bluuebunny/crossref_metadata_2025 huggingface dataset:
“Cooking and Active Leisure” TAS Program, Spain: A Program Impact Pathways (PIP) Analysis
Authors: Roura Elena , Pareja Sara Lucía , Milà Raimon , Cinca Núria
Published: November 2015

Background

The “Cooking and Active Leisure” Tu y Alícia por la Salud (CAL-TAS) Program is a school-based pilot that addresses healthy lifestyle needs of Spanish secondary school students with initiatives that research has proven to improve dietary and physical activity behaviors.

Objective

The objectives were to perform a Program Impact Pathways (PIP) analysis to describe key activities and processes of the CAL-TAS Program, identify Critical Quality Control Points (CCPs), and identify a suite of common indicators of healthy lifestyles to be applied across participant schools.

Methods

The CAL-TAS Program designers and implementation team developed this PIP analysis through an iterative process and presented the results for feedback at the seven-country Healthy Lifestyles Program Evaluation Workshop held in Granada, Spain, 13–14 September 2013, under the auspices of the Mondelēz International Foundation.

Results

The team identified three PIP CCPs: teachers' motivation and training, changes in students' knowledge of healthy lifestyles, and changes in students' healthy lifestyle behavior. The selected indicators of the program's impact on healthy lifestyles are adequacy of food intake, level of knowledge of healthy lifestyles gained, and adequacy of physical activity level according to World Health Organization recommendations. A clear definition of impact indicators, as well as collection of accurate data on healthy lifestyle behaviors and knowledge, is essential to understanding the effectiveness of this program before it can be scaled up.

Conclusions

CAL-TAS is an effective secondary school-based program encouraging healthy lifestyles. The PIP analysis was instrumental in identifying CCPs to sustain and improve the quality of the program. The team hopes to sustain and improve the program through these program evaluation recommendations.
Management of Acute Malnutrition in Infants Aged under 6 Months (MAMI): Current Issues and Future Directions in Policy and Research
Authors: Kerac Marko , Mwangome Martha , McGrath Marie , Haider Rukhsana , Berkley James A.
Published: November 2015

Background

Globally, some 4.7 million infants aged under 6 months are moderately wasted and 3.8 million are severely wasted. Traditionally, they have been overlooked by clinicians, nutritionists, and policy makers.

Objective

To present evidence and arguments for why treating acute malnutrition in infants under 6 months of age is important and outline some of the key debates and research questions needed to advance their care.

Methods

Narrative review.

Results and conclusions

Treating malnourished infants under 6 months of age is important to avoid malnutrition-associated mortality in the short term and adverse health and development outcomes in the long term. Physiological and pathological differences demand a different approach from that in older children; key among these is a focus on exclusive breastfeeding wherever possible. New World Health Organization guidelines for the management of severe acute malnutrition (SAM) include this age group for the first time and are also applicable to management of moderate acute malnutrition (MAM). Community-based breastfeeding support is the core, but not the sole, treatment. The mother—infant dyad is at the heart of approaches, but wider family and community relationships are also important. An urgent priority is to develop better case definitions; criteria based on mid-upper-arm circumference (MUAC) are promising but need further research. To effectively move forward, clinical trials of assessment and treatment are needed to bolster the currently sparse evidence base. In the meantime, nutrition surveys and screening at health facilities should routinely include infants under 6 months of age in order to better define the burden and outcomes of acute malnutrition in this age group.
Choice of Design and Outcomes in Trials among Children with Moderate Acute Malnutrition
Authors: Friis Henrik , Michaelsen Kim F. , Wells Jonathan C.
Published: November 2015

There is a need for trials on the effects of food aid products for children with moderate acute malnutrition, to identify how best to restore body tissues and function. The choice of control intervention is a major challenge, with both ethical and scientific implications. While randomized trials are needed, special designs, such as cluster-randomized, stepped-wedged or factorial designs may offer advantages. Anthropometry is widely used as the primary outcome in such trials, but anthropometric traits do not refer directly to specific organs, tissues, or functions. Thus, it is difficult to understand what components of health might be impacted by public health programs, or the underlying mechanisms whereby improved nutritional status might benefit short- and long-term health. Measurement of body composition, specific growth markers and functional outcomes may provide greater insight into the nature and implications of growth failure and recovery. There are now several methodologies suitable for application in infants and young children, e.g., measuring body composition with deuterium dilution, physical activity with accelerometers and linear growth with knemometers. To evaluate the generalizability of the findings from nutrition trials, it is important to collect data on baseline nutritional status.
Capacity-Building in the Management of Moderate Acute Malnutrition
Authors: Jackson Alan , Ashworth Ann
Published: November 2015

