bluuebunny/crossref_metadata_2025 huggingface dataset:
A Study on Optimum Mixture Ratio of Reactive Powder Concrete
Authors: Chen Mingyang , Zheng Wenzhong
Published: November 2018

To optimize the main components of reactive powder concrete (RPC) for various curing methods, based on the fluidity and compressive strength, an inclusive experimental research is conducted on 58 different mixture ratios. The results indicate that owing to the increase of the cement strength, the RPC fluidity decreases and the cement strength is not proportional to the compressive strength. The addition of the fly ash and the nano‐microbead is an effective way to improve the fluidity, and it is required at the low W/B ratio. However, the influence of the SF grade on the strength and fluidity is almost negligible. By considering the fluidity, strength, and economy of RPC as crucial design factors, SF90 is suggested. The contribution of the steel fiber to the compressive strength cannot be ignored. The upper envelope value of the steel fibers is required for the structure to resist appropriately against the fire. According to the test results, the mixture ratio formula is proposed through considering the characters of different compositions and curing methods. The strength coefficient k1 is introduced to verify the influence of the steel fiber content, and the parameters fb, αa, and αb in the formula are reevaluated. A reasonably good agreement between the calculated strength and those obtained from the tests is reported, except for the case of W/B = 0.16 with P.O.52.5 cement. The basic steps for preparations of different RPC strengths are given, which provide a valuable reference to choose appropriate raw materials and mixture ratio design for different strength values.
RK-AES: An Improved Version of AES Using a New Key Generation Process with Random Keys
Authors: Saha Rahul , Geetha G. , Kumar Gulshan , Kim Tai-hoon
Published: November 2018

Advanced Encryption Standard (AES) is a standard algorithm for block ciphers for providing security services. A number of variations of this algorithm are available in network security domain. In spite of the strong security features, this algorithm has been recently broken down by the cryptanalysis processes. Therefore, it is required to improve the security strength of this algorithm as AES is popular in commercial use. In this paper, we have shown the reasons of the loopholes in AES and also have provided a solution by using our Symmetric Random Function Generator (SRFG). The use of randomness in the key generation process in block cipher is novel in this domain. We have also compared our results with the original AES based upon some parameters such as nonlinearity, resiliency, balancedness, propagation characteristics, and immunity. The results show that our proposed version of AES is better in withstanding attacks.
Mammary Precancerous Stem and Non-Stem Cells Evolve into Cancers of Distinct Subtypes
Authors: Bu Wen , Liu Zhenyu , Jiang Weiyu , Nagi Chandandeep , Huang Shixia , Edwards Dean P. , Jo Eunji , Mo Qianxing , Creighton Chad J. , Hilsenbeck Susan G. , Leavitt Andrew D. , Lewis Michael T. , Wong Stephen T. C. , Li Yi
Published: November 2018

There are distinct cell subpopulations in normal epithelial tissue, including stem cells, progenitor cells, and more differentiated cells, all of which have been extensively studied for their susceptibility to tumorigenesis. However, normal cells usually have to progress through a precancerous lesion state before becoming a full-blown tumor. Precancerous early lesions are heterogeneous, and the cell subset that is the primary source of the eventual tumor remains largely unknown. By using mouse models that are tailored to address this question, we identified a keratin 6a-expressing precancerous stem cell (PcSC) subset and a more differentiated whey acidic protein-positive (WAP+) cell subset in mammary precancerous lesions initiated by the Wnt1 oncogene. Both cell subsets rapidly progressed to cancer upon introduction of constitutively active versions of either HRAS or BRAF. However, the resulting tumors were dramatically different in protein profiles and histopathology: keratin 6a+ precancerous cells gave rise to adenocarcinoma, whereas WAP+ cells yielded metaplastic carcinoma with severe squamous differentiation and more robust activation of MEK/ERK signaling. Therefore, both stem and non-stem cells in mammary precancerous lesions can contribute to the eventual cancers, but their differentiation status determines the resulting cancer phenotype. This work identifies a previously unknown player in cancer heterogeneity and suggests that cancer prevention should target precancerous cells broadly and not be limited to PcSC.

Significance:

This work uses a novel mouse mammary gland cancer model to show that tumors initiated from different precancerous mammary epithelial cells are distinct.
Revision of the subgenus Stigmatodipogon Ishikawa of the genus Dipogon Fox (Hymenoptera: Pompilidae: Pepsinae)
Authors: SHIMIZU AKIRA , LELEJ ARKADY S. , LOKTIONOV VALERY M. , NISHIMOTO YUTAKA , ENDO TOMOJI
Published: November 2018

