strategies to reduce financial barriers, and quality assessment of programs
From 2009 to 2010, the Community Food Security Coalition advocated for more federal support and funding for farm-to-school programs as Congress considered reauthorizing the Child Nutrition Act. Farm-to-school initiatives aim to improve the quality and healthfulness of student meals through the inclusion of more fresh fruits and vegetables provided…
Mekonnen, A.; Bezuayehu, T.O.; Woldehanna, T.; Jones, N.; Seager, J.; Alemu, T.; Asgedom, G.
As one of the poorest countries in the world, Ethiopia¿s rate of child malnutrition is one of the highest, even within sub¿Saharan Africa. The causes and relative importance of various determinants of malnutrition in Ethiopia are not well understood. This paper specifically explores some of the less
Lyn, Rodney; Maalouf, Joyce; Evers, Sarah; Davis, Justin; Griffin, Monica
The child care environment has emerged as an ideal setting in which to implement policies that promote healthy body weight of children. The purpose of this study was to assess the effect of a wellness policy and training program on the physical activity and nutrition environment in 24 child care centers in Georgia. We used the Environment and Policy Assessment and Observation instrument to identify changes to foods served, staff behaviors, and physical activity opportunities. Observations were performed over 1 day, beginning with breakfast and concluding when the program ended for the day. Observations were conducted from February 2010 through April 2011 for a total of 2 observations in each center. Changes to nutrition and physical activity in centers were assessed on the basis of changes in scores related to the physical activity and nutrition environment documented in the observations. Paired t test analyses were performed to determine significance of changes. Significant improvements to total nutrition (P environments of centers by enhancing active play (P = .02), the sedentary environment (P = .005), the portable environment (P = .002), staff behavior (P = .004), and physical activity training and education (P environment (P policies and training caregivers in best practices for physical activity and nutrition can promote healthy weight for young children in child care settings.
Wuehler, Sara E; El Hafed Ould Dehah, Cheikh Mohamed
Progress towards reducing mortality and malnutrition among children Burkina Faso, Chad, Mali, Mauritania, Niger, Senegal). These findings are available to assist countries in identifying inconsistencies and filling gaps in current programming. Between August and November of 2008, key informants responsible for conducting IYCN-related activities in Mauritania were interviewed, and 46 documents were examined on the following themes: optimal breastfeeding and complementary feeding practices, prevention of micronutrient deficiencies, prevention of mother-to-child transmission of human immunodeficiency virus (HIV), management of acute malnutrition, food security, and hygienic practices. Mauritania is on track to reaching the MDG of halving undernutrition among children infrastructure capacity building was also recently implemented in nutritionally high-risk regions, and increases were reported in exclusive breastfeeding rates among children <6 months. The recent National Behaviour Change Communication Strategy is intended to address the needs of adapting programme activities to local needs. Despite these noteworthy accomplishments, the prevalence of acute malnutrition remains high, mortality rates did not decrease as malnutrition rates decreased, the overall prevalence of desirable nutrition-related practices is low, and human resources are reportedly insufficient to carry out all nutrition-related programme activities. Very little nutrition research has been conducted in Mauritania, and key informants identified gaps in adapting international programmes to local needs. Monitoring and evaluation reports have not been rigorous enough to identify which programme activities were implemented as designed or whether programmes were effective at improving nutritional and health status of young children. Therefore, we could not confirm which programmes might have been responsible for the reported improvements, or if other population-wide changes contributed to these changes
Song, Won O; Song, SuJin; Nieves, Violeta; Gonzalez, Andie; Crockett, Elahé T
Children enrolled in Migrant and Seasonal Head Start (MSHS) programs are at high risks of health problems. Although non-family child care providers play important roles on children's health status as role models, educators, program deliverers, and information mediators, little is known about their nutritional health attitudes and behaviors, and weight status. Therefore, we investigated nutritional health attitudes and behaviors and their associations with overweight/obesity among child care providers in Michigan MSHS centers. A total of 307 child care providers aged ≥ 18 years working in 17 Michigan MSHS centers were included in this cross-sectional study conducted in 2013. An online survey questionnaire was used to collect data on nutritional health attitudes and behaviors of child care providers. Weight status was categorized into normal weight (18.5 ≤ BMI obese (BMI ≥ 30 kg/m(2)) based on child care providers' self-reported height and weight. Factor analysis was performed to investigate patterns of nutritional health attitudes and behaviors. Multivariate logistic regression was conducted to estimate the odds ratios (ORs) and 95 % confidence intervals (CIs) of overweight/obesity across tertiles of pattern scores taking the lowest tertile group as the reference group after adjustment for potential confounding variables. Three patterns of nutritional health attitudes and behaviors were identified: pattern 1) "weight loss practices with weight dissatisfaction", pattern 2) "healthy eating behaviors", and pattern 3) "better knowledge of nutrition and health". The pattern 1 scores were positively associated with overweight/obesity (Tertile 2 vs. Tertile 1: OR = 5.81, 95 % CI = 2.81-12.05; Tertile 3 vs. Tertile 1: OR = 14.89, 95 % CI = 6.18-35.92). Within the pattern 2, the OR for overweight/obesity in individuals with the highest scores was 0.37 (95 % CI = 0.19-0.75) compared with those with the lowest scores. However, the
Nordang, Sunniva; Shoo, Tiransia; Holmboe-Ottesen, Gerd; Kinabo, Joyce; Wandel, Margareta
Some progress has been achieved in reducing the prevalence of undernutrition among children under 5 years of age in Tanzania. In the Rukwa region (2010), the level of stunted and underweight children was 50·4 and 13·5 %, respectively. The aim of this study was to assess the nutritional status of children under 5 years of age, feeding practices and risk factors of undernutrition in a rural village in the Rukwa region, as well as to discuss the results in light of a similar study conducted in 1987/1988. This cross-sectional study was conducted in 152 households with children under 5 years of age. Data were obtained from the child's main caretaker and the household head, using a structured questionnaire and a 24 h dietary recall. Children's length/height and weight were measured. The prevalence of stunting and underweight was found to be 63·8 and 33·6 % (Z-scorechildren on the first day after birth. A thin gruel was introduced after a median of 2 months (25th-75th percentiles; 1-3). The time mothers spent farming was a significant risk factor for stunting (P=0·04). Illness, food shortage and dry-season cultivation were significant risk factors for underweight (Pfeeding practices were not in line with WHO recommendations. Women working in farms, food shortage, dry-season cultivation and diseases partly explain the children's poor nutritional status.
Saeed, Qamar; Shah, Nadia; Inam, Sumera; Shafique, Kashif
Malnutrition is a primary cause of child morbidity and mortality. The effects of maternal depressive symptoms on children's health, especially their nutritional status, have received less attention in developing countries but needs to be evaluated to understand the public health implications of maternal depression. The aim of the current study was to investigate the association between maternal depressive symptoms and children's nutritional status using data from low socioeconomic community in Pakistan. Maternal depressive symptoms defined as Aga Khan University Anxiety and Depression Scale score of 20 or greater was assessed for mothers with children under two years of age. Logistic regression models estimated the association between maternal depressive symptoms and stunting and underweight. Of 325 mothers, 40% scored positive on the depressive scale. The prevalence of stunting and underweight in children under two years was 36.6% and 35.4%, respectively. Maternal depressive symptoms were significantly associated with children being stunted and underweight. Mothers with depressive symptoms were more than three times likely to have stunted (odds ratio (OR) 3.15, 95% confidence interval (CI) 1.91-5.18, p value Maternal-related factors such as poor education, unemployment, and low household income were found to be significantly associated with higher odds of children's short stature and underweight.
Johnson, Kiersten B.; Jacob, Anila; Brown, Molly Elizabeth
Healthy forests provide human communities with a host of important ecosystem services, including the provision of food, clean water, fuel, and natural medicines. Yet globally, about 13 million hectares of forests are lost every year, with the biggest losses in Africa and South America. As biodiversity loss and ecosystem degradation due to deforestation continue at unprecedented rates, with concomitant loss of ecosystem services, impacts on human health remain poorly understood. Here, we use data from the 2010 Malawi Demographic and Health Survey, linked with satellite remote sensing data on forest cover, to explore and better understand this relationship. Our analysis finds that forest cover is associated with improved health and nutrition outcomes among children in Malawi. Children living in areas with net forest cover loss between 2000 and 2010 were 19% less likely to have a diverse diet and 29% less likely to consume vitamin A-rich foods than children living in areas with no net change in forest cover. Conversely, children living in communities with higher percentages of forest cover were more likely to consume vitamin A-rich foods and less likely to experience diarrhea. Net gain in forest cover over the 10-year period was associated with a 34% decrease in the odds of children experiencing diarrhea (P5.002). Given that our analysis relied on observational data and that there were potential unknown factors for which we could not account, these preliminary findings demonstrate only associations, not causal relationships, between forest cover and child health and nutrition outcomes. However, the findings raise concerns about the potential short- and long-term impacts of ongoing deforestation and ecosystem degradation on community health in Malawi, and they suggest that preventing forest loss and maintaining the ecosystems services of forests are important factors in improving human health and nutrition outcomes.
Rahman, Md Mosfequr; Saima, Umme; Goni, Md Abdul
This study examines the relationship between maternal household decision-making autonomy and children's nutritional status using data from 2011 Bangladesh Demographic and Health Survey. The analyses are restricted to 2056 currently married, nonpregnant women aged 15 to 49 years who had at least 1 birth 5 years preceding the survey. Theoretically relevant predictors of children's nutritional status including maternal autonomy are analyzed to identify factors significantly associated with children's nutritional status using stepwise logistic regression. Results indicate that 34.8% children are stunted, 16.1% are wasted, and 45.9% children are underweight. Children whose mothers participated in making all household decisions are 15%, 16%, and 32% significantly less likely to be stunted (odds ratio = 0.85; 95% CI = 0.67-0.98), underweight (odds ratio = 0.84; 95% CI = 0.70-0.98), and wasted (odds ratio = 0.68; 95% CI = 0.52-0.90), respectively, than mothers who did not participate in making any decision. Increasing maternal decision-making autonomy may reduce the prevalence of malnourished children as well as contribute to have a healthier future generation. © 2015 APJPH.
Iannotti, Lora L; Lutter, Chessa K; Bunn, David A; Stewart, Christine P
Eggs have been consumed throughout human history, though the full potential of this nutritionally complete food has yet to be realized in many resource-poor settings around the world. Eggs provide essential fatty acids, proteins, choline, vitamins A and B12 , selenium, and other critical nutrients at levels above or comparable to those found in other animal-source foods, but they are relatively more affordable. Cultural beliefs about the digestibility and cleanliness of eggs, as well as environmental concerns arising from hygiene practices and toxin exposures, remain as barriers to widespread egg consumption. There is also regional variability in egg intake levels. In Latin American countries, on average, greater proportions of young children consume eggs than in Asian or African countries. In China and Indonesia, nutrition education and social marketing have been associated with greater amounts of eggs in the diets of young children, though generally, evidence from interventions is minimal. Homestead chicken-and-egg production with appropriate vaccination, extension service, and other supports can simultaneously address poverty and nutrition in very poor rural households. With undernutrition remaining a significant problem in many parts of the world, eggs may be an uncracked part of the solution. © 2014 International Life Sciences Institute.
Ponce, Ninez; Shimkhada, Riti; Raub, Amy; Daoud, Adel; Nandi, Arijit; Richter, Linda; Heymann, Jody
There is recognition that social protection policies such as raising the minimum wage can favourably impact health, but little evidence links minimum wage increases to child health outcomes. We used multi-year data (2003-2012) on national minimum wages linked to individual-level data from the Demographic and Health Surveys (DHS) from 23 low- and middle-income countries (LMICs) that had least two DHS surveys to establish pre- and post-observation periods. Over a pre- and post-interval ranging from 4 to 8 years, we examined minimum wage growth and four nutritional status outcomes among children under 5 years: stunting, wasting, underweight, and anthropometric failure. Using a differences-in-differences framework with country and time-fixed effects, a 10% increase in minimum wage growth over time was associated with a 0.5 percentage point decline in stunting (-0.054, 95% CI (-0.084,-0.025)), and a 0.3 percentage point decline in failure (-0.031, 95% CI (-0.057,-0.005)). We did not observe statistically significant associations between minimum wage growth and underweight or wasting. We found similar results for the poorest households working in non-agricultural and non-professional jobs, where minimum wage growth may have the most leverage. Modest increases in minimum wage over a 4- to 8-year period might be effective in reducing child undernutrition in LMICs.
Bommersbach, T J; Fischer, P R; Pettifor, J M; Thacher, T D
We found a positive relationship between bone density in Nigerian children with and without rickets and that of their mothers. After treatment, children with rickets had greater bone density than children without rickets, indicating that children genetically programmed to have greater bone density may have a higher risk of rickets. To determine the relationship between bone density in children with and without rickets and that of their mothers METHODS: Using an unmatched case-control design, forearm areal bone mineral density (aBMD) was measured in 52 and 135 Nigerian children with and without rickets and their mothers, respectively. We performed multivariate linear regression analyses to assess the relationship between maternal and child aBMD Z-scores. Forearm aBMD Z-scores in children were associated with maternal aBMD Z-scores at metaphyseal (effect estimate 0.23; 95% CI 0.08 to 0.37) and diaphyseal (effect estimate 0.16; 0.01 to 0.30) sites, after adjustment for rickets in the child, child's age and sex, height-for-age Z-score, and weight-for-age Z-score. In the adjusted model, rickets was inversely associated with child's aBMD Z-score at the diaphyseal site only (- 0.45, - 0.65 to - 0.24). The positive relationship between maternal and child aBMD Z-scores was marginally greater in children with rickets (slope 0.56, r = 0.47) than without rickets (slope 0.19, r = 0.20) at the diaphyseal site only (P = 0.06 for interaction) but not at the metaphyseal site (slopes 0.35 and 0.30, respectively, P = 0.48). After treatment with calcium for 6 months, metaphyseal aBMD Z-scores were greater in children with treated rickets (effect estimate 0.26; 95% CI 0.02 to 0.49) than in those without rickets. In Nigerian children with and without rickets, forearm aBMD Z-scores were positively associated with maternal aBMD Z-scores. Active rickets in the child marginally modified the relationship at the diaphyseal site only. After treatment, children with
Vaughn, Amber E; Mazzucca, Stephanie; Burney, Regan; Østbye, Truls; Benjamin Neelon, Sara E; Tovar, Alison; Ward, Dianne S
Early care and education (ECE) settings play an important role in shaping the nutrition and physical activity habits of young children. Increasing research attention is being directed toward family child care homes (FCCHs) specifically. However, existing measures of child care nutrition and physical activity environments are limited in that they have been created for use with center-based programs and require modification for studies involving FCCHs. This paper describes the modification of the Environment and Policy Assessment and Observation (EPAO) for use in FCCHs. The EPAO underwent a through modification process that incorporated an updated format for the data collection instrument, assessment of emerging best practices, tailoring to the FCCH environment, and creation of a new scoring rubric. The new instrument was implemented as part of a larger randomized control trial. To assess inter-rater reliability, observations on 61 different days were performed independently by two data collectors. To assess construct validity, associations between EPAO scores and measures of children's dietary intake (Healthy Eating Index (HEI) score) and physical activity (accelerometer-measured minutes per hour of moderate to vigorous physical activity, MVPA) were examined. The modified EPAO assesses 38 nutrition and 27 physical activity best practices, which can be summarized into 7 nutrition-related and 10 physical activity-related environmental sub- scores as well as overall nutrition and overall physical activity scores. There was generally good agreement between data collectors (ICC > 0.60). Reliability was slightly lower for feeding practices and physical activity education and professional development (ICC = 0.56 and 0.22, respectively). Child HEI was significantly correlated with the overall nutrition score (r = 0.23), foods provided (r = 0.28), beverages provided (r = 0.15), nutrition education and professional development (r = 0.21), and nutrition policy (r
Amber E. Vaughn
Full Text Available Abstract Background Early care and education (ECE settings play an important role in shaping the nutrition and physical activity habits of young children. Increasing research attention is being directed toward family child care homes (FCCHs specifically. However, existing measures of child care nutrition and physical activity environments are limited in that they have been created for use with center-based programs and require modification for studies involving FCCHs. This paper describes the modification of the Environment and Policy Assessment and Observation (EPAO for use in FCCHs. Methods The EPAO underwent a through modification process that incorporated an updated format for the data collection instrument, assessment of emerging best practices, tailoring to the FCCH environment, and creation of a new scoring rubric. The new instrument was implemented as part of a larger randomized control trial. To assess inter-rater reliability, observations on 61 different days were performed independently by two data collectors. To assess construct validity, associations between EPAO scores and measures of children’s dietary intake (Healthy Eating Index (HEI score and physical activity (accelerometer-measured minutes per hour of moderate to vigorous physical activity, MVPA were examined. Results The modified EPAO assesses 38 nutrition and 27 physical activity best practices, which can be summarized into 7 nutrition-related and 10 physical activity-related environmental sub- scores as well as overall nutrition and overall physical activity scores. There was generally good agreement between data collectors (ICC > 0.60. Reliability was slightly lower for feeding practices and physical activity education and professional development (ICC = 0.56 and 0.22, respectively. Child HEI was significantly correlated with the overall nutrition score (r = 0.23, foods provided (r = 0.28, beverages provided (r = 0.15, nutrition education and professional
Zalilah, M S; Tham, B L
This study was conducted to determine the prevalence of household food insecurity and its potential risk factors and outcomes among the Orang Asli (Temuan) households. Socioeconomic, demographic and food security information of the households and anthropometric measurements and dietary intakes of preschoolers (n = 64) were obtained using a structured questionnaire. Food security was assessed using the Radimer/Cornell hunger and food insecurity instrument. Diet quality was based on 24 hour recall and analyzed according to the Malaysian RDA and Food Guide Pyramid. Majority of the households (82%) reported some kind of household food insecurity. The prevalence of significant underweight, stunting and wasting were 45.3%, 51.6% and 7.8%, respectively. Dietary intakes were less than 2/3 RDA levels for calories, calcium and iron. However, the intakes of protein, vitamin A, vitamin C and niacin exceeded the RDA and the sources for these nutrients were mainly rice, fish and green leafy vegetables. Among the five food groups, only the number of servings from cereals/cereal products/tubers group was achieved while that of the milk/diary products was the worst. Majority of the children (68.7%) had poor, 31.3% had fair and none with excellent diet quality. In general, diet quality and nutritional status of the children decreased as household food insecurity worsened. It is recommended that the nutritional problems of Orang Asli children be addressed through health, nutrition and economic programs and further studies should be carried out on determinants and consequences of household food insecurity.
Phuong H Nguyen
Full Text Available Improving maternal nutrition practices during pregnancy is essential to save lives and improve health outcomes for both mothers and babies. This paper examines the maternal, household, and health service factors influencing maternal nutrition practices in the context of a large scale maternal, newborn, and child health (MNCH program in Bangladesh. Data were from a household survey of pregnant (n = 600 and recently delivered women (n = 2,000. Multivariate linear and logistic regression analyses were used to examine the determinants of three outcomes: consumption of iron and folic acid (IFA tablets, calcium tablets, and diverse diets. Women consumed 94 ± 68 IFA and 82 ± 66 calcium tablets (out of 180 as recommended during pregnancy, and only half of them consumed an adequately diverse diet. Good nutrition knowledge was the key maternal factor associated with higher consumption of IFA (β = 32.5, 95% CI: 19.5, 45.6 and calcium tablets (β ~31.9, 95% CI: 20.9, 43.0 and diverse diet (OR = 1.8, 95% CI: 1.0-3.1, compared to poor knowledge. Women's self-efficacy in achieving the recommended practices and perception of enabling social norms were significantly associated with dietary diversity. At the household level, women who reported a high level of husband's support were more likely to consume IFA (β = 25.0, 95% CI: 18.0, 32.1 and calcium (β = 26.6, 95% CI: 19.4, 33.7 tablets and diverse diet (OR = 1.9, 95% CI: 1.2, 3.3, compared to those who received low support. Health service factors associated with higher intakes of IFA and calcium tablets were early and more prenatal care visits and receipt of free supplements. Combined exposure to several of these factors was attributed to the consumption of an additional 46 IFA and 53 calcium tablets and 17% higher proportions of women consuming diverse diets. Our study shows that improving knowledge, self-efficacy and perceptions of social norms among pregnant women, and increasing husbands' support, early
Lovell, Jennifer L
The aim of the present study was to investigate low-income parents' experiences receiving, making meaning of, and applying sociocultural messages about childhood health and nutrition. Semi-structured interviews were conducted with parents from 16 low-income Early Head Start families. Verbatim interview transcripts, observations, field notes, documentary evidence, and follow-up participant checks were used during grounded theory analysis of the data. Data yielded a potential theoretical model of parental movement toward action involving (a) the culture and context influencing parents, (b) parents' sources of social and cultural messages, (c) parental values and engagement, (d) parental motivation for action, (e) intervening conditions impacting motivation and application, and (f) parent action taken on the individual and social levels. Parent characteristics greatly impacted the ways in which parents understood and applied health and nutrition information. Among other implications, it is recommended that educators and providers focus on a parent's beliefs, values, and cultural preferences regarding food and health behaviors as well as his/her personal/family definition of "health" when framing recommendations and developing interventions. Copyright © 2015 Elsevier Ltd. All rights reserved.
771 children from Baras, Rizal, and Pasay City, Philippines were studied. House interviews of mothers using precoded questionnaires were conducted and the children were given a complete physical examination. The study objectives were to compare the health and nutritional status of children in a rural and an urban area in greater Manila and to determine how family size affects the nutritional status of children 3 years and younger. The following were among the study results: 1) the weight curves of both urban and rural groups were similar until age 4-1/2 years, but beyond this age the mean weight curve of the rural group exceeded that of the urban group; 2) urban children between ages 1-5 enjoyed a height advantage; 3) there was a positive correlation between malnutrition and excessive family size; 4) the high prevalence of malnutrition among children 1-4 years of age was due to food deprivation because of poverty, parental ignorance, inappropriate folklores, oversized families, high episodes of illnesses, and inadequate medical care; and 5) dietary assessment of both groups showed the inadequacy of the quality and quantity of basic nutrients and elements needed for growth, development, and repair of tissues.
Breck, Andrew; Goodman, Ken; Dunn, Lillian; Stephens, Robert L.; Dawkins, Nicola; Dixon, Beth; Jernigan, Jan; Kakietek, Jakub; Lesesne, Catherine; Lessard, Laura; Nonas, Cathy; O’Dell, Sarah Abood; Osuji, Thearis A.; Bronson, Bernice; Xu, Ye
This article describes the multi-method cross-sectional design used to evaluate New York City Department of Health and Mental Hygiene’s regulations of nutrition, physical activity, and screen time for children aged 3 years or older in licensed group child care centers. The Center Evaluation Component collected data from a stratified random sample of 176 licensed group child care centers in New York City. Compliance with the regulations was measured through a review of center records, a facility inventory, and interviews of center directors, lead teachers, and food service staff. The Classroom Evaluation Component included an observational and biometric study of a sample of approximately 1,400 children aged 3 or 4 years attending 110 child care centers and was designed to complement the center component at the classroom and child level. The study methodology detailed in this paper may aid researchers in designing policy evaluation studies that can inform other jurisdictions considering similar policies. PMID:25321635
Sharkey, Joseph R; Dean, Wesley R; Nalty, Courtney C
Nutritional health is essential for children's growth and development. Many Mexican-origin children who reside in limited-resource colonias along the Texas-Mexico border are at increased risk for poor nutrition as a result of household food insecurity. However, little is known about the prevalence of child hunger or its associated factors among children of Mexican immigrants. This study determines the prevalence of child hunger and identifies protective and risk factors associated with it in two Texas border areas. This study uses 2009 Colonia Household and Community Food Resource Assessment (C-HCFRA) data from 470 mothers who were randomly recruited by promotora-researchers. Participants from colonias near two small towns in two South Texas counties participated in an in-home community and household assessment. Interviewer-administered surveys collected data in Spanish on sociodemographics, federal food assistance program participation, and food security status. Frequencies and bivariate correlations were examined while a random-effects logistic regression model with backward elimination was used to determine correlates of childhood hunger. Hunger among children was reported in 51% (n = 239) of households in this C-HCFRA sample. Bivariate analyses revealed that hunger status was associated with select maternal characteristics, such as lower educational attainment and Mexican nativity, and household characteristics, including household composition, reliance on friend or neighbor for transportation, food purchase at dollar stores and from neighbors, and participation in school-based nutrition programs. A smaller percentage of households with child hunger participated in school-based nutrition programs (51%) or used alternative food sources, while 131 households were unable to give their child or children a balanced meal during the school year and 145 households during summer months. In the random effects model (RE = small town), increased household
Bhandari, Nita; Kabir, A K M Iqbal; Salam, Mohammed Abdus
Interventions to promote exclusive breastfeeding have been estimated to have the potential to prevent 13% of all under-5 deaths in developing countries and are the single most important preventive intervention against child mortality. According to World Health Organization and United Nations Children Funds (UNICEF), only 39% infants are exclusively breastfed for less than 4 months. This review examines programme efforts to scale up exclusive breastfeeding in different countries and draws lesson for successful scale-up. Opportunities and challenges in scaling up of exclusive breastfeeding into Maternal and Child Health programmes are identified. The key processes required for exclusive breastfeeding scale-up are: (1) an evidence-based policy and science-driven technical guidelines; and (2) an implementation strategy and plan for achieving high exclusive breastfeeding rates in all strata of society, on a sustainable basis. Factors related to success include political will, strong advocacy, enabling policies, well-defined short- and long-term programme strategy, sustained financial support, clear definition of roles of multiple stakeholders and emphasis on delivery at the community level. Effective use of antenatal, birth and post-natal contacts at homes and through community mobilization efforts is emphasized. Formative research to ensure appropriate intervention design and delivery is critical particularly in areas with high HIV prevalence. Strong communication strategy and support, quality trainers and training contributed significantly to programme success. Monitoring and evaluation with feedback systems that allow for periodic programme corrections and continued innovation are central to very high coverage. Legal framework must make it possible for mothers to exclusively breastfeed for at least 4 months. Sustained programme efforts are critical to achieve high coverage and this requires strong national- and state-level leadership.
Conkle, Joel; Ramakrishnan, Usha; Flores-Ayala, Rafael; Suchdev, Parminder S; Martorell, Reynaldo
Anthropometric data collected in clinics and surveys are often inaccurate and unreliable due to measurement error. The Body Imaging for Nutritional Assessment Study (BINA) evaluated the ability of 3D imaging to correctly measure stature, head circumference (HC) and arm circumference (MUAC) for children under five years of age. This paper describes the protocol for and the quality of manual anthropometric measurements in BINA, a study conducted in 2016-17 in Atlanta, USA. Quality was evaluated by examining digit preference, biological plausibility of z-scores, z-score standard deviations, and reliability. We calculated z-scores and analyzed plausibility based on the 2006 WHO Child Growth Standards (CGS). For reliability, we calculated intra- and inter-observer Technical Error of Measurement (TEM) and Intraclass Correlation Coefficient (ICC). We found low digit preference; 99.6% of z-scores were biologically plausible, with z-score standard deviations ranging from 0.92 to 1.07. Total TEM was 0.40 for stature, 0.28 for HC, and 0.25 for MUAC in centimeters. ICC ranged from 0.99 to 1.00. The quality of manual measurements in BINA was high and similar to that of the anthropometric data used to develop the WHO CGS. We attributed high quality to vigorous training, motivated and competent field staff, reduction of non-measurement error through the use of technology, and reduction of measurement error through adequate monitoring and supervision. Our anthropometry measurement protocol, which builds on and improves upon the protocol used for the WHO CGS, can be used to improve anthropometric data quality. The discussion illustrates the need to standardize anthropometric data quality assessment, and we conclude that BINA can provide a valuable evaluation of 3D imaging for child anthropometry because there is comparison to gold-standard, manual measurements.
Accelerating improvements in nutritional and health status of young children in the Sahel region of Sub-Saharan Africa: review of international guidelines on infant and young child feeding and nutrition.
Wuehler, Sara E; Hess, Sonja Y; Brown, Kenneth H
The United Nations Convention on the Rights of the Child holds governments responsible to ensure children's right to the highest attainable standard of health by providing breastfeeding support, and access to nutritious foods, appropriate health care, and clean drinking water. International experts have identified key child care practices and programmatic activities that are proven to be effective at reducing infant and young child undernutrition, morbidity, and mortality. Nevertheless, progress towards reducing the prevalence of undernutrition has been sporadic across countries of the Sahel sub-region of Sub-Saharan Africa. In view of this uneven progress, a working group of international agencies was convened to 'Reposition children's right to adequate nutrition in the Sahel.' The first step towards this goal was to organize a situational analysis of the legislative, research, and programmatic activities related to infant and young child nutrition (IYCN) in six countries of the sub-region: Burkina Faso, Chad, Mali, Mauritania, Niger, and Senegal. The purposes of this introductory paper are to review current information concerning the nutritional and health status of infants and young children in the Sahel and to summarize international guidelines on optimal IYCN practices. These guidelines were used in completing the above-mentioned situational analyses and encompass specific recommendations on: (i) breastfeeding (introduction within the first hour after birth, exclusivity to 6 months, continuation to at least 24 months); (ii) complementary feeding (introduction at 6 months, use of nutrient dense foods, adequate frequency and consistency, and responsive feeding); (iii) prevention and/or treatment of micronutrient deficiencies (vitamin A, zinc, iron and anaemia, and iodine); (iv) prevention and/or treatment of acute malnutrition; (v) feeding practices adapted to the maternal situation to reduce mother-to-child transmission of HIV; (vi) activities to ensure food
Atalah, E; Bustos, P; Rúz, M; Hurtado, C; Masson, L; Urteaga, C; Castaños, M; Godoy, R; Oliver, H; Araya, J
16 nursing mothers with regular height but low body weight were compared to 26 healthy and robust nursing controls to study the relationship between mother's alimentation and infant growth. An analysis of the diet of both groups revealed it to be 30.8% and 20% deficient, respectively. After 3 months of breast feeding, infants of mothers in the 1st. group were shorter and less heavy than infants of mothers in the 2nd. group. Chemical composition of breast milk did not show any significant difference between the 2 groups. On the other hand, a comparison of the infants' weight at 3 months with all the variables considered showed a significant correlation with birth weight, fat and energetic contents and linoleic acids of breast milk, and the mother's antropometric variables, while comparison of breast milk was not related with any maternal variables. Such results indicate that differences in infant growth depend more on the volume than on the composition of breast milk, and that the nutritional status of the mother is more important during pregnancy than during lactation.
