bluuebunny/crossref_metadata_2025 huggingface dataset:
Vegetable Oil of Poor Quality is Limiting the Success of Fortification with Vitamin A in Egypt
Authors: Laillou Arnaud , Hafez Saeb A. , Mahmoud Amal H. , Mansour Mohamed , Rohner Fabian , Fortin Sonia , Berger Jacques , Ibrahim Nabih A. , Moench-Pfanner Regina
Published: November 2015

Background

Fortification of vegetable oil with vitamin A is considered a cost-effective and simple to implement strategy, but the stability of vitamin A remains a limiting factor. To account for losses of vitamin A, oil producers add an overage. Optimizing the amount of this overage can result in considerable savings for industry and government while ensuring a supply of adequately fortified oil to consumers.

Objectives

To estimate vitamin A losses in oil with different chemical characteristics.

Methods

Samples of fortified oils with different chemical characteristics were collected from two Egyp- tian companies (oil A and B) and stored for 1 month. Vitamin A levels were analyzed periodically during stor- age to determine losses over time, and peroxide values were determined.

Results

Fortified oil B, with a high peroxide value (5.8 mEq/kg), exposed to sunlight had significantly higher losses of vitamin A after 4 weeks than fortified oil A, with a low peroxide value (0.4 mEq/kg): 31.1% vs. 19.7% ( p < .001), respectively. In semidark conditions, the vitamin A losses after 4 weeks in fortified oil B and fortified oil A were significantly different: 26.1% and 0.7% ( p < .001), respectively. In an accelerated storage test, the vitamin A loss in 8 days was 48.3% for fortified oil B and 4.2% for fortified oil A ( p < .001).

Conclusions

This study shows a significant effect of peroxide level (one indicator of the quality of oil) on the stability of vitamin A, regardless of storage conditions. To optimize and sustain vitamin A levels in fortified oil, governments and industries should minimize the perox- ide level to less than 2 mEq/kg at production.
A Situation Analysis of Public Health Interventions, Barriers, and Opportunities for Improving Maternal Nutrition in Bihar, India
Authors: Noznesky Elizabeth A. , Ramakrishnan Usha , Martorell Reynaldo
Published: November 2015

Background

Maternal underweight and anemia are highly prevalent in Bihar, especially among adolescent girls aged 15 to 19 years. Although numerous programs and platforms exist for delivering efficacious interventions for improving maternal nutrition, the coverage and quality of these interventions are low.

Objective

To examine existing interventions for reducing maternal undernutrition in Bihar and identify barriers to and opportunities for expanding their coverage and quality.

Methods

The research was conducted in New Delhi and Bihar between May and August 2010. Forty-eight key informant interviews were conducted with policy makers, program managers, and service providers at multiple levels. Secondary data were collected from survey reports and program documents. All data were analyzed thematically.

Results

Barriers to the delivery and uptake of interventions to improve maternal nutrition include the shortage of essential inputs, low prioritization of maternal undernutrition, sterilization bias within the family planning program, weak management systems, poverty, gender inequality, caste discrimination, and flooding. In order to overcome barriers and improve service delivery, the current government and its partners have introduced structural reforms within the public health system, launched new programs for underserved groups, developed innovative approaches, and experimented with new technologies.

Conclusions

Since coming to power, the Government of Bihar has achieved impressive increases in the coverage of prioritized health services, such as institutional deliveries and immunization. This success presents it with an excellent opportunity to further reduce maternal and infant mortality by turning its attention to the serious problem of maternal undernutrition and low birthweight.
Comparison of Estimates of the Nutrient Density of the Diet of Women and Children in Uganda by Household Consumption and Expenditures Surveys (HCES) and 24-Hour Recall
Authors: Jariseta Zo Rambeloson , Dary Omar , Fiedler John L. , Franklin Nadra
Published: November 2015

Background

Individual dietary intake data are important for informing national nutrition policy but are rarely available. National Household Consumption and Expenditures Surveys (HCES) may be an alternative method, but there is no evidence to assess their relative performance.

Objective

To compare HCES-based estimates of the nutrient density of foods consumed by Ugandan women (15 to 49 years of age) and children (24 to 59 months of age) with estimates based on 24-hour recall.

Methods

The 52 food items of the Uganda 2006 HCES were matched with nutrient content of foods in a 2008 24-hour recall survey, which were used to refine the HCES-based estimates of nutrient intakes. Two methods were used to match the surveys' food items. Model 1 identified the four or five most commonly consumed foods from the 24-hour recall survey and calculated their unweighted average nutrient contents. Model 2 used the nutrient contents of the single most consumed food from the 24-hour recall. For each model, 14 estimates of nutrient densities of the diet were made and 84 differences were compared.

Results

Models 1 and 2 were not significantly different. Of the model 2 HCES-24-hour recall comparisons, 67 (80%) did not find a significant difference. No significant differences were found for protein, fat, fiber, iron, thiamin, riboflavin, and vitamin B6 intakes. HCES overestimated intakes of vitamins C and B12 and underestimated intakes of vitamin A, folate, niacin, calcium, and zinc in at least one of the groups.