The systematics of the subgenus Stigmatodipogon Ishikawa of the genus Dipogon Fox is revised. Six species are listed. Two new species, Dipogon (Stigmatodipogon) kurokawai Shimizu, sp. nov. (Honshu, Japan) and D. (S.) lao Loktionov & Lelej, sp. nov. (Laos) are described and illustrated and other four species from Japan, the Russian Far East and Eastern Siberia are redescribed. A new combination is proposed for D. (S.) budrisi (Loktionov & Lelej, 2014), comb. nov. Nesting records of D. (S.) kurokawai and prey records of D. (S.) macrostigmatus Ishikawa, 1959 and D. (S.) petiolatus Lelej, 1986 are presented. These are the first records of biology for this subgenus. A key to species is provided.
Optimization of Deacidification with Hydroxyapatite by Response Surface Method
Authors: Bi Yong-Guang , Di Liu  , Yue Chun-Hua , Li Jin-Qiang
Published: November 2018

Hydroxyapatite nano particles (HAP) were prepared with sol–gel method and were used as adsorbent to adsorb HCl and H2SO4. Adsorbent dosage (X1), temperature (X2), initial pH (X3) and final pH (Y)
were regarded as independent and dependent variables, respectively. The effect of adsorbent dosage, temperature and initial pH on deacidification was discussed by response surface methodology (RSM), a three-level-three-factor Box-Behnken design (BBD) was employed to optimize the adsorption
conditions. The statistical analyses show that X1 and X2 have significant effect on deacidification of HCl and X3 has significant impact on deacidification of H2SO4. The optimum conditions are X1
of 0.020 g, X2 of 35 °C and X3 of 6 and predicted final pH of HCl is 7.166, for H2SO4, X1 of 0.020 g, X2 of 28.48 °C and X3 of 5.71 and predicted final pH of 7.084. Based
on these results, synthesized HAP can be used for acid adsorption and provide a theoretical basis to remove inorganic acids from old books with HAP in the next investigation.
Luminescence in Li6YGd(BO3)3:Tb3+,Dy3+ Phosphors
Authors: Fawad U. , Kim H. J. , Khan A. , Khan Matiullah , Muhammad Wazir
Published: November 2018

This work presents the synthesis of Li6YGd(BO3)3:Tb3+,Dy3+ (Lithium yttrium gadolinium borate) phosphors and characterization of their luminescence properties. The solid state reaction method was adopted for the synthesis of these
phosphors. These phosphors were optimized for the activators' concentrations i.e., 1.5 mol% for Tb3+ and 3 mol% for Dy3+. The homogeneous phase, uniform crystalline structure and overall uniform morphology of the synthesized phosphors were confirmed by X-ray diffraction
analysis (XRD) and scanning electron microscopy (SEM). The X-ray and ultraviolet-visible induced luminescence were measured. Several emission spectra were observed for these phosphors. The phosphors were characterized for X-ray induced integrated light yield and was found to be 60% for Li6YGd(BO3)3:Tb3+and
47% for Li6YGd(BO3)3:Dy3+ of that of commercially available X-ray imaging material Gd2O2S:Tb3+ (Gadox). The UV-induced integrated light yield of both Li6YGd(BO3)3:Tb3+,Dy3+
phosphors were measured to be 78% and 42% of commercial grade PDP material (Y,Gd)2O3:Eu3+), respectively. The 1931 Commission Internationale de l'Eclairage (CIE) chromaticity coordinates were also measured for the synthesized phosphors.
Theoretical Prediction of Size-Dependent Structures and Properties for the Asymmetric Clusters (HBrInN3)n (n = 1–6)
Authors: Ma Deng-Xue , Liu Guo-Kui , Yao Cui-Xia , Xia Qi-Ying , Mi Shi-Zhen
Published: November 2018

In order to search single-source precursors (SSP) for InN material, the structures, relative stabilities, and electronic properties of small asymmetric clusters (HBrInN3)n (n = 1–6) are systematically investigated at the B3LYP level. The optimized
clusters all contain cyclic structures (InNα)n and prefer 3-dimensional configurations for n = 2–6. The uncorrected binding energies (Eb), corrected binding energies (Eb-c) and average corrected binding
energies (Eb-c-ave) all reveal that all asymmetric clusters (HBrInN3)n (n = 1–6) can continue to gain energy with the cluster size n increasing. The relative stabilities of clusters (HBrInN3 )n
(n= 1–6) are analysed based on the second-order difference of energy (Δ2E) and HOMO–LUMO energy gap (Egap). It is found that the Δ2E exhibits a pronounced even–odd alternation phenomenon with variation
of the cluster size n. Compared with monomer HBrInN3, the N–N asymmetric stretching of N3 groups for asymmetric clusters (HBrInN3)n (n = 2–6) shows blue-shifted, however, the N–N symmetric stretching of N3
groups and In–H stretching vibration exhibit red-shifted, respectively. Thermodynamic properties increase linearly with the cluster size n as well as the temperature. The transformations of the clusters (HBrInN3)n (n = 2–6) from the monomer
are thermodynamically favorable at 298.2 K judged by Gibbs free energies.
Mechanical properties of new-manufactured sandwich composite having carbon fiber core
Authors: Kiyak Burak , Kaman Mete O
Published: November 2018