Corral-Terrazas, Martha; Martínez, Homero; Flores-Huerta, Samuel; Duque-L, Ma Ximena; Turnbull, Bernardo; Levario-Carrillo, Margarita
To identify the beliefs and knowledge of a group of rural physicians on the dietary management of children under five years of age, with acute diarrhea. Physicians' dietary management was compared with that recommended by the World Health Organization. A cognitive anthropology study was carried out from July to December 1998, on ten physicians that care for the infant population ascribed to Hospital Rural IMSS-Solidaridad of San Juanito Bocoyna, Chihuahua, Mexico. Data were collected through focus groups, case vignettes, free listing, pile sorting, and a semi-structured questionnaire, and then cross-referred. The physicians recognized the negative impact of diarrhea on the nutritional state of the child, but not all of them evaluated this state. Prevailing interventions were antibiotic therapy, fluid management, and feeding recommendations. Among the latter, the most consistent were breastfeeding, delayed feeding, and gradual feeding. The obtained information is in conflict with WHO's recommendations, specially with that of sustained feeding. The English version of this paper is available at: http://www.insp.mx/salud/index.html.
Spinks, Teagan; Hamilton, Kyra
To identify, using the Theory of Planned Behavior, the sociocognitive factors that influence mothers' decisions toward healthy eating and limiting discretionary choices (eg, lollipops) for their children aged 2-3 years. Prospective correlational design with a 1-week follow-up. A total of 197 mothers completed the main survey; 161 completed the follow-up behavior measure. Phase 1 assessed intention, attitude, subjective norm, and perceived behavioral control; and 2 additional variables of parental role construction and group norms. Phase 2 assessed follow-up behavior. Hierarchical multiple regressions (changes in multivariate coefficient) were used to predict mothers' intentions and actions for the two target behaviors. Attitude, subjective norm, and perceived behavioral control predicted intentions; and intentions and perceived behavioral control predicted behavior for healthy eating and discretionary choices. Parental role construction was a significant predictor of intentions for both target behaviors. Results provide support for the application of the Theory of Planned Behavior in this context, as well as the addition of parental role construction. The findings illustrate the potential importance of developing intervention programs that account for sociocognitive factors to modify mothers' child feeding practices that have implications for lifelong health outcomes. Copyright © 2016 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.
Valla, Frederic V; Ford-Chessel, Carole; Meyer, Rosan; Berthiller, Julien; Dupenloup, Christine; Follin-Arbelet, Nathalie; Hubert, Anna; Javouhey, Etienne; Peretti, Noel
The cornerstone of an optimal nutrition approach in PICUs is to evaluate the nutritional status of any patient. Anthropometric measurements and nutritional indices calculation allow for nutritional status assessment, which is not often part of routine management, as it is considered difficult to perform in this setting. We designed a study to evaluate the impact of a training program by the PICU nutritional support team on the implementation of routine anthropometric measurements on our PICU. A prospective study was performed over a 2-year period, which included: a baseline evaluation of nutritional assessment, knowledge, anthropometric measurements (weight, height, and head and mid upper arm circumferences), and nutritional indices calculation in patient files. This was followed by a training program to implement the newly developed nutrition assessment guidelines, which included anthropometrical measurements and also the interpretation of these. The impact of this nutritional assessment program was reviewed annually for 2 years after the implementation. PICU--Lyon, France. PICU nursing and medical staff, and patients admitted in February 2011, 2012, and 2013. Training program. Ninety-nine percent of staff (n = 145) attended the individual teaching. We found significant progress in nutritional awareness and confidence about nutritional assessment following the teaching program. In addition, an improvement in staff knowledge about undernutrition and its consequences were found. We enrolled 41, 55, and 91 patients in 2011, 2012, and 2013, respectively. There was a significant increase in anthropometric measurements during this time: 32%, 65% (p = 0.002), and 96% in 2013 (p importance and techniques of anthropometrical measurements has successfully been implemented in a PICU. It managed to improve staff knowledge and nutritional practice.
Ziaei, Shirin; Contreras, Mariela; Zelaya Blandón, Elmer; Persson, Lars-Åke; Hjern, Anders; Ekström, Eva-Charlotte
To evaluate the associations of women's autonomy and social support with infant and young child feeding practices (including consumption of highly processed snacks and sugar-sweetened beverages) and nutritional status in rural Nicaragua. Cross-sectional study. Feeding practices and children's nutritional status were evaluated according to the WHO guidelines complemented with information on highly processed snacks and sugar-sweetened beverages. Women's autonomy was assessed by a seventeen-item questionnaire covering dimensions of financial independence, household-, child-, reproductive and health-related decision making and freedom of movement. Women's social support was determined using the Duke-UNC Functional Social Support Questionnaire. The scores attained were categorized into tertiles. Los Cuatro Santos area, rural Nicaragua. A total of 1371 children 0-35 months of age. Children of women with the lowest autonomy were more likely to be exclusively breast-fed and continue to be breast-fed, while children of women with middle level of autonomy had better complementary feeding practices. Children of women with the lowest social support were more likely to consume highly processed snacks and/or sugar-sweetened beverages but also be taller. While lower levels of autonomy and social support were independently associated with some favourable feeding and nutrition outcomes, this may not indicate a causal relationship but rather that these factors reflect other matters of importance for child care.
Natale, Ruby A; Lopez-Mitnik, Gabriela; Uhlhorn, Susan B; Asfour, Lila; Messiah, Sarah E
This study examined the effect of an early childhood obesity prevention program on changes in Body Mass Index (BMI) z-score and nutrition practices. Eight child care centers were randomly assigned to an intervention or attention control arm. Participants were a multiethnic sample of children aged 2 to 5 years old (N = 307). Intervention centers received healthy menu changes and family-based education focused on increased physical activity and fresh produce intake, decreased intake of simple carbohydrate snacks, and decreased screen time. Control centers received an attention control program. Height, weight, and nutrition data were collected at baseline and at 3, 6, and 12 months. Analysis examined height, weight, and BMI z-score change by intervention condition (at baseline and at 3, 6, and 12 months). Pearson correlation analysis examined relationships among BMI z-scores and home activities and nutrition patterns in the intervention group. Child BMI z-score was significantly negatively correlated with the number of home activities completed at 6-month post intervention among intervention participants. Similarly, intervention children consumed less junk food, ate more fresh fruits and vegetables, drank less juice, and drank more 1% milk compared to children at control sites at 6 months post baseline. Ninety-seven percent of those children who were normal weight at baseline were still normal weight 12 months later. Findings support child care centers as a promising setting to implement childhood obesity prevention programs in this age group. © 2014 Society for Public Health Education.
The concept for the Co-ordinated Research Programme on isotopic evaluations of maternal and child nutrition to help prevent stunting was a consequence of discussions held between IAEA staff and participants in a regional training course on 'Isotope Techniques in Human Nutrition' held in Lima, Peru in June 1996. The intention then was to develop research on factors influencing the success of lactation and the consequent effects on the breast-fed child. The project would have Latin American participants to promote regional exchange of expertise and ideas. Initial participation was from Argentina, Chile, Mexico, Peru and Venezuela. Brazil and Pakistan have now been added to these. There are three Specific Research Objectives: (1) To develop stable isotope methods for measuring breast-milk intake using regionally available equipment. (2) To apply the methodology in the assessment of milk intake in infants in relation to maternal nutrition, socio-economic status and education, and infant nutrition and intake of macro- and micro-nutrients. (3) To use information gathered at 2) to determine the need for supplementation programmes for mothers and/or infants, and educational programmes for the mothers
Nnamdi Azikiwe University Journal of International Law and Jurisprudence. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 2 (2011) >. Log in or Register to get access to full text downloads.
Ickes, Scott B; Hurst, Taylor E; Flax, Valerie L
Understanding maternal factors that influence child feeding is necessary to inform intervention planning in settings in which mothers experience substantial social vulnerabilities. The purpose of this study was to assess maternal sociodemographic factors that may constrain women's caring capabilities and subsequent child nutrition in Uganda. We analyzed data from the 2006 and 2011 Uganda Demographic and Health Surveys to model the associations between maternal sociodemographic factors, child feeding practices, and anthropometry with multivariate logistic regression models. The proportion of children fed according to recommended guidelines declined in Uganda from 2006 to 2011. Mothers who lacked literacy skills were less likely to achieve recommended complementary feeding indicators; however, literacy was not associated with breastfeeding practices. Mothers in the upper 60% wealth percentile were more likely to meet minimum meal frequency, diversity, and adequacy indicators. Mothers who gave birth at health facilities (2006 OR: 0.49; 95% CI: 0.26, 0.91; P literacy skills, who deliver their children at home, and who lack formal education are particularly at risk of poor child feeding and represent a group that may benefit from enhanced interventions that address their particular vulnerabilities. Factors that contribute to improved maternal feeding capabilities but may impair breastfeeding practices need to be better understood. © 2015 American Society for Nutrition.
Ickes, Scott B; Hurst, Taylor E; Flax, Valerie L
Background: Understanding maternal factors that influence child feeding is necessary to inform intervention planning in settings in which mothers experience substantial social vulnerabilities. Objective: The purpose of this study was to assess maternal sociodemographic factors that may constrain women’s caring capabilities and subsequent child nutrition in Uganda. Methods: We analyzed data from the 2006 and 2011 Uganda Demographic and Health Surveys to model the associations between maternal sociodemographic factors, child feeding practices, and anthropometry with multivariate logistic regression models. Results: The proportion of children fed according to recommended guidelines declined in Uganda from 2006 to 2011. Mothers who lacked literacy skills were less likely to achieve recommended complementary feeding indicators; however, literacy was not associated with breastfeeding practices. Mothers in the upper 60% wealth percentile were more likely to meet minimum meal frequency, diversity, and adequacy indicators. Mothers who gave birth at health facilities (2006 OR: 0.49; 95% CI: 0.26, 0.91; P maternal education, and infant and young child feeding practices. Women with a formal education had children with lower stunting and underweight probabilities in both time periods (OR range: 0.43–0.74). Women who delivered in childbirth facilities were less likely to have a child with low weight-for-age, length-for-age, or weight-for-length z scores (OR range: 0.59–0.82). Marital status, the age at first child birth, not accepting domestic violence, freedom to travel away from home, and involvement in household and reproductive decisions were not associated with child anthropometry in either time period. Conclusions: Mothers with low literacy skills, who deliver their children at home, and who lack formal education are particularly at risk of poor child feeding and represent a group that may benefit from enhanced interventions that address their particular
Clair Null, PhD
Full Text Available Summary: Background: Poor nutrition and exposure to faecal contamination are associated with diarrhoea and growth faltering, both of which have long-term consequences for child health. We aimed to assess whether water, sanitation, handwashing, and nutrition interventions reduced diarrhoea or growth faltering. Methods: The WASH Benefits cluster-randomised trial enrolled pregnant women from villages in rural Kenya and evaluated outcomes at 1 year and 2 years of follow-up. Geographically-adjacent clusters were block-randomised to active control (household visits to measure mid-upper-arm circumference, passive control (data collection only, or compound-level interventions including household visits to promote target behaviours: drinking chlorinated water (water; safe sanitation consisting of disposing faeces in an improved latrine (sanitation; handwashing with soap (handwashing; combined water, sanitation, and handwashing; counselling on appropriate maternal, infant, and young child feeding plus small-quantity lipid-based nutrient supplements from 6–24 months (nutrition; and combined water, sanitation, handwashing, and nutrition. Primary outcomes were caregiver-reported diarrhoea in the past 7 days and length-for-age Z score at year 2 in index children born to the enrolled pregnant women. Masking was not possible for data collection, but analyses were masked. Analysis was by intention to treat. This trial is registered with ClinicalTrials.gov, number NCT01704105. Findings: Between Nov 27, 2012, and May 21, 2014, 8246 women in 702 clusters were enrolled and randomly assigned an intervention or control group. 1919 women were assigned to the active control group; 938 to passive control; 904 to water; 892 to sanitation; 917 to handwashing; 912 to combined water, sanitation, and handwashing; 843 to nutrition; and 921 to combined water, sanitation, handwashing, and nutrition. Data on diarrhoea at year 1 or year 2 were available for 6494 children and
Jackson, Margot I; Mayne, Patrick
Because children disproportionately live in poverty, they are especially vulnerable during economic crises, making the social safety net a key buffer against the effects of economic disadvantage on their development. The Great Recession of 2007-2009 had strong and lasting effects on American children and families, including striking negative effects on their health environments. Understanding access to the health safety net during this time of increased economic need, as well as the extent to which all children-regardless of age, income or race/ethnicity-share in the increased use of transfer programs, is therefore important in identifying the availability and accessibility of government assistance for those in need. Focusing on the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) program because of its strong effects on child development, we use longitudinal data from the Survey of Income and Program Participation (SIPP) to examine change and stability in children's WIC enrollment before, during and after the recession. Specifically, we examine: 1) whether children's WIC enrollment increased alongside changing family income, and 2) the extent to which changes in participation were shared by all subpopulations, regardless of age, income, and race/ethnicity. Analyses reveal that WIC participation among eligible children increased leading up to, during, and after the Great Recession, suggesting that the program was responsive to increasing economic need. Examining the distribution of WIC enrollment across demographic groups largely reveals a pattern of stable inequality in access and "take up." Children born to poorer and less-educated mothers were more likely to be enrolled prior to the recession, and these differences remain mostly constant during and after the recession. Eligible Hispanic children had consistently higher enrollment, particularly among those in families with foreign-born mothers. The findings suggest that not all
Hoddinott, John; Ahmed, Ishita; Ahmed, Akhter; Roy, Shalini
To examine the impact on infant and young child nutrition knowledge and practice of mothers who were neighbors of mothers participating in a nutrition Behavior Change Communication (BCC) intervention in rural Bangladesh. We analyzed data from 300 mothers whose neighbor participated in a nutrition BCC intervention and 600 mothers whose neighbor participated in an intervention that did not include BCC. We constructed measures capturing mothers' knowledge of infant and young child nutrition (IYCN) and measures of food consumption by children 6-24m. The effect on these outcomes of exposure to a neighbor receiving a nutrition BCC intervention was estimated using ordinary least squares and probit regressions. The study was registered with ClinicalTrials.gov (Study ID: NCT02237144). Having a neighboring mother participate in a nutrition BCC intervention increased non-participant mothers' IYCN knowledge by 0.17 SD (translating to 0.3 more correct answers). They were 14.1 percentage points more likely to feed their 6-24m children legumes and nuts; 11.6 percentage points more likely to feed these children vitamin A rich fruits and vegetables; and 10.0 percentage points more likely to feed these children eggs. Children of non-participant mothers who had a neighboring mother participate in a nutrition BCC intervention were 13.8 percentage points more likely to meet World Health Organization (WHO) guidelines for minimum diet diversity, 11.9 percentage points more likely to meet WHO guidelines for minimum acceptable diet, and 10.3 percentage points more likely to meet WHO guidelines for minimum meal frequency for children who continue to be breastfed after age 6m. Children aged 0-6m of non-participant mothers who are neighbors of mothers receiving BCC were 7.1 percentage points less likely to have ever consumed water-based liquids. Studies of nutrition BCC that do not account for information spillovers to non-participants may underestimate its benefits in terms of IYCN knowledge
Leroy, Jef L; Olney, Deanna; Ruel, Marie
Food-assisted maternal and child health and nutrition (FA-MCHN) programs are widely used to address undernutrition, but little is known about their effectiveness in improving child linear growth. We assessed the impact of Burundi's Tubaramure FA-MCHN program on linear growth. The program targeted women and their children during the first 1000 d and included 1) food rations, 2) strengthening of health services and promotion of their use, and 3) behavior change communication (BCC). A second objective was to assess the differential effect when varying the timing and duration of receiving food rations. We used a 4-arm, cluster-randomized controlled study to assess program impact with the use of cluster fixed-effects double-difference models with repeated cross-sectional data (baseline and follow-up 4 y later with ∼3550 children in each round). Treatment arms received food rations (corn-soy blend and micronutrient-fortified vegetable oil) for the first 1000 d (T24), from pregnancy through the child reaching 18 mo (T18), or from birth through the child reaching 24 mo ["no food during pregnancy" (TNFP)]. All treatment arms received BCC for the first 1000 d. The control arm received no food rations or BCC. Stunting (height-for-age z score 0.01). Secondary analyses showed that the effect was limited to children whose mother and head of household had some primary education and who lived in households with above-median assets. FA-MCHN programs are an effective development tool to improve child linear growth and can protect children from political and economic shocks in vulnerable countries such as Burundi. A better understanding of how to improve the nutritional status of children in the worst-off households is needed. This trial was registered at www.clinicaltrials.gov as NCT01072279.
Marijke de Cock
Full Text Available Abstract Background The presence of chemicals in the environment is ubiquitous. Human biomonitoring studies have shown that various chemicals can be detected in the majority of the population, including pregnant women. These compounds may pass the placenta, and reach the fetus. This early life exposure in particular may be detrimental as some chemicals may disrupt the endocrine system, which is involved in various processes during development. The LINC study is a prospective birth cohort designed to study associations between early life environmental exposures and child health, including growth and neurodevelopment. The purpose of this paper is to give an overview of this cohort. Methods and design Recruitment for this cohort has started in 2011 in three Dutch areas and is still ongoing. To date over 300 mother-child pairs have been included. Women are preferably included during the first trimester of pregnancy. Major congenital anomalies and twin births are reasons for exclusion. To assess exposure to environmental chemicals, cord blood, placenta, meconium and vernix are collected. Parents collect urine of the child shortly after birth and breast milk in the second month of life. Exposure to a broad range of environmental chemicals are determined in cord plasma and breast milk. Furthermore various hormones, including leptin and cortisone, are determined in cord plasma, and in heel prick blood spots (thyroxine. Data on anthropometry of the child is collected through midwives and youth health care centres on various time points until the child is 18 months of age. Furthermore cognitive development is monitored by means of the van Wiechen scheme, and information on behavioral development is collected by means of the infant behavior questionnaire and the child behavior checklist. When the child is 12 months of age, a house visit is scheduled to assess various housing characteristics, as well as hand-to-mouth behavior of the child. At this visit
Stewart, Christine P; Kariger, Patricia; Fernald, Lia; Pickering, Amy J; Arnold, Charles D; Arnold, Benjamin F; Hubbard, Alan E; Dentz, Holly N; Lin, Audrie; Meerkerk, Theodora J; Milner, Erin; Swarthout, Jenna; Colford, John M; Null, Clair
Poor nutrition and infectious diseases can prevent children from reaching their developmental potential. We aimed to assess the effects of improvements in water, sanitation, handwashing, and nutrition on early child development in rural Kenya. In this cluster-randomised controlled trial, we enrolled pregnant women in their second or third trimester from three counties (Kakamega, Bungoma, and Vihiga) in Kenya's western region, with an average of 12 households per cluster. Groups of nine geographically adjacent clusters were block-randomised, using a random number generator, into the six intervention groups (including monthly visits to promote target behaviours), a passive control group (no visits), or a double-sized active control group (monthly household visits to measure child mid-upper arm circumference). The six intervention groups were: chlorinated drinking water; improved sanitation; handwashing with soap; combined water, sanitation, and handwashing; improved nutrition through counselling and provision of lipid-based nutrient supplements; and combined water, sanitation, handwashing, and nutrition. Here we report on the prespecified secondary child development outcomes: gross motor milestone achievement assessed with the WHO module at year 1, and communication, gross motor, personal social, and combined scores measured by the Extended Ages and Stages Questionnaire (EASQ) at year 2. Masking of participants was not possible, but data assessors were masked. Analyses were by intention to treat. This trial is registered with ClinicalTrials.gov, number NCT01704105. Between Nov 27, 2012, and May 21, 2014, 8246 women residing in 702 clusters were enrolled. No clusters were lost to follow-up, but 2212 households with 2279 children were lost to follow-up by year 2. 5791 (69%) children were measured at year 1 and 6107 (73%) at year 2. At year 1, compared with the active control group, the combined water, sanitation, handwashing, and nutrition group had greater rates of
Prevención de la desnutrición de la madre y el niño: el componente de nutrición de la Iniciativa Salud Mesoamérica 2015 Preventing maternal and child malnutrition: The nutrition component of the Mesoamerican Health Initiative 2015
Juan A Rivera
Full Text Available Describir un plan maestro para el desarrollo de planes nacionales para prevenir la desnutrición materno-infantil en Mesoamérica en un plazo de cinco años. Para ello se elaboró un análisis sobre los principales problemas, políticas y programas de nutrición en Mesoamérica. A partir del análisis y de la revisión de la literatura sobre las mejores prácticas en el combate a la desnutrición, el Grupo Técnico de Nutrición desarrolló, discutió y validó el plan durante varias reuniones presenciales. Se desarrolló la teoría de cambio que identifica los problemas y barreras, las acciones propuestas, los cambios e impactos esperados. Se propone la implementación de paquetes de intervenciones para reducir la desnutrición y deficiencia de micronutrientes de utilidad para diversos contextos epidemiológicos. El plan maestro de nutrición constituye un insumo que puede facilitar la elaboración de propuestas de programas y políticas dirigidos a reducir la desnutrición y promover la toma de decisiones basadas en evidencia.To describe the regional master plan of nutrition to address maternal and child malnutrition in a 5- year period developed by the Nutrition Technical Group. The Nutrition Technical Group developed a situation analysis describing the main nutrition problems, policies and programs in Mesoamerica. The situation analysis and a literature review about effective interventions to address malnutrition were conducted to develop a nutrition master plan. The Nutrition Technical Group held various meetings to develop, discuss and validate the master plan. Theory of change identified problems and barriers, the actions to be developed, the changes and impacts expected. A package of interventions is proposed to reduce undernutrition and micronutrient deficiencies useful under different epidemiological contexts. The nutrition master plan provides a guideline of best practices that can be used for evidence-informed decision making and the
McAfee, Alison J; Mulhern, Maria S; McSorley, Emeir M; Wallace, Julie M W; Bonham, Maxine P; Faure, Jude; Romain, Sarah; Esther, Christina; Shamlaye, Conrad F; Watson, Gene E; Myers, Gary J; Clarkson, Thomas W; Davidson, Philip W; Strain, J J
To assess the nutritional adequacy of Seychellois children in relation to nutrients reported to be important for cognitive development. Dietary intakes were assessed by 4 d weighed food diaries and analysed using dietary analysis software (WISP version 3·0; Tinuviel Software, UK). Individual nutrient intakes were adjusted to usual intakes and, in order to investigate adequacy, were compared with the UK Estimated Average Requirements for children aged 4-6 years. Children 5 years old were followed up as part of the Seychelles Child Development Nutrition Study (SCDNS), located in the high-fish-consuming population of Mahé, Republic of Seychelles. Analysis was carried out on a sample of 229 children (118 boys, 111 girls). Children consumed a diet of which fortified cereal and milk products contributed the most to nutrient intakes. The majority (≥80 %) of children met requirements for several nutrients important for child development including Fe, folate and Se. Adjusted dietary intakes of Cu, Zn, iodine, niacin and vitamin A were below the Estimated Average Requirement or Recommended Nutrient Intake. Mean adjusted energy intakes (boys 4769 kJ/d (1139·84 kcal/d), girls 4759 kJ/d (1137·43 kcal/d)) were lower than the estimated energy requirement (boys 5104 kJ/d (1220 kcal/d), girls 5042 kJ/d (1205 kcal/d)) for 88 % of boys and 86 % of girls. Nutrition was adequate for most children within the SCDNS cohort. Low intakes of some nutrients (including Zn, niacin and vitamin A) could reflect nutritional database inaccuracies, but may require further investigation. The study provides valuable information on the adequacy of intakes of nutrients which could affect the growth and development of Seychellois children.
A Historical Review of Changes in Nutrition Standards of USDA Child Meal Programs Relative to Research Findings on the Nutritional Adequacy of Program Meals and the Diet and Nutritional Health of Participants: Implications for Future Research and the Summer Food Service Program.
Hopkins, Laura C; Gunther, Carolyn
The USDA child meal programs (CMPs) (National School Lunch Program (NSLP), School Breakfast Program (SBP), and Summer Food Service Program (SFSP) were established in 1946 (NSLP) and 1975 (SBP and SFSP) to improve the diet and nutritional health of US children. There is concern that participation in these programs may in fact be a contributor to the current childhood obesity epidemic. The purpose of this study was to determine if the CMPs are meeting their intended goal by reviewing the historical changes to nutrition standards of the CMPs in correspondence with the literature that examines the nutritional adequacy of meals served as part of these programs, as well as the dietary intakes and nutritional status of participants. Public Law and the Federal Register were reviewed and websites and online databases were systematically searched. NSLP and SBP first underwent updates to the nutrition standards in 1994 and subsequently 2010, whereas SFSP last underwent modifications in 2000. The majority of data, all collected prior to 2010, demonstrate that meals served as part of the NSLP and SBP are not meeting nutrition standards. In addition, the dietary intakes of NSLP and SBP participants are high in calories, fat, saturated fat, and sodium, and low in fiber. Studies examining the weight status and other nutrition-related health outcomes of NSLP and SBP participants have produced mixed results. In contrast, no studies published in the peer-reviewed literature have been conducted examining the nutritional adequacy of SFSP meals or the dietary intakes or nutritional health of SFSP participants. There are public reports available on the nutritionally adequacy of SFSP meals, however, they are severely outdated (1988 and 2003). Due to this dearth of information, a case study on a sample SFSP menu from summer 2015 was conducted; results showed that the meals are high in carbohydrate and protein content and insufficient in vegetable servings. There is critical need for policy
A Historical Review of Changes in Nutrition Standards of USDA Child Meal Programs Relative to Research Findings on the Nutritional Adequacy of Program Meals and the Diet and Nutritional Health of Participants: Implications for Future Research and the Summer Food Service Program
Laura C. Hopkins
Full Text Available Background: The USDA child meal programs (CMPs (National School Lunch Program (NSLP, School Breakfast Program (SBP, and Summer Food Service Program (SFSP were established in 1946 (NSLP and 1975 (SBP and SFSP to improve the diet and nutritional health of US children. There is concern that participation in these programs may in fact be a contributor to the current childhood obesity epidemic. Objective: The purpose of this study was to determine if the CMPs are meeting their intended goal by reviewing the historical changes to nutrition standards of the CMPs in correspondence with the literature that examines the nutritional adequacy of meals served as part of these programs, as well as the dietary intakes and nutritional status of participants. Methods: Public Law and the Federal Register were reviewed and websites and online databases were systematically searched. Results: NSLP and SBP first underwent updates to the nutrition standards in 1994 and subsequently 2010, whereas SFSP last underwent modifications in 2000. The majority of data, all collected prior to 2010, demonstrate that meals served as part of the NSLP and SBP are not meeting nutrition standards. In addition, the dietary intakes of NSLP and SBP participants are high in calories, fat, saturated fat, and sodium, and low in fiber. Studies examining the weight status and other nutrition-related health outcomes of NSLP and SBP participants have produced mixed results. In contrast, no studies published in the peer-reviewed literature have been conducted examining the nutritional adequacy of SFSP meals or the dietary intakes or nutritional health of SFSP participants. There are public reports available on the nutritionally adequacy of SFSP meals, however, they are severely outdated (1988 and 2003. Due to this dearth of information, a case study on a sample SFSP menu from summer 2015 was conducted; results showed that the meals are high in carbohydrate and protein content and insufficient in
Choy, Courtney C; Desai, Mayur M; Park, Jennifer J; Frame, Elizabeth A; Thompson, Avery A; Naseri, Take; Reupena, Muagututia S; Duckham, Rachel L; Deziel, Nicole C; Hawley, Nicola L
Young children are particularly vulnerable to malnutrition as nutrition transition progresses. The present study aimed to document the prevalence, coexistence and correlates of nutritional status (stunting, overweight/obesity and anaemia) in Samoan children aged 24-59 months. A cross-sectional community-based survey. Height and weight were used to determine prevalence of stunting (height-for-age Z-score +2) based on WHO growth standards. Anaemia was determined using an AimStrip Hemoglobin test system (Hb nutritional status outcomes, highlighting the need for condition-specific interventions in this age group. The observed prevalences of stunting, overweight/obesity and anaemia suggest that it is critical to invest in nutrition and develop health programmes targeting early childhood growth and development in Samoa.
Huicho, L.; Segura, E.R.; Huayanay-Espinoza, C.A.; Niño de Guzman, J.; Restrepo-Méndez, M.C.; Tam, Y.; Barros, A.J.D.; Victora, C.G.; Hernández-Peña, P.
Background Peru is an upper-middle-income country with wide social and regional disparities. In recent years, sustained multisectoral antipoverty programmes involving governments, political parties, and civil society have included explicit health and nutrition goals and spending increased sharply.
