Evidence on the relative importance of various factors associated with child anthropometric failures (ie, stunting, underweight, and wasting) and their heterogeneity across countries can inform ...global and national health agendas.
To assess the relative significance of factors associated with child anthropometric failures in 35 low- and middle-income countries (LMICs).
This cross-sectional study of 299 353 children who were born singleton and aged 12 to 59 months with nonpregnant mothers and valid anthropometric measures assessed the strengths of associations of 26 factors with child stunting, underweight, and wasting, using Demographic and Health Surveys (2007-2018) from 35 LMICs. Data analysis was conducted from July 2019 to February 2020.
A total of 9 direct factors (ie, dietary diversity score; breastfeeding initiation; vitamin A supplements; use of iodized salt; infectious disease in past 2 weeks; oral rehydration therapy for children with diarrhea; care seeking for suspected pneumonia; full vaccination; and indoor pollution) and 17 indirect factors (household wealth; maternal and paternal education; maternal and paternal height and body mass index; maternal autonomy for health care, movement, and money; water source; sanitation facility; stool disposal; antenatal care; skilled birth attendant at delivery; family planning needs; and maternal marriage age) were assessed.
Three anthropometric failure outcomes were constructed based on the 2006 World Health Organization child growth standards: stunting (height-for-age z score less than -2 standard deviations SDs), underweight (weight-for-age z score less than -2 SDs), and wasting (weight-for-height z score less than -2 SDs).
Among the 299 353 children aged 12 to 59 months included in the analysis, 38.8% (95% CI, 38.6%-38.9%) had stunting, 27.5% (95% CI, 27.3%-27.6%) had underweight, and 12.9% (95% CI, 12.8%-13.0%) had wasting. In the pooled sample, short maternal height was the strongest factor associated with child stunting (odds ratio OR, 4.7; 95% CI, 4.5-5.0; P < .001), followed by lack of maternal education (OR, 1.9; 95% CI, 1.8-2.0; P < .001), poorest household wealth (OR, 1.7; 95% CI,1.6-1.8; P < .001), and low maternal body mass index (OR, 1.6; 95% CI, 1.6-1.7; P < .001). Short paternal height was also significantly associated with higher odds of stunting (OR, 1.9; 95% CI, 1.7-2.2; P < .001). Consistent results were found for underweight (eg, short maternal height: OR, 3.5; 95% CI, 3.3-3.7; P < .001; lack of maternal education: OR, 1.8; 95% CI, 1.7-2.0; P < .001) and wasting (eg, low maternal body mass index: OR, 2.3; 95% CI, 2.1-2,4; P < .001; poorest household wealth: OR, 1.2; 95% CI, 1.1-1.3; P < .001). Parental nutritional status and household socioeconomic conditions ranked the strongest (1st to 4th) for most countries, with a few exceptions (eg, lack of maternal education ranked 18th-20th in 8 countries for child wasting). Other factors were not associated with anthropometric failures in pooled analysis and had large country-level heterogeneity; for example, unsafe water was not associated with child underweight in the pooled analysis (OR, 0.97; 95% CI, 0.95-1.00; P < .001), and it ranked from 4th to 20th across countries.
In this study, socioeconomic conditions and parental nutritional status were the strongest factors associated with child anthropometric failures. Poverty reduction, women's education, and nutrition programs for households could be important strategies for reducing child undernutrition; however, country-specific contexts should be considered in national policy discussions.
In the European Union (EU), between 44 and 76 million individuals of the 217 million EU employees suffer from allergic disease of the airways or the skin. Up to 90% of these persons are untreated or ...insufficiently treated. This has major socio-economic consequences such as absence from work (absenteeism), particularly reduced productivity at work (presenteeism).
We used published literature and online statistical information from Eurostat and Eurofound to assess the costs of allergic disease to society.
Allergies have an impact on direct, indirect, intangible and opportunity costs. Most importantly, for the EU, avoidable indirect costs per patient insufficiently treated for allergy range between €55 and €151 billion per annum due to absenteeism and presenteeism, that is, €2405 per untreated patient per year. On the other hand, appropriate therapy for allergic diseases is available at comparatively low costs at an average of €125 per patient annually, equalling only 5% of the costs of untreated disease, allowing potential savings of up to €142 billion.
A better care for allergies based on guideline-based treatment would allow Europe's economy substantial savings. In addition, allergies have an impact on learning and performance at school and university, leading to opportunity costs for society. This cannot be calculated moneywise but will have an impact in a modern knowledge-based society. Still allergies are trivialized in society, noting that the costs of therapy are paid by patients and healthcare services, whereas economic savings are made by employers and society. A change of this mindset is urgently needed.