In this study, mechanical properties of new-manufactured sandwich composites with various cell structures, having carbon fiber core have been investigated both numerically and experimentally. Three-point bending and compression tests are applied to the specimens as the experimental test approach. Failure behavior and strength of the specimens are extracted as a result of the measurements. The test results also give the opportunity to find out the optimum peak load/density ratio of various core types of sandwich composites. The commercial finite element software ANSYS has been used for numerical analysis. It should be remarked that a good agreement between numerical and experimental results is obtained. The cell shape and height are important parameters on peak load for bending. Additionally, change of cell density is a parameter having effect in same proportion for bending and compression peak loads for these type composites.
Incidence of idiopathic intracranial hypertension in Fife
Authors: Goudie Colin , Burr Jennifer , Blaikie Andrew
Published: November 2018

Background and aims

Idiopathic intracranial hypertension is a clinical syndrome of intracranial hypertension with normal cerebrospinal fluid in the absence of a mass lesion or hydrocephalus on brain imaging. Headache is the most common symptom of idiopathic intracranial hypertension, and about 10–15% of patients suffer from irreversible visual impairment. Previous estimates of the annual incidence of idiopathic intracranial hypertension vary worldwide from 0.03 to 2.2 per 100,000. The major risk factor implicated in idiopathic intracranial hypertension is body mass. Scotland has one of the worst records for obesity in the developed world, and the prevalence of obesity in Fife is higher than the Scottish average. Our aim was to record the incidence of idiopathic intracranial hypertension in NHS Fife over a one-year period.

Methods and results

Prospective study including every patient who was seen in the ophthalmology department in NHS Fife with a new diagnosis of idiopathic intracranial hypertension over a one-year period. Thirteen patients were seen with a new diagnosis of idiopathic intracranial hypertension from August 2013 to July 2014 giving an incidence of 3.56 per 100,000. Headache was the most common presenting symptom. Three patients were asymptomatic but were noted to have swollen optic discs during a routine sight test. One patient complained of visual symptoms. All patients were overweight. The mean BMI was 36 (range: 28–49).

Conclusion

The incidence of idiopathic intracranial hypertension in NHS Fife was significantly higher than previous estimates in the literature. This is probably due to a high level of obesity in Fife. Scotland is in the midst of an obesity epidemic and if this continues we may see increasing levels of idiopathic intracranial hypertension nationally with associated increasing incidence of visual impairment in young adults.
Optic atrophy after cabazitaxel treatment in a patient with castration-resistant prostate cancer: a case report
Authors: Diker Sevda , Diker Ömer
Published: November 2018

Taxanes are a group of cytotoxic anti-cancer agents used in the treatment of solid tumours. The neurotoxic adverse effects of docetaxel and paclitaxel, including optic neuropathy, are well known. Cabazitaxel is a new generation taxane showing lesser drug resistance when compared with previous ones. Optic atrophy due to the use of cabazitaxel has not been previously reported. Herein, we report a patient with prostate cancer who developed optic atrophy after cabazitaxel treatment.
The Silence of God: A Literary Study of Voice and Violence in the Book of Revelation
Authors: Martin Thomas W.
Published: November 2018

The violence of Revelation remains problematic. This study offers a literary-critical analysis of the text with postcolonial theory and an intertextual foray into 1 Kgs 19. It argues that God does not speak in direct voice as a character in the story until 21.5. Places where commentators understand a voice to be God’s are undercut by an underdetermined text. Since the implied author avoids bringing God onto the stage to authorize events, the narrator assumes that a proliferation of loud heavenly voices provides authorization of the visions and their violence. The narrator is demonstrably unreliable. At the end of the visions and in the epilogue the ‘still small voice’ of God and Jesus’ quiet voice speak. Both undercut the narrator’s interpretation of the visions. And by speaking quietly in present tense and without decibel adjectives it forces us to go back and reread the whole for how God is now renewing all creation and Jesus is now offering the water of the River of Life. The violence will need to be read as something other than it at first appeared.
Actors, Structure, and Processes: A Review and Conceptualization of Global Work Integrating IB and HRM Research
Authors: Reiche B. Sebastian , Lee Yih-teen , Allen David G.
Published: November 2018

As organizations increasingly fulfill their customer needs by getting their work done globally, there is a pressing need for the scientific community to further advance knowledge on global work, especially in terms of how to better conceptualize and integrate it. A particular opportunity for such development involves the cross-fertilization between the international business (IB) and human resource management (HRM) literatures, which serve as the focal domains to study global work phenomena but have treated global work largely as separate research streams. We therefore edited a special issue to contribute to a more integrative understanding of various aspects of global work across both domains. In this opening article, we review existing research on global work in the multinational enterprise from both IB and HRM perspectives. Subsequently, we present a shared conceptualization of global work that helps integrate theoretical and empirical research in both fields. We then introduce the articles in this special issue, before developing an integrative agenda for future research on global work.
Repairing Worlds: On Radical Openness beyond Fugitivity and the Politics of Care: Comments on David Goldberg’s Conversation with Achille Mbembe
Authors: Thompson Vanessa E.
Published: November 2018