Conclusions

The HCES-based estimates are a relatively good proxy for 24-hour recall measures of nutrient density of the diet. Further work is needed to ascertain nutrient adequacy using this method in several countries.
Flour Fortification in South Africa: Post-Implementation Survey of Micronutrient Levels at Point of Retail
Authors: Yusufali Rizwan , Sunley Nigel , de Hoop Maude , Panagides Dora
Published: November 2015

Background

Fortification of staple foods is an effective strategy to deliver and increase the intake of micronutrients in the diet and can reduce micronutrient deficiencies. It is important to ensure that the food vehicle consistently contains adequate amounts of nutrients at the point of consumption for effective impact.

Objective

This survey aimed to gauge the level of fortification of maize and wheat flour at the retail level compared with staple food fortification regulations in South Africa to better understand the current obstacles to effective delivery of micronutrients through flour fortification and consider approaches to strengthening the program.

Methods

White bread flour and maize meal samples were collected from retail points across all provinces and analyzed for vitamin A, iron, and nicotinamide, and a database capturing the origins of the sample was populated. Nicotinamide and vitamin A results were compared against each other and evaluated against food regulations.

Results

The level of compliance with statutory fortification requirements was low, both for bread flour and for maize meal. There is evidence of insufficient addition of premix as opposed to losses due to vitamin A stability as seen from the strong correlation between vitamin A and nicotinamide in maize meal.

Conclusions

The current levels of micronutrients added to maize meal and bread flour are unsatisfactory. This is likely to be because of insufficient addition of premix at the mills. This affects the availability and intake by consumers of fortified product and potentially prevents the desired reduction in vitamin and mineral deficiencies expected from the flour fortification program.
From Nutrition plus to Nutrition Driven: How to Realize the Elusive Potential of Agriculture for Nutrition?
Authors: Haddad Lawrence
Published: November 2015

Background

Agriculture has the potential to have a bigger impact on nutrition status than it currently does. The pathways between agriculture and nutrition are well known. Yet the evidence on how to increase the impact of agriculture on nutrition is weak.

Objective

To outline some of the possible reasons for the weak evidentiary link between agriculture and income and to highlight some approaches to incentivizing agriculture to give nutrition a greater priority.

Methods

A review of literature reviews and other studies.

Results

Agriculture does not have a strong poverty and nutrition impact culture, the statistical links between aggregate agriculture and nutrition data are weak, literature reviews to date have not been sufficiently clear on the quality of evidence admitted, and the evidence for the impact of biofortification on nutrition status is positive, but small. Some tools are proposed and described that may be helpful in raising the profile of nutrition outcomes, building nutrition outcomes into impact assessments of agriculture, measuring the commitment to undernutrition reduction, and helping to prioritize nutrition-relevant actions within agriculture. Leadership in agriculture and nutrition is also an understudied issue.

Conclusions

Agriculture has a vast potential to increase its impact on nutrition outcomes. We don't know if this potential is being fully realized as yet. I suspect it is not. Tools that help promote the visibility of nutrition within agriculture and the accountability of agriculture toward nutrition can possibly contribute to moving “from Nutrition Plus to Nutrition Driven” agriculture.
Increasing Fruit and Vegetable Consumption among Schoolchildren: Efforts in Middle-Income Countries
Authors: Wijesinha-Bettoni Ramani , Orito Aya , Löwik Marianne , McLean Catherine , Muehlhoff Ellen
Published: November 2015

Background

To reverse the trend of rising child obesity rates in many middle-income countries, recommendations include increasing fruit and vegetable consumption. Schools can positively impact children's eating behavior, and multicomponent interventions that include the curriculum, school food environments, and parental involvement are most effective.

Objective

To find out how fruits and vegetables feature in the dietary guidelines provided to schools, what specific schemes are available for providing these foods, the extent to which nutrition education is included in the curriculum, and how vegetables and fruits are procured in primary schools.

Methods

In 2008, a survey questionnaire previously validated and revised was sent electronically to national program managers and focal points for school feeding programs in 58 middle-income countries. The rationale was to obtain information relevant to the entire country from these key informants. The survey response rate was 46%. The information provided by 22 respondents in 18 countries was included in the current study. On average, respondents answered 88% of the questions analyzed in this paper. Of the respondents, 73% worked for the national authority responsible for school food programs, with 45% at the program coordinator or director level.

Results

Few countries have any special fruit and vegetable schemes; implementation constraints include cost and lack of storage facilities. Although 11 of 18 countries have both nutrient-based guidelines and school food guidelines for meals, fruits and vegetables are often not adequately specified.

