bluuebunny/crossref_metadata_2025_split huggingface dataset:
Economic Aspects of Agriculture and Nutrition: A Nigerian Case Study
Authors: Olayide S. O. , Olayemi J. K. 
Published: November 2018

This has been an overview, in economic terms, of the state of food and nutrition in Nigeria. It is confined to Nigeria for the obvious reason that one can best speak within the limits of his own experience. Nevertheless, what obtains in Nigeria is similar to what obtains in a number of other developing countries of Africa. Broadly speaking, it may not be true to say that most Nigerians are grossly undernourished or malnourished, but most of the population has always hovered around the minimum level of adequate nutrient intake. Furthermore, projected food supplies and demands indicate that the situation is not likely to improve much if the current trends continue. In general, the four main variables that influence the existing low rate of growth in food supply are: (11 the growing scarcity of traditional farm inputs, including the increasing man-land ratio, stagnant production technology, and low use of modern farm inputs; (2) marketing and price constraints; (3) profit constraints; and (4), organizational constraints. On the demand side, the variables are: (1) high income growth rate; (2) poor income distribution; (3) high consumer prices; and (4), socio-cultural factors. Instead of discussing solutions in terms of strategies for increasing food production and rationalizing food demand per se, this paper has discussed strategies for enhancing quantitative and qualitative food balance. By implication, these are strategies for, in time, ensuring quantitative and qualitative nutritional balance among nutrient sources, and among segments of the population. Because the ultimate objective of a nutrition policy is the welfare of the greatest proportion of the population, the long-term goal for the nation should be the reduction of the number of underfed or overfed people in the population, and the increase in the number of people who obtain optimum nutrition. The extreme of over-nutrition is as bad as the other extreme of undernutrition.
The Effect of Urbanization and Western Foods on Infant and Maternal Nutrition in the South Pacific
Authors: Lambert Julian 
Published: November 2018

Throughout the Pacific region, infant and maternal nutrition has been adversely affected by urbanization and the introduction of new foods. However, the process of urbanization is probably irreversible, at least for the foreseeable future, and few of us would deny the convenience of many imported foods. What is needed is to select the best of the foods that have been introduced and the most appropriate technology, and to preserve the best aspects of traditional life. For this the general public must be well informed. Therefore, a Pacific-wide nutrition education programme is required, tailored to meet the needs of each country, making fullest possible use of the mass media. Some of the changes that have already occurred are not necessarily irreversible. In Papua New Guinea the Government passed legislation in 1977 removing infant feeding bottles and nipples from general sale, allowing them to be available only on prescription. This legislation, coupled with a campaign to promote breast-feeding, led to a reduction in the percentage of bottle-fed infants in Port Moresby from 35 per cent in 1975 to 12 per cent in 1979 (10). Over the same period, the number of cases of diarrhoea in infants less than six months of age seen each year at Port Moresby General Hospital dropped from 83 to 28. In Micronesia a campaign to replace imported soft drinks with coconuts resulted in a drop of over 50 per cent in such imports (11). In Fiji, a Feed Fiji First-campaign, through the use of radio programmes, newspaper articles, the sale of T-shirts, and a nation-wide school garden contest, has succeeded in reviving interest in traditional crops. The superiority of breast-milk and many other traditional foods compared to imported foods is self-evident to those who know the facts. Consumer education must therefore be the main goal. Military records from New Caledonia and Tahiti show that in 1905 the average height of Polynesians recruited into the armed forces was 4 cm greater than that of Europeans. BY 1950 there was no difference, and by 1970 the Europeans were taller than the Polynesians. Apparently our grandparents could teach us a lot about good nutrition!
Realistic Approaches to World Hunger: How can they be Sustained?
Authors: Timmer C. Peter 
Published: November 2018

Realistic approaches to world hunger The three papers that follow were presented as the opening lectures of a symposium held at Harvard University in the spring of 1984, sponsored jointly by the Overseas Development Network, Inc. (ODD), and its Harvard affiliate chapter, the Harvard-Radcliffe International Development Forum. Entitled “Realistic Approaches to World Hunger,” the symposium brought together more than 20 speakers and 300 participants to discuss a wide range of development issues. ODN is a collaborative network of student groups and concerned citizens who are interested in responding constructively to the problems of world hunger and poverty. Its three main programmes focus on linking campus groups with development projects overseas, educating people in the United States about international development, and acting as a clearinghouse for development opportunities in the United States and abroad. ODN is unique in that it uses the energy and commitment of students to educate the broader public, as well as the students themselves, about the complexities and challenges facing developing countries. For more information, write to ODN, PO Box 1430, Cambridge, Mass. 02138 USA.
Urban Agriculture: Who Cultivates and why? a Case-Study of Lusaka, Zambia
Authors: Sanyal Bishwapriya 
Published: November 2018