Departing from the thought-provoking conversation between David Theo Goldberg and Achille Mbembe on the driving themes in Mbembe’s Critique of Black Reason, this commentary elaborates upon three topics that emerge in this conversation: the role of desire and how it is articulated in black abjection, the politics of care, and contemporary practices of repairing the injustices perpetrated in the context of European modernity. It is emphasized that black reason as a practice of repairing and transformation is especially enacted within contemporary movements like the refugee movements organized around the Black Mediterranean and in the lived freedom archives and abolitionist imaginaries of movements where gender and race cross-cut. Characterized by their transnational dimension and a radical openness towards new beginnings, these expressions of black reason imagine and reinvent justice and democracy anew.
Coastal homemaking: Navigating housing ideals, home realities, and more-than-human processes
Authors: Gillon Charles , Gibbs Leah
Published: November 2018

As urban populations expand, high natural amenity locales—forests, bushland, and coasts—are being transformed into highly desired, lucrative locations for new housing. This paper examines what it means to live in such an environment, tallying between the realised dream of that lifestyle and the everyday challenges (financial and labour) of navigating the elements at home. To do so, we bring two conceptual approaches into conversation: cultural geographies of home and homemaking, recognising home as a more-than-human process; and architecturally inflected geographies of buildings, attendant to building materials and socio-technical practices of maintenance and repair. Drawing on semi-structured walking interviews with 24 residents of a new coastal housing development in southern Sydney, Australia, the paper examines how coastal conditions and elements accelerate material decay, inciting and directing everyday homemaking practices: both proactive, in material selection, and reactive, in cleaning, repairing, maintaining, and replacing. We conclude by considering the differing economic rationalities of navigating the elements, and subsequent implications for household sustainability.
Ultrasensitive Doppler as a tool for the diagnosis of testicular ischemia during the Valsalva maneuver: a new way to explore varicoceles?
Authors: Rocher Laurence , Gennisson Jean-Luc , Baranger Jérôme , Rachas Antoine , Criton Aline , Izard Vincent , Bertolloto Michele , Bellin Marie-France , Correas Jean-Michel
Published: November 2018

Background

Varicocele is among the most common causes of male infertility because of various mechanism, including hypoxia.

Purpose

To evaluate testicular vascularization (TV) with ultrasensitive Doppler before and during the Valsalva maneuver (VM) and correlate TV changes to varicocele’s spermatic venous reflux graduated by color Doppler.

Material and Methods

From January to February 2016, 69 men (135 testis) referred for scrotal ultrasound were prospectively enrolled. An institutional review board approved the study. As gold standard, the spermatic venous reflux in the supratesticular region was assessed with color Doppler ultrasound and graded from 0 to III. A new ultra-sensitive Doppler (USD) sequence was performed on testicular parenchyma in an axial view. The TV changes before and during the VM were qualitatively graded from 0 to 2 using a visual scale by consensus. The vessels surface was quantified using customized MATLAB® software, and compared to the testicular delineated surface, resulting in a vessels surface ratio (VSR). The absolute and relative VSR difference before and during the VM was calculated. The qualitative scale and the quantitative VSR changes were compared with the spermatic venous reflux grade using an analysis of variance.

Results

A strong correlation has been found between the spermatic venous reflux grade and TV decrease during the VM using USD, for qualitative graduation as well as for quantitative measurement ( P < 0.0001).

Conclusion

TV assessed by USD decreased significantly during the VM in patients with varicocele; this decrease was significantly associated with spermatic venous reflux grade.
Combination of the double-microcatheter technique and triaxial system in coil packing for visceral and renal artery aneurysms
Authors: Goto Taeko , Shimohira Masashi , Ohta Kengo , Suzuki Kazushi , Sawada Yusuke , Shibamoto Yuta
Published: November 2018

Background

In coil packing for visceral artery aneurysms (VAAs), difficulties are sometimes associated with preserving the patency of the parent artery, particularly for wide-neck aneurysms. However, the double-microcatheter technique effectively prevents coil migration, while the triple-coaxial (triaxial) system is useful for reducing microcatheter kick-back.

Purpose

To assess the feasibility of combining these two techniques in coil packing for VAAs.

Material and Methods

Coil packing using the double-microcatheter technique and triaxial system was attempted for seven VAAs in six patients between August 2015 and January 2018. The technical success rate, packing density of aneurysms, complications related to the procedure, and occlusion status were evaluated. Technical success was defined as the completion of coil packing by immediate post-embolic angiography. The occlusion status was evaluated using time-resolved magnetic resonance angiography.

Results

There were three renal, three splenic, and one anterior superior pancreaticoduodenal aneurysms. The median size of VAAs was 13 mm (range = 8–21 mm), with five being classified as wide-neck aneurysms. The completion of coil packing was confirmed for all VAAs and the technical success rate was 100%. The median packing density was 28% (range = 22–40%). There were no complications related to the procedure. The median follow-up period was 14 months (range = 8–24 months). In six VAAs that were followed up, there were three complete occlusions, three neck remnants, and no body filling; re-treatment was not required in any patient.