Conclusions

In some countries, nutrition education, special activities, school gardens, and parental participation are used to promote fruits and vegetables. Specific schemes are needed in some, together with school food guidelines that include fruits and vegetables.
Prevalence of Overweight and Obesity among 6- to 9-Year-Old Schoolchildren in Cuenca, Ecuador: Relationship with Physical Activity, Poverty, and Eating Habits
Authors: Abril Victoria , Manuel-y-Keenoy Begoña , Solà Rosa , García Jorge Luis , Nessier Celeste , Rojas Rosendo , Donoso Silvana , Arija Victoria
Published: November 2015

Background

The high prevalence of childhood overweight and obesity is a health problem worldwide. In developing countries, we lack information on the extent of the problem and the risk factors involved.

Objective

To determine the prevalence rates of overweight and obesity and of abdominal obesity, and their relationship with physical activity, poverty, and eating habits in schoolchildren in Cuenca, Ecuador.

Methods

A cross-sectional survey in a representative sample ( n = 743) schoolchildren aged 6 to 9 years was conducted. Overweight and obesity were detected using the International Obesity Task Force cutoffs according to body mass index (BMI), and abdominal obesity was detected according to waist circumference. Poverty, physical activity, and eating habits were assessed with validated questionnaires.

Results

The prevalence rates of overweight and obesity and of abdominal obesity were 26.0% and 10.6%, respectively. There were no differences between the sexes, but the prevalence of overweight and obesity was 1.5- to 2-fold higher in 9-year-old than in 6-year-old children ( p < .05). Multivariate models demonstrated that higher BMI and waist circumference were significantly related to low physical activity and nonpoverty. Insufficient physical activity (in 75% of children) was associated with a 13% to 18% increased risk of overweight and obesity and abdominal obesity. Eating breakfast and eating more than three meals per day (in 96.7% and 85.9% of children, respectively) were not related to the prevalence of overweight and obesity. Eating fruits during school break was associated with a lower BMI.

Conclusions

The high prevalence of overweight and obesity observed in schoolchildren increased from the ages of 6 to 9 years and was associated with insufficient physical activity and nonpoverty. Promoting physical activity and fruit consumption in school snacks should be explored as intervention measures to prevent and reduce overweight and obesity in Cuenca schoolchildren.
Operational Guidance on the Use of Special Nutritional Products in Refugee Populations
Authors: Style Sarah , Tondeur Melody , Wilkinson Caroline , Oman Allison , Spiegel Paul , Kassim Ismail A. R. , Grijalva-Eternod Carlos , Dolan Carmel , Seal Andrew
Published: November 2015

Background

Stunting, acute malnutrition, and micronutrient malnutrition are persistent public health problems in refugee populations worldwide. In recent years there has been an increase in the availability and use of special nutritional products in emergency and development contexts to help address inadequate nutrient intakes from low-diversity diets. The availability of new special nutritional products, and the decision by the United Nations High Commissioner for Refugees (UNHCR) to use blanket supplementary feeding programs to prevent stunting and anemia, raised new challenges for designing, monitoring, and evaluating nutritional programs.

Objective

To develop an Operational Guidance on the use of special nutritional products for the prevention of micronutrient malnutrition, stunting, and acute malnutrition in refugee populations.

Methods

A literature review and a series of consultations with technical experts, operational organizations, and field staff were performed over a period of 2 years. The Operational Guidance was finalized and released in December 2011.

Results

The Operational Guidance describes six stages for defining nutritional problems and identifying possible solutions; assessing and managing risks; testing acceptability and adherence, program design and implementation; and monitoring and evaluation. Key performance indicators are defined and a working nomenclature for new special nutritional products is described.

Conclusions

The UNHCR Operational Guidance has filled an important gap in helping field staff deal with the opportunities and challenges of preventing under-nutrition through the use of new products in blanket supplementary feeding programs. The need for further integration of guidance on selective feeding programs is discussed.
Policy Implications of Using a Household Consumption and Expenditures Survey versus an Observed-Weighed Food Record Survey to Design a Food Fortification Program
Authors: Lividini Keith , Fiedler John L. , Bermudez Odilia I.
Published: November 2015

Background

Observed-Weighed Food Record Surveys (OWFR) are regarded as the most precise dietary assessment methodology, despite their recognized shortcomings, which include limited availability, high cost, small samples with uncertain external validity that rarely include all household members, Hawthorne effects, and using only 1 or 2 days to identify “usual intake.” Although Household Consumption and Expenditures Surveys (HCES) also have significant limitations, they are increasingly being used to inform nutrition policy.

Objective

To investigate differences in fortification simulations based on OWFR and HCES from Bangladesh.

Methods

The pre- and postfortification nutrient intake levels from the two surveys were compared.

Results

The total population-based rank orderings of oil, wheat flour, and sugar coverage were identical for the two surveys. OWFR found differences in women's and children's coverage rates and average quantities consumed for all three foods that were not detected by HCES. Guided by the Food Fortification Formulator, we found that these differences did not result in differences in recommended fortification levels. Differences were found, however, in estimated impacts: although both surveys found that oil would be effective in reducing the prevalence of inadequate vitamin A intake among both subpopulations, only OWFR also found that sugar and wheat flour fortification would significantly reduce inadequate vitamin A intake among children.

