Using data from a nationally representative nutrition surveillance system to assess trends and influence nutrition programs and policy

The Nutritional Surveillance Project (NSP*) of Helen Keller International (HKI), Bangladesh, implemented in partnership with the Government of Bangladesh’s (GOB) Institute of Public Health Nutrition (IPHN) from 1990 until 2006, is among the longest running surveillance systems; and was implemented with an overall goal to monitor nutrition and health status of children and mothers in Bangladesh. From 1990-1997, NSP data collection included rural and urban poor populations of disaster prone areas of Bangladesh. Since 1998, it evolved into a nationally representative nutrition surveillance system in rural Bangladesh and also continued assessing trends of malnutrition in urban poor areas. Over the 16 year period, the NSP produced plethora of information that was packaged and shared as bulletins, in peer reviewed journal articles, as presentations at conferences, seminars, workshops. The NSP had a flexible framework that allowed it to assess trends and underlying factors of malnutrition, monitor and evaluate selected programs and conduct special studies related to current and emerging issues. NSP findings were available to contribute to program development and supported policy discussions in-country and internationally. The NSP continuously highlighted the importance of monitoring, which is not only an indispensible element for a successful program, but also helps prioritization and decision making to maximize utilization of limited resources for developing countries burdened with numerous problems to address. The NSP provides an example of a technically sound surveillance system with rapid turnover of data and findings, which is imperative to successful program planning, policy formulation and tracking progress toward developmental goals.Le projet Nutritional Surveillance Project (NSP*) de l’association Helen Keller International (HKI), mis en œuvre au Bangladesh en partenariat avec l’Institute of Public Health Nutrition (IPHN), établissement gouvernemental du Bangladesh, entre 1990 et 2006, figure parmi les plus anciens systèmes de suivi encore utilisés. Son objectif était de suivre la nutrition et l’état de santé des enfants et des mères au Bangladesh. De 1990 à 1997, la collecte des données du NSP a porté sur des populations pauvres, rurales et urbaines, des régions du Bangladesh exposées aux catastrophes. Depuis 1998, le projet a évolué vers un système de suivi de la nutrition, représentatif de la politique nationale dans les régions rurales du pays, et a continué à évaluer les tendances de la malnutrition dans les zones urbaines pauvres. Au cours des seize dernières années, le NSP a généré une pléthore d’informations qui ont été regroupées et diffusées sous la forme de bulletins dans des revues spécialisées et sous la forme de présentations lors de conférences, séminaires et ateliers. Le cadre flexible du NSP a permis d’évaluer les tendances de la malnutrition et les facteurs sous-jacents, de suivre et d’évaluer les programmes sélectionnés et de conduire des études spécifiques liées à des problématiques actuelles et émergentes. Les résultats du NSP ont été utilisés pour développer des programmes et étayer des discussions sur les politiques mises en œuvre aux niveaux national et international. Le NSP a continuellement souligné l’importance du suivi, qui non seulement est indispensable à la réussite d’un programme, mais contribue aussi à la priorisation et à la prise de décisions permettant d’optimiser l’utilisation des ressources limitées pour les pays en développement qui doivent faire face à de nombreux problèmes. Le NSP est un exemple de système de suivi techniquement satisfaisant, impliquant une rotation rapide de données et de résultats, ce qui est impératif pour mener à bien la planification des programmes et l'élaboration de politiques adaptées, et pour suivre la progression vers les objectifs de développement fixés.El Proyecto de Vigilancia Nutricional (PVN*) de Helen Keller Internacional (HKI), Bangladés, puesto en marcha en colaboración con el Instituto de Nutrición Sanitaria Pública (INSP) del Gobierno de Bangladés (GB) desde 1990 hasta 2006, está entre los sistemas de vigilancia con mayor duración; y fue puesto en marcha con el objetivo general de controlar el estado nutricional y de salud de niños y madres en Bangladés. De 1990 a 1997, la recopilación de datos del PVN incluyó poblaciones rurales y urbanas pobres de áreas propensas a desastres en Bangladés. Desde 1998, evolucionó a un sistema de vigilancia nutricional representativo a nivel nacional en el Bangladés rural y también continuó evaluando las tendencias a la desnutrición en áreas urbanas pobres. A lo largo del período de 16 años, el PVN produjo una plétora de información que fue recopilada y compartida en forma de boletines, en publicaciones de periódicos revisadas por expertos, y como presentaciones en conferencias, seminarios y talleres. El PVN tuvo un marco flexible que le permitió evaluar las tendencias y factores subyacentes de la desnutrición, controlar y evaluar programas seleccionados y llevar a cabo estudios especiales relacionados con las cuestiones actuales y emergentes. Las conclusiones del PVN se pusieron a disposición para contribuir al desarrollo del programa y apoyaron debates políticos a nivel local e internacional. El PVN destacó continuamente la importancia de la vigilancia, que no es sólo un elemento indispensable para un programa de éxito, sino que también ayuda en la priorización y toma de decisiones para maximizar la utilización de recursos limitados para países en vías de desarrollo cargados con numerosos problemas para resolver. El PVN proporciona un ejemplo de un sistema de vigilancia técnicamente sólido con un rápido movimiento de datos y conclusiones, lo que es imprescindible para la planificación de un programa de éxito, formulación de políticas y seguimiento del progreso para lograr los objetivos del desarrollo