Conclusion

The combination of the double-microcatheter technique and triaxial system is a feasible method of coil packing for VAAs.
Open-book management in libraries: A case study of Bibliotheca Alexandrina
Authors: Ismael Nehal Fouad
Published: November 2018

The study aims at defining the requirements of applying open-book management and showing the stages and steps to apply this new management methodology in different types of libraries. The researcher selected Bibliotheca Alexandrina as a great culture minaret to measure the degree of practicing open-book management from the point of view of its employees in order to identify the constraints that limit the full application of open-book management in the library.
Neuroscience and Education: A Bridge Astray?
Authors: Dougherty Michael R. , Robey Alison
Published: November 2018

It is common to encounter the belief that neuroscience holds promise for advancing education practice—a belief that is predicated on the assumption that neuroscientific findings can be scaled up to inform our understanding of behavior in complex education settings. In this article, we argue that this belief is not just far-fetched but misdirected. Although we acknowledge the value of neuroscience for understanding brain mechanisms, we argue that it is largely unnecessary for the development of effective learning interventions. We demonstrate how neuroscience findings have failed to generalize to classroom contexts by highlighting the recent popularity and failed results from brain-training research. We end by providing two recommendations for how future researchers and policy makers should address neuroscience and its potential for education applications.
Causing someone else to commit suicide: Incitement or manslaughter?
Authors: McGorrery Paul , McMahon Marilyn
Published: November 2018

For more than half a century, Australian states and territories have criminalised the distinct offence of inciting another person to commit suicide. The maximum penalties for these offences vary and require the accused to have intended that the victim would commit suicide. In contrast, the offence of involuntary manslaughter does not require such an intention. Instead, a charge of manslaughter requires that the accused acted in a conscious and voluntary way that caused the victim’s death, and that their conduct was either criminally negligent or unlawful and dangerous. Drawing on cases from the United States and United Kingdom, this article suggests that in appropriate circumstances in Australia, especially in the context of family violence, offenders should be held criminally liable for manslaughter if they cause another person to commit suicide.
Listening to Bedouin fathers of children with autism spectrum disorder
Authors: Manor-Binyamini Iris
Published: November 2018

Although children across the world experience autism spectrum disorder (ASD), most research on ASD has been conducted using Western cultural perspectives and has focused primarily on mothers, leaving significant gaps in the literature. This study aimed to address these gaps by exploring the experiences of fathers raising children with ASD in a Bedouin community. To this end, a sample of 19 fathers of children (aged 6–15 years) with ASD living in recognized and unrecognized Bedouin settlements in the Negev participated in ethnographic, semi-structured interviews designed to investigate their experiences with raising a child with ASD in their community. Two major themes emerged: the challenges that Bedouin fathers of children with ASD face, and the influence of socio-demographic and cultural characteristics on their experience. Findings reflect the complex experiences of fathers raising children with ASD in the Bedouin community, stemming from their socio-cultural context and the limited knowledge and support services that are available in the community for these children. This article concludes with recommendations on how to enhance professional sensitivity and provide more culturally tailored services for parents of children with ASD.
The Demand for Higher-Status Food and Nutrition in Rural India: The Experience of Matar Taluka. II. Regression Analyses
Authors: Shah C. H.
Published: November 2018

This article is a continuation of one that appeared in the previous issue of the Food and Nutrition Bulletin (vol. 8, no. 2). This segment presents the results of regression analyses to determine the influence of variables including production profiles, housing conditions, and durable asset scores on food purchase patterns. Dr. Shah identifies two components of food costs: one to obtain sufficient nutrients (nutrient costs), and the other to satisfy preferences (preference costs). In examining total expenditures on foods from both status and basic groups, he finds that households deficient in calories are more willing than non-deficient households to pay for higher-preference foods that are not as cost-effective in terms of nutrients. There is a need for studies among other populations to determine the extent to which Dr. Shah's findings concerning the purchase of status foods are a generalized phenomenon.
Malnutrition and Infection in the Classroom: Summary and Conclusions
Authors: Pollitt Ernesto
Published: November 2018

As the final chapter in a monograph by the same title, this article presents an overview of the evidence discussed in the book. It demonstrates that poor nutrition and health pose a significant educational problem and suggests means to address this problem. Nutrition and health conditions are reviewed in terms of the developmental period in which a child is exposed and the effect on school learning. A summary table of salient findings lists a number of nutrition and health conditions that are educational-risk-factors contributing to educational inefficiency.
Variability of Total Energy and Protein Intake in Rural Bangladesh: Implications for Epidemiological Studies of Diet in Developing Countries
Authors: Torres Alberto , Willett Walter , Orav John , Chen Lincoln , Huq Emdadul
Published: November 2018

It has been recognized for some time that nutrient intakes show large day-to-day variations within the same individual in industrialized countries. However, little attention has been given to the quantification of within-and between-person components of the variation in developing countries. Within-person variability determines the number of measurements of dietary intake per person that will be needed to adequately represent the dietary intake of an individual over a period of time. A large within-person variation relative to the variation between persons in the intake of a nutrient decreases the strength of the observed association of the latter with an outcome of interest.