Conclusions

Despite the less precise measure of food consumption from HCES, the two surveys provide similar guidance for designing a fortification program. The external validity of these findings is limited. With relatively minor modifications, the precision of HCES in dietary assessment and the use of HCES in fortification programming could be strengthened.
Infant and Young Child Feeding Practices in Urban Philippines and Their Associations with Stunting, Anemia, and Deficiencies of Iron and Vitamin A
Authors: Rohner Fabian , Bradley A. Woodruff , Grant J. Aaron , Elizabeth A. Yakes , Lebanan May Antonnette O. , Rayco-Solon Pura , Saniel Ofelia P.
Published: November 2015

Background

The prevalence of stunting, underweight, and micronutrient deficiencies are persistently high in young children in the Philippines, and among other factors, suboptimal infant and young child feeding behavior may contribute to these forms of malnutrition.

Objective

To improve the understanding of contributors associated with the nutritional status of children 6 to 23 months of age living in urban areas of the Philippines.

Methods

A cross-sectional survey was conducted covering five urban centers in the Philippines. Data on infant and young child feeding and nutritional status (including wasting, stunting, underweight, anemia, iron deficiency, and vitamin A deficiency) were collected for 1,784 children.

Results

Among children from urban and predominantly poor and very poor households, 26% were stunted, 18% were underweight, and 5% were wasted. Forty-two percent were anemic, 28% were iron deficient, and 3% were vitamin A deficient. About half of the children were breastfed within an hour after birth, were breastfed at the time of the survey, and had been continuously breastfed up to 1 year of age. Of the factors investigated, low socio-economic status, use of cheaper cooking fuel, and nonuse of multivitamins were all independently associated with stunting. The prevalence of anemia, iron deficiency, and vitamin A deficiency were independently associated with the same factors and poorer sanitation facilities, lower maternal education, current unemployment, and inflammation.

Conclusions

These factors merit attention in future programming, and interventions may include promotion of the timely introduction of appropriate fortified complementary foods, the use of affordable multiple micronutrient preparations, and measures to reduce infections.
Developing Evidence-Based Advocacy and Policy Change Strategies to Protect, Promote, and Support Infant and Young Child Feeding
Authors: Hajeebhoy Nemat , Rigsby Andrew , McColl Alyson , Sanghvi Tina , Abrha Teweldebrhan Hailu , Godana Andenet , Roy Sumitro , Phan Linh Thi Hong , Vu Ha Thi Thu , Sather Megan , Uddin Belal
Published: November 2015

Background

Despite the existence of a strong evidence base for investing in infant and young child feeding (IYCF), sufficiently supported IYCF policies and programs are rare.

Objective

To develop evidence-based advocacy strategies in Bangladesh, Ethiopia, and Vietnam to enable policy change and to increase investments in and ensure scale-up and sustainability of IYCF programs.

Methods

Situational analysis, formative and opinion leader research, and stakeholder consultations were used to develop three contextualized advocacy strategies.

Results

Data were used to determine how IYCF was perceived and prioritized, identify opinion leaders and partners, identify barriers to and opportunities for strengthening commitment, and select messages, materials, and communication channels. Opinion leader research showed that malnutrition was a concern but not a priority for policy action. Where food security was an issue, poverty reduction strategies rather than IYCF programs were viewed as the solution. Few opinion leaders were aware of the importance of the first 1,000 days of life. In addition to policy gaps, awareness and implementation of existing policies were limited. This was often complicated by intragovernment conflicts and perspectives. Advocacy messages needed to be evidence based and delivered by credible champions. Engaging medical associations and the media presented an opportunity rarely leveraged in IYCF advocacy.

Conclusions

Although sociopolitical contexts may vary, awareness of the importance of IYCF is an overarching advocacy challenge. Consequently, investments in IYCF programs and policies lag. Evidence-based advocacy design has a potential for impact on national policies, investments, and commitment to implementation and should be used more widely to inform program design.
A Novel Mobile Phone Application to Assess Nutrition Environment Measures in Low- and Middle-Income Countries
Authors: Kanter Rebecca , Alvey Jeniece , Fuentes Deborah
Published: November 2015

Background

Consumer nutrition environment measures are important to understanding the food environment, which affects individual dietary intake. A nutrition environment measures survey for supermarkets (NEMS-S) has been designed on paper for use in Guatemala. However, a paper survey is not an inconspicuous data collection method.

Objective

To design, pilot test, and validate the Guatemala NEMS-S in the form of a mobile phone application (mobile app).

Methods

CommCare, a free and open-source software application, was used to design the NEMS-S for Guatemala in the form of a mobile app. Two raters tested the mobile app in a single Guatemalan supermarket. Both the interrater and the test—retest reliability of the mobile app were determined using percent agreement and Cohen's kappa score and compared with the interrater and test—retest reliability of the paper version.