Kim, Sunny S; Avula, Rasmi; Ved, Rajani; Kohli, Neha; Singh, Kavita; van den Bold, Mara; Kadiyala, Suneetha; Menon, Purnima
Convergence of sectoral programs is important for scaling up essential maternal and child health and nutrition interventions. In India, these interventions are implemented by two government programs - Integrated Child Development Services (ICDS) and National Rural Health Mission (NRHM). These programs are designed to work together, but there is limited understanding of the nature and extent of coordination in place and needed at the various administrative levels. Our study examined how intersectoral convergence in nutrition programming is operationalized between ICDS and NRHM from the state to village levels in Odisha, and the factors influencing convergence in policy implementation and service delivery. Semi-structured interviews were conducted with state-level stakeholders (n = 12), district (n = 19) and block officials (n = 66), and frontline workers (FLWs, n = 48). Systematic coding and content analysis of transcripts were undertaken to elucidate themes and patterns related to the degree and mechanisms of convergence, types of actions/services, and facilitators and barriers. Close collaboration at state level was observed in developing guidelines, planning, and reviewing programs, facilitated by a shared motivation and recognized leadership for coordination. However, the health department was perceived to drive the agenda, and different priorities and little data sharing presented challenges. At the district level, there were joint planning and review meetings, trainings, and data sharing, but poor participation in the intersectoral meetings and limited supervision. While the block level is the hub for planning and supervision, cooperation is limited by the lack of guidelines for coordination, heavy workload, inadequate resources, and poor communication. Strong collaboration among FLWs was facilitated by close interpersonal communication and mutual understanding of roles and responsibilities. Congruent or shared priorities and regularity of
Sunny S. Kim
Full Text Available Abstract Background Convergence of sectoral programs is important for scaling up essential maternal and child health and nutrition interventions. In India, these interventions are implemented by two government programs – Integrated Child Development Services (ICDS and National Rural Health Mission (NRHM. These programs are designed to work together, but there is limited understanding of the nature and extent of coordination in place and needed at the various administrative levels. Our study examined how intersectoral convergence in nutrition programming is operationalized between ICDS and NRHM from the state to village levels in Odisha, and the factors influencing convergence in policy implementation and service delivery. Methods Semi-structured interviews were conducted with state-level stakeholders (n = 12, district (n = 19 and block officials (n = 66, and frontline workers (FLWs, n = 48. Systematic coding and content analysis of transcripts were undertaken to elucidate themes and patterns related to the degree and mechanisms of convergence, types of actions/services, and facilitators and barriers. Results Close collaboration at state level was observed in developing guidelines, planning, and reviewing programs, facilitated by a shared motivation and recognized leadership for coordination. However, the health department was perceived to drive the agenda, and different priorities and little data sharing presented challenges. At the district level, there were joint planning and review meetings, trainings, and data sharing, but poor participation in the intersectoral meetings and limited supervision. While the block level is the hub for planning and supervision, cooperation is limited by the lack of guidelines for coordination, heavy workload, inadequate resources, and poor communication. Strong collaboration among FLWs was facilitated by close interpersonal communication and mutual understanding of roles and responsibilities
Tofail, Fahmida; Fernald, Lia Ch; Das, Kishor K; Rahman, Mahbubur; Ahmed, Tahmeed; Jannat, Kaniz K; Unicomb, Leanne; Arnold, Benjamin F; Ashraf, Sania; Winch, Peter J; Kariger, Patricia; Stewart, Christine P; Colford, John M; Luby, Stephen P
Poor nutrition and hygiene make children vulnerable to delays in growth and development. We aimed to assess the effects of water quality, sanitation, handwashing, and nutritional interventions individually or in combination on the cognitive, motor, and language development of children in rural Bangladesh. In this cluster-randomised controlled trial, we enrolled pregnant women in their first or second trimester from rural villages of Gazipur, Kishoreganj, Mymensingh, and Tangail districts of central Bangladesh, with an average of eight women per cluster. Groups of eight geographically adjacent clusters were block-randomised, using a random number generator, into six intervention groups (all of which received weekly visits from a community health promoter for the first 6 months and every 2 weeks for the next 18 months) and a double-sized control group (no intervention or health promoter visit). The six intervention groups were: chlorinated drinking water; improved sanitation; handwashing with soap; combined water, sanitation, and handwashing; improved nutrition through counselling and provision of lipid-based nutrient supplements; and combined water, sanitation, handwashing, and nutrition. Here, we report on the prespecified secondary child development outcomes: gross motor milestone achievement assessed with the WHO module at age 1 year, and communication, gross motor, personal social, and combined scores measured by the Extended Ages and Stages Questionnaire (EASQ) at age 2 years. Masking of participants was not possible. Analyses were by intention to treat. This trial is registered with ClinicalTrials.gov, number NCT01590095. Between May 31, 2012, and July 7, 2013, 5551 pregnant women residing in 720 clusters were enrolled. Index children of 928 (17%) enrolled women were lost to follow-up in year 1 and an additional 201 (3%) in year 2. 4757 children were assessed at 1 year and 4403 at 2 years. At year 1, compared with the control group, the combined water
松本, 眞一; Shinichi, Matsumoto; 桃山学院大学社会学部
This part study aims to research on the whole aspect of child protection in Canada. And so, this paper consists of five chapters as follows: (1)Canadian history of child protection, (2)definition of child abuse, (3)current situation of child protection in Canada, (4)outline of child protection and treatment, (5)triangular comparison of child protection and prevention in Canada, Australia and England. The first efforts at identifying and combating child abuse occurred in the latter part of the...
Luciana Rodrigues Vieira Batista
Full Text Available A relação entre alimentação, estado nutricional e a condição bucal ainda não está bem esclarecida, apresentando, muitas vezes, versões controversas e conhecimento limitado. Existe certa concordância de que a alimentação e, conseqüentemente, o estado nutricional, possam exercer certa influência sobre a condição bucal imediata e futura da criança. O objetivo desta comunicação é apresentar possíveis relações entre alimentação, estado nutricional e a condição bucal da criança. O estado nutricional pode afetar os dentes durante o seu período de formação e após a erupção na cavidade bucal. Os efeitos sistêmicos provenientes da nutrição podem alterar o desenvolvimento dos dentes, a quantidade e a qualidade da saliva, assim como os efeitos externos também podem determinar uma maior prevalência de cárie dentária, uma vez que tanto a quantidade de sacarose ingerida, quanto a freqüência de ingestão são importantes fatores envolvidos em sua etiologia. As reflexões deste trabalho sugerem a necessidade de ações interdisciplinares para obtenção de resultados na prevenção e no tratamento das doenças bucais.The relationship among food, nutritional status and oral condition is not yet well established, many times presenting controversial versions and limited knowledge. There seems to be an agreement that eating, and consequently, the nutritional status, may have a certain amount of influence over present and future oral conditions of the child. The objective of this communication is to discuss possible relations among food, nutritional status and oral condition in the child. Nutritional status may affect the teeth during their formation period and after eruption in the oral cavity. Systemic effects of nutrition may alter the development of teeth, quantity and quality of saliva, and the external effect may also determine a bigger prevalence of dental cavities, since both the quantity and the frequency of
Graziose, Matthew M; Downs, Shauna M; O'Brien, Quentin; Fanzo, Jessica
To systematically review the design, implementation and effectiveness of mass media and nutrition education interventions for improving infant and young child feeding (IYCF) practices and related psychosocial factors. A search of PubMed, Embase and PsycINFO databases, a Google search, and a consultation with experts in the field of IYCF performed in July 2016. Low- and middle-income countries, as defined by the World Bank Group. Eligible studies: included a mass media component (with or without nutrition education); conducted a pre-post evaluation (with or without a control group); assessed IYCF knowledge, attitudes, beliefs and/or practices; and were published in English between 2000 and present. Eighteen unique studies were identified that examined the effect of mass media (types included: television; print; voice and/or SMS (text) messages; radio; megaphones/loudspeakers; videos; social media; songs/dramas) and nutrition education interventions on IYCF practices within thirteen countries. Of these, fifteen studies reported improvements in breast- and/or complementary feeding practices, using indicators recommended by the WHO, and six studies reported improvements in related psychosocial factors. However, little detail was provided on the use of formative research, a formal behaviour change theory and behaviour change techniques. Few studies reported both dose delivered and participants' exposure to the intervention. Despite evidence of effectiveness, few common elements in the design of interventions were identified. Future research should consistently report these details to open the 'black box' of IYCF interventions, identify effective design components and ensure replicability.
This article presents the major progress on the actions of the Forest Department and Dry Zone Greening Department to arrest forestation and to combat desertification in the dry zone of central Myanmar
European Journal of Social Psychology, 35(6), 819-828. Bond, S. B., & Mosher, D. L. (1986). Guided imagery of rape: Fantasy, reality, and the...the Presidential action to improve the transition between DoD and DoVA care, and to combat homelessness and lack of healthcare for all combat veterans...article appeared in the journal Current Psychiatry Reports (Castro, et al., 2015). The review provides both a rich bibliography and options for
law and DoD policy.”11 A recent message from the Army Public Affairs Office (PAO) states, “Army policy prohibits the assignment of women Soldiers to...assignments of women soldiers. The Army’s message , “. . . the issue is resolved” is actually confusing. As female soldiers earn awards for valor in combat...percent of male graduates enter combat arms), and there is both explicit and subliminal mentorship of female cadets guiding them toward the more
Mehta, Kedar; Pandya, Chandresh; Chavda, Paragkumar; Solanki, Dipak
Health indicators of rural and urban India show a wide variation. Rural areas have received large focus in child health services, but on the flip side, urban areas have been the last to receive such attention. A cross-sectional study was conducted to include one randomly selected outreach session from all the 19 urban primary health centers of Vadodara city from April 2013 to May 2014. Nineteen session sites were observed for the process evaluation of three components of child health care, namely, "planning of Health and Nutrition Day," "availability of vaccines/logistics," and "direct observation of actual immunization process" at the site using a structured checklist. Most of the vaccines and logistics were present at all 19 sites visited, but adverse events following immunization kit were observed at ten sites (52%) only. Open vial policy, no-touch technique, and immediate cutting of syringe with hub cutter were implemented at all sites; however, completely filled Mamta Card was observed at 9 (47%) sites only. All four key messages were given at 5 (26%) sites only. Immunization services such as proper vaccine administration with no-touch technique and open vial policy were mainly focused; however, other services such as biomedical waste management, record keeping, and delivery of all four key messages need to be strengthened during Mamta Divas. Strengthening of other child health care services such as growth monitoring, Integrated Management of Neonatal and Childhood Illnesses, and referral services is required in urban areas.
Lim, Hyunjung; Kim, JiEun; Wang, Youfa; Min, Jungwon; Carvajal, Nubia A; Lloyd, Charles W
Childhood obesity has become a global epidemic. Development of effective and sustainable programs to promote healthy behaviors from a young age is important. This study developed and tested an intervention program designed to promote healthy eating and physical activity among young children in South Korea by adaptation of the US National Aeronautics and Space Administration (NASA) Mission X (MX) Program. The intervention program consisted of 4 weeks of fitness and 2 weeks of nutrition education. A sample of 104 subjects completed pre- and post-surveys on the Children's Nutrition Acknowledgement Test (NAT). Parents were asked for their children's characteristics and two 24-hour dietary records, the Nutrition Quotient (NQ) at baseline and a 6-week follow-up. Child weight status was assessed using Korean body mass index (BMI) percentiles. At baseline, 16.4% (boy: 15.4%; girl: 19.2%) of subjects were overweight or obese (based on BMI≥85%tile). Fat consumption significantly decreased in normal BMI children (48.6 ± 16.8 g at baseline to 41.9 ± 18.1 g after intervention, P < 0.05); total NQ score significantly increased from 66.4 to 67.9 ( P < 0.05); total NAT score significantly improved in normal BMI children (74.3 at baseline to 81.9 after the program), children being underweight (from 71.0 to 77.0), and overweight children (77.1 at baseline vs. 88.2 after intervention, P < 0.001). The 6-week South Korean NASA MX project is feasible and shows favorable changes in eating behaviors and nutritional knowledge among young children.
Hearings on a Bill to Make Permanent Certain Child Nutrition Programs. Hearings before the Subcommittee on Elementary, Secondary, and Vocational Education of the Committee on Education and Labor. House of Representatives, Ninety-Eighth Congress, Second Session on H.R. 7 (March 6, 7, and 13, 1984).
Congress of the U.S., Washington, DC. House Committee on Education and Labor.
This report documents hearings concerning H.R. 7, amending the National School Lunch Act and the Child Nutrition Act of 1963. This bill (the text of which is included) proposes to make permanent five child nutrition programs: the Women, Infants, and Children Feeding Program (WIC); the Commodity Distribution Program; the Summer Feeding Program;…
Strain, J J; Davidson, Philip W; Bonham, Maxine P; Duffy, Emeir M; Stokes-Riner, Abbie; Thurston, Sally W; Wallace, Julie M W; Robson, Paula J; Shamlaye, Conrad F; Georger, Lesley A; Sloane-Reeves, Jean; Cernichiari, Elsa; Canfield, Richard L; Cox, Christopher; Huang, Li Shan; Janciuras, Joanne; Myers, Gary J; Clarkson, Thomas W
Fish consumption during gestation can provide the fetus with long-chain polyunsaturated fatty acids (LCPUFA) and other nutrients essential for growth and development of the brain. However, fish consumption also exposes the fetus to the neurotoxicant, methyl mercury (MeHg). We studied the association between these fetal exposures and early child development in the Seychelles Child Development Nutrition Study (SCDNS). Specifically, we examined a priori models of Omega-3 and Omega-6 LCPUFA measures in maternal serum to test the hypothesis that these LCPUFA families before or after adjusting for prenatal MeHg exposure would reveal associations with child development assessed by the BSID-II at ages 9 and 30 months. There were 229 children with complete outcome and covariate data available for analysis. At 9 months, the PDI was positively associated with total Omega-3 LCPUFA and negatively associated with the ratio of Omega-6/Omega-3 LCPUFA. These associations were stronger in models adjusted for prenatal MeHg exposure. Secondary models suggested that the MeHg effect at 9 months varied by the ratio of Omega-6/Omega-3 LCPUFA. There were no significant associations between LCPUFA measures and the PDI at 30 months. There were significant adverse associations, however, between prenatal MeHg and the 30-month PDI when the LCPUFA measures were included in the regression analysis. The BSID-II mental developmental index (MDI) was not associated with any exposure variable. These data support the potential importance to child development of prenatal availability of Omega-3 LCPUFA present in fish and of LCPUFA in the overall diet. Furthermore, they indicate that the beneficial effects of LCPUFA can obscure the determination of adverse effects of prenatal MeHg exposure in longitudinal observational studies.
Upscaling Participatory Action and Videos for Agriculture and Nutrition (UPAVAN) trial comparing three variants of a nutrition-sensitive agricultural extension intervention to improve maternal and child nutritional outcomes in rural Odisha, India: study protocol for a cluster randomised controlled trial.
Kadiyala, Suneetha; Prost, Audrey; Harris-Fry, Helen; O'Hearn, Meghan; Pradhan, Ronali; Pradhan, Shibananth; Mishra, Naba Kishore; Rath, Suchitra; Nair, Nirmala; Rath, Shibanand; Tripathy, Prasantha; Krishnan, Sneha; Koniz-Booher, Peggy; Danton, Heather; Elbourne, Diana; Sturgess, Joanna; Beaumont, Emma; Haghparast-Bidgoli, Hassan; Skordis-Worrall, Jolene; Mohanty, Satyanarayan; Upadhay, Avinash; Allen, Elizabeth
Maternal and child undernutrition have adverse consequences for pregnancy outcomes and child morbidity and mortality, and they are associated with low educational attainment, economic productivity as an adult, and human wellbeing. 'Nutrition-sensitive' agriculture programs could tackle the underlying causes of undernutrition. This study is a four-arm cluster randomised controlled trial in Odisha, India. Interventions are as follows: (1) an agricultural extension platform of women's groups viewing and discussing videos on nutrition-sensitive agriculture (NSA) practices, and follow-up visits to women at home to encourage the adoption of new practices shown in the videos; (2) women's groups viewing and discussing videos on NSA and nutrition-specific practices, with follow-up visits; and (3) women's groups viewing and discussing videos on NSA and nutrition-specific practices combined with a cycle of Participatory Learning and Action meetings, with follow-up visits. All arms, including the control, receive basic nutrition training from government community frontline workers. Primary outcomes, assessed at baseline and 32 months after the start of the interventions, are (1) percentage of children aged 6-23 months consuming ≥ 4 out of 7 food groups per day and (2) mean body mass index (BMI) (kg/m 2 ) of non-pregnant, non-postpartum (gave birth > 42 days ago) mothers or female primary caregivers of children aged 0-23 months. Secondary outcomes are percentage of mothers consuming ≥ 5 out of 10 food groups per day and percentage of children's weight-for-height z-score cluster, defined as one or more villages with a combined minimum population of 800 residents. There are 37 clusters per arm, and outcomes will be assessed in an average of 32 eligible households per cluster. For randomisation, clusters are stratified by distance to nearest town ( 70%) proportion of Scheduled Tribe or Scheduled Caste (disadvantaged) households. A process evaluation will assess the
Prado, Elizabeth L.; Hartini, Sri; Rahmawati, Atik; Ismayani, Elfa; Hidayati, Astri; Hikmah, Nurul; Muadz, Husni; Apriatni, Mandri S.; Ullman, Michael T.; Shankar, Anuraj H.; Alcock, Katherine J.
Background: Evaluating the impact of nutrition interventions on developmental outcomes in developing countries can be challenging since most assessment tests have been produced in and for developed country settings. Such tests may not be valid measures of children's abilities when used in a new context. Aims: We present several principles for the…
de Sa, Joia; Bouttasing, Namthipkesone; Sampson, Louise; Perks, Carol; Osrin, David; Prost, Audrey
Chronic malnutrition in children remains highly prevalent in Laos, particularly among ethnic minority groups. There is limited knowledge of specific nutrition practices among these groups. We explored nutritional status, cultural beliefs and practices of Laos' Khmu ethnic group to inform interventions for undernutrition as part of a Primary Health Care (PHC) project. Mixed methods were used. For background, we disaggregated anthropometric and behavioural indicators from Laos' Multiple Indicator Cluster Survey. We then conducted eight focus group discussions and 33 semi-structured interviews with Khmu villagers and health care workers, exploring beliefs and practices related to nutrition. The setting was two rural districts in Luang Prabang province, in one of which the PHC project had been established for 3 years. There was a higher prevalence of stunting in the Khmu than in other groups. Disaggregation showed nutrition behaviours were associated with ethnicity, including exclusive breastfeeding. Villagers described strong adherence to post-partum food restrictions for women, while little change was described in intake during pregnancy. Most children were breastfed, although early introduction of pre-lacteal foods was noted in the non-PHC district. There was widespread variation in introduction and diversity of complementary foods. Guidance came predominantly from the community, with some input from health care workers. Interventions to address undernutrition in Khmu communities should deliver clear, consistent messages on optimum nutrition behaviours. Emphasis should be placed on dietary diversity for pregnant and post-partum mothers, encouraging exclusive breastfeeding and timely, appropriate complementary feeding. The impact of wider governmental policies on food security needs to be further assessed. © 2012 John Wiley & Sons Ltd.
The prevalence of maternal and child malnutrition in Bangladesh is one of the highest in the world. It is estimated that 50% of women of childbearing age suffer chronic energy deficiency (BMI<18.5), nearly half of infants are born with a low birth weight (<2.5 kg), and about
Huye, Holly F.; Bankston, Sarah; Speed, Donna; Molaison, Elaine F.
Purpose/Objectives: The purpose of this research was to determine the level of implementation and perceived value in creating knowledge and behavior change from the Color Me Healthy (CMH) training program in child care centers, family day carehomes, or Head Start facilities throughout Mississippi. Methods: A two-phase survey was used to initially…
Abdulrahman O Musaiger
Full Text Available Abdulrahman O Musaiger1, Hazzaa M Al Hazzaa2, Aayed Al-Qahtani3, Jalila Elati4, Jasem Ramadan5, Nebal A AboulElla6, Najat Mokhtar7, Hashem A Kilani81Arab Center for Nutrition, Bahrain; 2,3King Saud University, Saudi Arabia, 4National Institute of Nutrition, Tunisia; 5University of Kuwait, Kuwait; 6National Nutrition Institute, Egypt; 7Ibn Tofail University, Morocco; 8Sultan Qaboos University, OmanAbstract: Obesity has become a major public health problem in the Arab countries, creating a health and economic burden on these countries’ government services. There is an urgent need to develop a strategy for prevention and control of obesity. The third Arab Conference on Obesity and Physical Activity was held in Bahrain in January 2010, and proposed the Strategy to Combat Obesity and Promote Physical Activity in Arab Countries. This strategy provides useful guidelines for each Arab country to prepare its own strategy or plan of action to prevent and control obesity. The strategy focused on expected outcomes, objectives, indicators to measure the objectives, and action needs for 9 target areas: child-care centers for preschool children, schools, primary health care, secondary care, food companies, food preparation institutes, media, public benefit organizations, and the workplace. Follow-up and future developments of this strategy were also included.Keywords: obesity, physical activity, strategy, Arab countries
... DEPARTMENT OF AGRICULTURE Food and Nutrition Service Child and Adult Care Food Program: National... AGENCY: Food and Nutrition Service, USDA. ACTION: Notice. SUMMARY: This notice announces the annual... Namian, Section Head, Policy and Program Development Branch, Child Nutrition Division, Food and Nutrition...
Qu, Pengfei; Mi, Baibing; Wang, Duolao; Zhang, Ruo; Yang, Jiaomei; Liu, Danmeng; Dang, Shaonong; Yan, Hong
The objective of this study was to determine the relationship between the quality of feeding practices and children's nutritional status in rural western China. A sample of 12,146 pairs of 6- to 35-month-old children and their mothers were recruited using stratified multistage cluster random sampling in rural western China. Quantile regression was used to analyze the relationship between the Infant and Child Feeding Index (ICFI) and children's nutritional status. In rural western China, 24.37% of all infants and young children suffer from malnutrition. Of this total, 19.57%, 8.74% and 4.63% of infants and children are classified as stunting, underweight and wasting, respectively. After adjusting for covariates, the quantile regression results suggested that qualified ICFI (ICFI > 13.8) was associated with all length and HAZ quantiles (PFeeding practices were associated with the physical development of infants and young children, and proper feeding practices had a greater effect on poor physical development in infants and young children. For mothers in rural western China, proper guidelines and messaging on complementary feeding practices are necessary.
Tine T. Hansen
Objective: To evaluate implementation of the NTP at PHCs that provide antiretroviral therapy. Methods: A cross-sectional, descriptive study was conducted at 17 PHCs located within 3 districts of Western Cape Province. Two target groups were chosen: 32 staff members working at the sites and 21 women of child-bearing age enrolled in the NTP. Questionnaires were used to obtain data. Results: Only 2 women (10% lived in food-secure households; the rest were either at risk of hunger (29% or classified as hungry (61%. Most of the women knew they had to take the supplements to improve their nutritional status, but the majority only recalled receiving basic nutritional advice, and the information was mainly given verbally. Ten of the women had shared their supplements with others, mostly with their children. The study identified lack of clearly defined NTP responsibilities at the PHCs, causing confusion amongst the staff. Although many staff members expressed problems with the NTP, only 38% of them reported having routine evaluations regarding the programme. Conclusion: Several aspects compromised the effectiveness of the NTP, including socio- economic factors leading to clients’ non-compliance. The strategic organisation and implementation of the NTP varied between different PHCs offering antiretroviral therapy, and staff experienced difficulties with the logistics of the programme.
Nikièma, Laetitia; Huybregts, Lieven; Martin-Prevel, Yves; Donnen, Philippe; Lanou, Hermann; Grosemans, Joep; Offoh, Priscilla; Dramaix-Wilmet, Michèle; Sondo, Blaise; Roberfroid, Dominique; Kolsteren, Patrick
The period from conception to 24 months of age is a crucial window for nutrition interventions. Personalized maternal counseling may improve childbirth outcomes, growth, and health. We assessed the effectiveness of facility-based personalized maternal nutrition counseling (from pregnancy to 18 months after birth) in improving child growth and health in rural Burkina Faso. We conducted a paired cluster randomized controlled trial in a rural district of Burkina Faso with 12 primary health centers (clusters). Healthcare providers in the intervention centers received patient-centered communication and nutrition counseling training. Pregnant women in the third trimester living in the center catchment areas and intending to stay for the next 2 years were prospectively included. We followed 2253 mother-child pairs quarterly until the child was aged 18 months. Women were interviewed about counseling experiences, dietary practices during pregnancy, and their child's feeding practices and morbidity history. Anthropometric measurements were taken at each visit using standardized methods. The primary outcomes were the cumulative incidence of wasting, and changes in child weight-for-height z-score (WHZ). Secondary outcomes were the women's prenatal dietary practices, early breastfeeding practices, exclusive breastfeeding, timely introduction of complementary food, child's feeding frequency and dietary diversity, children's mean birth weight, endpoint prevalence of stunting, and cumulative incidence of diarrhea, fever, and acute respiratory infection. All analyses were by intention-to-treat using mixed effects models. The intervention and control arms each included six health centers. Mothers in the intervention arm had a significantly higher exposure to counseling with 11.2% for breastfeeding techniques to 75.7% for counseling on exclusive breastfeeding. Mothers of infants below 6 months of age in the intervention arm were more likely to exclusively breastfeed (54.3% vs 42
Dalmiya, Nita; Schultink, Werner
The importance of micronutrient deficiencies or "hidden hunger" was clearly emphasized by the inclusion of specific goals on iron, vitamin A, and iodine deficiency at the 1990 World Summit for Children and other major international nutrition conferences. Significant progress has since been made toward eliminating vitamin A and iodine deficiencies, with less progress made toward reducing the burden of iron-deficiency anemia. The role of international agencies, such as the World Health Organization, United Nations Children's Fund, Food and Agricultural Organization, and World Bank in assisting countries to make progress toward the World Summit for Children goals has been very important. International agencies have played a critical role in advocating for and raising awareness of these issues at the international, regional, and national levels among policymakers and the general population. Using a rights-based approach, UNICEF and other agencies have been instrumental in elevating to the highest political level the discussion of every child's right to adequate nutrition. International agencies have also been very supportive at the national level in providing technical guidance for programs, including monitoring and evaluation. These agencies have played a critical role in engaging the cooperation of other partners, including bilateral donors, non-governmental organizations, and the private sector for micronutrient programs. Furthermore, international agencies provide financial and material support for micronutrient programs. In the future, such agencies must continue to be heavily involved in programs to achieve the newly confirmed goals for 2010. The present paper focuses on the role of international agencies in combating micronutrient deficiencies, drawing on the lessons learned over the last decade. The first section of the paper summarizes the progress achieved since 1990, and the second section describes the specific role of international agencies in contributing
Lázaro Rodolfo Alfonso Novo
Full Text Available La fibrosis quística es la alteración genética de herencia autosómica recesiva más frecuente en la raza blanca. Habitualmente se manifiesta como enfermedad pulmonar obstructiva crónica, una típica elevación del cloro en el sudor, anormalidades gastrointestinales y nutricionales y azoospermia obstructiva que ocasiona la infertilidad masculina. Como enfermedad multisistémica crónica y progresiva, requiere de una terapia nutricional rigurosamente controlada. El desequilibrio energético-nutricional está dado por el aumento de las necesidades de energía y de proteínas, la disminución de la ingesta calórica y pérdidas aumentadas por las heces. Se hace necesaria la monitorización nutricional adecuada para proponer una intervención nutricional activa en un primer tiempo y, si la situación no se revierte, aplicar una intervención agresiva basada en soporte enteral a débito continuo. Estas medidas están encaminadas a favorecer la composición corporal, mejorar la afectación pulmonar, el desarrollo puberal y la calidad de vida del paciente.Cystic fibrosis is the most frequent genetic disorder of autosomal recessive inheritance in Caucasians. It is ordinarily manifested as chronic obstructive pulmonary disease, typical rise of chlorine in sweat, gastrointestinal and nutritional anomalies and obstructive azoospermia that cause masculine infertility. As a multi-systemic chronic progressive disease, it demands strictly controlled nutritional therapy. Energy-nutritional imbalance is given by the increase of energy and protein requirements, reduction of caloric ingestion and heavy losses in feces. Adequate nutritional monitoring to submit active nutritional intervention in the first phase is necessary; then, if the situation does not change, aggressive intervention based on continuos enteral feeding should be applied. These measures are aimed at favouring the body composition and improving the pulmonary condition, the puberal development
Full Text Available Introduction: Health indicators of rural and urban India show a wide variation. Rural areas have received large focus in child health services, but on the flip side, urban areas have been the last to receive such attention. Materials and Methods: A cross-sectional study was conducted to include one randomly selected outreach session from all the 19 urban primary health centers of Vadodara city from April 2013 to May 2014. Nineteen session sites were observed for the process evaluation of three components of child health care, namely, “planning of Health and Nutrition Day,” “availability of vaccines/logistics,” and “direct observation of actual immunization process” at the site using a structured checklist. Results: Most of the vaccines and logistics were present at all 19 sites visited, but adverse events following immunization kit were observed at ten sites (52% only. Open vial policy, no-touch technique, and immediate cutting of syringe with hub cutter were implemented at all sites; however, completely filled Mamta Card was observed at 9 (47% sites only. All four key messages were given at 5 (26% sites only. Conclusion: Immunization services such as proper vaccine administration with no-touch technique and open vial policy were mainly focused; however, other services such as biomedical waste management, record keeping, and delivery of all four key messages need to be strengthened during Mamta Divas. Strengthening of other child health care services such as growth monitoring, Integrated Management of Neonatal and Childhood Illnesses, and referral services is required in urban areas.
In this document the starting points are described which underlie the new framework for the nuclear-accident combat in the Netherlands. All the elaboration of this is indicated in main lines. The juridical consequences of the proposed structure are enlightened and the sequel activities are indicated. (H.W.). 6 figs.; 8 tabs
Rajesh K Chudasama
Full Text Available Background: The ICDS program aims at enhancing survival and development of children from the vulnerable sections of the society. The present study was conducted to assess supplementary nutrition (SN activities and its related issues at anganwadi centres. Material and methods: Total 60 anganwadi centres were selected including 46 anganwadi centres (AWCs from rural area and 14 AWCs from urban area during April 2012 to March 2013 from 12 districts of Gujarat. Five AWCs were selected from one district randomly. Detailed information was collected related to beneficiary’s coverage for SN, type of food provided under SN, and various issues related to supplementary nutrition at anganwadi centres.Results: High coverage of receiving SN among enrolled was reported in pregnant mothers (88.3%, lactating mothers (91.7% and adolescents (86.7%. Only 25% AWCs were providing hot cooked food (HCF to 3 to 6 years children. Less than half of the AWCs were providing ready to eat (RTE food to 6 months to 3 years children (48.3%, pregnant (46.7% and lactating (46.7% mothers, and adolescents (45.0%. Total 38.3% AWCs reported shortage of SN supply, more in rural (41.3% compare to urban (28.6%. Various problems were reported by anganwadi workers related to SN like lack of storage facility, non availability of separate kitchen, poor quality of food, irregular supply, inadequate supply, and fuel problem. Conclusion: The regular and adequate supply of SN will improve the provision of hot cooked food, ready to eat food and take home ration to the beneficiaries as per the norms, leading to improvement of overall nutritional status of the community.