This study quantified components of variation for 834 people of both sexes and various age groups and found that, although the diet in rural Bangladesh includes a limited number of food items-over 80% of calorie and protein intakes are provided by cereals, with rice being the main staple-the daily variability of nutrient intake in each individual over a year was as large as that reported for industrialized countries. The authors estimate that about seven days would be needed to assess total energy and protein intakes adequately, while much longer measurement periods would be needed for animal protein.
Social Science Perspectives on Primary Health Care Activities
Authors: Messer Ellen
Published: November 2018

This paper summarizes information on the characteristic-flaws in primary health care services, and their geographic patterns of occurrence, with reference to their local, medical, and bureaucratic contexts. The data are derived from published medical ethnographic reports, evaluations of programmes, surveys of physicians in developing countries, and some anecdotal reports. Several key issues emerge from this combination of sources. There is a lack of high-quality services in developing countries; most centres lack medicines, caring and skilled personnel, and convenient locations and scheduling. Also, the professional medical personnel are rarely sufficiently trained to communicate effectively with patients of different economic and ethnic backgrounds or to manage a health team of different backgrounds. The most successful programmes are those that have effective local leadership, adequate training, some curative potential, and powerful political will. The combined public health, medical, political science, sociological, and anthropological studies suggest no “cookbook” solutions as to what exact set of factors will make any programme successful. They appear to illustrate the effectiveness of flexible regional or local policies as opposed to global ones.
Environmental Factors, Maternal Attributes, and Children's Age at Introduction of Supplementary Foods in Rural and Urban Maharashtra and Gujarat
Authors: Subbulakshmi G. , Udipi S. A.
Published: November 2018

We studied the influence of environmental conditions on age at introduction of supplementary foods in 1,762 children. The conditions included religion, type of family, income, and use of health services as well as maternal age, literacy status, and work outside the home. All these factors resulted in frequent delays in the introduction of supplementary foods’ even to later than 12 months of age, and in the poor nutrition and health status of children. The study implies that nutrition education is essential for creating an awareness of desirable weaning practices among mothers.
A New Horizon: Addressing Food and Nutrition Problems in the Lao People's Democratic Republic
Authors: Kachondham Yongyout , Dhanamitta Sakorn
Published: November 2018

This paper provides information from the Lao People's Democratic Republic on household food security, current nutrition problems, their magnitudes and trends, food and nutrition policy and activities, and strategies for the development of short- and long-term approaches to dealing with the problems. Data were obtained during a recent UNl-CEF-supported consultancy, the objective of which was to assess young child nutrition and household food security as a prerequisite for recommending appropriate community-based primary health care and information system interventions. The data were collected through published and unpublished documents, observations of Lao PDR medical and health facilities, rural schools, and villages, and interviews with Laotian nutrition and health specialists. The findings show that house-hold food security rests unstably on a risk-diffusion strategy and women's participation. A number of nutrition disorders are also prevalent. Control strategies require both long- and short-term actions focusing on assessment, advocacy, planning, training, appropriate model development, and communication for food and nutrition.
Changing Nutritional Patterns in the Caribbean and Their Implications for Health
Authors: Sinha Dinesh P. , McIntosh Curtis E.
Published: November 2018

In the last 30 years, the health and nutrition of young children in the English-speaking Caribbean has improved significantly. Infant and child mortality rates and severe cases of PEM have declined. However, among adults obesity has increased and high morbidity and mortality rates due to chronic degenerative diseases have been reported. This paper reports on the food and nutrition patterns of the two countries that are at the upper and lower limits of economic development in the region, Barbados and Guyana respectively. In the last three decades, compared to Guyana, Barbados has made significant progress economically and has increased food availability. It has eliminated malnutrition in children; however, nutrition-related chronic diseases in adults have assumed epidemic proportions. Qualitative as well as quantitative aspects of the diet need to be addressed. Public education programmes need to be developed to encourage low-fat/high-complex-carbohydrate diets. In addition to diet. other lifestyle factors such as exercise, smoking, alcohol consumption. and psychosocial stress need to be addressed among the Caribbean populations.
Accuracy of Mothers’ Responses to Questions about Breast-Feeding Practices
Authors: Ríos Enrique , Neuhauser Linda , Margen Sheldon , Melnick Vijaya
Published: November 2018

Women giving birth to infants at 59 health facilities in three regions of Mexico were surveyed. Five hundred forty-six mothers were questioned on admission to the hospital about their plans for infant feeding when they returned home; 485 were questioned again prior to discharge; and 160 were interviewed a third time at home two weeks after discharge about their actual feeding practices. The results of a formal structured questionnaire asking about plans to use any of six specific milk and non-milk substances that are fed by bottle were compared with those of a questionnaire methodology in which the interviewers probed the answers. The study identified a third problem in dealing with self-reported information, in addition to the previously identified problems of memory failure and recall bias - which did not arise here - that of differences between respondents’ perception of their behaviour and their actual behaviour. By supplementing a formal questionnaire with more probing and less structured questions, these biases can be lessened and more accurate data obtained.
Secular Trends in Adult and Child Anthropometry in Four Guatemalan Villages
Authors: Ruel Marie T. , Rivera Juan , Castro Hilda , Habicht Jean-Pierre , Martorell Reynaldo
Published: November 2018