Results

Interrater reliability was very high between the paper survey and the mobile app (Cohen's kappa > 0.90). Test—retest reliability ranged from kappa 0.78 to 0.91. Between two certified NEMS-S raters, survey completion time using the mobile app was 5 minutes less than that with the paper form (35 vs. 40 minutes).

Conclusions

The NEMS-S mobile app provides for more rapid data collection, with equivalent reliability and validity to the NEMS-S paper version, with advantages over a paper-based survey of multiple language capability and concomitant data entry.
Assessing the Potential of Wild Foods to Reduce the Cost of a Nutritionally Adequate Diet: An Example from Eastern Baringo District, Kenya
Authors: Termote Céline , Raneri Jessica , Deptford Amy , Cogill Bruce
Published: November 2015

Background

Wild foods and their actual and potential contributions to nutrition security have rarely been studied or considered in nutrition and conservation programs.

Objective

To study the role of wild food biodiversity in achieving a cost reduction of a nutritionally adequate diet for women and young children in Kenya using linear programming.

Methods

An ethnobiological inventory of available food biodiversity was carried out by means of focus group discussions, and five wild foods were selected for further modeling. A market survey assessed available food prices by season. Diets were modeled to minimize cost and maximize nutrient adequacy using the Cost of Diet linear programming tool. Modeling was done without and with wild foods.

Results

The modeled diets without wild species were deficient in iron for all age groups during the dry season, deficient in vitamin B6 and calcium for infants aged 6 to 8 months during the dry season, and deficient in iron and zinc for infants aged 6 to 8 months over the whole year. Adding wild foods, especially Berchemia discolor, to the modeled diets resulted in a lower-cost diet, while meeting recommended iron intakes for women and children between 12 and 23 months of age. Even after integrating wild foods into the model, targeted approaches are needed to meet micronutrient requirements for infants from 6 to 8 and from 9 to 11 months of age.

Conclusions

An application of linear programming to screen available wild foods for meeting recommended nutrient intakes at a minimal cost was illustrated. This type of study helps to objectively assess the potential of biodiversity to contribute to diets and nutrition.
Developing Food Supplements for Moderately Malnourished Children: Lessons Learned from Ready-to-Use Therapeutic Foods
Authors: Briend André , Akomo Peter , Bahwere Paluku , de Pee Saskia , Dibari Filippo , Golden Michael H. , Manary Mark , Ryan Kelsey
Published: November 2015

Ready-to-use therapeutic foods (RUTFs) are solid foods that were developed by changing the formulation of the existing liquid diet, F-100, recommended by the World Health Organization (WHO) for the rapid catch-up phase of the treatment of children suffering from severe acute malnutrition (SAM). The resulting products proved highly effective in promoting weight gain in both severely and moderately wasted children and adults, including those infected with HIV. The formulation of the existing RUTFs, however, has never been optimized to maximize linear growth, vitamin and mineral status, and functional outcomes. The high milk content of RUTFs makes it an expensive product, and using lower quantities of milk seems desirable. However, the formulation of alternative, less expensive but more effective versions of RUTF faces difficult challenges, as there are uncertainties regarding the effect in terms of protein quality, antinutrient content, and flatulence factors that will result from the replacement of current dairy ingredients by less expensive protein-rich ingredients. The formulation of alternative RUTFs will require further research on these aspects, followed by efficacy studies comparing the future RUTFs to the existing formulations.
Epidemiology of Child Developmental Problems: The Extent of the Problems of Poor Development in Children from Deprived Backgrounds
Authors: Scott Keith G. , Avchen Rachel Nonkin , Hollomon Holly A.
Published: November 2015

The causes of negative child outcomes need to be reconceptualized in terms of the effects of multiple risks. This paper reviews the extent of the problems associated with adverse development in children from deprived backgrounds using two parallel lines of research: epidemiological evidence and early intervention. Epidemiological studies suggest that multiple risk factors interact, magnifying the chances of non-optimal development for at-risk populations. Furthermore, evidence from intervention studies suggests that full-service intervention models are the most effective format for reducing poor developmental outcomes for at-risk children.
Effects of Health and Nutrition on Cognitive and Behavioural Development in Children in the First Three Years of Life: Part 2: Infections and Micronutrient Deficiencies: Iodine, Iron, and Zinc
Authors: Grantham-McGregor Sally M. , Fernald Lia C. , Sethuraman Kavita
Published: November 2015

The following paper and its accompanying paper (Grantham-McGregor SM, et al. Effects of health and nutrition on cognitive and behavioural development in children in the first three years of life. Part 1: Low birthweight, breastfeeding, and protein-energy malnutrition. Food Nutr Bull 1999;20:53–75) review the literature on the conditions that are prevalent and considered to be likely to affect child development and are therefore of public health importance. the reviews are selective, and we have generally focused on recent work, particularly in areas that remain controversial. the reviews are restricted to nutritional and health insults that are important in the first three years of life. Where possible, we have discussed the better studies. This paper considers the effects of infections and the major micronutrient deficiencies: iodine, iron, and zinc.
A Developmental Function of Motor Activity among Nutritionally At-Risk Children
Authors: Pollitt Ernesto , Huang Jia-Fen , Jahari Abas
Published: November 2015

Learning about the dynamics of early childhood development in the context of poverty and malnutrition is an effective way to identify the periods of highest psychosocial vulnerability and the role of timing in the differential responsivity of young children to interventions. Motor activity under natural conditions is one area of development that requires further study because of its biological and psychological developmental importance. This paper presents an estimate of the development function of motor activity among poorly nourished children whose ages ranged from 12 to 30 months. It also focuses on the longitudinal relationship between the nature, level of motor development, and intensity of motor actions, on the one hand, and physical growth, dietary intake, and motor activity, on the other.