Intuitionistic regular subspaces in intuitionistic topological spaces

This paper explores the concept of intuitionistic topological spaces, delving into their definitions and essential properties. It also examines intuitionistic topological subspaces, providing insights into their characteristics. Additionally, the paper investigates intuitionistic regular spaces and demonstrates their hereditary nature, specifically focusing on  and . To illustrate these concepts in practical terms, the paper presents two real-world examples of intuitionistic sets. Through a comprehensive analysis of intuitionistic topological spaces and their subsets, the study sheds light on the inheritability of regularity in these spaces. Furthermore, the work emphasizes the significance of intuitionistic topological spaces within the realm of mathematical research, showcasing their applicability through concrete instances of intuitionistic sets

Assessing the value for money of an integrated health and wellbeing service in the UK

Lay health workers have been utilized to deliver health promotion programmes in a variety of settings. However, few studies have sought to determine whether these programmes represent value for money, particularly in a UK context. The present study involved an economic evaluation of Wellbeing for Life, an integrated health and wellbeing service in northern England. The service combined one-to-one interventions delivered by lay health workers (known as health trainers), group wellbeing interventions, volunteering opportunities and other community development activities. Value for money was assessed using an established economic model developed with input from a panel of commissioners and providers, and the main data source was the national health trainer data collection and reporting system. Between June 2015 and January 2017, behaviour change outcomes (i.e. whether client goals in relation to diet, physical activity, smoking or other behaviours, had been achieved) were recorded for 2433 of the 3179 individuals who accessed one-to-one interventions. The level of achievement observed gave an estimated total health gain of 287.7 quality-adjusted life years (QALYs). In addition, there were 4669 health-promoting events, five asset mapping projects and 1595 occurrences of signposting to other services. Combining the value of individual behaviour change with the value of these additional activities gave an overall net cost per QALY gained of £3,900 and a total estimated societal value of at least £3.45 for every £1 spent on the service. These results suggest that the Wellbeing for Life service offered good value for money. Further research is needed to systematically and comprehensively determine the societal value of similar holistic, asset-based and lay-led approaches

The association of serum ferritin with preeclampsia and its severity

Background: Preeclampsia, a pregnancy-related condition with heightened blood pressure and organ damage after 20 weeks, prompts concern. Serum ferritin, an iron-storing protein, gauged by blood tests, mirrors iron levels. Investigating link before conception between serum ferritin and preeclampsia could impact how we identify, manage, and treat this condition during pregnancy. Study aimed to assess the association of serum ferritin with preeclampsia and its severity. Methods: This case-control study was conducted in Bangabandhu Sheikh Mujib medical university hospital and Dhaka medical college hospital, Dhaka, Bangladesh from July 2011 to June 2012. A total of 100 pregnant women, comprising 50 cases (Preeclamptic) and 50 controls (Normal pregnant women), were purposively included as study subjects. Data analysis was performed using SPSS version 23.0. Results: In the case group, 64% were with mild and 36% with severe preeclampsia. Mean serum ferritin was significantly higher in cases than in controls (p<0.001); 76% of cases had elevated serum ferritin, compared to 44% in controls (p=0.001). Severe preeclampsia group had a mean serum ferritin of 192.8, mild preeclampsia group had 86.1, and normal pregnant women had 21.7 ng/ml, indicating higher serum ferritin with preeclampsia severity (p<0.001). Conclusions: Preeclamptic cases exhibit significantly elevated serum ferritin levels, with a fourfold increased likelihood compared to normal pregnancies. Furthermore, the severity of preeclampsia is associated with higher serum ferritin concentrations in comparison to uncomplicated pregnancies