Secular trends in the stature and head circumference of adults born between 1905 and 1959 and in the length of three-year-old children born between 1965 and 1985 from four villages of eastern Guatemala are analysed. Data were collected before (1968), during (1969–1977), and after (1988) a longitudinal protein-energy supplementation trial conducted in the four villages. No secular trends are observed in the age-adjusted height or the head circumference of the adults studied; similar results are obtained whether a longitudinal or a cross-sectional method is used to correct height for the effects of ageing. A positive and significant linear trend is observed in the length of the three-year-olds. The estimated increase of 2.5–3.3 cm seen over this 20-year period represents only approximately 27% of the total deficit in length seen in these children in 1968 (11 cm).
Nutritional Profile of the Population in a Food-For-Work Project Area: A Case Study from Samburu District, Kenya
Authors: Kielmann A. A. , Kielmann N. S. , Jansen A. A. J. , Njama D. N. , Maritim G. K. , Mwadime R. , Saidi K.
Published: November 2018

The nutrition status of Samburu tribesmen of northern Kenya and the potential nutritional effects of a food-for-work programme were assessed by anthropometric and dietary surveys over a period of five weeks. The investigations were carried out at four input localities, where the programme had provided a daily average of 173 kcal and 5 g protein per capita over the preceding year, and a fifth control area.

Compared with Kenya as a whole, the Samburu community showed an unexpectedly high prevalence of wasting: 74% of the surveyed individuals were below 90% of the NCHS weight-for-height median, and 34% were below 80%. Relative wasting was especially prevalent among school-age children, of whom 86% were below 90% and 44% were below 80% of the standard, and among elders, with 88% and 64% below these thresholds respectively. Mid-upper arm circumferences were lowest among school-age children (mean 14.6 cm). Haematocrits were low in all age and social groups. Aside from three preschool children with xerophthalmia, a number of both preschool and school-age children had clinical histories suggestive of earlier vitamin A deficiency. Goitre was more prevalent among the older generations than among school-age or preschool children, suggesting a periodic but not uninterrupted availability of iodized salt. In the input locations, both anthropometric and haematocrit values among the most vulnerable members of the communities, preschool children and women of reproductive age, were significantly higher than those for comparable groups in the control location. Overall, the food-for-work programme was judged to be a worthwhile effort to help Samburus to be once again self-sufficient.
Nutrition Indicators for Development: Priority and Intervention Efforts
Authors: de Guzman Ma. Patrocinio E. , Molano Wilma L.
Published: November 2018

Nutrition indicators are commonly used to measure the progress of development programmes and projects. They are used by planners and policy makers to establish baseline values, to focus attention on the problems of nutrition, and to identify development projects for nutritionally at-risk groups of the population. The selection and identification of nutrition indicators should be based on precise criteria: measurability, appropriateness, comprehensiveness, relevance, sensitivity, and impact orientation. The Philippines used five nutrition indicators in the update of the Philippine Development Plan, 1990–1992: percentage of preschool children with weight less than 75% of the standard weight for age, percentage of schoolchildren 7–10 years old with height less than 90% of standard height for age, percentage of schoolchildren 7–10 years old with weight less than 75% of standard weight for age, per capita energy intake, and percentage of households with energy intake less than 100% adequacy. These indicators were selected on the basis of their sensitivity, simplicity, and usefulness in appraising the effects of nutritional interventions and the ease of data collection.
Growth-Faltering Rates in California, Guatemala, and Tamil Nadu: Implications for Growth-Monitoring Programmes
Authors: Martorell Reynaldo , Shekar Meera
Published: November 2018

Criteria used in growth-monitoring programmes in developing countries were applied to three-month weight-gain data for children 12–24 months old in three populations: in Berkeley, California; Guatemala; and Tamil Nadu. A significant proportion of the Berkeley children showed growth faltering: 18% had at least one period in which they failed to gain any weight, and 37% had at least one in which they gained less than 300 g in three months. The frequency of faltering, however, was appreciably greater in Guatemala (45% and 82% respectively) and Tamil Nadu (42% and 74% respectively). These data raise concerns that growth-monitoring criteria, as used in most settings, identify too many children for special attention, perhaps more than can be handled by most programmes. Adjusting the criteria to select fewer children necessarily means departure from the simplest guidelines about focusing on the growth trajectory (i.e., up, fat, or down) to those that specify rates of weight gain by age. This may make growth monitoring impractical in many settings.
Growth Monitoring in the Context of a Primary Health Care Programme
Authors: Karim Fazlul , Huq Nasreen , Brown Laurine , Chowdhury A. Mushtaque R.
Published: November 2018