Contrary to the official view that rejects urban cultivation as an irrational activity by a small group of recent migrants who have yet to be integrated into the urban environment, urban agriculture is an innovative response by a majority of the urban poor, who are fully entrenched in an urban economy that currently lacks the capacity to provide them with sufficient real income. Though insufficient income is a primary reason, it is not the only factor affecting a household's decisions regarding cultivation. Low-income households consider urban cultivation as a form of long-term investment that requires a minimum threshold of predictability of return on the investment. To be sure of this return, most households must decide to live in the city on a permanent basis and gain access to land, which usually requires seven to eleven years of urban residence. Once the decision to invest is made, variations in the pattern of cultivation among households result from relative differences in access to land and the need to maximize the return on domestic labour time, the opportunity costs of which vary with household income. Variations in the pattern of crops between plots and rainy-season gardens also occur as a result of rational decisions by households to maximize the return on land at two different locations. The policy implications of these findings are at least threefold. First, since urban cultivation allows urban workers to survive with insufficient monetary income, not only should the harassment of cultivators be stopped but efforts should be made to encourage cultivation, particularly since the opportunities for these workers to increase their monetary income, at least in the short term, are minimal. Second, one sure way of encouraging cultivation is to provide assurance to low-income households regarding the return on their investment. This would involve ensuring that they have access to land through the granting of legal titles, either for renting, leasing, or owning land. Third, there is scope for further increases in the productivity of rainy-season gardens, for instance by providing better access to the peripheral areas and taking some measures to reduce the theft of produce. To be sure, bringing about changes in official attitudes towards urban cultivation and formulating new policies to encourage it are not easy tasks. There are interested social groups who benefit from the rising price of urban land, and they are bound to object to policies which will not contribute to property inflation. It is hoped that this article will at least help explode some of the myths about urban cultivation that are currently used to legitimize the arguments of these interests.
Feeding from the Family Pot for Prevention of Malnutrition
Authors: Walia B. N. S. , Gambhir S. K. , Kumar D. , Bhatia S. P. S. 
Published: November 2018

The following article on the use of foods from the “family pot” for the rehabilitation of malnourished children supports the conviction of many health workers that, in principle, this is the most practical approach to the prevention of malnutrition among pre-school children, even in impoverished families The small shifts in food distribution within the family that are required with this approach are of negligible significance for the other family members, but of critical importance for the young child. The problem in the past has been the lack of a means of persuading a mother of the need to feed her child more, particularly when she is already breast-feeding. This obstacle can be overcome if the mother can monitor the chid's growth and learn that a failure to gain weight from one weighing time to another means that more food is necessary. If there is evidence of disease, medical attention may also be indicated. Of course, the implementation of this approach is subject to cultural variation in the suitability of foods being used by the other members of the family. For reasons which include high fibre content, strong seasoning, and low nutrient density, some foods will not be appropriate for infants and young children. Also, the phrase “family pot” may well apply to some cultures, but in others there is no single pot, but rather a variety of foods, some of which are always suitable for the young child. If cultural variations are taken into account, the concept advanced by this article should be universally applicable.
Exploring the socioethical dilemmas in the use of a global health archive
Authors: Holmes Matthew James Vaughton , Morris Isla-Kate , Williams Anthony , Le Blond Jennifer , Cranna Victoria , Davey Gail 
Published: November 2018

A global health archive consisting of podoconiosis tissue slides and blocks (which was collected and imported into the UK before the introduction of the Human Tissue Act), was donated to Brighton & Sussex Medical School in 2014. There is little guidance on the socioethical and legal issues surrounding the retrospective use of archived or ‘abandoned’ tissue samples, which poses a number of questions relating to the ethical standing of the archive. There is a great deal of interpretation in the guidelines that are currently in existence; however, modern ethical principles cannot be applied as it is not feasible to either reconsent or retrospectively seek approval. Our research team believed that it was unethical to leave the archive in storage, as this option favours neither researcher nor subjects. Permission was obtained from the Human Tissue Authority and a local ethics board for the tissues to be utilized in on-going research on podoconiosis aetiology. There is a delicate balance between the benefits gained by society relating to the development and progress of scientific research and the risks to the donor regarding the reuse of their tissues. Clearer guidelines should be made available to ensure that researchers are able to reuse tissue archives in contemporary research.
Continuation of atypical antipsychotic medications in critically ill patients discharged from the hospital: a single-center retrospective analysis
Authors: Karamchandani Kunal , Schoaps Robert S. , Bonavia Anthony , Prasad Amit , Quintili Ashley , Lehman Erik B. , Carr Zyad J. 
Published: November 2018