Evidence from low- and middle-income countries indicates that although there is a willingness to prevent and treat malnutrition at scale, there is very limited capacity to achieve this. Three broad areas of concern are human resources and the quality of services; management systems and supplies; and demand side factors. This paper focuses on building human resources in the context of preventing and managing malnutrition. Training should provide several options and approaches suitable for different settings and focus on core competencies. Preservice training should be the main focus of training, while in-service training should be used for continuing medical education and refresher training. Communities of Practice, in which national and international health professionals come together to deepen their knowledge and pool their skills to pursue a common ambition, are seen as one way forward to building the necessary human resources for scaling up training.
How Strong is Our Evidence for Effective Management of Wasting? A Review of Systematic and other Reviews
Authors: Webb Patrick
Published: November 2015

A need for improved empirical evidence for the effectiveness of interventions used in the management of child wasting (moderate and/or severe acute malnutrition) has recently been highlighted. There is no lack of published studies in this field, but when examined through the lens of systematic review protocols, few of these studies stand up to rigorous methodological critique. This paper summarizes the current state of knowledge, as supported by high-quality research included in multiple systematic reviews. It also elaborates on the criteria and standards used in such reviews. The paper highlights the weaknesses of many studies that could, with more care during study design and reporting, result in a larger body of evidence being available to policy makers and program implementers dealing with child wasting.
Environmental Enteric Dysfunction: An Overview
Authors: Crane Rosie J. , Jones Kelsey D. J. , Berkley James A.
Published: November 2015

Background

Environmental enteric dysfunction (EED) refers to an incompletely defined syndrome of inflammation, reduced absorptive capacity, and reduced barrier function in the small intestine. It is widespread among children and adults in low- and middle-income countries. Understanding of EED and its possible consequences for health is currently limited.

Objective

A narrative review of the current understanding of EED: epidemiology, pathogenesis, therapies, and relevance to child health.

Methods

Searches for key papers and ongoing trials were conducted using PUBMED 1966–June 2014; ClinicalTrials. gov; the WHO Clinical Trials Registry; the Cochrane Library; hand searches of the references of retrieved literature; discussions with experts; and personal experience from the field.

Results

EED is established during infancy and is associated with poor sanitation, certain gut infections, and micronutrient deficiencies. Helicobacter pylori infection, small intestinal bacterial overgrowth (SIBO), abnormal gut microbiota, undernutrition, and toxins may all play a role. EED is usually asymptomatic, but it is important due to its association with stunting. Diagnosis is frequently by the dual sugar absorption test, although other biomarkers are emerging. EED may partly explain the reduced efficacy of oral vaccines in low- and middle-income countries and the increased risk of serious infection seen in children with undernutrition.

Conclusions

Despite its potentially significant impacts, it is currently unclear exactly what causes EED and how it can be treated or prevented. Ongoing trials involve nutritional supplements, water and sanitation interventions, and immunomodulators. Further research is needed to better understand this condition, which is of likely crucial importance for child health and development in low- and middle-income settings.
Metabolomics in Nutrition Research: Biomarkers Predicting Mortality in Children with Severe Acute Malnutrition
Authors: Freemark Michael
Published: November 2015

Background

Millions of the world's children suffer from malnutrition, which predisposes to death from diarrhea and a variety of infectious diseases. Mortality rates among infants and toddlers remain staggeringly high, in part because the pathogenesis of acute malnutrition and its complications remains poorly understood.

Objective

We used metabolomic analysis to characterize the metabolic status of Ugandan children with severe acute malnutrition (SAM) and to delineate changes in hormones, metabolites, growth factors, and cytokines during nutritional therapy. We hypothesized that hormonal and metabolic factors measured at presentation would associate with, or predict, subsequent mortality during treatment

Methods

This was a prospective cohort study of 75 severely malnourished children 6 months to 5 years of age treated as inpatients with F-75 and F-100 and supplemental micronutrients; after discharge, they received ready-to-use therapeutic food (RUTF). This increased the mean weight-for-height z-score (WHZ) from −4.27 to −1.75 SD. Blood samples were obtained at presentation, after 2 weeks of inpatient therapy, and after 4 to 10 weeks of RUTF. Plasma samples were analyzed by tandem mass spectrometry and microassays.

Results

At presentation there were high levels of non-esterified fatty acids (NEFA), ketones, and even-chain acylcarnitines, indicating active lipolysis and fatty acid oxidation. In contrast, albumin, amino acids, and C3 carnitine, a by-product of branched-chain amino acids, were low. Levels of insulin, insulin-like growth factor 1 (IGF-1), adiponectin, and leptin were low, while levels of ghrelin, growth hormone, cortisol, interleukin 6 (IL-6), peptide YY (PYY), and glucagon-like peptide 1 (GLP-1) were high. The metabolic and hormonal changes were reversed by formula feeding and RUTF. Biomarkers associated with mortality included HIV, WHZ, and mid-upper-arm circumference (MUAC); the biochemical factor associated most strongly with mortality was low leptin, a marker of adipose reserve and modulator of immune function.

