Development of a Locally Produced, Balanced Protein–Energy Food-Based Supplement and its Acceptance by Undernourished Pregnant Women in Northern Bangladesh

<p>Balanced protein–energy supplementation can improve the nutritional status of pregnant women and birthweight. The cost of prenatal supplementation is often beyond the reach of mothers in low-income countries. In this study of undernourished pregnant women, the aim was to develop an affordable, locally produced, balanced protein–energy food-based supplement and test its acceptance. A small business enterprise was established. With a commitment to local-level applied research, a balanced protein–energy supplement was developed using locally available, affordable, and preferred foods. A 30-day acceptability study was conducted among 10 pregnant women between September and October 2012 in a rural district of northern Bangladesh. A questionnaire was administered at days 15 and 30 to assess women’s perceptions and experience regarding compliance, organoleptic qualities, as well as personal and community attitudes toward the supplement and study. The primary outcome was compliance. All 10 women completed the 15- and 30-day questionnaires. The supplement was redeveloped at day 15 based on feedback from the follow-up survey and formal and informal feedback. By day 30, women consumed an average of 29.7 packets of the supplement of the 30 packets received. We concluded that the redeveloped locally produced food-based supplement was well accepted by pregnant women. Study findings have contributed toward the design of an efficacy trial currently underway.</p

Additional file 2: of A village-matched evaluation of providing a local supplemental food during pregnancy in rural Bangladesh: a preliminary study

Table S2. Village means for birth weight, weight at 1, 3, and 6, months, and MUAC at 6 months. (DOCX 9 kb

Deaths in young people after contact with the youth justice system: A retrospective data linkage study

Introduction: Young people who have contact with the youth justice system are distinguished by a high prevalence of complex, co-occurring health problems, including known risk factors for preventable mortality. However, almost nothing is known about health outcomes for these young people after separation from the youth justice system. Objectives and Approach: We aimed to examine the incidence, timing, causes and risk factors for death in justice-involved young people. We linked youth justice records in Queensland, Australia 1993-2016 (N=48,963) with adult correctional records and the National Death Index. We split the cohort into three subgroups: those who had ever been in detention (n=7,643), those supervised in the community but never detained (n=12,953), and those charged with an offence but never convicted (n=28,367). We calculated all-cause and cause-specific crude mortality rates (CMRs), and indirectly standardised mortality ratios (SMRs). We used Cox regression to identify static and time-varying risk factors for death. Results: During a median of 13.6 years of follow-up there were 1,452 deaths (3.0%). The all-cause CMR was 2.2 (95%CI 2.1-2.3) per 1000 person-years, and the all-cause SMR was 3.1 (95%CI 3.0-3.3). The leading external causes of death were suicide (32% of all deaths), transport accidents (16%), accidental drug-related causes (13%), and violence (3%). In adjusted analyses, independent risk factors for all-cause mortality included being male (HR=1.4, 95%CI 1.2-1.6) and older (>=15 vs. vs. charge only; HR=1.6, 95%CI 1.2-2.0) and subsequent incarceration as an adult (HR=1.8, 95%CI 1.4-2.4). Conclusion/Implications: Young people who have contact with the youth justice system are at markedly increased risk of preventable death, after separation from that system. Efforts to improve long-term health outcomes for justice-involved youth have the potential to reduce preventable deaths in these highly vulnerable young people

Additional file 1: of Queensland Alcohol-related violence and Night Time Economy Monitoring project (QUANTEM): a study protocol

Images of maps. The maps are of the Safe Night Precincts in Queensland that are referred to within the paper. (PDF 8544 kb