Nanocrystalline TiO2 (anatase) was synthesized successfully by the direct conversion of TiO2-sol at 85 deg C. The as-prepared TiO2 at 85 deg C were calcined at different temperatures and time in ...order to optimize the system with best electrochemical performance. The particle sizes of the synthesized materials were found to be in the range of 15-20nm as revealed by the HR-TEM studies. Commercial TiO2 anatase (micron size) was also studied for its Li-insertion and deinsertion properties in order to compare with the nanocrystalline TiO2. The full cell studies were performed with LiCoO2 cathode with the best performing nano-TiO2 as anode. The specific capacity of the nanocrystalline TiO2 synthesized at 500 deg C/2h in a half-cell configuration was 169mAhg-1 while for the cell with LiCoO2 cathode, it was 95mAhg-1 in the 2V region. The specific reversible capacity and the cycling performance of the synthesized nano-TiO2 anode in full cell configuration across LiCoO2 cathode are superior to that reported in the literature. Cyclic voltammetry measurements showed a larger peak separation for the micro-TiO2 than the nano-TiO2, clearly indicating the influence of nano-particle size on the electrochemical performance.
One of the main problems with hydrogen fuelled internal combustion engines is the high NO level due to rapid combustion. Use of diluents with the charge and retardation of the spark ignition timing ...can reduce NO levels in Hydrogen fuelled engines. In this work a single cylinder hydrogen fuelled engine was run at different equivalence ratios at full throttle. NO levels were found to rise after an equivalence ratio of 0.55, maximum value was about 7500
ppm. High reductions in NO emission were not possible without a significant drop in thermal efficiency with retarded spark ignition timings. Drastic drop in NO levels to even as low as 2490
ppm were seen with water injection. In spite of the reduction in heat release rate (HRR) no loss in brake thermal efficiency (BTE) was observed. There was no significant influence on combustion stability or HC levels.
AbstractObjectivesWe are often confronted in public health by associations that vary by population or subpopulation. Much effort has focused on the statistical and biological interpretation of such ...effect measure modification (EMM) because of the importance to public health. However, EMM remains difficult to conceptualize because it apparently violates everyday understanding of causes as usually acting consistently, making it difficult to predict when EMM may occur and raises questions about how to determine the external validity of interventions without extensive retesting by population or subpopulation. Study Design and SettingMethods exposition. ResultsWe propose that EMM can be thought of as mediation of an intervention (or exposure) on outcome by mechanism(s) whose relevance differs between population groups, which can be illustrated in causal diagrams, that is, directed acyclic graphs and selection diagrams, meaning external validity can be formally considered as mediation according to “selection variables.” EMM can then be represented graphically and its consequences predicted. ConclusionThis new conceptualization of EMM transforms EMM from a concept that violates everyday understanding of causes into an insight generating means of thinking about interventions (or exposures) in terms of their mediating mechanism(s) and corresponding population- or subpopulation-specific attributes to help target interventions effectively.
This study reported the tribological evaluation of polyolester based lubricant synthesised from waste feedstock. The transesterification process was adopted for the formulation of lubricant from ...waste mango seed kernel oil. The polyols used in this formulation are neopentyl glycol, trimethylolpropane and pentaerythritol. The tribological investigation was conducted using four ball tribometer as per ASTM D4172. The frictional and wear behavior of vegetable oil-based polyolester was analysed in addition to the wear morphology of investigated balls. The results indicated that the average frictional torque and mean wear diameter of pentaerythritol ester of waste mango seed oil was 0.12 Nm and 0.403 mm respectively and also found that the pentaerythritol ester showed improved tribological results as compared with other polyolesters say neopentyl glycol ester and trimethylolpropane ester of waste mango seed oil. The waste mange seed oil is found suitable candidate for the formulation of polyolester based sustainable lubricant.
Dietary diversity is an important indicator of child malnutrition. However, little is known about the geographic variation of diet indicators across India, particularly within districts and across ...states. As such, the purpose of this paper was to elucidate the small area variations in diet indicators between clusters within districts of India. Overall, we found that clusters were the largest source of variation for children not eating grains, roots, and tubers, legumes and nuts, dairy, vitamin A-rich vegetables and fruits, and other vegetables and fruits. We also found positive correlations between the district percent and cluster standard deviations of children not breastfeeding or eating grains, roots, and tubers, but negative correlations between the district percent and cluster standard deviation for the remaining seven outcomes. These findings underscore the importance of targeting clusters to improve child dietary diversity.