Conclusions

Low leptin predicts mortality in edematous and nonedematous patients with SAM. Leptin assays might be used to identify malnourished children at highest risk for death.
Weaning Foods in West Africa: Nutritional Problems and Possible Solutions
Authors: Onofiok N. O. , Nnanyelugo D. O.
Published: November 2015

Weaning practices and the problems of weaning foods in West Africa are reviewed. The low nutrient density and high bulk of the weaning foods, early introduction of solid foods, and unhygienic practices predispose infants to malnutrition, growth retardation, infection, and high mortality. Multi-approach strategies, involving the development of improved recipes and processing, nutrition education, access to safe water, good sanitation, economic empowerment of women, reduction in workload, and promotion of breastfeeding, are recommended solutions to the problems.
Forging Partnerships among Industry, Government, and Academic Institutions for Food Fortification
Authors: Maberly Glen F. , Bagrinsky Jack , Parvanta Claudia C.
Published: November 2015

This decade commenced with a declaration by the heads of state attending the World Summit for Children that they would pursue the virtual elimination of iodine and vitamin A deficiencies and reduce iron deficiency by 33% before the year 2000. The World Bank has estimated that the economic, socio-economic, and health benefits of sustained elimination could contribute as much as 5% of gross domestic product annually to an affected country for an investment of less than 0.3% of gross domestic product. By 1996, tremendous progress towards the elimination of iodine deficiency had been made, largely due to the involvement of the private food industry in the production and distribution of iodized salt. For goals in preventing vitamin A and iron deficiencies to be achieved, a similar commitment on the part of the food industry is necessary. In 1995 we conducted a survey of 95 representatives of multinational and national food companies and 68 representatives of government and international agencies about private–public partnerships to eliminate micronutrient malnutrition. The survey showed a lack of communication from the public sector to the private sector, although both sides suggest that such communication would be effective and desirable. An international dialogue entitled “Sharing Risk and Reward: Public–Private Collaboration to Eliminate Micronutrient Malnutrition” was held in Ottawa in December 1995, where a framework for communication was established. From this foundation, many countries have initiated or reopened dialogues among governments, industry, agencies, academia, and civic organizations to support the elimination of micronutrient malnutrition.
History of Fortification of Margarine with Vitamin A in the Philippines
Authors: Solon Florentino S.
Published: November 2015

The search for a suitable vehicle for vitamin A fortification in the Philippines led in 1991 to Star Margarine, a hydrogenated margarine product that had been popular in the country since 1931. The initial study to determine the stability of β-carotene and vitamin A (retinol palmitate) in the product showed high percentages of vitamin A retention and good thermal stability, as indicated by high vitamin A recovery after being heated. Later, a double-blind, randomized community trial to determine the effects of consumption of non-refrigerated vitamin A—fortified margarine on the vitamin A status of three- to six-year-old children also showed an increase in mean serum retinol in the experimental group and a decrease in the control group after six months of daily consumption of the product. The multiple adjusted increment over control was 2.4 μg/dl ( p<.001). The prevalence of low serum retinol (<20 μg/dl) decreased from 25.7% to 10.1% in the experimental group but remained unchanged in controls (26.7% to 27.7%) ( p<.01 at six months). Although its vitamin A content has been increased so that each serving of one tablespoon provides 100% of the recommended dietary allowance for Filipino young children, the marketed product has remained affordable to consumers and has been made more accessible by reducing container sizes. It has also received the Department of Health seal of recognition as a product that meets national fortification standards. The fortification of Star Margarine exemplifies the close collaboration of government and non-governmental organizations, industry, academics, and other sectors in confronting a public health problem.
Knowledge, Attitudes, and Practices of People in Ulaanbaatar, Mongolia, with Regard to Iodine-Deficiency Disorders and Iodized Salt
Authors: Yamada C. , Oyunchimeg D. , Igari T. , Buttumur D. , Oyunbileg M. , Umenai T.
Published: November 2015

In 1995 Mongolia introduced a national programme of salt iodization to eliminate iodine-deficiency disorders. To investigate the extent of acceptability and utilization of iodized salt, a study of people's knowledge, attitudes, and practice (KAP) was carried out in the capital city, Ulaanbaatar, in 1996 and 1997. A total of 838 people (housewives, parents of schoolchildren, post-partum women, and pregnant women) were interviewed about their KAP regarding iodine-deficiency disorders and iodized salt. In addition, the amount of salt consumption at the household level was examined. Over 95% of the study population knew about iodine-deficiency disorders and iodized salt, and most of them received the information from television and radio. About 90% of them had already used iodized salt. The price of iodized salt is a little higher than that of common salt, but it is still affordable for most people. This study demonstrates the possibility of the expansion of the programme nationwide.
Production and Nutritional Quality of Traditional Nigerian Masa from Mixtures of Rice, Pearl Millet, Cowpea, and Groundnut
Authors: Nkama Iro , Malleshi Nagappa G.
Published: November 2015