Two cohorts (12 and 18 months old) of rural West Javanese children were studied. Motor activity, energy intake, physical growth, and motor development were measured every two months. A motor activity score was calculated based on the estimated energy cost and intensity of each activity and their frequency and duration during each of the periods of observation. Intensity was classified according to a three-point scale (high = 1.25, moderate = 1.0, low = 0.75). the Bayley Scale of Motor Development and a scale of motor milestones were used to assess motor development (e.g., crawling, creeping, walking, and running).

The developmental function of activity was curvilinear. It showed a moderately fast acceleration from 12 to about 18 to 20 months; at that point the curve reached a plateau. the functions of growth and energy intake were linear. the average motor behaviour of these children was characterized by its low level of intensity. Although the relationship between motor activity and motor development was relatively close up to about 20 months, thereafter the motor activity and motor development scores were independent of each other. the changes in activity level were primarily determined by a significant decline of involvement in activities having a low energy cost and an increase in activities having moderate or high energy cost. the decline of motor activity observed at 18 months is reminiscent of the decline in growth velocity observed during the first six months of life among malnourished children. It is plausible that the pattern of activity observed could be explained by either contextual or cultural factors.
Field Tests for Iodate in Salt
Authors: Diosady L. L. , Alberti J. O. , FitzGerald S. , Mannar M. G. Venkatesh
Published: November 2015

Commercially available field test kits for the determination of iodate in salt were tested to evaluate their performance and to devise improvements in their range and accuracy. Dropper tests based on the blue colour of the starch-iodine complex formed with iodine released by excess potassium iodide gave rapid qualitative indication of the presence of iodate. Because of the dark colour of the complex, the tests were found to be quantitative over only a limited range, typically 0 to 20 μg of iodine per gram of salt. We have developed methods for improving the reliability and colour reproducibility of these types of kits. Instructions for producing reliable kits of this type with improved colour reproducibility are presented. Improved qualitative tests in the range of 0 to 50 μg/g were obtained with a simple liquid-phase colourimetric system, based on the same chemistry. A field test kit was developed and tested in laboratories in India and Zimbabwe, as well as in our laboratory in Toronto. the test gave reproducible results, comparable to those of titration, with a typical standard deviation of ± 5 μg/g. the range of measurements can be extended to 100 μg/g by dilution. Instructions for preparing these kits are presented.
The Nature of Child Malnutrition and Its Long-Term Implications
Authors: Martorell Reynaldo
Published: November 2015

The problem of malnutrition in poor societies is best viewed as a “syndrome of developmental impairment,” which includes growth failure; delayed motor, cognitive, and behavioural development; diminished immunocompetence; and increased morbidity and mortality. Growth retardation is often found in association with other problems, such as vitamin A deficiency and anaemia. These clusters of nutritional problems flourish during periods of vulnerability, namely in utero and during the first three years of life, and affect at least a third of all young children in developing countries. Survivors of malnutrition in early childhood suffer functional disadvantages as adults, including diminished intellectual performance, low work capacity, and increased risk of delivery complications. the prevention of low birthweight and the promotion of adequate growth and development during early childhood will result in healthier, more productive adults. Such investments, because they build human capital, are best viewed as long-term economic strategies.
The Practice of Public Nutrition: Key Contributors and the Need for a Shared Understanding of the Problems
Authors: Beaudry Micheline
Published: November 2015

The effective resolution of major nutrition problems requires interdisciplinary and intersectoral approaches, and is of public interest; therefore a “public action” approach such as that described by Drèze and Sen in “Hunger and Public Action” is proposed to help define the key contributors required. Public action comprises action taken by members of the public, not merely for the public. It could include actions of very diverse public institutions, both collaborative and adversarial, in addition to those of government and the private sector, provided they can influence communities, families, and individuals, are taken in collaboration, and share a common purpose. Conditions of effective collaboration, including the need to arrive at a broad and shared understanding of the problem, are highlighted. the potentially critical role of academic and research institutions is briefly reviewed, and it is suggested that they may not be fully contributing to the necessary advances in broadening the understanding of nutrition problems.
Public Policy in Nutrition: Us Nutrition Safety Net Past, Present, and Future
Authors: Kennedy Eileen
Published: November 2015