A review of some properties of persistent homology

Every day, enormous complex geometric data are accumulating rapidly, and qualitative analysis is needed, which cannot be done properly without studying the shapes of those data. Persistent homology describes the homology of data sets of arbitrary size, producing state-of-the art results in data analysis across a significant number of fields and sparking a rigorous study of persistence in homology theory. In this study, persistent homology has been demonstrated as a homology theory by satisfying the Eilenberg-Steenrod axioms. A brief background on persistent homology groups has been written to understand their construction. Then other definitions of persistent homology based on functors and graded modules have also been reviewed. The Mayer-Vietoris-Vietorisfor persistent homology has been derived as a property of persistent homology. Subsequently, a long, exact sequence for persistent homology has been constructed. Furthermore, the stability of persistent homology has been examined carefully. Finally, the Diamond principle of persistent homology has been explained briefly. This study can be used to investigate new properties of persistent homology, among other benefits

Minding the Gap

The chapter examines inequalities in mental health in Stockton-on-Tees using data from a longitudinal household survey

Micronutrient Adequacy in the Diet of Reproductive-Aged Adolescent Girls and Adult Women in Rural Bangladesh

Micronutrient deficiencies remain a serious nutritional concern in Bangladesh, especially among rural women of reproductive age (WRA). This study assesses the diet quality of reproductive-aged adolescent girls and adult women (referred to together as WRA in this study), including socio-demographic factors associated with their diet quality. The diet quality of adolescent girls was compared with that of adult women to assess which group was most at risk. The diet quality was measured by calculating the nutrient adequacy ratio (NAR), using the preceding 24 h dietary recall method. The mean adequacy ratio (MAR) was calculated as an overall measure of diet quality using the NAR. Nearly three quarters of WRA (adolescents: 73.1–88.5%; adult women: 72.9–86.4%) had an inadequate intake of calcium, vitamin A, folic acid, and vitamin B12. The prevalence of inadequate dietary intakes of calcium, zinc, and energy was significantly higher in adolescent girls (p < 0.001) than in adult women. Overall diet quality was significantly better in adult women (0.51 ± 0.21, p < 0.001) than in adolescent girls (0.49 ± 0.22). Age, marital status, educational level, and monthly household income were important factors associated with the diet quality of WRA. Micronutrient inadequacy is widely prevalent in the diets of WRA in Bangladesh, and adolescent girls with poor socio-economic status and lower educational levels are at higher risk

Regional inequalities in self-reported conditions and non-communicable diseases in European countries: Findings from the European Social Survey (2014) special module on the social determinants of health

Background: Within the European Union (EU), substantial efforts are being made to achieve economic and social cohesion, and the reduction of health inequalities between EU regions is integral to this process. This paper is the first to examine how self-reported conditions and non-communicable diseases (NCDs) vary spatially between and within countries. Methods: Using 2014 European Social Survey (ESS) data from 20 countries, this paper examines how regional inequalities in self-reported conditions and NCDs vary for men and women in 174 regions (levels 1 and 2 Nomenclature of Statistical Territorial Units, ‘NUTS’). We document absolute and relative inequalities across Europe in the prevalence of eight conditions: general health, overweight/obesity, mental health, heart or circulation problems, high blood pressure, back, neck, muscular or joint pain, diabetes and cancer. Results: There is considerable inequality in self-reported conditions and NCDs between the regions of Europe, with rates highest in the regions of continental Europe, some Scandinavian regions and parts of the UK and lowest around regions bordering the Alps, in Ireland and France. However, for mental health and cancer, rates are highest in regions of Eastern European and lowest in some Nordic regions, Ireland and isolated regions in continental Europe. There are also widespread and consistent absolute and relative regional inequalities in all conditions within countries. These are largest in France, Germany and the UK, and smallest in Denmark, Sweden and Norway. There were higher inequalities amongst women. Conclusion: Using newly available harmonized morbidity data from across Europe, this paper shows that there are considerable regional inequalities within and between European countries in the distribution of self-reported conditions and NCDs