Masa (waina) is a Nigerian yeast-fermented puff batter of millet or rice cooked in a pan with individual cuplike depressions. It resembles the Indian idli in shape and dosa in taste. Since masa is a single cereal food, its protein is of relatively poor nutritional quality. Studies were conducted to assess the feasibility of supplementing millet or rice with grain legumes for masa preparation. Based on a least-cost computer programme, masa formulations containing millet or rice blended with cowpea or groundnut were prepared and their chemical and nutritional qualities were evaluated. Phosphorus and calcium concentrations were low, and magnesium and sodium concentrations were high. Significant improvements in lysine (9%–75%), threonine (16%–25%), and isoleucine (10%–28%) were observed for some masa samples. The biological value (81%–93%), apparent digestibility (82%–88%), and net protein utilization (74%–79%) of all masa samples showed improved nutritional qualities. Supplemented masa was nutritionally better than masa made from millet or rice alone.
World Bank Support for Early Childhood Development: Case Studies from Kenya, India, and the Philippines
Authors: Balachander Jayshree
Published: November 2015

The World Bank's portfolio of early childhood development projects is large (more than US$600 million) and is rapidly growing as a result of a recognition that early childhood is a crucial phase of human development, and that integrated health, nutrition, and stimulation of young children can have substantial economic benefit. the current conceptual framework underlying the World Bank's support for early childhood development is loosely defined as including all interventions directed at children or their caregivers to promote child development, preferably integrated as a package of health, nutrition, and early education services and targeted (but not exclusively) to the poorest households and including partnerships with other providers of such services. This paper analyses three World Bank-financed early childhood development projects in Kenya, India, and the Philippines and the issues arising from the design and approach to early childhood development in the projects. the key challenges for World Bank support to early childhood development are the following processes: developing a strong conceptual framework, delivering properly sequenced and truly integrated services at the level of the beneficiary, assuring that the poorest families are reached, providing adequate support to community-based workers, designing optimal, cost-effective interventions, measuring effectiveness, ensuring sustainability, and making partnerships work.
Successful Start of Salt Iodization in Laos
Authors: Coppens Monique , Phanlavong Arounny , Keomoungkhoune Intong , Dung Nguyen Tri , Gutekunst Rainer , Mannar M. G. Venkatesh , Thilly Claude
Published: November 2015

An assessment of the severity of iodine-deficiency disorders and of the iodized salt programme in Laos was undertaken in 1996 through a field study among 957 schoolchildren in seven schools of different regions in Laos. Urinary iodine concentrations in 225 samples were remarkably lower in schools from the north than in those from the south, a finding similar to that from a national survey in 1993. However, in 1996 the median concentrations of urinary iodine were much higher than in 1993:85 versus 5 μg/L in the northern sites and 195 versus 22 μg/L in the southern sites. the prevalence of consumption of iodized salt, introduced only six months to one year before, had increased from 69% to 91%, levels that could explain the nearly normal and normal urinary iodine concentrations. the wide range of mild to very severe iodine-deficiency disorders found by palpation of goitre most likely reflected a delay in the regression of the thyroid gland due to the rather recent introduction of iodized salt and due to the varying severity of iodine-deficiency disorders in the different sites before the start of the programme. in one of the six salt production plants with moderate capacity in Laos, the consistency of the salt-iodization process was checked and found to be good. the iodine concentration was 15 to 45 ppm in 90% of the salt lots sampled, as compared with the criterion of 30 ppm. At consumption 82% of the salt samples were also found to be adequately iodized, with an iodine concentration of 15 ppm or more. These data reflect the initial success of the iodized salt programme in Laos, but they also emphasize the need for an evaluation of the iodine-deficiency disorder situation in different demographic and social settings, as well as for the systematic monitoring of the iodized salt programme at the production, distribution, and consumption levels, accompanied by sufficient social marketing to maintain attention on this public health problem.
Field Tests for Iodide in Salt
Authors: Diosady L. L. , Alberti J. O. , FitzGerald S. , Mannar M. G. Venkatesh
Published: November 2015

Rapid field tests for the determination of iodide in salt were developed, based on the oxidation of iodide to iodine and reaction of the released iodine with starch to produce a coloured complex that could be visually related to the iodide content of the salt. Potassium iodate and ferric chloride were used as oxidizing agents in the two versions of the test that were examined in detail. the reaction with ferric chloride gave a test with a wider useful concentration range. It had the added advantage of not producing false readings for iodine by reacting with reducing agents that were present in the salt as natural impurities or as a result of fraud. A simple test kit suitable for field use was developed and tested with iodized salts produced using salts from Canada and Ecuador. the kit results were compared with results obtained by neutron activation analysis using the SLOWPOKE nuclear reactor facility of the University of Toronto and by standard iodometric titration. the test kits readily analysed for iodine levels between 0 and 50 ppm, with an accuracy of ± 10 ppm and a reproducibility of ± 5 ppm. Inexpensive rapid tests using these kits may be useful in monitoring iodine levels in areas where salt iodization is based on potassium iodide, because of the presence of impurities in the salt supply that reduce the stability of the usual iodizing agent, potassium iodate.
Nutrifit Programme to Improve Health-Related Fitness among Young Thai Schoolchildren
Authors: Kijboonchoo Kallaya , Thasanasuwan Wiyada , Yamborisut Uruwan
Published: November 2015