The paper reviews the history leading to the creation of the US Safety Net as well as synthesis and critique of evaluation research for the three major programmes: Food Stamps, School Feeding, and WIC. the effects of the cadre of safety net programmes on household income are examined. the recent Welfare Reform Legislation changed the nature and scope of the nutrition safety net. the implications of these changes for income, diet, and nutritional status are discussed as well as critical issues for maintaining the effectiveness of the nutrition safety net in the future.
Is One Nutritional Benchmark Appropriate? Dilemma in Nutritional Assessment and Growth Monitoring of Children under Five Years of Age in Fiji
Authors: Saito Shoko , Marks Geoffrey C.
Published: November 2015

The same criteria for assessing nutritional status of children, including internationally recommended anthropometric reference data and standard cut-off values, are commonly applied across different ethnic groups and to meet several programme objectives. the situation in Fiji is used to illustrate some issues that arise from this. Fiji has two major ethnic groups with very different physiques, Fijians and Indians. When using the same weight-forage criteria to assess children of both ethnic groups, the results always show a much higher prevalence of underweight among Indian than among Fijian children. Yet, it is Fijian children who have a higher infant mortality rate due to infections and diarrhoeal diseases and have a higher hospital admission rate due to malnutrition. Work pressures in clinics militate against using different criteria for growth monitoring and meeting clinic reporting requirements. the implications are discussed. the “best” criteria here will differ across programme objectives but must also take account of the work setting.
Management of patients with faecal incontinence
Authors: Duelund-Jakobsen Jakob , Worsoe Jonas , Lundby Lilli , Christensen Peter , Krogh Klaus
Published: November 2015

Faecal incontinence, defined as the involuntary loss of solid or liquid stool, is a common problem affecting 0.8–8.3% of the adult population. Individuals suffering from faecal incontinence often live a restricted life with reduced quality of life. The present paper is a clinically oriented review of the pathophysiology, evaluation and treatment of faecal incontinence.

First-line therapy should be conservative and usually include dietary adjustments, fibre supplement, constipating agents or mini enemas. Biofeedback therapy to improve external anal sphincter function can be offered but the evidence for long-term effect is poor. There is good evidence that colonic irrigation can reduce symptoms and improve quality of life, especially in patients with neurogenic faecal incontinence. Surgical interventions should only be considered if conservative measures fail. Sacral nerve stimulation is a minimally invasive procedure with high rate of success. Advanced surgical procedures should be restricted to highly selected patients and only performed at specialist centres. A stoma should be considered if other treatment modalities fail.
Effects of Academic Achievement, Sex, and Community of Residence on Four Types of Career Indecision
Authors: Hall Alex S. , Kelly Kevin R.
Published: November 2015

The effects of academic achievement and sex on four types of career indecision of young adolescents were examined in two studies. In the first study, high achievers were found to perceive fewer external barriers to the pursuit of their career goals than average achievers. There also were significant Achievement by Sex interactions. High-achievement female students indicated less of a need for support in career decision making than all other students. High-achievement males reported a higher level of overall career indecision than high-achievement females. The second study was conducted to determine the effects of sex and community of residence on the career indecision of very high achievers. There were several significant Sex by Community of Residence interactions. Differences between female and male students from urban schools were particularly prominent. The educational and counseling implications of both studies are discussed.
The Incidence of Perfectionism in Honors and Regular College Students
Authors: Parker Wayne D. , Adkins Karen K.
Published: November 2015

Using the Multidimensional Perfectionism Scale (Frost, Martin, Lahart, & Rosenblate, 1990) measures of perfectionism in a group of 90 Honors College students and 95 more typical peers were compared. Honors College students received significantly higher scores with a moderate effect size on the subscales of Concern Over Mistakes, Personal Standards, Parental Expectations, and the total score of overall perfectionism. This result is in contrast to recent findings of no difference in perfectionism scores between gifted and typical younger students. It is unclear if the finding of elevated perfectionism among Honors College students is indicative of predisposition to maladjustment or is a healthy component of the pursuit of academic excellence among the highly able.
A Career in Teaching: Comparing Views of Gifted and Talented Adolescents
Authors: Kher-Durlabhji Neelam , Lacina-Gifford Lorna J. , Carter Richard C. , Lalande Lynn K.
Published: November 2015

A key determinant of the quality of teachers graduating from teacher preparation programs is the applicant pool in these programs. Research suggests that gifted students are discouraged from entering the teaching profession. The views of gifted adolescents toward the teaching profession compared to other professions, and the perceived level of support from significant adults for choosing the teaching profession, were analyzed in this study. The views of gifted adolescents were obtained to aid in the design of structured career counseling programs for this population. Survey data to address the above objectives were obtained from three groups of gifted seventh and eighth graders and compared to “regular” students' responses. Top ranked occupations for the gifted groups were scientist or doctor. The regular students' top choices were doctor and lawyer with a scientist ranked low. All groups rated sales and teaching the lowest. A majority of the students indicated that significant adults would encourage or strongly encourage their choice of the teaching profession.
Educational Innovation
Authors: Liu Jing-Qiu
Published: November 2015