Background: Atypical antipsychotics (AAP) have been associated with reduced duration of delirium in the intensive care setting. However, long-term use of these drugs is associated with significant adverse events, including increased all-cause mortality in the elderly. Inappropriate continuation of AAPs after discharge from the intensive care unit (ICU) is worrisome and needs to be addressed. The aim of this work was to assess the prevalence of continuation of AAPs after hospital discharge and evaluate the associated risk factors. Method: This was a single-center retrospective chart analysis in the setting of adult ICUs at a tertiary care academic medical center. It involved all adult patients admitted to the ICU and initiated on AAPs from January 2012 to December 2014. The measurements were: (1) prevalence of ICU-initiated AAP continuation following hospital discharge, (2) risk factors associated with continuation of AAPs following hospital discharge, and (3) risk of continuation of AAPs in patients ⩾65 years of age. Results: A total of 55% of ICU patients initiated on AAPs were discharged from the hospital with a prescription for continued AAP therapy. Male sex and discharge location were highly associated with continuation upon discharge. Older patients (⩾65 years of age) were not at a higher risk of being continued on these drugs after discharge. Conclusion: Male sex and discharge to a healthcare facility were associated with a higher rate of continuation. Research into practical methods to reduce their continuation upon discharge should be performed to mitigate the long-term risks of AAP administration.
End-user involvement in developing and field testing an online contraceptive decision aid
Authors: Hooiveld Truus , Molenaar Joyce M , van der Heijde Claudia M , Meijman Frans J , Groen Theo P , Vonk Peter 
Published: November 2018

Objectives: Decision aids in the field of healthcare contribute to informed decision making. To increase the usefulness and effectiveness of decision aids, it is important to involve end-users in the development of these tools. This article reports on the development of an online contraceptive decision aid. Methods: An exploratory, qualitative study was conducted in the Netherlands between 2014 and 2016. The development process of the decision aid consisted of six steps and included a needs assessment and field test. Interviews were conducted with 17 female students. Results: The needs assessment provided information on the preferred content and structure of a contraceptive decision aid and guided the development of the online contraceptive decision aid prototype. Participants had an overall positive impression of the decision aid prototype during the field test. Minor revisions were made based on participants’ feedback. Participants expected that the decision aid would positively contribute to decision making by increasing knowledge and awareness regarding the available contraceptive methods and their features and attributes, and by opening up to other options than the known methods. Conclusion: The developed contraceptive decision aid can contribute to better informed decision making and consultation preparation. Involving end-users in development seems valuable to adapt decision aids to specific needs and to identify in what way a decision aid influences decision making.
Barriers to Education and Shared Decision Making in the Chronic Kidney Disease Population: A Narrative Review
Authors: Cassidy Brendan P. , Getchell Leah E. , Harwood Lori , Hemmett Juliya , Moist Louise M. 
Published: November 2018

Purpose of review: Provision of education to inform decision making for renal replacement therapy (RRT) is a key component in the management of chronic kidney disease (CKD), yet patients report suboptimal satisfaction with the process of selecting a dialysis modality. Our purpose is to review the influencers of RRT decision making in the CKD population, which will better inform the process of shared decision making between clinicians and patients. Sources of information: PubMed and Google Scholar. Methods: A narrative review was performed using the main terms “chronic kidney disease,” “CKD,” “dialysis,” “review,” “decision-making,” “decision aids,” “education,” and “barriers.” Only articles in English were accessed. The existing literature was critically analyzed from a theoretical and contextual perspective and thematic analysis was performed. Key findings: Eight common themes were identified as influencers for decision making. “Patient-focused” themes including social influence, values and beliefs, comprehension, autonomy and sociodemographics, and “clinician-focused” themes including screening, communication, and engagement. Early predialysis education and decision aids can effectively improve decision making. Patient-valued outcomes need to be more fully integrated into clinical guidelines. Limitations: This is not a systematic review; therefore, no formal tool was utilized to evaluate the rigor and quality of studies included and findings may not be generalizable. Implications: Standardized comprehensive RRT education programs through multidisciplinary health teams can help optimize CKD patient education and shared decision making. Involving patients in the research process itself and implementing patient values and preferences into clinical guidelines can help to achieve a patient-centered model of care.
Tissue Expansion for Severe Foot and Ankle Deformities: A 16-Year Review
Authors: Nickel Kevin J. , Van Slyke Aaron C. , Knox Aaron D. , Wing Kevin , Wells Neil 
Published: November 2018