A Nutrifit programme, consisting of a nutrition education and physical training model, was developed by modifying an established Fitnessgram as a tool. the programme was tested among 514 schoolchildren aged eight to nine years who were enrolled in two provincial government schools (A and B) and two private schools (C and D) in the Bangkok Metropolitan Area. Health-related fitness tests using the Fitnessgram were administered in all four schools, followed by the Nutrifit programme intervention in schools B and D. the intervention included 10 nutrition and physical training education sessions during the regular physical education classes. During the seven-month programme period, though the nutritional status of children did not show a significant change, improvement in health-related fitness tests was noted in both non-intervened and intervened schools. It is recommended that the Nutrifit programme be incorporated into the school curriculum as a measure of nutrition and fitness aimed at health promotion and disease prevention.
The Aims and Content of Public Nutrition
Authors: Mason John B.
Published: November 2015

The meeting explored how greater professional solidarity and cooperation among those working in nutrition could accelerate progress in tackling malnutrition worldwide, with particular emphasis on problems of poor people in poor countries. the case is made in other papers that malnutrition merits renewed effort because of its profound biological effects, including intergenerational effects; its impact on educability and human capital formation; and the recognition of good nutrition as a human right. Although the recent past has seen a number of approaches, community-based programs and micronutrient interventions have proved especially successful; this has led to broad agreement on strategy, as articulated notably by UNICEF. the purpose of now bringing ideas and people together under the heading of public nutrition—which has the implications of population-level and of shared responsibility—is to build on experience and to contribute to improving nutrition much faster than at present. the scope of public nutrition covers knowledge and research on nutrition problems, and controlling these by intervention; it extends beyond the public health field to include, for example, aspects of economics and humanitarian assistance. How to apply knowledge to programmes and how to best foster effective interventions are key issues. A starting point is to support research (with priority to programme impact evaluations), training (curricula are being developed), and networking. Follow-up means the collaboration of those concerned with nutrition to generate momentum for public nutrition.
Report of an International Union of Nutrition Sciences (IUNS) Satellite Meeting on Public Nutrition at the 16th International Congress of Nutrition held in Montreal, 24–26 July 1997
Authors: Mason John B. , Rogers Beatrice L. , Agyeman Yaw
Published: November 2015

This report summarizes the scope of ideas introduced and debated at the first meeting on public nutrition, convened in Montreal as a Satellite Meeting of the 16th International Congress of Nutrition in the summer of 1997. Consensus was reached, in principle, on the issue of definition and why defining the field was necessary. from this emerged strategic themes related to advocacy, capacity building, training, and research, along with future collaboration for generating momentum for the field. Proposed follow-up strategies include explorations of national and regional networks and meetings, systematic advocacy to raise the profile and clarify issues in public nutrition, and curriculum development to provide adequate training for professionals in the field.
Patterns of Change in Food Consumption and Dietary Fat Intake in Chinese Adults, 1989–1993
Authors: Guo Xuguang , Popkin Barry M. , Zhai Fengying
Published: November 2015

Dietary and socio-economic data were collected from over 5,600 Chinese adults aged 20 to 45 in 1989, 1991, and 1993. Adults were categorized by income and other socio-economic variables, and dietary changes between 1989 and the subsequent two periods were studied. the quantities and proportions of animal foods and edible oils consumed increased dramatically, while daily consumption of grains and potatoes decreased by about 41 to 77 g. This decrease was greatest among coarse grains (corn, millet, and sorghum). the largest contributors to increased fat intake were edible oils, high-fat red meat, and lard and butter. Those eating more grain consumed less fat. Among high-income persons in 1993, 58% had a higher fat intake than recommended (> 30% of calories from fat), 31% had a high intake of saturated fat (> 10% of calories from saturated fat), and 40% had a cholesterol intake exceeding 300 mg/day. the corresponding figures were 27%, 15%, and 21% among low-income persons. This study raises important concerns about some long-term adverse consequences of economic change in China.
The Case for Promoting Multiple Vitamin And Mineral Supplements for Women of Reproductive Age in Developing Countries
Authors: Huffman Sandra L. , Baker Jean , Shumann Jill , Zehner Elizabeth R.
Published: November 2015