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Cheng, Feon W.; Monnat, Shannon M.; Lohse, Barbara
BACKGROUND NEEDs for Bones (NFB), based on the Health Belief Model, is a 4-lesson osteoporosis-prevention curriculum for 11-14 year-olds. This study examined the relationship between enjoyment of food tastings and interest in NFB. METHODS NFB was administered by teachers as part of standard practice and evaluated after the 4th lesson using a 21-item survey. Significant clustering of students within classrooms required use of random-intercept multilevel ordinal regression models in SAS proc GLIMMIX, with students nested within classrooms. Analyses considered tasting experience, eating attitudes, sex, grade, and cohort. RESULTS Students (N = 1619; 50% girls) participated from 85 4th-8th grade classrooms (47% 6th grade; 31% 7th grade) in 16 Pennsylvania SNAP-Ed eligible schools over 2 academic years. For all foods tasted, students who did not enjoy the food tasting were less interested in the lesson than students who did enjoy the food tasting (all p nutrition education on osteoporosis prevention, supporting resource allocation and inclusion of food tasting activities in school-age nutrition education. PMID:26032277
Berlin, Linda; Norris, Kimberly; Kolodinsky, Jane; Nelson, Abbie
Farm-to-school (FTS) programs are gaining attention for many reasons, one of which is the recognition that they could help stem the increase in childhood overweight and obesity. Most FTS programs that have been evaluated have increased students' selection or intake of fruits and vegetables following the incorporation of FTS components. However, the wide range of activities that are typically part of FTS programs make it difficult to pinpoint which components have the greatest potential to improve students' health behaviors. Within the field of nutrition education, theory-based interventions that target the key underlying factors influencing health behavior offer the most promise. We review existing research on dietary health impacts and implications of 3 key FTS-related activities and explore the component activities of FTS in terms of their potential to address the key constructs of social cognitive theory (SCT)--which is a current best practice in the field of nutrition--suggesting that FTS programs incorporating a diverse set of activities appear to be most promising. We find that components of FTS programs incorporate many of the key theoretical constructs in SCT, and show that FTS programs have great potential to facilitate movement toward desired dietary changes. However, it is unlikely that a set of activities in any one current FTS program addresses multiple constructs of the theory in a systematic manner. More intentional inclusion of diverse activities would likely be beneficial. Future research can test these assertions. © 2013, American School Health Association.
Nearly 200 million young children in developing countries around the world are stunted due to in great extent to malnutrition during infancy. Even though breast feeding is the best nourishment a mother can provide to her baby, after about six months of age, complementary foods, also called as weaning foods, are needed to meet the infant's nutritional recommendations. On the other hand, complementary feeding sometimes reduces breast milk intake and can introduce a potential source of contamination leading to a number of gastrointestinal infections, which can substantially impair growth. Thus, it is very important to accurately measure the amount of breast milk consumed and also to assess the amount and quality of complementary foods introduced to the infant's diet. An isotopic method for measuring breast milk intake based on deuterium dilution and kinetics has been validated using isotope ratio mass spectrometry (IRMS). Recently, a more economical infrared spectroscopy (IS) method has also been used and validated against IRMS. The objectives of this CRP were i) to develop stable isotope methods for measuring breast milk intake using regionally available equipment, ii) use isotopic methods to evaluate nutrient reserves, namely vitamin A, iron and zinc, and energy expenditure in mothers to determine the relative needs for nutritional supplements of mothers in the region, and iii) to use isotopic techniques to compare the nutrient density of milk with nutrient levels in the mother to learn for which nutrients breast milk is a reliable indicator of maternal nutrient reserves in marginally nourished women
Cheng, Feon W; Monnat, Shannon M; Lohse, Barbara
NEEDs for Bones (NFB), based on the Health Belief Model, is a 4-lesson osteoporosis-prevention curriculum for 11- to 14-year-olds. This study examined the relationship between enjoyment of food tastings and interest in NFB. NFB was administered by teachers as part of standard practice and evaluated after the fourth lesson using a 21-item survey. Significant clustering of students within classrooms required use of random-intercept multilevel ordinal regression models in SAS proc GLIMMIX, with students nested within classrooms. Analyses considered tasting experience, eating attitudes, sex, grade, and cohort. Students (N = 1619; 50% girls) participated from 85 fourth to eighth grade classrooms (47% sixth grade and 31% seventh grade) in 16 Pennsylvania SNAP-Ed eligible schools over 2 academic years. For all foods tasted, students who did not enjoy the food tasting were less interested in the lesson than students who did enjoy the food tasting (all p < .001); refried beans (odds ratio [OR] = 0.30), soy milk (OR = 0.55), cranapple juice (OR = 0.51), sunflower kernels (OR = 0.48), and Swiss cheese (OR = 0.49). The relationship persisted net of covariates. Enjoyment of food tasting activities can predict interest in nutrition education on osteoporosis prevention, supporting resource allocation and inclusion of food tasting activities in school-age nutrition education. © 2015, American School Health Association.
Wirth, James P; Matji, Joan; Woodruff, Bradley A; Chamois, Sylvie; Getahun, Zewditu; White, Jessica M; Rohner, Fabian
The prevalence of stunting in Sub-Saharan Africa has changed little since 2000, and the number of stunted children has increased. In contrast, Ethiopia is an example where the national stunting prevalence and number of stunted children have decreased consistently. We compare regional differences and temporal patterns in stunting with large-scale program coverage to identify where and when programs may have led to reductions in stunting. Data from three national demographic and health surveys and population statistics illustrate, at the regional level, where and when the prevalence and number of stunted children changed since 2000. Reports from large-scale nutrition and health programs were used to identify ecologic associations between geographic program coverage and reductions in stunting. From 2000 to 2005, the decline in the national stunting prevalence was mainly a result of reductions in Oromiya, SNNP and Tigray. Few nutrition programs had high coverage during this time, and economic growth may have contributed to stunting reduction by increasing household wealth and investments in sanitation. From 2005 to 2011, declines in stunting prevalence in Amhara, SNNP, Somali and Oromiya were largely responsible for national reductions. Numerous programs were implemented at scale and could have plausibly improved stunting. While ecologic relationships suggest that economic growth and large-scale programs may have contributed to the reduction in stunting in Ethiopia, stunting did not decrease in all regions despite increased program coverage expansion of the health system. Additional impact evaluations are needed identify the most effective programs to accelerate the reduction in the prevalence and number of stunted children. © 2016 John Wiley & Sons Ltd. © 2016 John Wiley & Sons Ltd.
1 AIR COMMAND AND STAFF COLLEGE AIR UNIVERSITY MUSIC AND COMBAT MOTIVATION by Sally C. Maddocks, Major, USAF Master of...Today, each soldier can carry their own preferred library of music including thousands of songs in their pocket. Are broadcasts still relevant...accordance with Air Force Instruction 51-303, it is not copyrighted, but is the property of the United States government. 3 Music has the power
Mena, Noereem Z.; Risica, Patricia; Gorham, Gemma; Gans, Kim M.
Abstract Background: It is important to understand the perceptions and beliefs of family child care providers (FCCPs) regarding which factors influence children's physical activity (PA), screen-time (ST), and dietary behaviors in order to develop and implement appropriate obesity prevention interventions. The aim of this qualitative study was to explore the aforementioned perceptions and beliefs of FCCPs in Rhode Island. Methods: Four focus groups (n = 30) were held with FCCPs. Providers were female, Hispanic, and Spanish speaking. Providers were asked about different aspects of feeding, PA, and ST behaviors. Themes were coded using NVivo10 (QSR International Pty Ltd, Doncaster, Victoria, Australia). Content analysis was used to analyze final themes. Results: Providers understood the importance of providing opportunities for healthy eating and PA for the children they cared for, but there was room for improvement, especially with regard to certain feeding and ST practices. Several barriers were evident, including the lack of physical infrastructure for PA, cultural beliefs and practices related to child feeding, and difficulties working with parents to provide consistent messages across environments. Conclusions: Given that FCCPs are aware of the importance of healthy eating and PA, there is a need to address the specific barriers they face, and operationalize some of their knowledge into practical everyday actions. This formative work will inform the development of a culturally relevant, multicomponent intervention for ethnically diverse FCCPs to improve the food and PA environments of their homes, which should, in turn, improve the dietary, PA, and ST behaviors of the 2- to 5-year-old children they care for. PMID:26332455
Tovar, Alison; Mena, Noereem Z; Risica, Patricia; Gorham, Gemma; Gans, Kim M
It is important to understand the perceptions and beliefs of family child care providers (FCCPs) regarding which factors influence children's physical activity (PA), screen-time (ST), and dietary behaviors in order to develop and implement appropriate obesity prevention interventions. The aim of this qualitative study was to explore the aforementioned perceptions and beliefs of FCCPs in Rhode Island. Four focus groups (n = 30) were held with FCCPs. Providers were female, Hispanic, and Spanish speaking. Providers were asked about different aspects of feeding, PA, and ST behaviors. Themes were coded using NVivo10 (QSR International Pty Ltd, Doncaster, Victoria, Australia). Content analysis was used to analyze final themes. Providers understood the importance of providing opportunities for healthy eating and PA for the children they cared for, but there was room for improvement, especially with regard to certain feeding and ST practices. Several barriers were evident, including the lack of physical infrastructure for PA, cultural beliefs and practices related to child feeding, and difficulties working with parents to provide consistent messages across environments. Given that FCCPs are aware of the importance of healthy eating and PA, there is a need to address the specific barriers they face, and operationalize some of their knowledge into practical everyday actions. This formative work will inform the development of a culturally relevant, multicomponent intervention for ethnically diverse FCCPs to improve the food and PA environments of their homes, which should, in turn, improve the dietary, PA, and ST behaviors of the 2- to 5-year-old children they care for.
Li, M; Xue, H; Wen, M; Wang, W; Wang, Y
Obesity is a serious threat to global health. School is a key setting for obesity intervention. Research on school risk factors for child obesity is limited in developing countries. To examine regional variations in obesity and school environments/policies and their associations among students in China. Analyses were based on the first nationally representative sample of 8573 9 th graders in 110 middle schools from 28 regions across China. Multilevel models tested associations between school factors and child self-reported weight outcomes and by school urbanicity setting (urban, rural). Overweight/obesity rate is higher among boys and in urban areas. Schools in rural areas, or less developed regions, promote longer on-campus life, as is indicated by the presence of school cafeterias, night study sessions and longer class hours. Multilevel models show that (i) school cafeterias (OR = 2.53, 95% CI = 1.35-4.75) and internet bars close to school (OR = 1.63, 95% CI = 1.15-2.30) are associated with increased overweight/obesity risk in rural areas, especially for boys; (ii) school night study sessions are associated with lower overweight/obesity risk (OR = 0.69, 95% CI = 0.50-0.96) in rural areas. China has large regional disparities in school environment/policies related to nutrition and physical activity. Some school factors are associated with students' weight status, which vary across gender and areas. Future school-based interventions should attend to diverse regional contexts. © 2016 World Obesity Federation.
Integrating Nutrition Interventions into an Existing Maternal, Neonatal, and Child Health Program Increased Maternal Dietary Diversity, Micronutrient Intake, and Exclusive Breastfeeding Practices in Bangladesh: Results of a Cluster-Randomized Program Evaluation.
Nguyen, Phuong Hong; Kim, Sunny S; Sanghvi, Tina; Mahmud, Zeba; Tran, Lan Mai; Shabnam, Sadia; Aktar, Bachera; Haque, Raisul; Afsana, Kaosar; Frongillo, Edward A; Ruel, Marie T; Menon, Purnima
Background: Maternal undernutrition is a major concern globally, contributing to poor birth outcomes. Limited evidence exists on delivering multiple interventions for maternal nutrition simultaneously. Alive & Thrive addressed this gap by integrating nutrition-focused interpersonal counseling, community mobilization, distribution of free micronutrient supplements, and weight-gain monitoring through an existing Maternal, Neonatal, and Child Health (MNCH) program in Bangladesh. Objectives: We evaluated the effect of providing nutrition-focused MNCH compared with standard MNCH (antenatal care with standard nutrition counseling) on coverage of nutrition interventions, maternal dietary diversity, micronutrient supplement intake, and early breastfeeding practices. Methods: We used a cluster-randomized design with cross-sectional surveys at baseline (2015) and endline (2016) ( n ∼ 300 and 1000 pregnant or recently delivered women, respectively, per survey round). We derived difference-in-difference effect estimates, adjusted for geographic clustering and infant age and sex. Results: Coverage of interpersonal counseling was high; >90% of women in the nutrition-focused MNCH group were visited at home by health workers for maternal nutrition and breastfeeding counseling. The coverage of community mobilization activities was ∼50%. Improvements were significantly greater in the nutrition-focused MNCH group than in the standard MNCH group for consumption of iron and folic acid [effect: 9.8 percentage points (pp); 46 tablets] and calcium supplements (effect: 12.8 pp; 50 tablets). Significant impacts were observed for the number of food groups consumed (effect: 1.6 food groups), percentage of women who consumed ≥5 food groups/d (effect: 30.0 pp), and daily intakes of several micronutrients. A significant impact was also observed for exclusive breastfeeding (EBF; effect: 31 pp) but not for early initiation of breastfeeding. Conclusions: Addressing nutrition during pregnancy
Uddin, Shahadat; Mahmood, Hana; Senarath, Upul; Zahiruddin, Quazi; Karn, Sumit; Rasheed, Sabrina; Dibley, Michael
Effective public policies are needed to support appropriate infant and young child feeding (IYCF) to ensure adequate child growth and development, especially in low and middle income countries. The aim of this study was to: (i) capture stakeholder networks in relation to funding and technical support for IYCF policy across five countries in South Asia (i.e. Sri Lanka, India, Nepal, Bangladesh and Pakistan); and (ii) understand how stakeholder networks differed between countries, and identify common actors and their patterns in network engagement across the region. The Net-Map method, which is an interview-based mapping technique to visualise and capture connections among different stakeholders that collaborate towards achieving a focused goal, has been used to map funding and technical support networks in all study sites. Our study was conducted at the national level in Bangladesh, India, Nepal, and Sri Lanka, as well as in selected states or provinces in India and Pakistan during 2013-2014. We analysed the network data using a social network analysis software (NodeXL). The number of stakeholders identified as providing technical support was higher than the number of stakeholders providing funding support, across all study sites. India (New Delhi site - national level) site had the highest number of influential stakeholders for both funding (43) and technical support (86) activities. Among all nine study sites, India (New Delhi - national level) and Sri Lanka had the highest number of participating government stakeholders (22) in their respective funding networks. Sri Lanka also had the highest number of participating government stakeholders for technical support (34) among all the study sites. Government stakeholders are more engaged in technical support activities compared with their involvement in funding activities. The United Nations Children's Emergency Fund (UNICEF) and the World Health Organization (WHO) were highly engaged stakeholders for both funding and
Full Text Available Abstract Background Effective public policies are needed to support appropriate infant and young child feeding (IYCF to ensure adequate child growth and development, especially in low and middle income countries. The aim of this study was to: (i capture stakeholder networks in relation to funding and technical support for IYCF policy across five countries in South Asia (i.e. Sri Lanka, India, Nepal, Bangladesh and Pakistan; and (ii understand how stakeholder networks differed between countries, and identify common actors and their patterns in network engagement across the region. Methods The Net-Map method, which is an interview-based mapping technique to visualise and capture connections among different stakeholders that collaborate towards achieving a focused goal, has been used to map funding and technical support networks in all study sites. Our study was conducted at the national level in Bangladesh, India, Nepal, and Sri Lanka, as well as in selected states or provinces in India and Pakistan during 2013–2014. We analysed the network data using a social network analysis software (NodeXL. Results The number of stakeholders identified as providing technical support was higher than the number of stakeholders providing funding support, across all study sites. India (New Delhi site – national level site had the highest number of influential stakeholders for both funding (43 and technical support (86 activities. Among all nine study sites, India (New Delhi – national level and Sri Lanka had the highest number of participating government stakeholders (22 in their respective funding networks. Sri Lanka also had the highest number of participating government stakeholders for technical support (34 among all the study sites. Government stakeholders are more engaged in technical support activities compared with their involvement in funding activities. The United Nations Children’s Emergency Fund (UNICEF and the World Health Organization (WHO
Sinharoy, Sheela S; Schmidt, Wolf-Peter; Cox, Kris; Clemence, Zachary; Mfura, Leodomir; Wendt, Ronald; Boisson, Sophie; Crossett, Erin; Grépin, Karen A; Jack, William; Condo, Jeanine; Habyarimana, James; Clasen, Thomas
To explore associations of environmental and demographic factors with diarrhoea and nutritional status among children in Rusizi district, Rwanda. We obtained cross-sectional data from 8847 households in May-August 2013 from a baseline survey conducted for an evaluation of an integrated health intervention. We collected data on diarrhoea, water quality, and environmental and demographic factors from households with children <5, and anthropometry from children <2. We conducted log-binomial regression using diarrhoea, stunting and wasting as dependent variables. Among children <5, 8.7% reported diarrhoea in the previous 7 days. Among children <2, stunting prevalence was 34.9% and wasting prevalence was 2.1%. Drinking water treatment (any method) was inversely associated with caregiver-reported diarrhoea in the previous 7 days (PR = 0.79, 95% CI: 0.68-0.91). Improved source of drinking water (PR = 0.80, 95% CI: 0.73-0.87), appropriate treatment of drinking water (PR = 0.88, 95% CI: 0.80-0.96), improved sanitation facility (PR = 0.90, 95% CI: 0.82-0.97), and complete structure (having walls, floor and roof) of the sanitation facility (PR = 0.65, 95% CI: 0.50-0.84) were inversely associated with stunting. None of the exposure variables were associated with wasting. A microbiological indicator of water quality was not associated with diarrhoea or stunting. Our findings suggest that in Rusizi district, appropriate treatment of drinking water may be an important factor in diarrhoea in children <5, while improved source and appropriate treatment of drinking water as well as improved type and structure of sanitation facility may be important for linear growth in children <2. We did not detect an association with water quality. © 2016 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.
Ashraful Islam Khan
Full Text Available Background: Nutritional insults and conditions during fetal life and infancy influence subsequent growth and body composition of children. Objectives: Effects of maternal food and micronutrient supplementation and exclusive breastfeeding counseling on growth of offspring aged 0–54 months and their body composition at 54 months of age were studied. Methods: In the MINIMat trial (ISRCTN16581394 in Matlab, Bangladesh, pregnant women were randomized to early (around 9 weeks or usual invitation (around 20 weeks to food supplementation and to one of the three daily micronutrient supplements: 30-mg Fe and 400-µg folic acid (Fe30F, 60-mg Fe and 400-µg folic acid (Fe60F, and multiple micronutrient supplements (MMS. The supplements were also randomized to exclusive breastfeeding (EBF counseling or to usual health messages. Results: No differences in background characteristics were observed among the intervention groups. There was also no differential effect of prenatal interventions on birthweight or birthlength. Early food supplementation reduced the level of stunting from early infancy up to 54 months of age among boys (average difference – 6.5% units, 95% confidence interval [CI] 1.7–11.3, p=0.01 but not among girls (average difference – 2.4% units, 95% CI −2.2–7.0, p=0.31. MMS resulted in more stunting compared to standard Fe60F (average difference – 4.8% units, 95% CI 0.8–8.9, p=0.02. Breastfeeding counseling prolonged the duration of EBF (difference – 35 days, 95% CI 30.6–39.5, p<0.001. Neither pregnancy interventions nor breastfeeding counseling influenced the body composition of children at 54 months of age. Conclusion: Early food supplementation during pregnancy reduced the occurrence of stunting among boys aged 0–54 months, while prenatal MMS increased the proportion of stunting. Food and micronutrient supplementation or EBF intervention did not affect body composition of offspring at 54 months of age. The effects of
Rao, A R
Although child survival programs may help to increase the life span of poor children in developing countries such as India, the quality of life will remain unchanged unless the value of involving children in health education efforts is recognized. The primary health care strategy seeks to involve children and communities in making decisions and taking actions to improve their health. Children can be engaged in the learning process through activities such as helping to care for younger siblings, educating children of their own age who are not attending school, and spreading preventive health messages to their homes and communities. Numerous studies have confirmed that children are easily motivated to play such roles and have the desire to transfer their knowledge to others; however, it is essential that health education messages are appropriate for the level of the child. Specific messages with tested effectiveness in child-to-child programs include accident prevention, dental hygiene, neighborhood hygiene, use of oral rehydration in cases of diarrhea, recognition of signs of major illness, care of sick children, use of play and mental stimulation to enhance children's development, and the making of toys and games to aid growth. Children can further be instructed to identify peers with sight and hearing problems as well as those with nutritional deficiencies. In the Malvani Project in Bombay, children are given responsibility for the health care of 3-4 families in their neighborhood. In the NCERT Project in New Delhi, children are organizing artistic exhibitions and plays to convey health messages to their peers who are not in school. Also in New Delhi, the VHAI Project has enlisted children in campaigns to prevent diarrhea and dehydration, smoking, and drug use.
The paper discusses the role of nutritional information for addressing under-five child malnutrition in Tanzania. The paper is based on a master's dissertation whose objective was to determine the sources of nutritional information used to provide nutritional information to mothers in Maternal and Child Health (MCH) clinics, ...
Kruse, Alexandra Y; Høgh, Birthe
International child health has improved. Better healthcare strategies, like IMCI, have contributed implementing basic interventions: vaccinations, nutrition supplement, oral rehydration and antibiotics. But 11 million children still die every year before they turn five, most from infectious...
Nutrition support is a vitally important issue in the pretransplantation period. Once a child has been assessed and placed on a list for transplantation the child must see a dietitian to optimise the child's nutritional status as this is vital to improve the outcome at surgery. Children with chronic liver disease who are candidates for ...
34At the capstone event, performers will demonstrate a ve - hicle that exhibits the following behaviors: safe vehicle- following; operation with...that "toe to toe nuclear combat rent to possible invasion by hostile enabled a combatant, with relative with the Ruskies" 2 was insane , irra- forces
Full Text Available Aims: to systematically identify global research gaps and resource priorities for integrated community case management (iCCM. Methods: an iCCM Child Health and Nutrition Research Initiative (CHNRI Advisory Group, in collaboration with the Community Case Management Operational Research Group (CCM ORG identified experts to participate in a CHNRI research priority setting exercise. These experts generated and systematically ranked research questions for iCCM. Research questions were ranked using a “Research Priority Score” (RPS and the “Average Expert Agreement” (AEA was calculated for every question. Our groups of experts were comprised of both individuals working in Ministries of Health or Non Governmental Organizations (NGOs in low– and middle–income countries (LMICs and individuals working in high–income countries (HICs in academia or NGO headquarters. A Spearman's Rho was calculated to determine the correlation between the two groups' research questions' ranks. Results: The overall RPS ranged from 64.58 to 89.31, with a median score of 81.43. AEA scores ranged from 0.54 to 0.86. Research questions involving increasing the uptake of iCCM services, research questions concerning the motivation, retention, training and supervision of Community Health Workers (CHWs and concerning adding additional responsibilities including counselling for infant and young child feeding (IYCF and treatment of severe acute malnutrition (SAM ranked highly. There was weak to moderate, statistically significant, correlation between scores by representatives of high–income countries and those working in–country or regionally (Spearman's ρ = 0.35034, P < 0.01. Conclusions: Operational research to determine optimal training, supervision and modes of motivation and retention for the CHW is vital for improving iCCM, globally, as is research to motivate caregivers to take advantage of iCCM services. Experts working in–country or regionally in
Full Text Available Abstract Background Evidence suggests that differences exist in physical activity (PA participation among Culturally and Linguistically Diverse (CALD children and adolescents. It is possible that these differences could be influenced by variations in measurement technique and instrument reliability. However, culturally sensitive instruments for examining PA behaviour among CALD populations are lacking. This study tested the reliability of the Child and Adolescent Physical Activity and Nutrition Survey (CAPANS-PA recall questionnaire among a sample of Chinese-Australian youth. Methods The psychometric property of the CAPANS-PA questionnaire was examined among a sample of 77 Chinese-Australian youth (aged 11 - 14 y who completed the questionnaire twice within 7 days. Test-retest reliability of individual items and scales within the CAPANS-PA questionnaire was determined using Kappa statistics for categorical variables and intraclass correlation coefficients (ICC for continuous variables. Results The CAPANS-PA questionnaire demonstrated acceptable test-retest reliability for frequency and duration of time spent in weekly Moderate to Vigorous Physical Activity (MVPA (ICC ≥ 0.70 for all participants. Test-retest reliability for time spent in weekly sedentary activities was acceptable for females (ICC = 0.82 and males (ICC = 0.72. Conclusions The results suggest the CAPANS-PA questionnaire provides reliable estimates for type, frequency and duration of MVPA participation among Chinese-Australian youth. Further investigation into the reliability of the sedentary items within the CAPANS-PA is required before these items can be used with confidence. This study is novel in that the reliability of instruments among CALD groups nationally and internationally remains sparse and this study contributes to the wider body of available psychometrically tested instruments. In addition, this study is the first to our knowledge to successfully engage and
Hall, Elisha; Chai, Weiwen; Albrecht, Julie A.
Background: Nutrition education delivered by classroom teachers has become a popular intervention designed to combat childhood obesity. However, few qualitative studies have explored nutrition education with teachers Purpose: The purpose of this study was to explore how elementary teachers describe their experience with nutrition education.…
Bevins, Rick A; Wilkinson, Jamie L; Sanderson, Sam D
Current US FDA-approved biological therapies for treating smoking target central nervous system processes. Although these therapies have had some success, relapse within a year is still high. Clearly additional strategies are needed to aid individuals in maintaining abstinence. We briefly discuss promising research using vaccines to combat smoking and then identify some potentially important directions for future research. Immunization with a nicotine vaccine generates drug-specific antibodies that sequester some of the nicotine in the peripheral circulation preventing it from entering the brain, thus decreasing its addictive effects. Albeit promising, much more research is necessary to identify more efficacious vaccine designs and formulations, as well as optimal immunization regimens. A further understanding of the factors contributing to the substantial individual differences in immunogenicity to these vaccines and how to best use vaccines in combination with other treatment strategies will increase the success of intervention efforts.
A segurança alimentar e nutricional e o uso da abordagem de direitos humanos no desenho das políticas públicas para combater a fome e a pobreza Food and nutritional security and the use of a human rights-based approach on the development of public policies to fight hunger and poverty
Maria de Fátima Machado de Albuquerque
Full Text Available Este ensaio tem como objetivo enfatizar a importância da utilização da abordagem de direitos humanos no desenho das políticas públicas para combater a fome e a pobreza no Brasil. Inicialmente foi apresentado um marco teórico sobre o conceito de segurança alimentar e nutricional e o direito humano à alimentação adequada. Também foram identificadas as obrigações do Estado para a realização do direito humano à alimentação adequada, bem como o que se identifica como potenciais violações deste direito. Depois se buscou discutir o significado de uma abordagem baseada nos direitos e como esta abordagem pode contribuir para a promoção do direito à alimentação adequada. Foi realizada uma breve reflexão sobre a questão da (insegurança alimentar, suas diversas formas de avaliação e sobre a importância de investigar mais detalhadamente as repercussões desta questão sobre o indivíduo e a família, inclusive daquelas que participam de programas sociais.This essay aims to discuss the meaning of a human rights-based approach in the context of the public policies used in the fight against hunger and poverty in Brazil. Some aspects were presented such as the accepted concepts of food and nutritional security and the human right to appropriate nutrition. The obligations of the State to fulfill the human right to appropriate nutrition were also identified as well as that which is seen as potential violations of this right. Then, the meaning of a rights-based approach and how this approach can contribute to promote the right to appropriate nutrition were discussed. A concise reflection was done on the food (insecurity issue, its many ways of assessment and the importance of investigating in a more detailed manner the repercussions of this issue on individuals and families, including those who are benefited by social programs.
Early Childhood Screen Time and Parental Attitudes Toward Child Television Viewing in a Low-Income Latino Population Attending the Special Supplemental Nutrition Program for Women, Infants, and Children.
Asplund, Karin M; Kair, Laura R; Arain, Yassar H; Cervantes, Marlene; Oreskovic, Nicolas M; Zuckerman, Katharine E
Early childhood media exposure is associated with obesity and multiple adverse health conditions. The aims of this study were to assess parental attitudes toward childhood television (TV) viewing in a low-income population and examine the extent to which child BMI, child/parent demographics, and household media environment are associated with adherence to American Academy of Pediatrics (AAP) guidelines for screen time. This was a cross-sectional survey study of 314 parents of children ages 0-5 years surveyed in English or Spanish by self-administered questionnaire at a Special Supplemental Nutrition Program for Women, Infants and Children (WIC) clinic in Oregon. In this majority Latino sample (73%), half (53%) of the children met AAP guidelines on screen time limits, 56% met AAP guidelines for no TV in the child's bedroom, and 29% met both. Children were more likely to meet AAP guidelines when there were child screen time. Programs aimed at reducing child screen time may benefit from interventions that address parental viewing habits.
presence of local or systemic infection, nutritional status, and nonspecific serum markers of inflammation such as white blood cell count (WBC), erythro...6. Wang CJ, Huang HY, Pai CH: Shock wave-enhanced neovascularization at the tendon -bone junction: an experiment in dogs. J Foot Ankle Surg 2002
Setting research priorities for maternal, newborn, child health and nutrition in India by engaging experts from 256 indigenous institutions contributing over 4000 research ideas: a CHNRI exercise by ICMR and INCLEN.
Arora, Narendra K; Mohapatra, Archisman; Gopalan, Hema S; Wazny, Kerri; Thavaraj, Vasantha; Rasaily, Reeta; Das, Manoj K; Maheshwari, Meenu; Bahl, Rajiv; Qazi, Shamim A; Black, Robert E; Rudan, Igor
Health research in low- and middle- income countries (LMICs) is often driven by donor priorities rather than by the needs of the countries where the research takes place. This lack of alignment of donor's priorities with local research need may be one of the reasons why countries fail to achieve set goals for population health and nutrition. India has a high burden of morbidity and mortality in women, children and infants. In order to look forward toward the Sustainable Development Goals, the Indian Council of Medical Research (ICMR) and the INCLEN Trust International (INCLEN) employed the Child Health and Nutrition Research Initiative's (CHNRI) research priority setting method for maternal, neonatal, child health and nutrition with the timeline of 2016-2025. The exercise was the largest to-date use of the CHNRI methodology, both in terms of participants and ideas generated and also expanded on the methodology. CHNRI is a crowdsourcing-based exercise that involves using the collective intelligence of a group of stakeholders, usually researchers, to generate and score research options against a set of criteria. This paper reports on a large umbrella CHNRI that was divided into four theme-specific CHNRIs (maternal, newborn, child health and nutrition). A National Steering Group oversaw the exercise and four theme-specific Research Sub-Committees technically supported finalizing the scoring criteria and refinement of research ideas for the respective thematic areas. The exercise engaged participants from 256 institutions across India - 4003 research ideas were generated from 498 experts which were consolidated into 373 research options (maternal health: 122; newborn health: 56; child health: 101; nutrition: 94); 893 experts scored these against five criteria (answerability, relevance, equity, innovation and out-of-box thinking, investment on research). Relative weights to the criteria were assigned by 79 members from the Larger Reference Group. Given India's diversity
M.Com. (Economics) Combating poverty is at the frontier of analyses in South Africa today. The study to combat poverty in South Africa is six-fold. After setting the nature of the study to be pursued in Chapter 1, the dissertation analyses the theories of poverty in Chapter 2. The record of poverty in South Africa is analysed in Chapter 3. Chapter 4 focuses on the methods to combat poverty in South Africa. Chapter 5 is a summary of the main findings of the study. A proposed structure plan ...