Background: Tissue expansion in the lower extremity is controversial, with studies reporting complication rates as high as 83%. Few studies have looked at tissue expansion prior to orthopaedic correction of severe foot and ankle deformities, and those available are restricted to clubfoot in the pediatric population. Here, we report the largest case series on the use of tissue expanders for the reconstruction of severe foot and ankle deformity and the only report in adults. Methods: This is a retrospective chart review of the senior author’s practice over a 16-year study period. All patients over 18 years of age who underwent tissue expansion prior to definitive orthopaedic correction of a severe foot and ankle deformity were included. Patient demographics, etiology of deformity, rate of expansion, and complications were recorded. Major complications were defined as those which required surgical intervention. Data were analyzed using descriptive statistics. Results: Nineteen cases were performed on 16 patients. Our overall complication rate was 31.6% (6/19), with major complications occurring in 21.1% (4/19) of cases, and minor complications occurring in 10.5% (2/19) of cases. Despite this, 94.7% (18/19) of cases went on to receive definitive orthopaedic correction after tissue expansion. No demographic parameters were associated with occurrence of complications. Conclusions: This represents the largest report on lower extremity tissue expansion for severe foot and ankle deformity correction. While we observed complications in 31.6% of patients, 94.7% of cases went on to receive definitive orthopaedic correction with successful primary closure.
Is There an Association Between Hyperbaric Oxygen Therapy and Improved Outcome of Deep Chemical Peeling? A Randomized Pilot Clinical Study
Authors: Wiser Itay , Roni Averbuch Sagie , Ziv Ella , Friedman Mony , Efraty Shay , Heller Lior , Landau Marina , Friedman Tali 
Published: November 2018

Background: Phenol chemical peeling (PCP) treatment is associated with prolonged recovery and sustained adverse events. Hyperbaric oxygen therapy (HBOT) is known to accelerate wound healing. The purpose of the current study was to evaluate the effect of HBOT on PCP recovery period and adverse events. Methods: This is a pilot randomized controlled clinical study. Women following PCP underwent 5 consecutive daily HBOT sessions, compared with PCP alone. Pain, pruritus, erythema, crusting, scaling, and edema were daily evaluated up to 28 days following PCP. Photographs taken on days 14 and 35 following PCP were assessed. Confidence to appear in public was assessed 14 days following PCP. Results: Eight participants equally assigned to HBOT and control groups. Lower severity scores for erythema, scaling, and pruritus were documented in the HBOT group (mean difference 1.19, P = .006; .84, P = .04; and 2.19, P = .001, respectively). Photographic assessment severity score was higher for skin tightness, edema, erythema, crusting, and scaling in the control group on day 14 post PCP ( P < .05) and for erythema on day 35 post PCP ( P < .05). Epithelialization percentage was higher in the HBOT group on day 14 post PCP compared with controls (98.5% ± 1% vs 94.2% ± 1%; P = .021). The HBOT group scored higher in confidence to appear in public (20.8 ± 1.7 vs 14.5 ± 1.3; P = .029). Conclusion: Hyperbaric oxygen therapy following PCP is associated with faster recovery as assessed by both patients and caregivers. So far, HBOT was mainly used in the treatment of problematic or chronic wounds. Our study suggests expanding the indications in which hyperbaric oxygen treatment is applicable and recommended.
Rational Choice with Intransitive Preferences
Authors: Panda Santosh C. 
Published: November 2018

Traditional rational choice theory assumes that the weak preference relation of an agent is an ordering that is it satisfies reflexivity, completeness and transitivity. It is also well known that the ordering property is essential to build the traditional ordinal utility analysis of consumer behaviour. However, there can be many situations when the weak preference relation of an agent may violate transitivity property, and hence, is not an ordering. In such situations traditional ordinal utility analysis breaks down. This paper develops a framework and discusses all the important results of rational choice theory when preferences are intransitive. It looks at weaker rationality properties such as quasi-transitivity and acyclicity and based on that it introduces weaker concepts of rationality such as quasi-transitive rationality and acyclic rationality and characterizes them. It also brings in the congruence axioms and property of path independence, and establishes the link with rationality. Finally, it analyzes how the results will change if we bring in restricted domain assumption of the choice function. JEL Classification: D01, D10, D11
Spillovers and R&D Incentive under Incomplete Information
Authors: Chatterjee Rittwik , Chattopadhyay Srobonti , Kabiraj Tarun 
Published: November 2018

Spillovers of R&D outcome affect the R&D decision of a firm. The present paper discusses the R&D incentives of a firm when the extent of R&D spillover is private information to each firm. We construct a two-stage game involving two firms when the firms first decide simultaneously whether to invest in R&D or not, then they compete in quantity. Assuming general distribution function of firm types we compare R&D incentives of firms under alternative scenarios based on different informational structures. The paper shows that while R&D spillovers reduce R&D incentives under complete information unambiguously, however, it can be larger under incomplete information. JEL Classification: D43, D82, L13, O31