Women in developing countries often consume inadequate amounts of micronutrients because of their limited intake of animal products, fruits, vegetables, and fortified foods. Intakes of micronutrients less than the recommended values increase a woman's risk of having micronutrient deficiencies. the adverse effects of deficiencies in vitamin A, iron, and folic acid, including night-blindness in pregnant and lactating women and iron-deficiency anaemia, are well known. Low intakes of these and other nutrients, including zinc, calcium, riboflavin, vitamin B6, and vitamin B12, also have consequences for women's health, pregnancy outcome, and the health and nutritional status of breastfed children. Multiple deficiencies coexist, so the benefit of multiple micronutrient supplements is becoming increasingly apparent. Supplementation of women with multiple vitamins and minerals should be one component of a strategy to improve micronutrient status among women in developing countries. However, there are several issues for programme managers to consider before implementing programmes. Which reference standards will be used to determine nutrient levels to include in the supplements? Which nutrients will be included and in what quantities? Which factors need to be considered in purchasing supplements? These issues are discussed, and guidance is provided on the selection of appropriate supplements for pregnant women and women of reproductive age in developing countries.
Clinical Screening May be a Cost-Effective Way to Screen for Severe Anaemia
Authors: Dusch Erin , Galloway Rae , Achadi Endang , Jus'at Idrus , Sibale Chakunja , Franco Ciro , Cousens Simon , Morison Linda
Published: November 2015

Clinical screening for pallor is one of the most common methods of screening for anaemia. Health workers examine the face, inner lower eyelids or conjunctiva, palms, nail beds, and other body parts for paleness or pallor that may be a sign of anaemia. MotherCare found 17 studies that evaluated the sensitivity and specificity of using pallor to identify individuals with anaemia. the focus was to review the sensitivity of pallor screening to detect individuals with severe anaemia and to make recommendations to improve the sensitivity of screening for pallor. the studies confirmed that sensitivities increased as the haemoglobin level decreased.
Performance validation case study: Federal office building with an integrated facade
Authors: Perepelitza Mark , Petterson Lisa , Turpin Kate
Published: November 2015

The General Services Administration Edith Green Wendell Wyatt building has undergone an extensive retrofit and is distinguished by its new integrated facade.1 It has been transformed from a poorly performing office building into a highly efficient Leadership in Energy and Environmental Design (LEED) Platinum facility. The unitized curtain wall includes fixed exterior shading tuned for each solar orientation. The new interior environment optimizes daylight and electric lighting, thermal comfort, and air quality. This article reports on post-occupancy evaluations to validate and fine-tune the performance of Edith Green Wendell Wyatt building. The focus is on post-occupancy evaluation studies that relate to the integrated facades. Overall, post-occupancy evaluations address three categories: (1) resource use and generation—energy and water, (2) occupant satisfaction, and (3) indoor environmental quality measurements. During design, the impact of building enclosure measures and internal loads was linked directly to the selection of the mechanical system. The team determined that strategic use of glazing and exterior shading would support highly efficient hydronic radiant heating and cooling. Post-occupancy evaluation methods include installed data sources (from the building management system and other installed measurement and verification systems) and proposed field testing. Occupant satisfaction has been evaluated with an on-line survey from the Center for the Built Environment. The results have been filtered by solar orientation, floor, and other criteria to understand the facades’ impact on occupant satisfaction. Pre-occupancy results and additional benchmarking compare the results with government and other general office buildings. As of January 2015, many of the post-occupancy evaluation studies have been completed, but some are still on-going. Post-occupancy evaluation objectives include: demonstrating federal energy compliance, refining building performance, and providing feedback for future work.
Everyday Stressors of Academically Gifted Adolescents
Authors: Baker Jean A.
Published: November 2015

This study evaluated everyday “hassles” and other stressors experienced by academically gifted, exceptionally academically gifted, and academically average adolescents. The results suggest that gifted and non-gifted adolescents experienced similar levels and types of everyday stressors. However, exceptional and to some degree gifted girls endorsed more perfectionistic tendencies than did their average peers. The need for affective education and psychosocial interventions for gifted students in schools is discussed.

Adolescence is a time of increased stress for all youth. Educators of the gifted have had a long and enduring concern about the special stressors and pressures affecting gifted adolescents (e.g., Hollingworth, 1942; Seeley, 1993). Although gifted students are often posited to have strong psychosocial characteristics (e.g., Clark, 1988), we also have documentation that giftedness can generate stress and conflict for some students (e.g., Whitmore, 1980). Although we might expect high levels of stress from gifted students experiencing psychosocial or educational difficulties (i.e., underachieving gifted students), we have little normative information about problems and strains experienced by “typical” gifted adolescents. This study focused on specific stressors endorsed by academically gifted adolescents and compared them to those endorsed by their peers of average academic ability.
The Development of Math Talent: Influences on Students at a Women's College
Authors: Gavin M. Katherine
Published: November 2015

An examination of the distribution of women who earn doctorates in mathematics and science presents a picture of uneven advancement. Women are clustered in the life sciences with far fewer majoring in the physical sciences, mathematics, engineering, and computer sciences.

Recent studies attempting to identify factors that influence a woman's choice of career in the mathematical fields have focused on either women who have completed doctorates or formal training in their chosen fields or women presently in graduate programs in mathematics. This study focuses on math majors still in college, specifically 16 females at a highly selective liberal arts women's college, and factors that influenced their choice of this major and future career plans. A qualitative research methodology was employed using questionnaires, interviews with the students and the mathematics faculty, participant observation in mathematics classrooms, and document reviews of college and departmental publications.