Kruse, Alexandra Y; Høgh, Birthe
diseases and neonatal complications, over half associated with malnutrition. Conditions we could prevent and treat. One of UN's Millennium Development Goals is to reduce child mortality. However child health is more than mortality and morbidity indicators, it includes growth and development. Udgivelsesdato......International child health has improved. Better healthcare strategies, like IMCI, have contributed implementing basic interventions: vaccinations, nutrition supplement, oral rehydration and antibiotics. But 11 million children still die every year before they turn five, most from infectious...
Rasmussen, Christopher J.
Athletes engaged in heavy endurance training often seek additional nutritional strategies to help maximize performance. Specific nutritional supplements exist to combat certain factors that limit performance beginning with a sound everyday diet. Research has further demonstrated that safe, effective, legal supplements are in fact available for today's endurance athletes. Several of these supplements are marketed not only to aid performance but also to combat the immunosuppressive effects of intense endurance training. It is imperative for each athlete to research the legality of certain supplements for their specific sport or event. Once the legality has been established, it is often up to each individual athlete to decipher the ethics involved with ingesting nutritional supplements with the sole intent of improving performance.
Octavio de Magalhães
Full Text Available O outor estuda os processos de combate aos acidentes pelas picadas dos escorpiões, visando: a Profilaxia e b Terapêutica. Refere-se à luta nos campos e nas cidades e aqui, dentro e fora dos domicílios. Assinala os diferentes métodos para o combate a êsses artrópodos peçonhentos. Fala na luta direta, indireta, na vacinação pelo anaveneno, na propaganda pela educação racional da população contra o perigo dos acidentes. Refere-se à "cata" dos escorpiões, à luta química, ao emprêgo de animais escorpiófagos, á feitura de casas e jardins anti-escorpiões. Na primeira parte do presente trabalho o autor trata da luta química pelo d. D. T. contra os tityus bahiensis e serrulatus, concluindo que êste corpo químico é um poderoso elemento de luta contra êstes escorpiões. Na segunda parte do trabalho, o autor trata da terapêutica dos acidentes. Mostra a necessidade do emprêgo convenientemente da única terapêutica racional e eficaz contra a intoxicação escorpiônica: a soroterapia específica. Assinala a necessidade da injeção de doses maciças de um sôro de alta valência, preparado em bovídeos, para evitar o mais possível o choque anafilático, no menor tempo possível após as picadas. Aconselha o empêgo de anaveneno escorpiônico, para vacinação principalmente de crianças de baixa idade, nos lugares fortemente infestados pelos escorpiões (principalmente Tityus serrulatus, maximé quando no local não houver sôro anti-escorpiônico específico, como meio preventivo contra a gravidade das intoxicações. Cita finalmente os trabalhos recentes de Grasset, Shaasfsma e Hodgson, na África do Sul, que confirmam muitas idéias do autor e mostram a unidade universal do síndromo escorpiônico descrito no Brasil.
Brusher, Edward A
Combat and Operational Stress (COS) includes all the physiological and emotional stresses encountered as a direct result of the dangers and mission demands of combat. Combat and Operational Stress Control (COSC) in the US. Army may be defined as programs developed and actions taken by military leadership to prevent, identify, and manage adverse Combat and Operational Stress Reactions (COSR) in units. This program optimizes mission performance, conserves the fighting strength, and prevents or minimizes adverse effects of COSR on Soldiers and their physical, psychological, intellectual, and social health. Its goal is to return Soldiers to duty expeditiously. COSC activities include routine screening of individuals when recruited; continued surveillance throughout military service, especially before, during, and after deployment; and continual assessment and consultation with medical and other personnel from garrison to the battlefield.
Convertino, Victor A; Cooke, William H; Salinas, Jose; Holcomb, John B
The US Army Institute of Surgical Research (USAISR) has the lead for directing the Research Program Area for Advanced Triage Capabilities for Combat Medics in the Medical Research and Materiel Command (MRMC...
Full Text Available Biocorrosion has been considered as big trouble in many industries and marine environments due to causing of great economic loss. The main disadvantages of present approaches to prevent corrosion include being limited by environmental factors, being expensive, inapplicable to field, and sometimes inefficient. Studies show that polymer coatings with anticorrosion and antimicrobial properties have been widely accepted as a novel and effective approach to prevent biocorrosion. The main purpose of this review is to summarize up the progressive status of polymer coatings used for combating microbial corrosion. Polymers used to synthesize protective coatings are generally divided into three categories: (i traditional polymers incorporated with biocides, (ii antibacterial polymers containing quaternary ammonium compounds, and (iii conductive polymers. The strategies to synthesize polymer coatings resort mainly to grafting antibacterial polymers from the metal substrate surface using novel surface-functionalization approaches, such as free radical polymerization, chemically oxidative polymerization, and surface-initiated atom transfer radical polymerization, as opposed to the traditional approaches of dip coating or spin coating.
Effect of integrated responsive stimulation and nutrition interventions in the Lady Health Worker programme in Pakistan on child development, growth, and health outcomes: a cluster-randomised factorial effectiveness trial.
Yousafzai, Aisha K; Rasheed, Muneera A; Rizvi, Arjumand; Armstrong, Robert; Bhutta, Zulfiqar A
Stimulation and nutrition delivered through health programmes at a large scale could potentially benefit more than 200 million young children worldwide who are not meeting their developmental potential. We investigated the feasibility and effectiveness of the integration of interventions to enhance child development and growth outcomes in the Lady Health Worker (LHW) programme in Sindh, Pakistan. We implemented a community-based cluster-randomised effectiveness trial through the LHW programme in rural Sindh, Pakistan, with a 2 × 2 factorial design. We randomly allocated 80 clusters (LHW catchments) of children to receive routine health and nutrition services (controls; n=368), nutrition education and multiple micronutrient powders (enhanced nutrition; n=364), responsive stimulation (responsive stimulation; n=383), or a combination of both enriched interventions (n=374). The allocation ratio was 1:20 (ie, 20 clusters per intervention group). The data collection team were masked to the allocated intervention. All children born in the study area between April, 2009, and March, 2010, were eligible for enrolment if they were up to 2·5 months old without signs of severe impairments. Interventions were delivered by LHWs to families with children up to 24 months of age in routine monthly group sessions and home visits. The primary endpoints were child development at 12 and 24 months of age (assessed with the Bayley Scales of Infant and Toddler Development, Third Edition) and growth at 24 months of age. Analysis was by intention to treat. This trial is registered with ClinicalTrials.gov, number NCT007159636. 1489 mother-infant dyads were enrolled into the study, of whom 1411 (93%) were followed up until the children were 24 months old. Children who received responsive stimulation had significantly higher development scores on the cognitive, language, and motor scales at 12 and 24 months of age, and on the social-emotional scale at 12 months of age, than did those who
Corkins, Mark R; Daniels, Stephen R; de Ferranti, Sarah D; Golden, Neville H; Kim, Jae H; Magge, Sheela N; Schwarzenberg, Sarah Jane
Nutrition is a critical factor for appropriate child and adolescent development. Appropriate nutrition changes according to age. Nutrition is an important element for prevention of disease development, especially for chronic diseases. Many children and adolescents live in environments that do not promote optimum nutrition. Families must work to provide improved food environments to encourage optimum nutrition. Early primordial prevention of risk factors for chronic disease, such as cardiovascular disease, is important, and dietary habits established early may be carried through adult life. Copyright © 2016 Elsevier Inc. All rights reserved.
Melda Kamil Ariadno
Full Text Available Piracy at sea has been a threat to international navigation ever since the sea traverse by ships from west to east and north to south. Threat to international trade has resulted to various efforts in combating piracy regionally as well as internationally. International law has differentiated between piracy and sea-armed robbery, while the first requires regional or international cooperation due to universal jurisdiction, the second will directly fall under the jurisdiction of coastal state. Strait of Malacca has been used by international navigation and very fragile to the threat of piracy or even appropriately called as sea armed robbery since most of the time happened in the part of Indonesian territorial sea. Various efforts to combat piracy have been carried out by Indonesia including to cooperate with Malaysia and Singapore. This article discuss about piracy at sea, its legal definition and effort to combat piracy.
Floyd, Latosha; Phillips, Deborah A.
The U.S. military has come to realize that providing reliable, high-quality child care for service members' children is a key component of combat readiness. As a result, the Department of Defense (DoD) has invested heavily in child care. The DoD now runs what is by far the nation's largest employer-sponsored child-care system, a sprawling network…
Low income and lack of knowledge about child nutrition have been identified as key constraints to the use of Animal Source Foods (ASF) in the diets of young Ghanaian children. To improve ASF consumption among children in Ghana, the Enhancing Child Nutrition through Animal Source Food Management (ENAM) project ...
Rico, Emily; Fenn, Bridget; Abramsky, Tanya; Watts, Charlotte
If effective interventions are to be used to address child mortality and malnutrition, then it is important that we understand the different pathways operating within the framework of child health. More attention needs to be given to understanding the contribution of social influences such as intimate partner violence (IPV). To investigate the relationship between maternal exposure to IPV and child mortality and malnutrition using data from five developing countries. Population data from Egypt, Honduras, Kenya, Malawi and Rwanda were analysed. Logistic regression analysis was used to generate odds ratios of the associations between several categories of maternal exposure to IPV since the age of 15 and three child outcomes: under-2-year-old (U2) mortality and moderate and severe stunting (Honduras) to 46.2% (Kenya). For child stunting, prevalence ranged from 25.4% (Egypt) to 58.0% (Malawi) and for U2 mortality from 3.6% (Honduras) to 15.2% (Rwanda). In Kenya, maternal exposure to IPV was associated with higher U2 mortality (adjusted odds ratio (OR)=1.42, 95% CI 1.18 to 1.71) and child stunting (adjusted OR=1.36, 95% CI 1.16 to 1.61). In Malawi and Honduras, marginal associations were observed between IPV and severe stunting and U2 mortality, respectively, with strength of associations varying by type of violence. The relationship between IPV and U2 mortality and stunting in Kenya, Honduras and Malawi suggests that, in these countries, IPV plays a role in child malnutrition and mortality. This contributes to a growing body of evidence that broader public health benefits may be incurred if efforts to address IPV are incorporated into a wider range of maternal and child health programmes; however, the authors highlight the need for more research that can establish temporality, use data collected on the basis of the study's objectives, and further explore the causal framework of this relationship using more advanced statistical analysis.
Child anthropometry data quality from Demographic and Health Surveys, Multiple Indicator Cluster Surveys, and National Nutrition Surveys in the West Central Africa region: are we comparing apples and oranges?
Corsi, Daniel J; Perkins, Jessica M; Subramanian, S V
There has been limited work comparing survey characteristics and assessing the quality of child anthropometric data from population-based surveys. To investigate survey characteristics and indicators of quality of anthropometric data in children aged 0-59 months from 23 countries in the West Central Africa region. Using established methodologies and criteria to examine child age, sex, height, and weight, we conducted a comprehensive assessment and scoring of the quality of anthropometric data collected in 100 national surveys. The Multiple Indicator Cluster Surveys (MICS) and Demographic and Health Surveys (DHS) collected data from a greater number of younger children than older children while the opposite was found for the National Nutrition Surveys (NNS). Missing or implausible height/weight data proportions were 12% and 8% in MICS and DHS compared to 3% in NNS. Average data quality scores were 14 in NNS, 33 in DHS, and 41 in MICS. Although our metric of data quality suggests that data from the NNS appear more consistent and robust, it is equally important to consider its disadvantages related to access and lack of broader socioeconomic information. In comparison, the DHS and MICS are publicly-accessable for research and provide socioeconomic context essential for assessing and addressing the burden of undernutrition within and between countries. The strengths and weaknesses of data from these three sources should be carefully considered when seeking to determine the burden of child undernutrition and its variation within countries.
Castro, Carl A; Hoge, Charles W; Milliken, Charles W; McGurk, Dennis; Adler, Amy B; Cox, Anthony; Bliese, Paul D
.... Destruction, injury, and death were ever present in the combat zone. Transitioning from combat to home can be difficult, and many Soldiers encounter readjustment problems ranging from elevated post-traumatic stress disorder (PTSD...
Ickes, Scott B; Wu, Michael; Mandel, Maia P; Roberts, Alison C
Maternal capabilities-qualities of mothers that enable them to leverage skills and resources into child health-hold potential influence over mother's adoption of child caring practices, including infant and young child feeding. We developed a survey (n = 195) that assessed the associations of 4 dimensions of maternal capabilities (social support, psychological health, decision making, and empowerment) with mothers' infant and young child feeding practices and children's nutritional status in Uganda. Maternal responses were converted to categorical subscales and an overall index. Scale reliability coefficients were moderate to strong (α range = 0.49 to 0.80). Mothers with higher social support scores were more likely to feed children according to the minimum meal frequency (odds ratio [OR] [95% confidence interval (CI)] = 1.38 [1.10, 1.73]), dietary diversity (OR [95% CI] = 1.56 [1.15, 2.11]), iron rich foods, (OR [95% CI] = 1.47 [1.14, 1.89]), and minimally acceptable diet (OR [95% CI] = 1.55 [1.10, 2.21]) indicators. Empowerment was associated with a greater likelihood of feeding a minimally diverse and acceptable diet. The maternal capabilities index was significantly associated with feeding the minimum number of times per day (OR [95% CI] = 1.29 [1.03, 1.63]), dietary diversity (OR [95% CI] = 1.44 [1.06, 1.94]), and minimally acceptable diet (OR [95% CI] = 1.43 [1.01, 2.01]). Mothers with higher psychological satisfaction were more likely to have a stunted child (OR [95% CI] = 1.31 [1.06, 1.63]). No other associations between the capabilities scales and child growth were significant. Strengthening social support for mothers and expanding overall maternal capabilities hold potential for addressing important underlying determinants of child feeding in the Ugandan context. © 2017 John Wiley & Sons Ltd.
Fenn, Bridget; Colbourn, Tim; Dolan, Carmel; Pietzsch, Silke; Sangrasi, Murtaza; Shoham, Jeremy
Cash-based interventions (CBIs), offer an interesting opportunity to prevent increases in wasting in humanitarian aid settings. However, questions remain as to the impact of CBIs on nutritional status and, therefore, how to incorporate them into emergency programmes to maximise their success in terms of improved nutritional outcomes. This study evaluated the effects of three different CBI modalities on nutritional outcomes in children under 5 y of age at 6 mo and at 1 y. We conducted a four-arm parallel longitudinal cluster randomised controlled trial in 114 villages in Dadu District, Pakistan. The study included poor and very poor households (n = 2,496) with one or more children aged 6-48 mo (n = 3,584) at baseline. All four arms had equal access to an Action Against Hunger-supported programme. The three intervention arms were as follows: standard cash (SC), a cash transfer of 1,500 Pakistani rupees (PKR) (approximately US$14; 1 PKR = US$0.009543); double cash (DC), a cash transfer of 3,000 PKR; or a fresh food voucher (FFV) of 1,500 PKR; the cash or voucher amount was given every month over six consecutive months. The control group (CG) received no specific cash-related interventions. The median total household income for the study sample was 8,075 PKR (approximately US$77) at baseline. We hypothesized that, compared to the CG in each case, FFVs would be more effective than SC, and that DC would be more effective than SC-both at 6 mo and at 1 y-for reducing the risk of child wasting. Primary outcomes of interest were prevalence of being wasted (weight-for-height z-score [WHZ] nutrition resilience. Purchasing restrictions applied to food-based voucher transfers could have unintended effects, and their use needs to be carefully planned to avoid this. ISRCTN registry ISRCTN10761532.
Vest, Bonnie M; Hoopsick, Rachel A; Homish, D Lynn; Daws, Rachel C; Homish, Gregory G
The goal of this work was to examine associations among childhood trauma, combat trauma and substance use (alcohol problems, frequent heavy drinking (FHD), current cigarette smoking, and current/lifetime drug use) and the interaction effects of childhood trauma and combat exposure on those associations among National Guard/Reserve soldiers. Participants (n = 248) completed an electronic survey asking questions about their military experiences, physical and mental health, and substance use. Childhood trauma and combat exposure were examined jointly in regression models, controlling for age, marital satisfaction, and number of deployments. Childhood trauma was associated with current drug use (trend level, OR = 1.44, 95% CI: 0.97, 2.14; p = .072) in the main effect model; however, there was not a significant interaction with combat. Combat exposure had a significant interaction with childhood trauma on alcohol problems (b = -0.56, 95% CI: -1.12, -0.01; p = .048), FHD (b = -0.27, 95% CI: -0.47, -0.08; p = .007), and lifetime drug use (OR = 1.78, 95% CI: 1.04, 3.04; p = .035). There were no associations with either of the trauma measures and current cigarette smoking. Our results demonstrate that childhood and combat trauma have differential effects on alcohol use, such that combat trauma may not add to the effect on alcohol use in those with greater child maltreatment, but may contribute to greater alcohol use among those with low child maltreatment. As expected, childhood and combat trauma had synergistic effects on lifetime drug use. Screening for multiple types of trauma prior to enlistment and/or deployment may help to identify at-risk individuals and allow time for early intervention to prevent future adverse outcomes.
Oudenhuijzen, A.J.K.; Haar, F.B. ter
Today’s combat helmet is becoming more than only a means to protect the warriors head. It is increasingly also used as a platform for sensors and has to integrate with other protection devices. As such, the combat helmet is becoming an integrated system with higher demands on combat helmet fit and
Anjos, Luiz Antonio Dos; Silveira, Willian Dimas Bezerra da
The objective of this study was to identify and describe the growth and nutritional anthropometric profile of children enrolled in the Sesc National Network of Elementary Education. It is a cross-sectional study conducted among 20,113 students (9,992 girls) from 83 schools aged from 3 to 17. Nutritional status was determined using the body mass index for age and stature for age according to the WHO criteria. Stunting was observed in only 1.6% (girls) and 1.3% (boys). Overweight + obesity was observed in 29.7% of the schoolchildren (27.6% of girls and 32.3% of boys). In the children and in boys. These findings corroborate the reported situation in national and international studies and reinforce the need for monitoring and intervening in the nutritional status of schoolchildren.
Niura Aparecida de Moura Ribeiro Padula
Full Text Available Inquérito epidemiológico realizado pela Secretaria de Estado da Saúde de São Paulo e Secretaria Municipal de Saúde de Bauru visou à realização de exames de plumbemia em 853 crianças de 0 a 12 anos, em Bauru, São Paulo, Brasil (2002, a partir de indícios de chumbo oriundo de resíduos industriais nas proximidades de uma fábrica de baterias. Os níveis sangüíneos de chumbo no grupo controle foram inferiores aos apresentados pelo grupo exposto (p An epidemiological survey was carried out by technicians of the State Health Secretary and the Municipal Health Secretary of Bauru, São Paulo, Brazil, due to excessive atmospheric lead emissions caused by a battery manufacturer. This survey included 853 children from 0 to 12 years old, in a 1,000-meter area from the polluting source, in Bauru (2002. The blood lead levels of children in the exposed group were higher than those in the control group (p < 0.05. 314 children were found to have dosages equal or superior to 10µg/dl, the limit stipulated by Centers for Disease Control and Prevention. Public services, universities, and volunteers developed some activities aiming at child diagnosis and treatment. The Municipal Health Secretary coordinated remediation initiatives such as: scraping the superficial surface of streets, internal aspiration of houses with professional equipment, and washing and sealing tanks. Through this work, the Lead Poisoning Study and Research Group (GEPICCB shares an integrated, interdisciplinary, and interinstitutional action proposal.
The nutritional disturbances are frequent by adolescents. That is a psychological defense against dependance toward the mother but also a middle to remain in a childish position i.e. either as a fat baby - in the fall of obesity- or as the ideal pre- or bisexual great child - in the case of anorexia.
Andrew A Farke
Full Text Available The horns and frill of Triceratops and other ceratopsids (horned dinosaurs are interpreted variously as display structures or as weapons against conspecifics and predators. Lesions (in the form of periosteal reactive bone, healing fractures, and alleged punctures on Triceratops skulls have been used as anecdotal support of intraspecific combat similar to that in modern horned and antlered animals. If ceratopsids with different cranial morphologies used their horns in such combat, this should be reflected in the rates of lesion occurrence across the skull.We used a G-test of independence to compare incidence rates of lesions in Triceratops (which possesses two large brow horns and a smaller nasal horn and the related ceratopsid Centrosaurus (with a large nasal horn and small brow horns, for the nasal, jugal, squamosal, and parietal bones of the skull. The two taxa differ significantly in the occurrence of lesions on the squamosal bone of the frill (P = 0.002, but not in other cranial bones (P > 0.20.This pattern is consistent with Triceratops using its horns in combat and the frill being adapted as a protective structure for this taxon. Lower pathology rates in Centrosaurus may indicate visual rather than physical use of cranial ornamentation in this genus, or a form of combat focused on the body rather than the head.
Ghasson Shabha, Facilities Management MSc course leader at the School of Property, Construction and Planning at Birmingham City University, examines the effectiveness of current design and management intervention systems in combating MRSA and other hospital-acquired infections in British hospitals.
Addresses the nature and ramifications of various training stress syndromes (overtraining, under-recovery, distress, staleness, and burnout) that can accompany inappropriate training practices, examining the interventions that players and coaches can use to combat these syndromes (including physical, psychological, and performance interventions),…
Aleksandr F. Mitrofanov
Full Text Available The article presents an overview of small combat boats. The author provides a description and gives an analysis of the characteristics of the boat "Raptor", boat "BK-16", boat "Strizh-4-1 DSh", and assault boat "BK-10".
Mackey, Tim K; Kohler, Jillian; Lewis, Maureen; Vian, Taryn
Corruption is a critical challenge to global health efforts, and combating it requires international action, advocacy, and research. Copyright © 2017 The Authors, some rights reserved; exclusive licensee American Association for the Advancement of Science. No claim to original U.S. Government Works.
(6) Several forms of mental torture of the child. (7) The use of the child in war and combat. (8) Early and child marriage. (9) Abortion and child abandonment. (10) Battering, physical abuse, violent acts, kicking and slapping. (11) Forced Labour, economic exploitation and street hawking. (12) Rejection, denial and deprivation.
Nonas, Cathy; Silver, Lynn D; Kettel Khan, Laura
In 2006, the New York City Department of Health and Mental Hygiene, seeking to address the epidemic of childhood obesity, issued new regulations on beverages, physical activity, and screen time in group child care centers. An evaluation was conducted to identify characteristics of New York City child care centers that have implemented these regulations and to examine how varying degrees of implementation affected children's behaviors. This article discusses results of this evaluation and how findings can be useful for other public health agencies. Knowing the characteristics of centers that are more likely to comply can help other jurisdictions identify centers that may need additional support and training. Results indicated that compliance may improve when rules established by governing agencies, national standards, and local regulatory bodies are complementary or additive. Therefore, the establishment of clear standards for obesity prevention for child care providers can be a significant public health achievement.
Silver, Lynn D.; Kettel Khan, Laura
In 2006, the New York City Department of Health and Mental Hygiene, seeking to address the epidemic of childhood obesity, issued new regulations on beverages, physical activity, and screen time in group child care centers. An evaluation was conducted to identify characteristics of New York City child care centers that have implemented these regulations and to examine how varying degrees of implementation affected children’s behaviors. This article discusses results of this evaluation and how findings can be useful for other public health agencies. Knowing the characteristics of centers that are more likely to comply can help other jurisdictions identify centers that may need additional support and training. Results indicated that compliance may improve when rules established by governing agencies, national standards, and local regulatory bodies are complementary or additive. Therefore, the establishment of clear standards for obesity prevention for child care providers can be a significant public health achievement. PMID:25321629
Congress of the U.S., Washington, DC. House Committee on Education and Labor.
This report outlines amendments to the National School Lunch Act (NSLA) to improve the nutritional well-being of children under the age of 6 living in homeless shelters, and for other purposes. These amendments: (1) modify the homeless children feeding project authorized by the NSLA so that greater program flexibility is provided and more grantees…
McCaughtry, Nate; Fahlman, Mariane; Martin, Jeffrey J.; Shen, Bo
Background: Health professionals are looking to nutrition-based youth health interventions in K-12 schools to combat the growing obesity crisis; however, none have explored the influences of interventions guided by constructivist learning theory. Purpose: This study examined the influences of a constructivist-oriented nutrition education program…
Reid, R S
The UNICEF message to the pediatricians and child health experts attending the Regional Pediatric Congress of the Union of National Pediatric Societies of Turkish Republics is that the way children are conceptualized in the development process has a major impact on poverty. UNICEF argues that human resource development is the safest way out of population pressure, vanishing forests, and despoiled rivers. Thailand, South Korea, Taiwan, and Singapore are examples of countries that "sacrificed, deferred consumer gratification of the elites, and disciplined themselves" in order to provide better care for their children in terms of good nutrition, good health care, and rigorous primary and secondary education for all children. Family planning was available to all parents. The emphasis was on hygiene, immunization, clean water supplies, and sanitation. Lower infant and child mortality created confidence in child survival and parental willingness to have fewer children. The working population is healthier due to the state nutrition programs and a better skilled labor force due to education and training. These countries are no longer underdeveloped because of the priority on children for over a generation and a half. Robert Heilbroner has described this strategy for development as based on social development, human development, and protection of children aged under 5 years. The Alma Ata conference in 1976 was instrumental in focusing on the health of the child by setting a standard of health for all by the year 2000. Many countries are moving in the direction proposed in these agendas. The result has been a 33% reduction in child mortality within 10 years and greater immunization in some developing countries than in Europe and North America. Immunization rates in Ankara, Turkey; Calcutta, India; Lagos, Nigeria; and Mexico City are higher than in Washington, D.C. or New York City. The 1990 World Summit for Children found that the following rules are applicable to
Ryan, Julie JCH
Malicious email is, simply put, email with a malicious purpose. The malicious purpose could be fraud, theft, espionage, or malware injection. The processes by which email execute the malicious activity vary widely, from fully manual (e.g. human-directed) to fully automated. One example of a malicious email is one that contains an attachment which the recipient is directed to open. When the attachment is opened, malicious software is installed on the recipient's computer. Because malicious email can vary so broadly in form and function, automated detection is only marginally helpful. The education of all users to detect potential malicious email is important to containing the threat and limiting the damage. It is increasingly necessary for all email users to understand how to recognize and combat malicious email. Detecting and Combating Malicious Email describes the different types of malicious email, shows how to differentiate malicious email from benign email, and suggest protective strategies for both perso...
Tamara Díaz Lorenzo
Full Text Available La diarrea funcional se presenta con frecuencia en la práctica pediátrica y generalmente no se asocia a alteraciones nutricionales, pero sí a esquemas dietéticos incorrectos. Con el objetivo de determinar la evaluación nutricional de los niños con este tipo de afección, y la influencia de la dieta en la aparición de la enfermedad, se realizó un estudio descriptivo transversal con 44 niños menores de 36 meses de edad, que fueron atendidos entre el 2003 y el 2005 en la consulta de gastroenterología del Hospital Pediátrico Universitario Pedro Borrás Astorga. Según los Criterios de Roma II, el diagnóstico correspondiente fue el de diarrea funcional. No hubo afectación nutricional relevante. La evaluación dietética demostró una alimentación no saludable, debida fundamentalmente al consumo poco variado, no equilibrado ni adecuado de los alimentos, que contribuyó a la génesis de las diarreas.Functional diarrhea appears frequently in the pediatric practice and it is not generally associated with nutritional disorders, but with inappropriate diet schemes. In order to determine the nutritional evaluation of the children with this type of affection, and the influence of the diet on the appearance of the disease, a cross-sectional descriptive study was conducted among 44 children under 36 months old that received attention at the gastroenterology office of “Pedro Borras Astorga” University Pediatric Hospital between 2003 and 2005. According to the criteria of Rome II, they were diagnosed functional diarrhea. No significant nutritional affection was observed. The dietetic evaluation showed an unhealthy nutrition that contributed to the genesis of the diarrea.
smuggling networks capable of trafficking WMD- related materiel or finished weapons; the status of CBRN detection capa- bilities at land/ sea /air points of... dead , more than 800 injured) causes discussion of terrorist use of high explosives as a “WMD” incident. The FBI and FEMA create a terrorist...Counterproliferation This will bring you to the Nuclear and Counterprolif- eration page. Scroll towards the bottom and you will see Combating WMD Journal
the late Mr. Charles A. Ravenstein , Deputy Chief of the Research Division, for his help with unit honors; Mr. Lloyd H. Comett, Jr., former Director...Washington: Albert F. Simpson Historical Research Center and Office of Air Force History, 1978-1979. Ravenstein , Charles A. Air Force Combat Wings...Robert D. and Wilhelmine Burch. Air Operations in the Lebanon Crisis of 1958. Washington: USAF Historical Division Liaison Office, 1962. Ravenstein
Yuxin Chen; Yogesh V. Joshi; Jagmohan S. Raju; Z. John Zhang
In mature markets with competing firms, a common role for advertising is to shift consumer preferences towards the advertiser in a tug-of-war, with no effect on category demand. In this paper, we analyze the effect of such “combative” advertising on market power. We show that, depending on the nature of consumer response, combative advertising can reduce price competition to benefit competing firms. However, it can also lead to a procompetitive outcome where individual firms advertise to incr...
Full Text Available in Africa Marthie Grobler, Joey Jansen van Vuuren Council for Scientific and Industrial Research Defence, Peace, Safety & Security © CSIR 2007 www.csir.co.za Combating cyber crime in Africa is a reality • Computer crime... throughout the African community, especially not to those areas with limited connectivity © CSIR 2007 www.csir.co.za Primary cyberspace threats and trends: Shortage of IT education • Building on the digital divide...
requirements and sets standards that will take time and money to meet. It is an opportunity because the DODI will fo- cus attention on CBRN... infertile by Salt. Source: Death Valley (photo courtesy of pdphoto.org). Combating WMD Journal Issue 3 56 the earliest use of weapons. Poi...considered a psychological weapon. The recipients of a barrage of Greek fire could not explain how the fire would ignite spontaneously, rise up, be
Pawel Rouba Billowicz
Full Text Available “Combats Escènics” és un treball que tracta sobre la interpretació artística de la violència d’artistes de l’espectacle per tal de divertir el públic i emetre un missatge humanista mitjançant una coreografia ritual. En aquest estudi es presenta una classificació del combat escènic des del doble vessant agonista/antagonista, es realitza un passeig històric de la representació artística del combat a través de les diferents etapes i de les diverses cultures, s’aborda la preparació escènica de l’actor i del coreògraf, i s’entreveuen les perspectives de futur d’aquesta modalitat artística. Estudi realitzat per Pawel Rouba Billewicz (Inowroclaw, Polònia, 1939 - Barcelona, 2007, director, coreògraf, actor, mestre d’armes, mestre del gest i de la pantomima i professor de l’INEF de Catalunya. Aquest article, editorialment inèdit, es publica postmortem per Apunts. Educació Física i Esports com a homenatge i reconeixement de l’autor per la seva extraordinària i polivalent aportació al camp de l’art i l’Activitat Física i l’Esport.