This article depicts a secondary gifted program in Beijing, the People's Republic of China, based on my recent visit to it. The program has been in operation for almost nine years. Students in the program complete the regular eight years of elementary and secondary education (grades 5 to 12) in four years. At the age of 14, they are admitted into universities for undergraduate studies. This article covered the factors contributing to the uniqueness of the program, which comprises multiple-criteria screening and selection of candidates, a comprehensively designed curriculum, whole class instruction, and diverse learning opportunities. The issues affecting the development of the program were also explored.
Different Strokes: Perceptions of Social and Emotional Development among Early College Entrants
Authors: Noble Kathleen D. , Arndt Tara , Nicholson Tristan , Sletten Thor , Zamora Arturo
Published: November 2015

The University of Washington's Early Entrance Program (EEP) enables intellectually advanced adolescents to enter college without attending high school. The program has a demonstrated, positive effect on gifted students' academic development. What is less clear is the social and emotional impact of early college entrance. Thirty-one Early Entrance students participated in one-hour focus group discussions in which they discussed their social and emotional experiences as young college students. Although participants expressed varying degrees of comfort in diverse social situations, all believed themselves to be more mature than they would have been had they gone to high school, and all reported themselves to be well-socialized. According to participants, the principle socio-emotional strengths of the EEP are its acceptance of individual differences, its encouragement of excellence and personal responsibility, and the solidarity and sense of belonging it offers students.
Postoperative Infection After Anterior Cruciate Ligament Reconstruction
Authors: Gobbi Alberto , Karnatzikos Georgios , Chaurasia Sanyam , Abhishek Mudhigere , Bulgherhoni Erica , Lane John
Published: November 2015

Context:

Infection after anterior cruciate ligament reconstruction (ACLR) is uncommon; if it occurs, it can lead to disastrous complications.

Objective:

To analyze post-ACLR infections and identify related complications to provide the most effective treatment protocol.

Study Design:

Clinical review.

Level of Evidence:

Level 4.

Results:

Among approximately 1850 ACLRs performed by a single surgeon over the past 20 years, 7 cases of post-ACLR infection were identified (incidence, 0.37%). Five patients presenting with low-severity infection were successfully treated without any complication or residual functional disability. The remaining 2 patients, although successfully treated, presented with minor residual limitations. From a literature review, 16 studies including 246 cases of infection were reported among 35,795 ACLRs, making the rate of infection 0.68% (range, 0.14%-2.6%).

Conclusion:

With proper treatment protocols, post-ACLR infection is rare but can compromise outcomes.
A Tale of Two Forums: One Professor's Path to Improve Learning through a Common Online Teaching Tool
Authors: Nash John
Published: November 2015

As institutional and market pressures move more faculty into the online teaching space, renewed discussions are occurring about how to best teach online, and what features of online courses are best to employ. A distance learning staple, the online discussion, or asynchronous discussion forum (ADF) is an easy strategy for faculty to employ in an online course. However, tying ADFs to course goals, and ensuring they are deployed in ways that truly advance student learning is more difficult. This article provides an overview of ADFs and their role in the online teaching environment. The author reviews his own experiences with ADFs in a graduate educational administration course. Using a theoretical framework for quality distance education, the author critiques his own early efforts and subsequent improvements, ultimately providing a structure for other faculty to use as a model for their own ADF implementations.
Incidental prostate cancer diagnosed following a transurethral resection of the prostate: A national database analysis in England
Authors: Anastasiadis Eleni , van der Meulen Jan , Emberton Mark
Published: November 2015

Objectives:

The aim was to compare prostate cancer and all-cause mortality in patients diagnosed with prostate cancer following a transurethral resection of the prostate (TURP) (incidental prostate cancer, IPC), to men diagnosed with localised non-incidental prostate cancer (NIPC).

Patients and methods:

Men diagnosed with localised prostate cancer between 2000 and 2008 were identified from the English national cancer registry. Their records were linked to the Hospital Episode Statistics (HES) database of hospital admissions in England to identify men who had a TURP. Men were considered to have IPC if prostate cancer was diagnosed less than 60 days after TURP. Mortality rates were calculated using the Kaplan–Meier method. Mortality rate ratios (RR) comparing IPC and NIPC were calculated with multivariable Poisson regression adjusting for age group, co-morbidities, year of diagnosis and radical treatment.

Results:

A total of 192,960 men were included. Of these, 6666 (3.5%) had IPC and 186,294 (96.5%) NIPC. Median follow-up was 4.7 years (0.5–11.0). Ten-year prostate cancer mortality was 17.1% in IPC, 19.0% in NIPC. With adjustment, the prostate cancer-specific mortality in IPC was 30% lower than NIPC (RR 0.70, 95% CI 0.65–0.75, p<0.001), with no difference in all-cause mortality.

Conclusion:

Ten-year prostate cancer mortality in IPC was 17%. Men with IPC had lower prostate cancer-specific mortality than other prostate cancer patients.