Findings revealed that positive school experiences and certain shared personality characteristics were integral in students' decisions to continue the study of mathematics in college.
The Preparation and Performance of Freshmen in University Honors Programs
Authors: Guerrero Janis K. , Riggs Shelley A.
Published: November 2015

This study sought to investigate the level of performance exhibited by university honors freshmen and to explore the knowledge and skill demands of advanced higher education programs in order to construct an empirical base for the development of standards for gifted learners in grades K-12. A sample of 145 faculty members from 28 honors programs at flagship universities across the United States participated in the telephone survey conducted during the summer of 1994. The survey asked respondents to assess their students' process skills of critical thinking, creative thinking, problem solving, research, written and oral communication, and leadership. Also, respondents assessed their students' knowledge deficiencies and identified qualities that distinguish exceptional students. Respondents reported moderate satisfaction with student performance of the process skills. Subjects appeared to concur with Renzulli's (1986) construct of task commitment when they identified motivation, attitude, intellectual curiosity, and discipline as important distinguishing factors of outstanding honors students.
The Effect on Mathematics Achievement and Attitude of Homogeneous and Heterogeneous Grouping of Gifted Sixth-Grade Students
Authors: Hunt Barbara
Published: November 2015

The primary purpose of this study was to identify the effect on mathematics achievement and attitude of homogeneous and heterogeneous grouping of gifted sixth grade students. The secondary purpose was to find the effect on mathematics achievement and attitude of homogeneous and heterogeneous grouping on average- and low-ability students. There were 208 subjects in the study. The results indicated that there was a positive effect for achievement in mathematics for identified gifted sixth graders in homogeneous grouping when compared to gifted students in heterogeneous grouping using the TOMA (Test of Mathematical Abilities) – Computation Subtest. No statistically significant difference was found for mathematics achievement for average and low ability students based on grouping. Quantitative and qualitative results will be shared related to students' attitudes toward grouping.
Betty's Story
Authors: Sanders Michael
Published: November 2015

This life history is created within the context of a larger study. Purposeful sampling was used to identify six college-aged, self-identified intellectuals from a group of students in a University Scholars program at a large university. The group included three men and three women all around 20 years old.

Multiple interviews with member checks were used to create textual data from each participant. Participants discussed personal independence, the desire to learn, the meaning of the term “intellectual,” attitudes toward schooling, their teachers, educational programs for intellectually gifted students, social and cultural interests, their personal lives, and other topics. The analysis of the data used textual information from the interviews combined with information from sociological and anthropological sources to situate the participants' life stories in social, historical, and cultural contexts thereby creating life histories.

A life lived is what actually happens. A life experienced consists of the images, feelings, desires, thoughts, and meanings known to the person whose life it is … A life as told, a life history, is a narrative, influenced by the cultural conventions of telling, by the audience, and by the social context (Denzin, 1989, p. 30).
The Impact of Social Skills Training on the Self-concepts of Gifted High School Students
Authors: Clark Jennifer J. , Dixon David N.
Published: November 2015

In an exploratory outcome study, the social self-concepts of four gifted high school students attending a rigorous residential program were examined as they participated in a social skills workshop. Subjects participated in a pre-test measurement of their global self-concept using the Marsh Self-Description Questionnaire III which differentiates between social self-concept and academic self-concept. The subjects then participated in a three-week social skills workshop that was patterned after the Culcross and Jenkins-Friedman (1988) model. A post-test self-concept measurement was gathered Contrary to the hypothesis, the subjects did not demonstrate an increase in their social self-concepts. Implications of this study and suggestions for future research are presented.
Clinical Pearls in Using Antiarrhythmic Drugs in the Outpatient Setting
Authors: Parker Mary H. , Sanoski Cynthia A.
Published: November 2015

A role for oral antiarrhythmic drugs (AADs) remains in clinical practice for patients with atrial and ventricular arrhythmias in spite of advances in nonpharmacologic therapy. Pharmacists play a vital role in the appropriate use of AAD dosing, administration, adverse effects, interactions, and monitoring. Pharmacists who are involved in providing care to patients with cardiac arrhythmias must remain updated regarding the efficacy and safety of the most commonly used AADs. This review will address key issues for appropriate initiation and maintenance of commonly selected Vaughan-Williams Class Ic and III agents in the outpatient setting.
Teaching in Educational Leadership Using Web 2.0 Applications: Perspectives on What Works
Authors: Shinsky E. John , Stevens Hans A.
Published: November 2015

To prepare 21st Century school leaders, educational leadership professors need to learn and teach the utilization of increasingly sophisticated technologies in their courses. The co-authors, a professor and an educational specialist degree candidate, describe how the use of advanced technologies — such as Wikis, Google Docs, Wimba Classroom, and Discussion Board — have served as a catalyst for learning among educational leadership students. Details regarding how technology has been used in one course are described, demonstrating how various apps and software applications can easily be applied in other courses.
Mississippi
Authors: Putnam Michael , Cabrera Jill
Published: November 2015