The empirical relationship between income inequality and health has been much debated and discussed. Recent reviews suggest that the current evidence is mixed, with the relationship between state ...income inequality and health in the United States (US) being perhaps the most robust. In this paper, we examine the multilevel interactions between state income inequality, individual poor self-rated health, and a range of individual demographic and socioeconomic markers in the US. We use the pooled data from the 1995 and 1997 Current Population Surveys, and the data on state income inequality (represented using Gini coefficient) from the 1990, 1980, and 1970 US Censuses. Utilizing a cross-sectional multilevel design of 201,221 adults nested within 50 US states we calibrated two-level binomial hierarchical mixed models (with states specified as a random effect). Our analyses suggest that for a 0.05 change in the state income inequality, the odds ratio (OR) of reporting poor health was 1.30 (95% CI: 1.17–1.45) in a conditional model that included individual age, sex, race, marital status, education, income, and health insurance coverage as well as state median income. With few exceptions, we did not find strong statistical support for differential effects of state income inequality across different population groups. For instance, the relationship between state income inequality and poor health was steeper for whites compared to blacks (
OR
=
1.3
4
; 95% CI: 1.20–1.48) and for individuals with incomes greater than $75,000 compared to less affluent individuals (
OR
=
1.6
5
; 95% CI: 1.26–2.15). Our findings, however, primarily suggests an overall (as opposed to differential) contextual effect of state income inequality on individual self-rated poor health. To the extent that contemporaneous state income inequality differentially affects population sub-groups, our analyses suggest that the adverse impact of inequality is somewhat stronger for the relatively advantaged socioeconomic groups. This pattern was found to be consistent regardless of whether we consider contemporaneous or lagged effects of state income inequality on health. At the same time, the contemporaneous main effect of state income inequality remained statistically significant even when conditioned for past levels of income inequality and median income of states.
Background Early life adversities may play a role in the associations observed between neighbourhood contextual factors and health behaviours. Methods We examined whether self-reported adverse ...experiences in childhood (parental divorce, long-term financial difficulties, serious conflicts, serious/chronic illness or alcohol problem in the family, and frequent fear of a family member) explain the association between adulthood neighbourhood disadvantage and co-occurrence of behavioural risk factors (smoking, moderate/heavy alcohol use, physical inactivity). Study population consisted of 31 271 public sector employees from Finland. The cross-sectional associations were analysed using two-level cumulative logistic regression models. Results Childhood adverse experiences were associated with the sum of risk factors (cumulative OR 1.32 (95% CI 1.25 to 1.40) among those reporting 3–6 vs 0 adversities). Adverse experiences did not attenuate the association between neighbourhood disadvantage and risk factors; this cumulative OR was 1.52 (95% CI 1.43 to 1.62) in the highest versus lowest quartile of neighbourhood disadvantage when not including adversities, and 1.50 (95% CI 1.40 to 1.60) when adjusted for childhood adversities. In adversity-stratified analyses those reporting 3–6 adversities had 1.60-fold (95% CI 1.42 to 1.80) likelihood of risk factors if living in the neighbourhood of the highest disadvantage, while in those with fewer adversities this likelihood was 1.09–1.34-fold (95% CI 0.98 to 1.53) (p interaction 0.07). Conclusions Childhood adverse experiences and adulthood neighbourhood disadvantage were associated with behavioural risk factors. Childhood experiences did not explain associations between neighbourhood disadvantage and the risk factors. However, those with more adverse experiences may be susceptible for the socioeconomic conditions of neighbourhoods.
The activity concentration of 238U, 232Th and 40K were measured in the soil samples collected from Fast Reactor Fuel Cycle Facility (FRFCF) site, using high-resolution gamma-ray spectrometry. This ...study is aimed to establish the baseline data of naturally occurring radionuclides within the site. The average activity concentrations were found to be 416.5, 61.7 and 622.3 Bq kg-1 for 40K, 238U and 232Th, respectively. The activity concentrations and its radiological indices were evaluated and were compared with the international values reported by the United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR). The ratio of 40K/232Th and 40K /238U were calculated, which indicates the presence of 5.79 and 2.69 times more K-bearing minerals as compared with Th and U-bearing minerals in the soil samples, respectively. The study provides baseline information on concentration of radionuclides and background radiological assessment of the FRFCF site.
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