P C Rogers
A nutritional perspective within pediatric oncology is usually just related to the supportive care aspect during the management of the underlying malignancy. However, nutrition has a far more fundamental importance with respect to a growing, developing child who has cancer as well as viewing cancer from a nutritional cancer control perspective. Nutrition is relevant to all components of cancer control including prevention, epidemiology, biology, treatment, supportive care, rehabilitation, and...
Major deficiency disorders, including vitamin A deficiency, are especially common in countries in which rice is the staple food. In response to the devastating effects of vitamin A deficiency, which may include blindness and, even death, "Golden Rice" has been developed to deliver this nutrient to those populations who need it most. The case of Golden Rice is used to demonstrate the challenges of radical GMO opposition, consumer acceptance, and regulation of biotechnology-derived foods.
Major deficiency disorders, including vitamin A deficiency, are especially common in countries in which rice is the staple food. In response to the devastating effects of vitamin A deficiency, which may include blindness and, even death, "Golden Rice” has been developed to deliver this nutrient to those populations who need it most. The case of Golden Rice is used to demonstrate the challenges of radical GMO opposition, consumer acceptance, and regulation of biotechnology-derived foods
Integrated nutritional intervention among mothers of under-five children in rural communities of a developing country: its effects on maternal practice of complementary feeding and child's nutritional status.
Information on nutritional status of children under five years is an indicator of the nutritional situation in society. Identification of core factors influencing nutrition of this population supports plans to alleviate child malnutrition and its consequences. This study sought to determine the nutritional status of children under five ...
Nutrition education has been used as a weapon against childhood malnutrition in Ghana, however, there is little evidence concerning its impact on maternal nutritional knowledge and child nutritional status. The purpose of this study was to find out whether changes have occurred in maternal nutritional knowledge during an ...
Gottlieb, Carissa A; Maenner, Matthew J; Cappa, Claudia; Durkin, Maureen S
Child disability is an emerging global health priority. To address the need for internationally comparable information about the frequency and situation of children with disabilities, UNICEF has recommended that countries include the Ten Questions screen for disability in the Multiple Indicator Cluster Survey (MICS) programme. We examined child disability screening and its association with nutrition and early learning in countries with low and middle incomes. Cross-sectional data for the percentage of children screening positive for or at risk of disability were obtained for 191 199 children aged 2-9 years in 18 countries participating in the third round of MICS in 2005-06. Screening results were descriptively analysed according to sociodemographic, nutritional, early-learning, and schooling variables. We constructed a weighted analysis to account for the sampling design in every country and tested for differences within countries using chi(2) analyses. A median 23% (range 3-48) of children aged 2-9 years screened positive for disability in the 18 participating countries. For children aged 2-4 years, screening positive for disability was significantly more likely in children who were not breastfed versus those who were (median 36% [9-56] vs 26% [4-51]) in eight of 18 countries, in children who had not received vitamin A supplementation versus those who had (36% [7-53] vs 29% [4-50]) in five of ten countries assessed, in children who met criteria for stunting (26% [6-54]) or being underweight (36% [3-61]) versus those who did not (25% [3-42] and 26% [4-43], respectively) in five of 15 countries assessed for stunting and in seven of 15 countries assessed for being underweight, and in those who participated in few early-learning activities versus others (31% [7-54] vs 24% [4-51]) in eight of 18 countries. Children aged 6-9 years who did not attend school screened positive for disability more often than did children attending school (29% [2-83] vs 22% [3-47]) in eight
Puett, Chloe; Salpéteur, Cécile; Lacroix, Elisabeth; Houngbé, Freddy; Aït-Aïssa, Myriam; Israël, Anne-Dominique
Background Despite growing interest in use of lipid nutrient supplements for preventing child malnutrition and morbidity, there is inconclusive evidence on the effectiveness, and no evidence on the cost-effectiveness of this strategy. Methods A cost effectiveness analysis was conducted comparing costs and outcomes of two arms of a cluster randomized controlled trial implemented in eastern Chad during the 2010 hunger gap by Action contre la Faim France and Ghent University. This trial assessed...
Evers, Connie Liakos
This book presents nutrition education activities and strategies that are child-tested and teacher-endorsed. It targets educators, nutrition professionals, parents, and other caregivers, offering the tools to teach children ages 6-10 years about nutrition in a meaningful, integrated way. Divided by subject, this resource integrates nutrition into…
Alejandro Torres Amaro
between the nutritional support established during the firsts hours after resuscitation with some prognostic indicators in burnt children. Methods: an analytical and retrospective study was conducted including 252 children admitted in the burn service of the "Juan Manuel Márquez" Teaching Children Hospital of Marianao in La Habana with a stay higher of 7 days during the decade of 2000 to 2009. From the audit of medical records it was obtained the following prognostic indicators of burnt child: burnt body surface, stay time, weight loss percentage and mortality. Likewise it was possible to obtain information about the type of metabolic nutritional support used during treatment. Results: the above mentioned more used support was mixed where is combined the peripheral enteral and parenteral modality covering the 52 % of treated patients. The children with less percentage of weight loss (under 10 % received the exclusive enteral way (53,1 % of treated cases and in the 37,4 % the support was mixed, but using the peripheral modality of parenteral use. Conclusions: the nutritional strategy used in burnt child may to modify some prognostic indicators and must to be a therapeutical priority to prevent the clinical deterioration of these patients.
Rogers, P C
A nutritional perspective within pediatric oncology is usually just related to the supportive care aspect during the management of the underlying malignancy. However, nutrition has a far more fundamental importance with respect to a growing, developing child who has cancer as well as viewing cancer from a nutritional cancer control perspective. Nutrition is relevant to all components of cancer control including prevention, epidemiology, biology, treatment, supportive care, rehabilitation, and survivorship. This article briefly describes this perspective of nutrition within a cancer control context and is a summary of the presentation at the "1st International SIOP-PODC Workshop on Nutrition in Children with Cancer" held in Mumbai.
... Label? • The Read the Label approach to combating childhood obesity is all about empowerment. • By educating kids, families and communities about using the Nutrition Facts Label on food packages, we are equipping ...
Flanagan, Stephen C; Kotwal, Russ S; Forsten, Robert D
Protracted use of stressors during military training courses does not necessarily enhance a Soldier?s ability to regulate stress on the battlefield. Extensive stress during training can be a contributing factor to suboptimal neurologic and overall long-term health. Prolonged high-stress military training programs, as well as extended duration combat deployments, should be comprehensively scrutinized for opportunities to preserve health and increase combat effectiveness. Contemporary research in neuroscience and psychology can provide insight into training techniques that can be used to control stress and optimize performance in combat. Physical fitness training programs can elevate the stress threshold. Extensive situational training can also inoculate Soldiers to specific combat stressors. Training methods such as these will enable Soldiers to achieve higher levels of performance while under enemy fire and are encouraged for units deploying to combat. combat stress, military training, military deployment, physical training, post-traumatic stress disorder, sleep deprivation, stress inoculation training. 2012.
Fenn, Bridget; Sangrasi, Ghulam Murtaza; Puett, Chloe; Trenouth, Lani; Pietzsch, Silke
Cash-based transfer programmes are an emerging strategy in the prevention of wasting in children, especially targeted at vulnerable households during periods of food insecurity or during emergencies. However, the evidence surrounding the use of either cash or voucher transfer programmes in the humanitarian context and on nutritional outcomes is elusive. More evidence is needed not only to inform the global community of practice on best practices in humanitarian settings, but also to help strengthen national mitigation responses. The Research for Food Assistance on Nutrition Impact Pakistan study (REFANI-P) sets out to evaluate the impact of three cash-based interventions on nutritional outcomes in children aged less than five years from poor and very poor households in Dadu District. This four-arm parallel cluster randomised controlled trial is set among Action Against Hunger (ACF) programme villages in Dadu District, Sindh Province. Mothers are the target recipients of either seasonal unconditional cash transfers or fresh food vouchers. A comparison group receives 'standard care' provided by the ACF programme to which all groups have the same access. The primary outcomes are prevalence of wasting and mean weight-for-height Z-score (WHZ) in children. Impact will be assessed at 6 months and at 1 year from baseline. Using a theory-based approach we will determine 'how' the different interventions work by looking at the processes involved and the impact pathways following the theory of change developed for this context. Quantitative and qualitative data are collected on morbidity, health seeking, hygiene and nutrition behaviours, dietary diversity, haemoglobin concentration, women's empowerment, household food security and expenditures and social capital. The direct and indirect costs of each intervention borne by the implementing organisation and their partners as well as by beneficiaries and their communities are also assessed. The results of this trial will provide
2 74. Sleeps less than most kids during day 0 1 2 98. Withdrawn, doesn’t involved with others and/or night (describe): 0 2 99. Worries 0 1 2 100...crackers 12. drink 13. egg food 15. grapes 16. gum 17. hamburger 18. hotdog 19. ice cream 20. juice 21. meat milk orange 24. pizza 25...ANIMALS 55. bear 56. bee bird 58. bug 59. bunny 60. cat 61. UJ.llVn.vu 62. cow dog 64. duck 65. elephant 66. fish 67. frog 68. horse 69
Surani, Salim R; Surani, Saherish S; Sadasiva, Sreevidya; Surani, Zoya; Khimani, Amina; Surani, Sara S
Sleep deprivation among teens is a major health issue. Only 15% of teens get 8.5 h of sleep on school nights. Sleep deprivation can lead to poor grades, sleepiness and moodiness. We undertook a study to assess the prevalence of sleep habit disturbance among elementary school students in South Texas with Hispanic ethnicity predominance. We also found how much a video based on sleep education had an impact on these children. Once the Corpus Christi Independent School District (CCISD) approved the collection of baseline sleep data, questionnaires were administered using the Children's Sleep Habit Questionnaire (CSHQ.) These questionnaires were distributed prior to the viewing of the educational and animated movie KNIGHTS (Keep Nurturing and Inspiring Good Habits in Teen Sleep). Four months later, a random follow-up was performed and the children were requested to respond to the same CSHQ. 264 children from two elementary schools participated in this educational program. At baseline, 55.56% of the children had trouble sleeping. When the questionnaire was administered four months later, only 23.26% (p sleeping. Additionally, at baseline, approximately 60-70% children had some baseline bedtime resistance, anxiety dealing with sleep, issues with sleep duration and/or awakenings in the middle of the night. In the follow up questionnaire, results showed significant improvements in overall sleep habits, bedtime resistance, sleep anxiety and night awakenings amongst students (p sleep duration and daytime sleepiness. Sleep deprivation and good sleep habits remain as a pervasive challenge among elementary school students. Administering an animated video about sleep education along with a provider-based education may be an effective tool for educating elementary school students and decreasing the prevalence of these sleep-related issues. Future prospective randomized studies are suggested.
IRB exemption and survey development and deployment. Based on feedback from Fort Drum, we created an internet -based version of the survey, to...Caucasian, 3% as African American, and 5% as Latina , 3% as Asian American, 3% as American Indian, and 6% as other. As we targeted spouses of children aged...of technology, such as the cotton gin or the automobil.e,’ on life in America 18. Knows how to use maps and globes to locate and gain 1 2 3 DK
Sam, Victoria Nyarkoah
Child labor is a threatening evil. It is particularly dangerous because it involves the sacrifice of a child’s future welfare in exchange for immediate benefit; it is a difficult phenomenon to combat because it involves questions of power within the households. This study attempts to comprehensively investigate various dimensions of child labor in Ghana and show whether its ban will be beneficial to the country.
Uchil, Rajesh R; Kohli, Gurdeep Singh; Katekhaye, Vijay M; Swami, Onkar C
The global burden of antimicrobial resistance is rising and is associated with increased morbidity and mortality in clinical and community setting. Spread of antibiotic resistance to different environmental niches and development of superbugs have further complicated the effective control strategies. International, national and local approaches have been advised for control and prevention of antimicrobial resistance. Rational use of antimicrobials, regulation on over-the-counter availability of antibiotics, improving hand hygiene and improving infection prevention and control are the major recommended approaches. Thorough understanding of resistance mechanism and innovation in new drugs and vaccines is the need. A multidisciplinary, collaborative, regulatory approach is demanded for combating antimicrobial resistance.
Vir, Sheila C.
Abstract The implications of direct nutrition interventions on women's nutrition, birth outcome and stunting rates in children in South Asia are indisputable and well documented. In the last decade, a number of studies present evidence of the role of non?nutritional factors impacting on women's nutrition, birth outcome, caring practices and nutritional status of children. The implications of various dimensions of women's empowerment and gender inequality on child stunting is being increasingl...
Gulzar, Saleema Aziz; Vertejee, Samina; Pirani, Laila
Child labour is a global practice and has many negative outcomes. According to International Labour Organization, child labour is the important source of child exploitation and child abuse in the world today. The Human Rights Commission of Pakistan has estimated the number of Pakistani working children to be around 11-12 millions, out of which, at least, half the children are under the age of ten years. It portrays the society's attitude towards child care. It is therefore, essential to break this vicious cycle and hence, enable the society to produce healthy citizens. This article analyzes the determinants of child labour in the Pakistani context and its implications for child's life, in specific, and for the nation, in general, utilizing the model developed by Clemen-stone & McGuire (1991). Since this practice has complex web of causation, a multidisciplinary approach is required to combat this issue through proposed recommendations.
Full Text Available OBJETIVO: Se realizó una intervención comunitaria bajo la estrategia de promoción de la salud, con el objetivo de desarrollar un programa de educación para la salud con mujeres. MÉTODOS: Se analizó la metodología de educación popular; con la finalidad de generar procesos organizativos y de participación social que mejoren la nutrición y sobrevivencia infantil. RESULTADOS: Los principales resultados, se relacionan con la generación de procesos autogestivos, la conformación de un grupo de promotoras de salud que han impulsado la organización de las mujeres enfocando su trabajo a mejorar la nutrición infantil y la salud familiar. Las promotoras han tomado en sus manos el programa de vigilancia epidemiológica en nutrición infantil y en conjunto con las mujeres han emprendido una serie de acciones para mejorar la nutrición de los niños y los porcentajes de desnutrición en los niños que participan en el programa de nutrición infantil han iniciado un descenso (64% a 62%. CONCLUSIONES: Los programas de nutrición infantil tienen mayores posibilidades de éxito en la medida que logran involucrar a la población en la resolución de esta problemática, eso es posible cuando se utiliza una metodología que propicie la participación de los individuos y se generen espacios que les permitan realizar una práctica transformadora de su realidad. La metodología de la educación popular proporciona las pautas en ese sentido. Es necesario continuar ampliando las experiencias educativas en educación para la salud con este tipo de metodología.OBJECTIVE: Community intervention was undertaken using the health promotion strategy, the objetive being to develop a health education program for women. METHODS: The popular education methodology was used with the purpose of generating organizational and social participation processes to improve hates of child nutrition and survival. RESULTS: The main results are linked with the generation of community
Full Text Available In seeking to combat the growing phenomenon of child marriage among Syrian refugees, it is vital to engage the whole range of actors involved, and to recognise that girls and boys have the capacity to address this issue in their own communities.
Naotunna, N P G C R; Dayarathna, M; Maheshi, H; Amarasinghe, G S; Kithmini, V S; Rathnayaka, M; Premachandra, L; Premarathna, N; Rajasinghe, P C; Wijewardana, G; Agampodi, T C; Agampodi, S B
Nutritional status of pre adolescent children is not widely studied in Sri Lanka. The purpose of this study was to determine the nutritional status among pre-adolescent school children in a rural province of Sri Lanka. A school based cross sectional study was carried out in North Central Province in 100 rural schools, selected using multi stage cluster sampling with probability proportionate to size. Children in grade one to five were enrolled with a maximum cluster size of fifty. Anthropometric measurements were done by trained data collectors and venesection was done at site by trained nurses. WHO AnthoPlus was used to calculate the BMI, height for age and weight for age Z scores. Survey design adjusted prevalence estimates with linearized standard errors were generated using svy function of STATA. Mean haemoglobin concentration (Hb) was calculated using methaeamoglobin method. Screening for iron deficiency and thalassemia trait was done using peripheral blood films. Height and weight measurements were done for 4469 of children and the Hb data was available for 4398 children. Based on the survey design adjusted estimates, prevalence of severe thinness, thinness, overweight and obesity in this population was 8.60% (SE 0.94), 2.91%(SE 0.74), 2.95%(0.26) and 2.43%(SE 0.92) respectively. Similarly, survey design adjusted prevalence of underweight and stunting were, 25.93% (95% CI 24.07-27.89%) and 43.92%(95% CI 40.55-47.56%). Adjusted mean estimates for hemoglobin was 12.20 (95% CI 12.16-12.24) g/dL. Prevalence of anemia was 17.3% (n = 749). Prevalence of mild and moderate anemia was 9.4 and 7.6% respectively. This study confirms that malnutrition is still a major problem in North Central Province, Sri Lanka.
Christiansen, Bryan J
.... The candidates are a Littoral Combat Ship with a surface warfare module, a National Security Cutter augmented with offensive and defensive weaponry, a "Sea Lance" inshore combat vessel, and a Combat...
Skow, Andrew; Porada, William
The proper management of energy becomes a complex task in fighter aircraft which have high angle of attack (AOA) capability. Maneuvers at high AOA are accompanied by high bleed rates (velocity decrease), a characteristic that is usually undesirable in a typical combat arena. Eidetics has developed under NASA SBIR Phase 1 and NAVAIR SBIR Phase 2 contracts a system which allows a pilot to more easily and effectively manage the trade-off of energy (airspeed or altitude) for turn rate while not imposing hard limits on the high AOA nose pointing capability that can be so important in certain air combat maneuver situations. This has been accomplished by incorporating a two-stage angle of attack limiter into the flight control laws. The first stage sets a limit on AOA to achieve a limit on the maximum bleed rate (selectable) by limiting AOA to values which are dependent on the aircraft attitude and dynamic pressure (or flight path, velocity, and altitude). The second stage sets an AOA limit near the AOA for C(sub l max). One of the principal benefits of such a system is that it enables a low-experience pilot to become much more proficient at managing his energy. The Phase 2 simulation work is complete, and an exploratory flight test on the F-18 HARV is planned for the Fall of 1994 to demonstrate/validate the concept.
Full Text Available Se presenta la evaluación del Programa Materno Infantil y Nutrición (PROMIN, dirigido a embarazadas y niños menores de cinco años, ejecutado en el Municipio de Rosario, Argentina. El objetivo es identificar los condicionantes que operaron en la puesta en la marcha según: el ambiente organizacional percibido por los jefes de los Centros de Salud y Desarrollo Infantil; la gestión de las actividades de los equipos de salud y las representaciones de la población en torno a la accesibilidad y aceptabilidad con el programa. Se seleccionaron como casos, dos servicios de salud bajo programa durante 1998. Se utilizaron estrategias cuantitativas y cualitativas. Los resultados indican que el ambiente organizacional condicionó diferencialmente las estrategias de intervención en ambos centros. Las coberturas alcanzadas fueron diferentes en ambos centros, con una meta del 80%. El registro de las actividades por parte de los equipos da cuenta de un cumplimiento parcial y heterogéneo en ambos espacios. Las madres reconocen las instituciones por su prestigio, conocen el alcance de las prestaciones y de los servicios más allá de PROMIN. La aceptabilidad se expresó como la provisión de complementación alimenicia.This study is based on an evaluation of the Maternal and Child Health and Nutrition Program (PROMIN targeting pregnant women and their children under five years of age. The objective was to identify the conditioning factors for the Program's implementation in Rosario, Argentina. There were three levels of analysis: the organizational environment as perceived by the Executive Directors of the Health and Child Development Centers; management of interventions by the health teams; and the community's perception of the program's accessibility and acceptability. Two centers were chosen for the year 1998. Empirical evidence was obtained through quantitative and qualitative procedures. The results suggest that the two centers' respective
Reliability and relative validity of a child nutrition questionnaire to simultaneously assess dietary patterns associated with positive energy balance and food behaviours, attitudes, knowledge and environments associated with healthy eating
Magarey Anthea M
Full Text Available Abstract Background Food behaviours, attitudes, environments and knowledge are relevant to professionals in childhood obesity prevention, as are dietary patterns which promote positive energy balance. There is a lack of valid and reliable tools to measure these parameters. The aim of this study was to determine the reliability and relative validity of a child nutrition questionnaire assessing all of these parameters, used in the evaluation of a community-based childhood obesity prevention project. Methods The development of the 14-item questionnaire was informed by the aims of the obesity prevention project. A sub-sample of children aged 10–12 years from primary schools involved in the intervention was recruited at the project's baseline data collection (Test 1. Questionnaires were readministered (Test 2 following which students completed a 7-day food diary designed to reflect the questionnaire. Twelve scores were derived to assess consumption of fruit, vegetables, water, noncore foods and sweetened beverages plus food knowledge, behaviours, attitudes and environments. Reliability was assessed using (a the intra class correlation coefficient (ICC and 95% confidence intervals to compare scores from Tests 1 and 2 (test-retest reliability and (b Cronbach's alpha (internal consistency. Validity was assessed with Spearman correlations, bias and limits of agreement between scores from Test 1 and the 7-day diaries. The Wilcoxon signed rank test checked for significant differences between mean scores. Results One hundred and forty one students consented to the study. Test 2 (n = 134 occurred between eight and 36 days after Test 1. For 10/12 scores ICCs ranged from 0.47–0.66 (p 0.05 for 10/12 (test-retest reliability and 3/7 (validity scores. Conclusion This child nutrition questionnaire is a valid and reliable tool to simultaneously assess dietary patterns associated with positive energy balance, and food behaviours, attitudes and environments in
Buffet, Y; Mazet, P
The authors report a very illustrative case of analytic depression in an infant under two years of age. The significance of this observation is in the overwhelming nature of symptoms with a characteristic marasmus syndrome fitting classic descriptions, and in the deliberate approach which led a pedo-psychiatric team to an understanding of the problems and to a rapid and dramatic reparation. By the ascription of a significant role to the impact of mother-child, mother-family and social circle relationships, involved members were able to determine their place and reassume their role and function. This approach also draws attention to the susceptibility and vulnerability of children to separation and severance of bonds.
Sharbaugh, Carolyn S., Ed.
This report summarizes proceedings and recommendations of a workshop on trends, needs, and issues in maternal and child nutrition services and presents 28 major recommendations and associated action strategies which address general areas, women's nutrition for optimal reproductive health, infant nutrition, child nutrition, adolescent nutrition,…
Watson, Gene E; Evans, Katie; Thurston, Sally W; van Wijngaarden, Edwin; Wallace, Julie M W; McSorley, Emeir M; Bonham, Maxine P; Mulhern, Maria S; McAfee, Alison J; Davidson, Philip W; Shamlaye, Conrad F; Strain, J J; Love, Tanzy; Zareba, Grazyna; Myers, Gary J
Dental amalgam is approximately 50% metallic mercury and releases mercury vapor into the oral cavity, where it is inhaled and absorbed. Maternal amalgams expose the developing fetus to mercury vapor. Mercury vapor can be toxic, but uncertainty remains whether prenatal amalgam exposure is associated with neurodevelopmental consequences in offspring. To determine if prenatal mercury vapor exposure from maternal dental amalgam is associated with adverse effects to cognition and development in children. We prospectively determined dental amalgam status in a cohort of 300 pregnant women recruited in 2001 in the Republic of Seychelles to study the risks and benefits of fish consumption. The primary exposure measure was maternal amalgam surfaces present during gestation. Maternal occlusal points were a secondary measure. Outcomes were the child's mental (MDI) and psychomotor (PDI) developmental indices of the Bayley Scales of Infant Development-II (BSID-II) administered at 9 and 30 months. Complete exposure, outcome, and covariate data were available on a subset of 242 mother-child pairs. The number of amalgam surfaces was not significantly (p>0.05) associated with either PDI or MDI scores. Similarly, secondary analysis with occlusal points showed no effect on the PDI or MDI scores for boys and girls combined. However, secondary analysis of the 9-month MDI was suggestive of an adverse association present only in girls. We found no evidence of an association between our primary exposure metric, amalgam surfaces, and neurodevelopmental endpoints. Secondary analyses using occlusal points supported these findings, but suggested the possibility of an adverse association with the MDI for girls at 9 months. Given the continued widespread use of dental amalgam, we believe additional prospective studies to clarify this issue are a priority. Copyright © 2012 Elsevier Inc. All rights reserved.
Malnutrition is a common event in children with cancer. Both cancer and its therapies contribute to malnutrition in different proportion. Malnutrition predisposes the child to increased morbidity, poorer outcome and reduction in quality of life. To prevent and/or treat malnutrition, children with cancer need to be evaluated their nutritional status and need to be supported nutritionally. (Journal of Current Pediatrics 2009; 7: 31-6)
... 7 Agriculture 4 2010-01-01 2010-01-01 false Apportionment of Funds for Nutrition Education and... NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE CHILD NUTRITION PROGRAMS NUTRITION EDUCATION AND TRAINING PROGRAM Pt. 227, App. Appendix to Part 227—Apportionment of Funds for Nutrition Education and Training...
... 7 Agriculture 4 2010-01-01 2010-01-01 false State plan for nutrition education and training. 227... NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE CHILD NUTRITION PROGRAMS NUTRITION EDUCATION AND TRAINING PROGRAM State Coordinator Provisions § 227.37 State plan for nutrition education and training. (a) General...
... Human Development (National Institute of Child Health and Human Development) Also in Spanish KidsHealth (Nemours Foundation) School Meals Contacts by State (Food and Nutrition Service) Patient Handouts Feeding patterns and diet -- children ...
Full Text Available ... Parents Parents site Sitio para padres General Health Growth & Development Infections Diseases & Conditions Pregnancy & Baby Nutrition & Fitness ... Out Food Labels Healthy Food Shopping If My Child Has Food Allergies, What Should I Look for ...
Full Text Available ... Parents site Sitio para padres General Health Growth & Development Infections Diseases & Conditions Pregnancy & Baby Nutrition & Fitness Emotions & ... Out Food Labels Healthy Food Shopping If My Child Has Food Allergies, What Should I Look for ...
What does an enabling environment for infant and young child nutrition look like at implementation level? Perspectives from a multi-stakeholder process in the Breede Valley Sub-District, Western Cape, South Africa.
Du Plessis, L M; McLachlan, M H; Drimie, S E
Breede Valley is a sub-district of the Cape Winelands district, Western Cape Province, South Africa. The administrative capital of the district is situated in the semi-rural town Worcester. Findings of a baseline survey in Worcester revealed poor infant feeding practices and childhood under- and overnutrition, with particular concern over high levels of stunting and low dietary diversity. Maternal overweight and obesity was high. These characteristics made the site suitable to study multi-sectoral arrangements for infant and young child nutrition (IYCN). The purpose of this study was to explore elements of an enabling environment with key stakeholders aimed at improving IYCN at implementation level. Focus group discussions and interviews were conducted with representatives from two vulnerable communities; local and district government; higher education institutions; business; and the media in the Breede Valley. Audio recordings were transcribed and data were analysed with the Atlas.TI software programme. The participants viewed knowledge and evidence about the first 1000 days of life as important to address IYCN. The impact of early, optimal nutrition on health and intellectual development resonated with them. The IYCN narrative in the Breede Valley could therefore be framed around nutrition's development impact in a well-structured advocacy campaign. Participants felt that capacity and resources were constrained by many competing agendas spreading public resources thinly, leaving limited scope for promotion and prevention activities. "People" were viewed as a resource, and building partnerships and relationships, could bridge some shortfalls in capacity. Conversations about politics and governance elicited strong opinions about what should be done through direct intervention, policy formulation and legislation. A lead government agency could not be identified for taking the IYCN agenda forward, due to its complexity. Participants proposed it should be referred to
Koletzko, Berthold; Szajewska, Hania; Ashwell, Margaret
The Early Nutrition Academy and the Child Health Foundation, in collaboration with the Committee on Nutrition, European Society for Paediatric Gastroenterology, Hepatology and Nutrition, held a workshop in March 2011 to explore guidance on acquiring evidence on the effects of nutritional...... interventions in infants and young children. The four objectives were to (1) provide guidance on the quality and quantity of evidence needed to justify conclusions on functional and clinical effects of nutrition in infants and young children aged...
Marina Vieira da Silva
Full Text Available O estudo descreve o estado nutricional de 2 096 pré-escolares atendidos nos 27 Centros Educacionais e Creches do município de Piracicaba, estado de São Paulo. Observa-se que 5,1% das crianças apresentam déficit de altura/idade (escore ZAI The study describes the nutritional status of 2 096 preschool children attending 27 Educational Centers and Day-Care Centers in Piracicaba, state of São Paulo. Five point one percent of the children are observed to present a height/age deficit (score HAZ<-2.0 and a proportion of 1.2 with weight/height deficit (score WHZ<-2.0. The results reveal that per capita income, mother schooling, type of sewage, type of housing and attendance time at are the variables that cause impact on the HAZ score of the children.The positive association detected between attendance time at and -Z score of height for age stresses the importance of these investments as means to protect children, mainly against chronic malnutrition, as basic care with health, feeding and hygiene is associated with education. The day-care center also provides the participation of mothers in the work market, which is very important in poor families in order to increase family income.
... and Shareables Autoimmune Diseases Breastfeeding Cancer Fitness and Nutrition Heart Disease and Stroke HIV and AIDS Mental ... health topic Autoimmune Diseases Breastfeeding Cancer Fitness and Nutrition Heart Disease and Stroke HIV and AIDS Mental ...
Butler, Frank K
Tactical Combat Casualty Care (TCCC) is a set of evidence-based, best-practice prehospital trauma care guidelines customized for use on the battlefield. The origins of TCCC were nontraditional. The TCCC program began as a Naval Special Warfare biomedical research effort launched after the realization that extremity hemorrhage, a leading cause of preventable death on the battlefield, was not being treated with a readily available and highly effective intervention: the tourniquet. This insight prompted a systematic reevaluation of all aspects of battlefield trauma care that was conducted from 1993 to 1996 as a joint effort by special operations medical personnel and the Uniformed Services University of the Health Sciences. The product of that 3-year research project was TCCC, the first-ever set of battlefield trauma care guidelines designed to combine good medicine with good small-unit tactics. Published by Elsevier Inc.