The funding mechanism for the public schools in the state of Mississippi had been surprisingly stable for a number of years. The funding formula existed in its same form for over a half century before it was substantially changed in 1994 when the Mississippi Adequate Education Program (MAEP) legislation was passed. This is the first external analysis of the MAEP since its inception. An analysis of the horizontal equity is undertaken to determine the state of equality between districts in the state. Vertical equity is examined to determine if disparity exists between unequal circumstances of school districts. In addition, the federal range ratio is scrutinized for appropriate variances between the highest funded school districts and their counterparts in the state of Mississippi. Although this study shows gains in horizontal equity, it reveals a weakening of vertical equity. In combination, more funding is available per student overall, but school districts are not receiving sufficient funds to equitably educate children with specific needs, such as living in an area with extremely low socioeconomic conditions. Results of this research strongly suggest Mississippi will continue to languish in academic achievement until MAEP is fully funded on a consistent basis.
Blood basophil activation is a reliable biomarker of allergic bronchopulmonary aspergillosis in cystic fibrosis
Authors: Gernez Yael , Waters Jeffrey , Mirković Bojana , Lavelle Gillian M. , Dunn Colleen E. , Davies Zoe A. , Everson Cassie , Tirouvanziam Rabindra , Silver Elana , Wallenstein Sylvan , Chotirmall Sanjay H. , McElvaney Noel G. , Herzenberg Leonore A. , Moss Richard B.
Published: November 2015

The diagnosis of cystic fibrosis (CF) patients with allergic bronchopulmonary aspergillosis (ABPA) is clinically challenging, due to the absence of an objective biological test. Since blood basophils play a major role in allergic responses, we hypothesised that changes in their surface activation pattern discriminate between CF patients with and without ABPA.

We conducted a prospective longitudinal study (Stanford cohort) comparing basophil activation test CD203c levels by flow cytometry before and after activation withAspergillus fumigatusallergen extract or recombinantAspf1 in 20 CF patients with ABPA (CF-ABPA) and in two comparison groups: CF patients withA. fumigatuscolonisation (AC) but without ABPA (CF-AC; n=13) and CF patients without either AC or ABPA (CF; n=12). Patients were tested every 6 months and when ill with pulmonary exacerbation. We also conducted cross-sectional validation in a separate patient set (Dublin cohort).

Basophil CD203c surface expression reliably discriminated CF-ABPA from CF-AC and CF over time. Ex vivostimulation withA. fumigatusextract or recombinantAspf1 produced similar results within the Stanford (p<0.0001) and the Dublin cohorts. CF-ABPA patients were likelier to have elevated specific IgE toA. fumigatusand were less frequently co-infected withStaphylococcus aureus.

Basophil CD203c upregulation is a suitable diagnostic and stable monitoring biomarker of ABPA in CF.
Two matrix metalloproteinase classes reciprocally regulate synaptogenesis
Authors: Dear Mary Lynn , Dani Neil , Parkinson William , Zhou Scott , Broadie Kendal
Published: November 2015

Synaptogenesis requires orchestrated intercellular communication between synaptic partners, with trans-synaptic signals necessarily traversing the extracellular synaptomatrix separating presynaptic and postsynaptic cells. Extracellular matrix metalloproteinases (Mmps) regulated by secreted tissue inhibitors of metalloproteinases (Timps), cleave secreted and membrane-associated targets to sculpt the extracellular environment and modulate intercellular signaling. Here, we test Mmp roles at the neuromuscular junction (NMJ) model synapse in the reductionist Drosophila system, which contains just two Mmps (secreted Mmp1 and GPI-anchored Mmp2) and one secreted Timp. We find all three matrix metalloproteome components co-dependently localize in the synaptomatrix. We find both Mmp1 and Mmp2 independently restrict synapse morphogenesis and functional differentiation. Surprisingly, either dual knockdown or simultaneous inhibition of the two Mmp classes together restores normal synapse development, identifying a novel reciprocal suppression mechanism. We find the two Mmp classes co-regulate a Wnt trans-synaptic signaling pathway modulating structural and functional synaptogenesis, including the GPI-anchored heparan sulfate proteoglycan (HSPG) Wnt co-receptor Dally-like Protein (Dlp), cognate receptor Frizzled-2 and Wingless ligand. Loss of either Mmp1 or Mmp2 reciprocally misregulates Dlp at the synapse, with normal signaling restored by co-removal of both Mmp classes. Correcting Wnt co-receptor Dlp levels in both mmp mutants prevents structural and functional synaptogenic defects. Taken together, these results identify a novel Mmp mechanism that fine-tunes HSPG co-receptor function to modulate Wnt signaling to coordinate synapse structural and functional development.