During the last decade, growth monitoring has been promoted us an important intervention for child survival, but questions have been raised about its electiveness and feasibility in less-developed countries. A growth-monitoring programme was carried out by the Bangladesh Rural Advancement Committee for over four years, covering about 20,000 children under two years of age. The programme was equally accessible to all socioeconomic groups and both sexes. Children were weighed monthly in village centres, and their mothers were given health and nutrition education. A recent evaluation found modest coverage (43 %) of the target children. Accuracy in determining ages of the target children was reasonably good, with more than 90% within 30 days of actual age. Eighty-seven per cent of the Salter round scales used gave accurate results, compared with only 17% of the Salter cylinder scales. Local volunteers, mostly women, participated in growth-monitoring sessions by weighing, recording, and demonstrating how to prepare supplementary diets. Growth monitoring was associated with increased use of selected child-survival interventions such as immunization. The nutrition status of participating children was not significantly better than that of a comparable group of children who did not participate (p =.051).
Potentiating Effects of Malnutrition on Child Mortality: Epidemiologic Evidence and Policy Implications
Authors: Pelletier David L.
Published: November 2018

The physiological synergism between malnutrition and infection has been recognized for some time, its implications have not been addressed in current child survival policies and programmes. A recent analysis of 28 epidemiologic studies of the malnutrition-mortality relationship concluded that the relationship is consistent across diverse world populations; a significant effect exists of mild to moderate malnutrition (MMM), as well as of severe malnutrition; and the effect is not simply due to confounding by socioeconomic factors or inter-current illness. In addition, evidence supports the hypothesis that malnutrition and infection have multiplicative effects on child mortality, not the additive effects implicitly assumed. An empirically based model suggests that by potentiating infection, malnutrition accounts for 56% of child deaths, 83% of which are due to MMM. These estimates are far higher than conventional figures that do not take account of potentiation and MMM.
Anaemia and Haemoglobin Status: A New Concept and a New Method of Assessment
Authors: Gross Rainer , Gliwitzki Marcus , Gross Patrick , Frank Klaus
Published: November 2018

Traditionally, anaemia has been determined and interpreted by the magnitude and severity of iron deficiency and the impact of intervention strategies. Internationally, it is defined as a state in which the quality and/or quantity of circulating red cells are reduced below a normal level The body employs several mechanisms during the development of anaemia to maintain the oxygen supply to the tissues. Thus, applying any quantitative cut-off point as an indicator for anaemia may lead to misclassification, since haemoglobin concentration does not necessarily reflect the level of tissue oxygen supply. Ideally, an assessment strategy should be able to determine both the degree of haemoglobin oxygenation and the haemoglobin concentration at a tissue level. The Erlangen microlight-guide spectrophotometer is a non-invasive instrument that can assess both capillary blood oxygenation and relative haemoglobin concentration.
Female Nutritional Status across the Life-Span in Sub-Saharan Africa. 2. Causes and Consequences
Authors: Leslie Joanne , Essama Suzanne Bibi , Ciemins Elizabeth
Published: November 2018

This article reviews existing data concerning the causes and consequences of female malnutrition in sub-Saharan Africa. As in most parts of the world, the primary cause of female malnutrition is household food insecurity compounded by low household and individual incomes. Gender-specific factors that further undermine women's nutritional status are the severe physiological burden of frequent child-bearing and the continuous long hours of energy-intensive work. Negative consequences of malnutrition among females include high rates of mortality and morbidity, impaired learning, low birthweights, and reduced energy for discretionary activities. We question the conclusion of other studies that African women have developed special “adaptive mechanisms” to compensate for nutritional deprivation, and recommend that further research investigate the hidden individual and societal costs of malnutrition among women.
Blood Cholesterol and Triglycerides in Adolescent Egyptian Girls: Relation to Anthropometric Measurements
Authors: Hakim Iman A. , Awad Amina H. , Mohamed Nagwa H. , El-Husseiny Salwa
Published: November 2018

High serum cholesterol is a major risk factor for atherosclerosis. This cross-sectional study (n = 102) investigated the levels of total cholesterol (TC) and triglycerides (TG) in Egyptian girls aged 11 to 16 years attending a middle-class public school. The mean TC level was 194.27 ± 21.97 mg/dl, and 33.33% of girls had TC levels > 200 mg/dl. The mean TG level was 160.07 ± 30.83 mg/dl, with 3.92% of the girls showing TG levels > 2 00 mg/dl. Most of the girls (65.69%) were overweight, with body mass index (BMI) >25. Univariate analyses revealed an association of TC and TG with all anthropometric measures. Using stepwise regression analyses, the best model for prediction of TC was with BMI and central body fat (explaining 24.76% of TC variance); the final model for TG was with BMI, central body fat, and abdominal skinfold thickness (explaining 47.49% of TG variance). Our data show that these adolescent Egyptian girls were heavier and had higher blood lipid concentrations than subjects in the Bogalusa study and other studies worldwide. Further studies are needed to determine the factors associated with these higher lipid levels and to develop appropriate intervention programmes.