Fowlkes, Jennifer; Dickinson, Sandra; Lazarus, Todd
Bleeding from extremity wounds is the number one cause of preventable death on the battlefield and current research stresses the importance of training in preparing every Soldier to use tourniquets. HapMed is designed to provide tourniquet application training to combat medics and Soldiers using a blended training solution encompassing information, demonstration, practice, and feedback. The system combines an instrumented manikin arm, PDA, and computer. The manikin arm provides several training options including stand-alone, hands-on skills training in which soldiers can experience the actual torque required to staunch bleeding from an extremity wound and be timed on tourniquet application. This is more realistic than using a block of wood to act as a limb, which is often how training is conducted today. Combining the manikin arm with the PDA allows instructors to provide scenario based training. In a classroom or field setting, an instructor can specify wound variables such as location, casualty size, and whether the wound is a tough bleed. The PDA also allows more detailed feedback to be provided. Finally, combining the manikin arm with game-based technologies, the third component, provides opportunities to build knowledge and to practice battlefield decision making. Not only do soldiers learn how to apply a tourniquet, but when to apply a tourniquet in combat. The purpose of the paper is to describe the learning science underlying the design of HapMed, illustrate the training system and ways it is being expanded to encompass other critical life-saving tasks, and report on feedback received from instructors and trainees at military training and simulation centers.
Athletic Performance 71% Nutrition and Coronary Heart Disease 68% Weight Control 67% Nutrition and Cancer 61% Sugar and Fiber in the Diet 46% Vegetarianism ...interested 4 0 .9% D. Not interested E. Don’t know 20. Diet , Nutrition and Athletic Performance 20 .9%A. Fairly interested 29 .3% B. Moderately interested...identify by block number) The objectives of this research centered in two major areas. A computerized nutritional analysis of the diet offered to USAFA
Grueninger, Bob; Yeagle, Bill
The demographics of the population 65 years and older are described within the context of attitudes toward aging prevalent in society today. A description is presented of the physical signs of aging. The benefits of exercise are discussed as well as the importance of proper nutrition. Suggestions are listed regarding diet and exercise. A…
African Journal of Food, Agriculture, Nutrition and Development ... Child malnutrition remains a serious public health problem in Kwale District of Kenya. ... The relative importance of demographic and socioeconomic factors, as well as prevailing child health and nutrition practices on the growth and survival of children in the ...
Watson, Gene E.; Evans, Katie; Thurston, Sally W.; van Wijngaarden, Edwin; Wallace, Julie M. W.; McSorley, Emeir M.; Bonham, Maxine P.; Mulhern, Maria S.; McAfee, Alison J.; Davidson, Philip W.; Shamlaye, Conrad F.; Strain, J.J.; Love, Tanzy; Zareba, Grazyna; Myers, Gary J.
Background Dental amalgam is approximately 50% metallic mercury and releases mercury vapor into the oral cavity, where it is inhaled and absorbed. Maternal amalgams expose the developing fetus to mercury vapor. Mercury vapor can be toxic, but uncertainty remains whether prenatal amalgam exposure is associated with neurodevelopmental consequences in offspring. Objective To determine if prenatal mercury vapor exposure from maternal dental amalgam is associated with adverse effects to cognition and development in children. Methods We prospectively determined dental amalgam status in a cohort of 300 pregnant women recruited in 2001 in the Republic of Seychelles to study the risks and benefits of fish consumption. The primary exposure measure was maternal amalgam surfaces present during gestation. Maternal occlusal points were a secondary measure. Outcomes were the child’s mental (MDI) and psychomotor (PDI) developmental indices of the Bayley Scales of Infant Development-II (BSID-II) administered at 9 and 30 months. Complete exposure, outcome, and covariate data were available on a subset of 242 mother-child pairs. Results The number of amalgam surfaces was not significantly (p>0.05) associated with either PDI or MDI scores. Similarly, secondary analysis with occlusal points showed no effect on the PDI or MDI scores for boys and girls combined. However, secondary analysis of the 9 month MDI was suggestive of an adverse association present only in girls. Conclusion We found no evidence of an association between our primary exposure metric, amalgam surfaces, and neurodevelopmental endpoints. Secondary analyses using occlusal points supported these findings, but suggested the possibility of an adverse association with the MDI for girls at 9 months. Given the continued widespread use of dental amalgam, we believe additional prospective studies to clarify this issue are a priority. PMID:23064204
Michigan State Univ., East Lansing. Cooperative Extension Service.
Definitions, advantages, and functions of nutrition are the starting point for this food service training manual, which includes lessons on proteins, carbohydrates, minerals, and water- and fat-soluble vitamins. Energy foods for child nutrition programs are also identified, as are balanced diets and meal pattern guidelines. Class activities,…
much higher. Commanders need to ensure adequate child care plans are developed by unit members to keep d:wn the incidence of nondeployability or delayed...1991, speaking in Wash, DC "Then there’s the argument that men will be overprotective of women. When men are overprotective of men, we give them
Grunert, Klaus G
because consumers will avoid products that the label shows to be nutritionally deficient, but also because food producers will try to avoid marketing products that appear, according to the label, as nutritionally problematic, for example, because of a high content of saturated fat or salt. Nutrition......Nutrition labeling refers to the provision of information on a food product’s nutritional content on the package label. It can serve both public health and commercial purposes. From a public health perspective, the aim of nutrition labeling is to provide information that can enable consumers...... to make healthier choices when choosing food products. Nutrition labeling is thus closely linked to the notion of the informed consumer, that chooses products according to their aims, on the basis of the information at their disposal. Because many consumers are assumed to be interested in making healthy...
... Intervention Health and Nutrition Infant and Early Childhood Mental Health Sleep Social and Emotional Development Temperament Trauma and Stress View All Early Learning Child Care Early Literacy Early Math and Science Language and Communication Play School Readiness Screen Time Social ...
James, Vicki; McCamey, Jody
This illustrated guide for pregnant teenagers discusses the nutritional needs of the mother and her unborn child in a month-by-month format. The information presented for each of the 9 months typically includes a sample daily menu; a checklist of recommended servings per day for each of four food groups; a description of the usual emotional and…
Nemet, Dan; Eliakim, Alon
There is a growing interest in the field of pediatric sports nutrition because of the will to lead the child athlete to high achievements, with minimal impairment of growth and development. In this article, we review some of the new data concerning the possible short-term and long-term effects of nutrition on children's performance, current and future health. Growing children engaged in strenuous exercise have several physiologic and metabolic characteristics that distinguish them from adults and require specific nutritional considerations. There is currently not enough evidence to support either carbohydrate loading or increased protein intake in the diet of the child athlete. Creatine use, although common among youth, is not recommended. Adequate hydration is essential to optimal performance. Consumption of iron-rich foods should be encouraged, as depleted iron stores are common in young athletes. In female athletes, nutritional deficiencies could lead to athletic amenorrhea and bone loss, and the resolution of energy deficits can restore normal bone formation and the return of menses. In the highly competitive world of the child athlete, proper nutrition is of essence. Unfortunately, most of the knowledge in this field is based on adult literature. Age-specific research would lead to a better understanding of what constitutes 'a healthy diet' in the context of the growing athlete and may be a first step toward achieving these necessary insights.
Morse, Troy C
Military requirements development involves operational commanders conducting analyses of a variety of combat scenarios to assess force structure and material requirements to meet their military objectives...
Ribeyron, P.J.; Sark, W.G.J.H.M. van; Zietek, G.
Photovoltaics (PV) offer a promising solution for CO2 emission reductions and climate change combat. However, before its wide spread on the market, PV needs to find new approaches to make solar cells competitive with respect to conventional electricity sources.
The state of Maryland has made a strong commitment to combating climate change and reducing : greenhouse gas emissions. This research investigated the state of practice of innovative contracting : solutions to reduce emissions from highway constructi...
Dunne, James R; Lee, Tzong-Hae; Burns, Christopher; Cardo, Lisa J; Curry, Kathleen; Busch, Michael P
...) in civilian trauma patients receiving allogenic red blood cell (RBC) transfusions. We explored the incidence of TA-MC in combat casualties receiving FrWB compared with patients receiving standard stored RBC transfusions. Methods...
Chambers, Jay W., Jr; Morgan, Michael; Antonetti, Lou; Carson, Charles; Curry, Peter; Curtin, Leslie; Miller, Keith; Munoz-Atkinson, John; Shrank, Richard; Tapper, Mark
... this national security threat and develop a plausible strategy to combat it. Their time at the University had been intended to be one of study and reflection to prepare for leadership challenges ahead...
.... A survey addressing comfort parameters was administered to each subject. Boot impact tests revealed that all of the commercially available boots tested superior to the standard-issue jungle and leather combat boots...
The purpose of the Littoral Combat Ship (LCS) is to provide the Navy with an affordable, small, multi-mission ship capable of independent, interdependent, and integrated operations inside the littorals...
Full Text Available In the complex of motivating variables that define the push and pull factors behind recruitment and participation in civil conflict, "radicalization"—or "violent extremism"—is not conceived as a very strong motive, as is the case with studies on terrorism. As part of disarming youth combatants,the linkages between reintegration outcomes and possible rerecruitment into radical and extremist violence must be better understood to mitigate such risks. In our analysis, the policies guiding reintegration of child soldiers and youth should be better attuned to the relationship between recruitment motivations and reintegration outcomes, and must be approached from a political lens rather than a purely technical one. The risk of radicalization and involvement in violent extremism is ultimately a structural challenge, which needs to address root causes of recruitment rather than trying to find a solution through a band-aid approach of stopgap reintegration assistance.
CONTRACT NUMBER: W81XWH-16-1-0303 TITLE: Exploiting Inhibitory Siglecs to Combat Food Allergies PARTNERING INVESTIGATOR: Matthew Macauley, Ph.D...SUBTITLE Exploiting Inhibitory Siglecs to Combat Food Allergies 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Michael...Furthermore, two novel transgenic mouse models were generated, one expresses human CD22 on B cells and the other expresses human CD33 on mast cells
Mooren, Emily M.
Approved for public release; distribution is unlimited Crucial to the safe and effective operation of U.S. Navy vessels is the quick and accurate identification of aircraft in the vicinity. Modern technology and computer-aided decision-making tools provide an alternative to dated methods of combat identification. By utilizing the Soar Cognitive Architecture's reinforcement learning capabilities in conjunction with combat identification techniques, this thesis explores the potential for the...
Hojsak, Iva; Bronsky, Jiri; Campoy, Cristina
Young child formulae (YCF) are milk-based drinks or plant protein-based formulae intended to partially satisfy the nutritional requirements of young children ages 1 to 3 years. Although widely available on the market, their composition is, however, not strictly regulated and health effects have...... not been systematically studied. Therefore, the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) Committee on Nutrition (CoN) performed a systematic review of the literature to review the composition of YCF and consider their role in the diet of young children....... The review revealed limited data but identified that YCF have a highly variable composition, which is in some cases inappropriate with very high protein and carbohydrate content and even high amounts of added sugars. Based on the evidence, ESPGHAN CoN suggests that the nutrient composition of YCF should...
Sep 9, 2011 ... Background: Child abuse is defined as denying a child his or her rights such as food, clothing, education, health and emotional support. The forms of child abuse include physical, sexual, emotional, nutritional, child labour and abandonment. Objective: To describe the types of child abuse seen among the ...
Full Text Available Recently, the influence of genetics on sports performance has received increased attention from many researchers. In combat sports, some investigations have also been conducted. This article’s main objective was to review the representation of specific gene polymorphisms in combat sports athletes compared to controls. The following databases were searched: PubMed, Web of Science and SportDiscus. The terms used in this search involved combat sports (boxing, karate, judo, mixed martial arts, taekwondo and wrestling, genes, genetics and candidate genes. Articles published until November 2013 were included if combat sports athletes were considered as a single group (i.e., not mixed with athletes of other sports. Seven studies were found, with two presenting no difference between combat sports athletes and controls, two presenting higher frequencies of candidate genes related to a more endurance-related profile compared to controls, and three where a more power-related gene overrepresentation was found in comparison to controls. Taken together, the initial studies about the genetic characteristics of combat sports athletes are controversial, which is probably due to the mixed (aerobic and anaerobic characteristic and to the multifactorial performance determinants of these sports.
O'Keefe, Eoin; Shohet, Adam; Swan, Martin
Historically, it is believed that fratricide accounts for up to 15% of friendly casualties during operations and a UK MoD report identifies that almost half of all such casualties occur in situations involving ground units only. Such risks can be mitigated, to an extent, via operational awareness and effective communications. However, recent conflicts have involved a much more dynamic, complex and technically sophisticated battlefield than previously experienced. For example, Operation Telic (Desert Storm) involved almost one million combatants and ten thousand armoured vehicles in the coalition force, advancing across an extensive battlefront at high speed during daylight and at night, making effective use of a range of electro-optic sensors. The accelerated tempo of battle means that front lines can undergo rapid, punctuated advances that can leave individual combat units with a much degraded situational awareness, particularly of where they are in relation to other 'friendly' combatants. Consequently, there is a need for a robust, low cost, low weight, compact, unpowered, interoperable, Combat Identification technique for use with popular electro-optic sensors which can be deployed, and is effective, at the individual combat unit level. In this paper we discuss ground-to-ground combat identification materials that meet these requirements, all of which are based on the air-to-ground Mirage TM vehicle marking material. We show some preliminary ground-to-ground data collected from the new variant Mirage TM material in recent experimental trials conducted during the day, evening and at night.
Ighoyota B. AJENAGHUGHRURE
Full Text Available Military infantry recruits, although trained, lacks experience in real-time combat operations, despite the combat simulations training. Therefore, the choice of including them in military operations is a thorough and careful process. This has left top military commanders with the tough task of deciding, the best blend of inexperienced and experienced infantry soldiers, for any military operation, based on available information on enemy strength and capability. This research project delves into the design of a mission combat efficiency estimator (MCEE. It is a decision support system that aids top military commanders in estimating the best combination of soldiers suitable for different military operations, based on available information on enemy’s combat experience. Hence, its advantages consist of reducing casualties and other risks that compromises the entire operation overall success, and also boosting the morals of soldiers in an operation, with such information as an estimation of combat efficiency of their enemies. The system was developed using Microsoft Asp.Net and Sql server backend. A case study test conducted with the MECEE system, reveals clearly that the MECEE system is an efficient tool for military mission planning in terms of team selection. Hence, when the MECEE system is fully deployed it will aid military commanders in the task of decision making on team members’ combination for any given operation based on enemy personnel information that is well known beforehand. Further work on the MECEE will be undertaken to explore fire power types and impact in mission combat efficiency estimation.
McLaughlin, Bernadette; Gormley, T. R. (Thomas Ronan)
Most children now consume a lunch at school; the lunch may be supplied through the school itself, it may be prepared in the home and sent with the child, and/or the child may purchase food in a shop adjacent to the school. Whatever the source, the nutritional quality of the lunch is important as the child requires a good level of nutrition during school hours in order to maintain concentration and learn efficiently. Two physiological states i.e. malnutrition and hunger, can seriously impair t...
Szwajcer, E.M.; Hiddink, G.J.; Koelen, M.A.; Woerkum, van C.M.J.
Background: Research has shown that especially pregnant women, and also women with a wish for a child, have increased nutrition awareness. Seeking nutrition information seemed to be an important determinant for nutrition awareness. However, little research has been carried out about
... or puts a child at risk of harm. Child abuse can be physical, sexual or emotional. Neglect, or not providing for a child's needs, is also a form of abuse. Most abused children suffer greater emotional than physical damage. An abused child may become depressed. He or she may withdraw, ...
Hefferon, Kathleen L
Great progress has been made over the past decade with respect to the application of biotechnology to generate nutritionally improved food crops. Biofortified staple crops such as rice, maize and wheat harboring essential micronutrients to benefit the world's poor are under development as well as new varieties of crops which have the ability to combat chronic disease. This review discusses the improvement of the nutritional status of crops to make a positive impact on global human health. Several examples of nutritionally enhanced crops which have been developed using biotechnological approaches will be discussed. These range from biofortified crops to crops with novel abilities to fight disease. The review concludes with a discussion of hurdles faced with respect to public perception, as well as directions of future research and development for nutritionally enhanced food crops.
In many parts of the world, the food security of households and the nutrition security of individual household members, in particular that of children, are still at risk, in spite of the progress made in combatting hunger at the global level. The prevailing opinion among scientists and development
Tirado, M C; Crahay, P; Mahy, L; Zanev, C; Neira, M; Msangi, S; Brown, R; Scaramella, C; Costa Coitinho, D; Müller, A
Climate change further exacerbates the enormous existing burden of undernutrition. It affects food and nutrition security and undermines current efforts to reduce hunger and promote nutrition. Undernutrition in turn undermines climate resilience and the coping strategies of vulnerable populations. The objectives of this paper are to identify and undertake a cross-sectoral analysis of the impacts of climate change on nutrition security and the existing mechanisms, strategies, and policies to address them. A cross-sectoral analysis of the impacts of climate change on nutrition security and the mechanisms and policies to address them was guided by an analytical framework focused on the three 'underlying causes' of undernutrition: 1) household food access, 2) maternal and child care and feeding practices, 3) environmental health and health access. The analytical framework includes the interactions of the three underlying causes of undernutrition with climate change,vulnerability, adaptation and mitigation. Within broad efforts on climate change mitigation and adaptation and climate-resilient development, a combination of nutrition-sensitive adaptation and mitigation measures, climate-resilient and nutrition-sensitive agricultural development, social protection, improved maternal and child care and health, nutrition-sensitive risk reduction and management, community development measures, nutrition-smart investments, increased policy coherence, and institutional and cross-sectoral collaboration are proposed as a means to address the impacts of climate change to food and nutrition security. This paper proposes policy directions to address nutrition in the climate change agenda and recommendations for consideration by the UN Framework Convention on Climate Change (UNFCCC). Nutrition and health stakeholders need to be engaged in key climate change adaptation and mitigation initiatives, including science-based assessment by the Intergovernmental Panel on Climate Change (IPCC
Full Text Available Cash-based interventions (CBIs, offer an interesting opportunity to prevent increases in wasting in humanitarian aid settings. However, questions remain as to the impact of CBIs on nutritional status and, therefore, how to incorporate them into emergency programmes to maximise their success in terms of improved nutritional outcomes. This study evaluated the effects of three different CBI modalities on nutritional outcomes in children under 5 y of age at 6 mo and at 1 y.We conducted a four-arm parallel longitudinal cluster randomised controlled trial in 114 villages in Dadu District, Pakistan. The study included poor and very poor households (n = 2,496 with one or more children aged 6-48 mo (n = 3,584 at baseline. All four arms had equal access to an Action Against Hunger-supported programme. The three intervention arms were as follows: standard cash (SC, a cash transfer of 1,500 Pakistani rupees (PKR (approximately US$14; 1 PKR = US$0.009543; double cash (DC, a cash transfer of 3,000 PKR; or a fresh food voucher (FFV of 1,500 PKR; the cash or voucher amount was given every month over six consecutive months. The control group (CG received no specific cash-related interventions. The median total household income for the study sample was 8,075 PKR (approximately US$77 at baseline. We hypothesized that, compared to the CG in each case, FFVs would be more effective than SC, and that DC would be more effective than SC-both at 6 mo and at 1 y-for reducing the risk of child wasting. Primary outcomes of interest were prevalence of being wasted (weight-for-height z-score [WHZ] < -2 and mean WHZ at 6 mo and at 1 y. The odds of a child being wasted were significantly lower in the DC arm after 6 mo (odds ratio [OR] = 0.52; 95% CI 0.29, 0.92; p = 0.02 compared to the CG. Mean WHZ significantly improved in both the FFV and DC arms at 6 mo (FFV: z-score = 0.16; 95% CI 0.05, 0.26; p = 0.004; DC: z-score = 0.11; 95% CI 0.00, 0.21; p = 0.05 compared to the CG
Pietzsch, Silke; Sangrasi, Murtaza; Shoham, Jeremy
Background Cash-based interventions (CBIs), offer an interesting opportunity to prevent increases in wasting in humanitarian aid settings. However, questions remain as to the impact of CBIs on nutritional status and, therefore, how to incorporate them into emergency programmes to maximise their success in terms of improved nutritional outcomes. This study evaluated the effects of three different CBI modalities on nutritional outcomes in children under 5 y of age at 6 mo and at 1 y. Methods and findings We conducted a four-arm parallel longitudinal cluster randomised controlled trial in 114 villages in Dadu District, Pakistan. The study included poor and very poor households (n = 2,496) with one or more children aged 6–48 mo (n = 3,584) at baseline. All four arms had equal access to an Action Against Hunger–supported programme. The three intervention arms were as follows: standard cash (SC), a cash transfer of 1,500 Pakistani rupees (PKR) (approximately US$14; 1 PKR = US$0.009543); double cash (DC), a cash transfer of 3,000 PKR; or a fresh food voucher (FFV) of 1,500 PKR; the cash or voucher amount was given every month over six consecutive months. The control group (CG) received no specific cash-related interventions. The median total household income for the study sample was 8,075 PKR (approximately US$77) at baseline. We hypothesized that, compared to the CG in each case, FFVs would be more effective than SC, and that DC would be more effective than SC—both at 6 mo and at 1 y—for reducing the risk of child wasting. Primary outcomes of interest were prevalence of being wasted (weight-for-height z-score [WHZ] child being wasted were significantly lower in the DC arm after 6 mo (odds ratio [OR] = 0.52; 95% CI 0.29, 0.92; p = 0.02) compared to the CG. Mean WHZ significantly improved in both the FFV and DC arms at 6 mo (FFV: z-score = 0.16; 95% CI 0.05, 0.26; p = 0.004; DC: z-score = 0.11; 95% CI 0.00, 0.21; p = 0.05) compared to the CG. Significant
of family size, household food security status, and child care practices on the nutritional status of under-five children in. Ile-Ife, Nigeria. The study employed a descriptive ... generations with the poor nutrition of its children10. The major nutritional problems found in .... at an alpha level of 0.05. Results. Parental Characteristics.
This chapter is intended to provide a timely overview of the current state of research at the intersection of nutrition and epigenetics. I begin by describing epigenetics and molecular mechanisms of eigenetic regulation, then highlight four classes of nutritional exposures currently being investiga...
Missouri State Dept. of Health, Jefferson City.
This guide deals with various aspects of sports and nutrition. Twelve chapters are included: (1) "Sports and Nutrition"; (2) "Eat to Compete"; (3) "Fit Folks Need Fit Food"; (4) "The Food Guide Pyramid"; (5) "Fat Finder's Guide"; (6) "Pre- and Post-Event Meals"; (7) "Tips for the…
Danny Kurniawan Darianto
Full Text Available A patient undergoing surgery faces great physiologic and psychologic stress. so nutritional demands are greatly increased during this period and deficiencies can easily develop. If these deficiencies are allowed to develop and are not in screening, serious malnutrition and clinical problem can occur. Therefore careful attention must be given to a patient's nutritional status in preparation of surgery, as well as to the individual nutritional needs. If these needs are met, complications are less likely developing. Natural resources provide for rapid recovery. Proper nutrition can speed healing in surgical patients with major trauma, severe malnutition, burns, and other severe illnesses. New techniques for tube feeding, intravenous nutrition for patients with serious weight loss due to gastrointestinal disorders, and use of supplements can hasten wound healing and shorten recovery times.
Full-day-care pre-schools contribute significantly to the nutritional intake and acquisition of dietary habits of the pre-school child. The present study investigated nutritional practices in full-day-care pre-schools in Dublin, Ireland, aiming to determine the nutritional support that pre-school managers deem necessary, thereby facilitating the amelioration of existing pre-school nutritional training and practices.
Health systems in sub-Saharan Africa face a “triple” burden: a high prevalence of childhood malnutrition, an increase in diet-related chronic diseases, and an HIV ... in HIV-affected households, and the need to reverse increasing rates of childhood obesity in urban areas, brought about by easier access to fast foods and less ...
... and Digestive and Kidney Diseases) Eating Well While Eating Out (Nemours Foundation) Also in Spanish Energy Drinks and ... or Hype? (Nemours Foundation) Also in Spanish Figuring Out Fat and Calories (Nemours Foundation) Also in Spanish Guide to Eating for Sports (Nemours Foundation) Also in Spanish MyPlate ...
Daniela P. POPA
- A faulty legislation that allows them to circumvent the failure to pay taxes. Measures to combat tax evasion must act in the areas of legislative, administrative and educational. The legislative drafting tax legislation seeks appropriate, clear, concise, stable and consistent. It is also necessary to eliminate or withdrawal of exemptions, reductions and deductions that give rise to multiple interpretations. In terms of administrative measures aimed at creating a comprehensive and operational information system, ensuring adequate administrative structures and instruments effectively combating tax evasion and training specialists with morality and professionalism required of shapes and sizes evasion.
Full Text Available Following the terrorist attacks in the USA on September 11th, 2001, it was discovered that money laundering was a significant source of finance for terrorists. Although, the amount of money that involve is not as involve as in drug and gun trafficking, terrorist financing had been the most important substance to be monitor. Further, various legal measures have been taken internationally in order to combat terrorist financing. This research analyses the legal measures that have been taken internationally and at EU level to combat terrorist financing. Key words: Money Laundering, Terrorist Financing, International Legal measures, EU.
Pettersson, Stefan; Berg, Christina M
The purpose of the current study was to investigate elite female (n = 21) and male (n = 47) combat sports athletes' (n = 68; mean age (± SD) 21.3 ± 3.8 years; mean height 177 ± 10.2 cm) dietary intake between weigh-in and the first bout in Olympic combat sports. The data were collected at 6 separate tournaments and measurements included estimated food records, time for recovery, and body weight (BW) at weigh-in and first match. In total, 33 athletes participated in wrestling and taekwondo, sports with extended recovery times, and 35 athletes in judo and boxing, sports with limited recovery time. The results displayed that despite a mean consumption of food and drinks corresponding to 4.2 kg, the athletes only regained an average of 1.9 kg BW during recovery. Water accounted for 86% of the total intake. For each liter of water consumed, athletes gained 0.57 kg BW, when excluding heavy weight athletes (n = 5). Carbohydrate consumption was 5.5 g/kg BW, compared with the recommended 8-10 g/kg BW. In total, one-quarter of the consumed water originated from carbohydrate-rich drinks. Given the average recovery time of 18 (wrestling, taekwondo) versus 8 hr (judo, boxing), the former group consumed twice the amount of water, carbohydrates, protein, and fat as the latter group. In conclusion, a large proportion of the participants did not meet the recovery nutrition guidelines for carbohydrates. In addition, the discrepancy between nutrient intake and weight gain points to the physiological barriers to retaining fluids during a limited recovery time after engaging in weight making practices.
Rao, P S S; John, A S
Across-sectional epidemiological study was carried out at a Leprosy Referral Hospital in Delhi to assess the nutritional status of multibacillary leprosy patients in comparison to the general population using BMI. 150 people affected with multibacillary leprosy were included in the study, of whom 108 (72%) had WHO Grade 2 disability. 100 non leprosy patients were also included as a control group. Socio-demographic and clinical details as well as their height and weight were measured and the BMI computed. The findings clearly showed that under-nutrition (BMI disability made the incidence of under-nutrition more likely. The duration of disease, number of lesions or bacterial index had no impact on the level of nutrition. There may be multiple factors working together to lead to this under-nutrition and these are discussed briefly. If, we aim to provide high quality services with a holistic approach, a mandatory BMI should be calculated for every patient and if under nourished, a qualitative diet summary should be done and suitable nutritional advice given. Further, studies are needed for a better understanding of the occurrence and progression of under-nutrition in leprosy to find efficient ways to combat this problem.
Pettersson, Stefan; Ekström, Marianne Pipping; Berg, Christina M
Context The combination of extensive weight loss and inadequate nutritional strategies used to lose weight rapidly for competition in weight-category sports may negatively affect athletic performance and health. Objective To explore the reasoning of elite combat-sport athletes about rapid weight loss and regaining of weight before competitions. Design Qualitative study. Setting With grounded theory as a theoretical framework, we employed a cross-examinational approach including interviews, observations, and Internet sources. Sports observations were obtained at competitions and statements by combat-sport athletes were collected on the Internet. Patients or Other Participants Participants in the interviews were 14 Swedish national team athletes (9 men, 5 women; age range, 18 to 36 years) in 3 Olympic combat sports (wrestling, judo, and taekwondo). Data Collection and Analysis Semistructured interviews with 14 athletes from the Swedish national teams in wrestling, judo, and taekwondo were conducted at a location of each participant's choice. The field observations were conducted at European competitions in these 3 sports. In addition, interviews and statements made by athletes in combat sports were collected on the Internet. Results Positive aspects of weight regulation other than gaining physical advantage emerged from the data during the analysis: sport identity, mental diversion, and mental advantage. Together and individually, these categories point toward the positive aspects of weight regulation experienced by the athletes. Practicing weight regulation mediates a self-image of being “a real athlete.” Weight regulation is also considered mentally important as a part of the precompetition preparation, serving as a coping strategy by creating a feeling of increased focus and commitment. Moreover, a mental advantage relative to one's opponents can be gained through the practice of weight regulation. Conclusions Weight regulation has mentally important functions
Pettersson, Stefan; Ekström, Marianne Pipping; Berg, Christina M
The combination of extensive weight loss and inadequate nutritional strategies used to lose weight rapidly for competition in weight-category sports may negatively affect athletic performance and health. To explore the reasoning of elite combat-sport athletes about rapid weight loss and regaining of weight before competitions. Qualitative study. With grounded theory as a theoretical framework, we employed a cross-examinational approach including interviews, observations, and Internet sources. Sports observations were obtained at competitions and statements by combat-sport athletes were collected on the Internet. Participants in the interviews were 14 Swedish national team athletes (9 men, 5 women; age range, 18 to 36 years) in 3 Olympic combat sports (wrestling, judo, and taekwondo). Semistructured interviews with 14 athletes from the Swedish national teams in wrestling, judo, and taekwondo were conducted at a location of each participant's choice. The field observations were conducted at European competitions in these 3 sports. In addition, interviews and statements made by athletes in combat sports were collected on the Internet. Positive aspects of weight regulation other than gaining physical advantage emerged from the data during the analysis: sport identity, mental diversion, and mental advantage. Together and individually, these categories point toward the positive aspects of weight regulation experienced by the athletes. Practicing weight regulation mediates a self-image of being "a real athlete." Weight regulation is also considered mentally important as a part of the precompetition preparation, serving as a coping strategy by creating a feeling of increased focus and commitment. Moreover, a mental advantage relative to one's opponents can be gained through the practice of weight regulation. Weight regulation has mentally important functions extending beyond the common notion that combat-sport athletes reduce their weight merely to gain a physical edge
... and its impact on the educational development of the child. Based on the prevalence of abuses in the school, the author recommends that there should be public enlightenment programme and education to combat the mass ignorance on the acts that constitute abuse and to protect the Nigerian child against these abuses ...
Poverty, trade and child labour in the developing world: an analysis of efforts to combat child labour in Uganda. W M Tarinyeba. Abstract. No Abstract. East African Journal of Peace and Human Rights Vol. 13 (2) 2007 pp. 294-308. Full Text: EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD ...
Siem, Frederick M; Murray, Michael W
.... The present research was designed to examine the relationship between personality and combat performance using the "Big Five" model of personality and a multicomponent model of pilot combat performance...
... (Meta-Language for Combat Simulations) and its associated parser and C++ code generator were designed to reduce the amount of time and developmental efforts needed to build sophisticated real world combat simulations. A C++...
Reinbott, Anika; Jordan, Irmgard
Women's diets often decrease with regard to amounts per meal and day as well as diversity if a household's access to food is limited. The result is a monotonous diet that, in particular, negatively affects women's nutritional status during pregnancy and lactation and, thus, the infant. The infant's diet is of utmost importance, as it needs to meet the nutrient requirements especially during the first 2 years of life, a critical window for the child's healthy development. In Cambodia, infant and young child feeding (IYCF) practices are poor. Preparation of a special complementary meal in addition to breast milk feeds for children aged 6-23 months is often not a common habit. Instead, children eat watery, plain rice porridges that do not meet the nutrient requirements at this young age. A lack of adequate caring practices such as responsive feeding exacerbates the risk of malnutrition. Caregivers are often unaware of the importance of nutrition during the first 2 years of life regarding its effects on children's growth. In 2012, a randomized controlled trial (RCT) was started in two provinces of northern Cambodia: Oddar Meanchey and Preah Vihear. To contribute to reducing child mortality by addressing malnutrition among children 6-23 months of age, the Food and Agriculture Organization of the United Nations (FAO) implemented a nutrition-sensitive agriculture project with nutrition-specific actions, i.e. a nutrition education intervention was embedded in a food security project. Wealth, a child's age, and maternal education were identified as determinants of a child's dietary diversity. The older the child and/or the wealthier the household, the more diverse the child's diet. Maternal education was positively associated with the child's dietary diversity. Household dietary diversity was significantly associated with child dietary diversity in a model including group, child's age, maternal education, and wealth as confounders. The RCT also showed that a 2- to 3-month
Glenn, D Michael; Beckham, Jean C; Feldman, Michelle E; Kirby, Angela C; Hertzberg, Michael A; Moore, Scott D
The current study provides a portrait of emotional-behavioral functioning within a small sample of Vietnam veterans with combat-related posttraumatic stress disorder (PTSD), their partners, and older adolescent and adult children. Veterans, their partners and children reported moderate-low to moderate-high levels of violent behavior. In addition, partner and veteran hostility scores were elevated relative to gender and age matched norms. Partners also reported heightened levels of psychological maltreatment by veterans. Veterans' combat exposure was positively correlated with hostility and violent behavior among children but unrelated to partner variables. Veterans' reports of PTSD symptoms were positively associated with reports of hostility and violence among children, and hostility and general psychological distress among partners. Veterans' violent behavior was also positively correlated with children's violent behavior, but did not yield significant correlations with other child or partner variables. Findings are discussed in relation to prior work and directions for future research are addressed.
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 .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
Food we eat has an important influence on health and well-being. Many eating habits are established in childhood. 456 children aged eight to 12 years participated in this survey of food eaten at school. Of all the food items eaten as a snack, 48.6% were categorised as junk. 75.8% of the sandwiches brought to school for lunch were made with white bread. Of the remaining food items brought for lunch 63.5% were of the junk variety. Compared with those who brought a snack or lunch from home, those given money to buy their own were more likely to eat junk (p < 0.01). Food eaten at school reflects approximately one third of a child\\'s daily food intake but health food practises for even a third of food intake may be of a value for health and long term eating habits. Nutritional education with the reinforcement of high nutritional standards in schools could improve the situation.
Smith, Scott M.
Optimal nutrition will be critical for crew members who embark on space exploration missions. Nutritional assessment provides an opportunity to ensure that crewmembers begin their missions in optimal nutritional status, to document changes during a mission and, if necessary, to provide intervention to maintain that status throughout the mission, and to assesses changes after landing in order to facilitate the return to their normal status as soon as possible after landing. We report here the findings from our nutritional assessment of astronauts who participated in the International Space Station (ISS) missions, along with flight and ground-based research findings. We also present ongoing and planned nutrition research activities. These studies provide evidence that bone loss, compromised vitamin status, and oxidative damage are the critical nutritional concerns for space travelers. Other nutrient issues exist, including concerns about the stability of nutrients in the food system, which are exposed to longterm storage and radiation during flight. Defining nutrient requirements, and being able to provide and maintain those nutrients on exploration missions, will be critical for maintaining crew member health.
34 2. Kapap..................................................................................................34 3. Krav ...training aspects to introduce the core values that are the foundation of the Navy and Marine Corps: honor, courage, and commitment ( MA 1.16, 2010...military service members should train in combatives (Wagner and Nardia, 2010). 3. Krav Maga The original concept of Krav Maga was to absorb any
Teacher stressors and the effects of stressors on teachers' decisions to remain in the profession are reviewed in this article. A discussion of what teachers can do to combat their stress and perform their duties for longevity in the classroom includes practical and researched strategies. Teachers cannot be expected to resolve all the issues of…
to 06-06-2011 4. TITLE AND SUBTITLE Submarine Combat Systems Engineering Project 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ...AND ALLOCATIONS ..............................................25 E. APPLYING FITTS ’ LIST...25 Figure 8 Fitts ’ List [Schmidt, 2010
Africanity: A Combative Ontology. Archie Mafeje. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners · Terms and Conditions of Use · Contact AJOL · News. OTHER RESOURCES... for Researchers · for Journals · for Authors · for Policy ...
recent years has been directed toward prophylaxis, not treatment. The formation of heterotopic ossification has been ob- served following total hip ...common indications for excision of combat- related heterotopic ossification in our military patients are pain that is caused by wearing a prosthesis ...transfemoral amputation with limited hip flexion due to direct impingement of severe heterotopic ossification against the anterior pelvic brim and acetabulum
Gupta, A.; Siebert, U.
This article describes the strategies and activities of the Forest Integrity Network. One of the most important underlying causes of forest degradation is corruption and related illegal logging. The Forest Integrity Network is a timely new initiative to combat forest corruption. Its approach is to
of diabetes increases and leads to increased demands on future health care. Recognizing the challenges a new generation of soldiers poses from a...Physical Fitness School, “ IET Standardized Physical Training Guide,” Basic Combat Training Directorate (4 January 2005): 9. 22 Joseph J. Knapik et al
Combative activities (boxing, wrestling, kung fu, etc.) are seen as having a positive influence on alienated inner city youth. Potential contributions of such activities in a school curriculum or recreation program include involvement, security, self-concept, and self-realization. Participants may be able to free themselves from such stereotype…
Mason, J B; Mitchell, J T
The concept of nutritional surveillance is derived from disease surveillance, and means "to watch over nutrition, in order to make decisions that lead to improvements in nutrition in populations". Three distinct objectives have been defined for surveillance systems, primarily in relation to problems of malnutrition in developing countries: to aid long-term planning in health and development; to provide input for programme management and evaluation; and to give timely warning of the need for intervention to prevent critical deteriorations in food consumption. Decisions affecting nutrition are made at various administrative levels, and the uses of different types of nutritional surveillance information can be related to national policies, development programmes, public health and nutrition programmes, and timely warning and intervention programmes. The information should answer specific questions, for example concerning the nutritional status and trends of particular population groups.Defining the uses and users of the information is the first essential step in designing a system; this is illustrated with reference to agricultural and rural development planning, the health sector, and nutrition and social welfare programmes. The most usual data outputs are nutritional outcome indicators (e.g., prevalence of malnutrition among preschool children), disaggregated by descriptive or classifying variables, of which the commonest is simply administrative area. Often, additional "status" indicators, such as quality of housing or water supply, are presented at the same time. On the other hand, timely warning requires earlier indicators of the possibility of nutritional deterioration, and agricultural indicators are often the most appropriate.DATA COME FROM TWO MAIN TYPES OF SOURCE: administrative (e.g., clinics and schools) and household sample surveys. Each source has its own advantages and disadvantages: for example, administrative data often already exist, and can be
visibility to that level. Other basemaps used by the Combat Stories Map , such as “ Open Street Map ” and “World Imagery,” do provide details to the...organizing their combat experiences.41 The Combat Stories Map allows users to zoom in to street level to identify specific locations where their combat... Map zoom in and out at preset scales depending on what one can clearly discern at that scale. Hence, one can clearly distinguish streets at the
Hayes, Jonathan L.
Approved for public release; distribution is unlimited Despite the proliferation of technology and near-global Internet accessibility, a web-based program incorporating interactive maps to record personal combat experiences does not exist. The Combat Stories Map addresses this deficiency. The Combat Stories Map is a web-based Geographic Information System specifically designed to collect and store U.S. service members' georeferenced combat stories. The stories are immediately available for...
This document presents the Dutch National Plan combat nuclear accidents (NPK). Ch. 2 discusses some important starting points which are determining for the framework and the performance of the NPK, in particular the accident typology which underlies the plan. Also the new accident-classification system for the Dutch nuclear power plants, the standardization for the measures to be taken and the staging around nuclear power plants are pursued. In ch. 3 the legal framework of the combat nuclear accidents is described. In particular the Nuclear-power law, the Accident law and the Municipality law are pursued. Also the role of province and municipality are described. Ch. 4 deals with the role of the owner/licensee of the object where the accident occurs, in the combat of accident. In ch. 5 the structure of the nuclear-accident combat at national level is outlined, subdivided in alarm phase, combat phase and the winding-up phase. In ch.'s 6-12 these phases are elaborated more in detail. In ch.'s 10-13 the measures to be taken in nuclear accidents, are described. These measures are distinguished with regard to: protection of the population and medical aspects, water economy, drinking-water supply, agriculture and food supply. Ch. 14 describes the responsibility of the burgomaster. Ch.'s 15 and 16 present an overview of the personnel, material, procedural and juridical modifications and supplements of existing structures which are necessary with regard to the new and modified parts of the structure. Ch. 17 indicates how by means of the appropriate education and exercise it can be achieved that all personnel, services and institutes concerned possess the knowledge and experience necessary for the activities from the NKP to be executed as has been described. Ch. 18 contains a survey of activities to be performed and a proposal how these can be realized. (H.W.). figs.; tabs
Full Text Available In literature, the term adapted sport indicates sports activities, modified and adapted to persons with disabilities. In spite of their highly prominent values, combat sports are underrepresented among persons with disabilities in Serbia. The benefits of combat sports practicing are numerous, and at some international hospitals, martial sports and arts already have an important role in the treatment of traumatized and disabled persons. Currently, the programme of Paralympic Games includes only two sports, these are fencing and judo, in male and female competition. Almost certainly, karate will also be included in the programme of Paralympic Games, and there are similar ambitions in the case of taekwondo as well. In addition to these sports, some martial arts, especially aikido, thai-chi-chuan and qigong, have obtained significant representation and interest among persons with disabilities. The reasons for weaker interest in other martial sports and arts, should be sought in the fact that they are underrepresented among this population, and that these persons are not offered the possibility of organized practice of such sports. Orientation towards a combat sport brings great refreshment and powerful emotional experience to each practitioner, and this fact has special significance to persons with disabilities. In Serbia, combat sports are not widely represented among persons with disabilities, and only the wrestlers with impaired hearing have achieved significant success on the international stage. On the other hand, the popularity of combat sports among persons with disabilities in the world is significantly growing. It is necessary to take concrete steps to make it so in Serbia as well.
Evans, Alexandra E; Dave, Jayna; Tanner, Andrea; Duhe, Sonya; Condrasky, Margaret; Wilson, Dawn; Griffin, Sarah; Palmer, Meredith; Evans, Martin
The specific aim for this pilot study was to evaluate the effectiveness of a nutrition and media literacy intervention targeting elementary students and their parents. The purpose of the intervention was to increase child fruit and vegetables (FV) consumption and change the home nutrition environment (measured with FV availability and accessibility and parental social support). During the intervention, students learned about nutrition, the role media plays in shaping values concerning nutrition, and developed a media campaign for their parents. A quasi-experimental research design was used to evaluate the effectiveness of the intervention. The media intervention was effective in changing the home environment.
Maternal perception of child's nutritional status has a potential impact on the identification, prevention, and treatment of childhood overweight. Thus, the aim of this study was to evaluate the prevalence of misperception and factors associated with maternal perception of the nutritional status of first- to third-grade elementary school students from private schools in the Federal District, Brazil. This cross-sectional study was conducted with 554 mother-child pairs. Children's nutritional status was assessed by measuring their weight and height. The mothers completed an online questionnaire about sociodemographic data, maternal nutritional status, maternal perception of her own nutritional status (silhouette scale for female adults), and maternal perception of child's nutritional status (silhouette scale for children). Only 30.0% of the mothers were successful in choosing the most appropriate silhouette to represent child's nutritional status. Highly educated mothers (Adjusted OR = 1.51) and mothers of male children (Adjusted OR = 2.53) or of non-overweight children (Adjusted OR = 1.65) were more likely to underestimate child's nutritional status. Conversely, mothers below 35 years of age (Adjusted OR = 1.85) and mothers of female children (Adjusted OR = 2.24) or of overweight children (Adjusted OR = 1.94) were more likely to overestimate child's nutritional status. There was a high prevalence of misperception, which shows the need for interventions for children that take into account the relevance of mother's role and the adequate recognition of child's nutritional status. PMID:28445494
Pedroso, Jéssica; Toral, Natacha; Gubert, Muriel Bauermann
Maternal perception of child's nutritional status has a potential impact on the identification, prevention, and treatment of childhood overweight. Thus, the aim of this study was to evaluate the prevalence of misperception and factors associated with maternal perception of the nutritional status of first- to third-grade elementary school students from private schools in the Federal District, Brazil. This cross-sectional study was conducted with 554 mother-child pairs. Children's nutritional status was assessed by measuring their weight and height. The mothers completed an online questionnaire about sociodemographic data, maternal nutritional status, maternal perception of her own nutritional status (silhouette scale for female adults), and maternal perception of child's nutritional status (silhouette scale for children). Only 30.0% of the mothers were successful in choosing the most appropriate silhouette to represent child's nutritional status. Highly educated mothers (Adjusted OR = 1.51) and mothers of male children (Adjusted OR = 2.53) or of non-overweight children (Adjusted OR = 1.65) were more likely to underestimate child's nutritional status. Conversely, mothers below 35 years of age (Adjusted OR = 1.85) and mothers of female children (Adjusted OR = 2.24) or of overweight children (Adjusted OR = 1.94) were more likely to overestimate child's nutritional status. There was a high prevalence of misperception, which shows the need for interventions for children that take into account the relevance of mother's role and the adequate recognition of child's nutritional status.
Haggblade, Steven; Duodu, Kwaku G; Kabasa, John D; Minnaar, Amanda; Ojijo, Nelson K O; Taylor, John R N
Sub-Saharan Africa is the last region to undergo a nutrition transition and can still avoid its adverse health outcomes. The article explores emerging responses to "bend the curve" in sub-Saharan Africa's nutrition transition to steer public health outcomes onto a healthier trajectory. Early responses in 3 countries at different stages of food system transformation are examined: South Africa-advanced, Ghana-intermediate, and Uganda-early. By comparing these with international experience, actions are proposed to influence nutrition and public health trajectories as Africa's food systems undergo rapid structural change. Arising from rapid urbanization and diet change, major public health problems associated with overweight are taking place, particularly in South Africa and among adult women. However, public health responses are generally tepid in sub-Saharan Africa. Only in South Africa have policy makers instituted extensive actions to combat overweight and associated noncommunicable diseases through regulation, education, and public health programs. Elsewhere, in countries in the early and middle stages of transition, public health systems continue to focus their limited resources primarily on undernutrition. Related pressures on the supply side of Africa's food systems are emerging that also need to be addressed. Three types of intervention appear most feasible: maternal and child health programs to simultaneously address short-term undernutrition problems while at the same time helping to reduce future tendencies toward overweigh; regulatory and fiscal actions to limit access to unhealthy foods; and modernization of Africa's agrifood food system through job skills training, marketing reforms, and food industry entrepreneurship. © The Author(s) 2016.
Nobre, Érica Bezerra; Brentani, Alexandra Valéria Maria; Ferraro, Alexandre Archanjo
Summary Introduction: Many of the health behaviors involved in the emergence of chronic non-communicable diseases (CNCD) are originated in childhood under parental influence. Mothers are the ones most involved in the education and health care of children. Lifestyle (LS) is a social determinant of health. Very few studies tried to understand the influence of maternal LS on child nutrition. Objective: To verify the association between maternal behavioral and non-behavioral LS and nutritional ...
Full Text Available In Bangladesh, a large number of children are deprived of their basic human rights due to unacceptable health, nutrition, education as well as social conditions. In addition, children are exposed to severe forms of sexual, physical and mental abuses at home, in the work place, in institutions and other public places. The nature and extent of violence against children irrespective of age, sex and class has been increasing day by day. These include physical torture, rape, homicide and sometimes heinous attacks with acid. Children are also victims of child labor and trafficking, both of which are treated as the most severe form of child exploitation and child abuse in the world today. This review article is aimed to focus on the present situation of various forms of child abuses in our country. Data collection is based on secondary sources of information from Dhaka Medical College Hospital, One Stop Crisis Center (OCC,UNICEF, Ministry of Home Affairs, Ministry of Women and Children Affairs, several Dhaka based organizations and news paper clipping. Ibrahim Med. Coll. J. 2015; 9(1: 18-21
... Human Development (National Institute of Child Health and Human Development) Also in Spanish Find a Registered Dietitian Nutritionist (Academy of Nutrition and Dietetics) Patient Handouts Eating right during pregnancy ( ...
Metabolomics provides a holistic approach to investigate the perturbations in human metabolism with respect to a specific exposure. In nutritional metabolomics, the research question is generally related to the effect of a specific food intake on metabolic profiles commonly of plasma or urine...... strategy influences the patterns identified as important for the nutritional question under study. Therefore, in depth understanding of the study design and the specific effects of the analytical technology on the produced data is extremely important to achieve high quality data handling. Besides data...... handling, this thesis also deals with biological interpretation of postprandial metabolism and trans fatty acid (TFA) intake. Two nutritional issues were objects of investigation: 1) metabolic states as a function of time since the last meal and 2) markers related to intakes of cis- and trans-fat. Plasma...
As an organization, the IAEA has a statutory requirement to “accelerate and enlarge the contribution of atomic energy to peace, health and prosperity throughout the world.” Good nutrition is the cornerstone of good health and the development of nations. That’s why the IAEA is involved in nutrition. The IAEA’s Member States use nuclear methods to move their nutrition programmes forward. These nuclear techniques include the use of stable isotopes (which have no radioactivity) to better understand how nutrients are absorbed, utilized, or stored in the body. These very precise and powerful techniques can be safely and non-invasively used on everyone, from babies to the elderly, in order to determine nutritional status, and measure the effectiveness of nutrition programmes. Nuclear techniques often provide answers that are not available by any other means. By training Member States in the use of nuclear techniques for nutrition, the IAEA complements the work that these countries are doing with other international organizations and not-for-profit groups around the world to combat malnutrition in all its forms and to promote health
This article provides the reader with steps needed to accurately assess patient nutrition behaviors that contribute to weight gain, inability to lose weight, or inability to sustain weight loss. Evidence-based approaches in nutrition therapy that can create the daily energy deficit needed to produce 1/2 to 2 pounds of weight loss per week, and the strategies to create the energy deficit, are presented. To optimize health, long-term weight loss maintenance is needed. The benefits of using a multidisciplinary team approach in treating obesity are highlighted. Copyright © 2016 Elsevier Inc. All rights reserved.
Guy, Stacey; Ratzki-Leewing, Alexandria; Gwadry-Sridhar, Femida
Increasing epidemic proportions of overweight children in the United States presents formidable challenges for education and healthcare. Given the popularity and pervasiveness of video gaming culture in North American children, the perfect opportunity arises to investigate the potential of video games to promote healthful behaviour. Our objective was to systematically review the literature for possible benefits of active and educational video games targeting diet and physical activity in children. A review of English-language journal articles from 1998 to 2011 using EMBASE and PubMed was conducted. Thirty-four studies concerned with children, video games, physical, and/or nutritional outcomes were included. Results of these studies that showed some benefit (increased physical activity and nutritional knowledge as a result of gaming) demonstrate the possibility of video games to combat childhood obesity-looking beyond the stigma attached to gaming.
Full Text Available Increasing epidemic proportions of overweight children in the United States presents formidable challenges for education and healthcare. Given the popularity and pervasiveness of video gaming culture in North American children, the perfect opportunity arises to investigate the potential of video games to promote healthful behaviour. Our objective was to systematically review the literature for possible benefits of active and educational video games targeting diet and physical activity in children. A review of English-language journal articles from 1998 to 2011 using EMBASE and PubMed was conducted. Thirty-four studies concerned with children, video games, physical, and/or nutritional outcomes were included. Results of these studies that showed some benefit (increased physical activity and nutritional knowledge as a result of gaming demonstrate the possibility of video games to combat childhood obesity—looking beyond the stigma attached to gaming.
Gerits, Evelien; Verstraeten, Natalie; Michiels, Jan
ABSTRACT In nature, bacteria predominantly reside in structured, surface-attached communities embedded in a self-produced, extracellular matrix. These so-called biofilms play an important role in the development and pathogenesis of many infections, as they are difficult to eradicate due to their resistance to antimicrobials and host defense mechanisms. This review focusses on the biofilm-forming periodontal bacterium Porphyromonas gingivalis. Current knowledge on the virulence mechanisms underlying P. gingivalis biofilm formation is presented. In addition, oral infectious diseases in which P. gingivalis plays a key role are described, and an overview of conventional and new therapies for combating P. gingivalis biofilms is given. More insight into this intriguing pathogen might direct the development of better strategies to combat oral infections. PMID:28473880
Stahl, Elizabeth C; Brown, Bryan N
Declining function of the immune system, termed "immunosenescence," leads to a higher incidence of infection, cancer, and autoimmune disease related mortalities in the elderly population. (1) Increasing interest in the field of immunosenescence is well-timed, as 20% of the United States population is expected to surpass the age of 65 by the year 2030. (2) Our current understanding of immunosenescence involves a shift in function of both adaptive and innate immune cells, leading to a reduced capacity to recognize new antigens and widespread chronic inflammation. The present review focuses on changes that occur in haematopoietic stem cells, macrophages, and T-cells using knowledge gained from both rodent and human studies. The review will discuss emerging strategies to combat immunosenescence, focusing on cellular and genetic therapies, including bone marrow transplantation and genetic reprogramming. A better understanding of the mechanisms and implications of immunosenescence will be necessary to combat age-related mortalities in the future.
Some incident response practitioners feel that they have been locked in a battle with cyber criminals since the popular adoption of the internet. Initially, organisations made great inroads in preventing and containing cyber attacks. In the last few years, however, cyber criminals have become adept at eluding defence security technologies and rapidly modifying their exploit strategies for financial or political gains. Similar to changes in military combat tactics, cyber criminals utilise distributed attack cells, real-time communications, and rapidly mutating exploits to minimise the potential for detection. Cyber criminals have changed their attack paradigm. This paper describes a new incident response paradigm aimed at combating the new model of cyber attacks with an emphasis on agility to increase the organisation's ability to respond rapidly to these new challenges.
... support & care > living with sma > medical issues > nutrition Nutrition Good nutrition is essential to health and growth. ... must make decisions based on their own needs. Nutrition Considerations Since we are still waiting for clinical ...
Sedová, L; Seda, O
The importance of nutrition for human health and its influence on the onset and course of many diseases are nowadays considered as proven. Only the recent development of molecular biology and biochemical methods allows the elucidation of the molecular mechanisms of diet constituent actions and their subsequent effect on homeostatic mechanisms in health and disease states. The availability of the draft human genome sequence as well as the genome sequences of model organisms, combined with the functional and integrative genomics approaches of systems biology, bring about the possibility to identify alleles and haplotypes responsible for specific reaction to the dietary challenge in susceptible individuals. Such complex interactions are studied within the newly conceived field, the nutrition genomics (nutrigenomics). Using the tools of highly parallel analyses of transcriptome, proteome and metabolome, the nutrition genomics pursues its ultimate goal, i.e. the individualized diet, respecting not only quantitative and qualitative nutritional needs and the actual health status, but also the genetic predispositions of an individual. This approach should lead to prevention of the onset of such diseases as obesity, hypertension or type 2 diabetes, or enhance the efficiency of their therapy.
strategy influences the patterns identified as important for the nutritional question under study. Therefore, in depth understanding of the study design and the specific effects of the analytical technology on the produced data is extremely important to achieve high quality data handling. Besides data...
Discusses the inclusion of child day centers on college campuses and what it takes to provide safe, successful, and fun places that support students, faculty, and staff needs. Areas addressed include safety and security, class and room size, inclusion of child-size toilets, and interior color schemes. (GR)
Early Childhood Screen Time and Parental Attitudes Toward Child Television Viewing in a Low-Income Latino Population Attending the Special Supplemental Nutrition Program for Women, Infants, and Children
Asplund, Karin M.; Kair, Laura R.; Arain, Yassar H.; Cervantes, Marlene; Oreskovic, Nicolas M.; Zuckerman, Katharine E.
Background: Early childhood media exposure is associated with obesity and multiple adverse health conditions. The aims of this study were to assess parental attitudes toward childhood television (TV) viewing in a low-income population and examine the extent to which child BMI, child/parent demographics, and household media environment are associated with adherence to American Academy of Pediatrics (AAP) guidelines for screen time.
the early stages of the wars suggest that 10-18% of combat troops experience deployment-related psychological health problems, such as posttraumatic...also includes gestalt -therapy techniques designed to target loss and moral injury. In our open pilot trial, we demonstrated treatment acceptability...to determine whether AD is as least as effective as CPT, cognitive only version (CPT-C), in terms of its impact on deployment-related psychological
training, Combat Training Centers, Centers of Excellence, and how it is equipping its soldiers. Sustaining the Army’s ability to operate and thrive...in the urban environment must elevate in importance for Army leaders moving forward. All other environmental training must become second tier...end of the day, all three companies advanced less than one block.119 On the third day of the battle, February 2, Hotel Company, 2nd Battalion, 5th
LL.B. No one definition of terrorism has gained universal acceptance. The lack of agreement on a definition of terrorism has been a major obstacle to meaningful international countermeasures to combat terrorism. There are 12 International Conventions related to terrorism and an explicit definition is still missing. Many states have tried to define terrorism and none of these definitions has been implemented, either by the United Nations or these states. There are many International Convent...
SUBJECT TERMS Combat stress, substance abuse , alcohol , brief intervention, military personnel 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF...ORGANIZATION: Research Triangle Institute Research Triangle Park, NC 27709-2194 REPORT DATE: October 2015 TYPE OF REPORT: Annual PREPARED FOR...RETURN YOUR FORM TO THE ABOVE ADDRESS. 1. REPORT DATE October 2015 2. REPORT TYPE Annual 3. DATES COVERED 15 Sep 2014 – 14 Sep 2015 4. TITLE AND
review. The day on which the oath is taken is a holiday for that unit. 49 Many units distinguish their uniqueness and create unit iden- tity through a...They include highland aborigines , overseas Chinese, Chams, and Khmers who occasionally came into conflict with the dominant Vietnamese. 6 Primary...literature in the appendix. 23. For example, see Kellet, Combat Motivation. This work is based on a study of US, British, and Canadian Armed Forces. . 0 7-w
depress- ing growth. The travel, tourism , accom- Major Miemie Winn Byrd, USA, is the Deputy Economic Advisor, U.S. Pacific Command, and has...For instance, Lloyd’s of London Combating Terrorism A Socio-Economic Strategy Asia-Pacific Economic Cooperation summit in Busan , South Korea A P... well . In today’s increasingly competitive business environment, these corporations must continuously maintain their competitive advantage. Therefore
forth between these two models in real time . This proof-of-concept is a demonstration of a crowd model that can communicate with a combat simulation...human cognitive agents form to the various ‘ social identities’ to which they are exposed. An interesting treatment of crowds in the context of networks ...the degree to which different ethinicities within the crowd influence each individual in terms of interpersonal disances and amount of desire to follow
... receiving SNAP benefits as eligible for free school lunches under the Richard B. Russell National School Lunch Act and for free school breakfasts under the Child Nutrition Act of 1966 without further... School Lunch Act and free breakfasts under the Child Nutrition Act of 1966, at schools without further...
Marchand, Valerie; Motil, Kathleen J
Undernutrition, growth failure, overweight, micronutrient deficiencies, and osteopenia are nutritional comorbidities that affect the neurologically impaired child. Monitoring neurologically impaired children for nutritional comorbidities is an integral part of their care. Early involvement by a multidisciplinary team of physicians, nurses, dieticians, occupational and speech therapists, psychologists, and social workers is essential to prevent the adverse outcomes associated with feeding difficulties and poor nutritional status. Careful evaluation and monitoring of severely disabled children for nutritional problems are warranted because of the increased risk of nutrition-related morbidity and mortality.
Lai, C W; Chan, W K
To understand legislation combating counterfeit drugs in Hong Kong. This study consisted of two parts. In part I, counterfeit drugs–related ordinances and court cases were reviewed. In part II, indepth interviews of the stakeholders were described. Hong Kong. All Hong Kong ordinances were screened manually to identify those combating counterfeit drugs. Court cases were searched for each of the identified cases. Then, the relevant judgement justifications were analysed to identify sentencing issues. Indepth interviews with the stakeholders were conducted to understand their perceptions about such legislation. Trade Marks Ordinance, Patents Ordinance, Trade Descriptions Ordinance, and Pharmacy and Poisons Ordinance were current legislative items combating counterfeit drugs. Sentencing criteria depended on: intention to deceive, quantity of seized drugs, presence of expected therapeutic effect or toxic ingredients, previous criminal records, cooperativeness with Customs officers, honest confessions, pleas of guilty, types of drugs, and precautionary measures to prevent sale of counterfeit drugs. Stakeholders’ perceptions were explored with respect to legislation regarding the scale and significance of the counterfeit drug problem, penalties and deterrents, drug-specific legislation and authority, and inspections and enforcement. To plug the loopholes, a specific law with heavy penalties should be adopted. This could be supplemented by non-legal measures like education of judges, lawyers, and the public; publishing the names of offending pharmacies; and emphasising the role of pharmacists to the public.