759 research outputs found

    Drivers of under-five stunting trend in 14 low- and middle-income countries since the turn of the millennium : a multilevel pooled analysis of 50 demographic and health surveys

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    Background: Understanding the drivers contributing to the decreasing trend in stunting is paramount to meeting the World Health Assembly's global target of 40% stunting reduction by 2025. Methods: We pooled data from 50 Demographic and Health Surveys since 2000 in 14 countries to examine the relationships between the stunting trend and potential factors at distal, intermediate, and proximal levels. A multilevel pooled trend analysis was used to estimate the association between the change in potential drivers at a country level and stunting probability for an individual child while adjusting for time trends and child-level covariates. A four-level mixed-effects linear probability regression model was fitted, accounting for the clustering of data by sampling clusters, survey-rounds, and countries. Results: Stunting followed a decreasing trend in all countries at an average annual rate of 1.04 percentage points. Among the distal factors assessed, a decrease in the Gini coefficient, an improvement in women's decision-making, and an increase in urbanization were significantly associated with a lower probability of stunting within a country. Improvements in households' access to improved sanitation facilities and drinking water sources, and children's access to basic vaccinations were the important intermediate service-related drivers, whereas improvements in early initiation of breastfeeding and a decrease in the prevalence of low birthweight were the important proximal drivers. Conclusions: The results reinforce the need for a combination of nutrition-sensitive and -specific interventions to tackle the problem of stunting. The identified drivers help to guide global efforts to further accelerate stunting reduction and monitor progress against chronic childhood undernutrition

    Excellence in Teaching and Learning in Reusable Learning Objects

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    Our ongoing work at London Metropolitan University investigates effective ways to design learning environments that add mobile learning into blended higher education modules. Our approach is one of evolutionary, iterative refinement of the learning environment based on student feedback. Blended learning effectiveness can be viewed as a function of effective pedagogical practices. Accordingly, a key question is: What combination of instructional strategies and delivery media will best produce the desired learning outcome for the intended audience? The paper will (i) outline the background issues that led to the development of the blended mLearning approach (ii) describe the initial survey that informed our design, (iii) outline the blended mLearning design, (iv) present our evaluation findings with students, and (v) conclude by commenting on the wider applicability of our approach.London Metropolitan Universit

    TEXAS AGRICULTURE BY CONGRESSIONAL DISTRICT: 1993-1996

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    Texas Agriculture by Congressional Districts: 1993-96 is an update of previous editions of this publication. Commodity sales by county are estimates made by county agents and, therefore, are not official. In all but 4 of 30 Texas congressional districts, production agriculture accounts for over 100millioninsales.In18ofthedistricts,farmprogramcommoditiesrepresentover100 million in sales. In 18 of the districts, farm program commodities represent over 50 million in sales.Production Economics,

    Metrology System for a Large, Somewhat Flexible Telescope

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    A proposed metrology system would be incorporated into a proposed telescope that would include focusing optics on a rigid bench connected via a deployable mast to another rigid bench holding a focal-plane array of photon counting photodetectors. Deformations of the deployable mast would give rise to optical misalignments that would alter the directions (and, hence, locations) of incidence of photons on the focal plane. The metrology system would measure the relative displacement of the focusing- optics bench and the focal-plane array bench. The measurement data would be used in post-processing of the digitized photodetector outputs to compensate for the mast-deformation-induced changes in the locations of incidence of photons on the focal plane, thereby making it possible to determine the original directions of incidence of photons with greater accuracy. The proposed metrology system is designed specifically for the Nuclear Spectroscopic Telescope Array (NuSTAR) a proposed spaceborne x-ray telescope. The basic principles of design and operation are also applicable to other large, somewhat flexible telescopes, both terrestrial and spaceborne. In the NuSTAR, the structural member connecting the optical bench and the photodetector array would be a 10-m-long deployable mast, and there is a requirement to keep errors in measured directions of incidence of photons below 10 arc seconds (3 sigma). The proposed system would include three diode lasers that would be mounted on the focusing-optics bench. For clarity, only one laser is shown in the figure, which is a greatly simplified schematic diagram of the system. Each laser would be aimed at a position-sensitive photodiode that would be mounted on the detector bench alongside the aforementioned telescope photodetector array. The diode lasers would operate at a wavelength of 830 nm, each at a power of 200 mW. Each laser beam would be focused to a spot of .1-mm diameter on the corresponding position-sensitive photodiode. To reduce the effect of sunlight on the measurements, a one-stage light baffle and an 830-nm transmission filter of 10-nm bandwidth would be placed in front of the position- sensitive photodiode. For each metrology reading, the output of the position-sensitive detector would be sampled and digitized twice: once with the lasers turned on, then once with the lasers turned off. The data from these two sets of samples would be subtracted from each other to further reduce the effects of sun glints or other background light sources

    The contribution of Thai fisheries to sustainable seafood consumption : national trends and future projections

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    Sustainably feeding a growing human population is one of the greatest food system challenges of the 21st century. Seafood plays a vital role in supporting human wellbeing, by providing bioavailable and nutrient-dense animal-source food. In Thailand, seafood demand is increasing, and wild capture fishery yields have plateaued, due to oceanic ecosystem degradation and fishery stock exploitation. In this study, we investigated the supply trend of fishery products and subsequent seafood-derived nutrient availability over the last decade. In addition, we explored the possibility of predicting seafood availability and consumption levels, including adherence to Thailand’s national food guide and global dietary recommendations for sustainable seafood consumption. Our findings indicate that, at national-level, fishery products supplied between 19% and 35% of the Thai populations recommended dietary protein intake, 4–6% of calcium, 6–11% of iron, and 2–4% of zinc from 1995 to 2015. Nevertheless, our research also reports that if Thailand’s wild-caught seafood production were to decrease by 13%, as is highly likely, by 2030, the country might face a per capita supply deficit of fish and shellfish to meet healthy and sustainable dietary recommendations (28–30 g/day), let alone the current Thai average intake (32 g/day). Although a 1% per year increase in aquaculture production might bridge this supply gap, policymakers and relevant fishery stakeholders must consider the long-term environmental impacts of such an approach in Thailand

    A randomized, placebo-controlled trial of late Na current inhibition (ranolazine) in coronary microvascular dysfunction (CMD): impact on angina and myocardial perfusion reserve.

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    AimsThe mechanistic basis of the symptoms and signs of myocardial ischaemia in patients without obstructive coronary artery disease (CAD) and evidence of coronary microvascular dysfunction (CMD) is unclear. The aim of this study was to mechanistically test short-term late sodium current inhibition (ranolazine) in such subjects on angina, myocardial perfusion reserve index, and diastolic filling.Materials and resultsRandomized, double-blind, placebo-controlled, crossover, mechanistic trial in subjects with evidence of CMD [invasive coronary reactivity testing or non-invasive cardiac magnetic resonance imaging myocardial perfusion reserve index (MPRI)]. Short-term oral ranolazine 500-1000 mg twice daily for 2 weeks vs. placebo. Angina measured by Seattle Angina Questionnaire (SAQ) and SAQ-7 (co-primaries), diary angina (secondary), stress MPRI, diastolic filling, quality of life (QoL). Of 128 (96% women) subjects, no treatment differences in the outcomes were observed. Peak heart rate was lower during pharmacological stress during ranolazine (-3.55 b.p.m., P < 0.001). The change in SAQ-7 directly correlated with the change in MPRI (correlation 0.25, P = 0.005). The change in MPRI predicted the change in SAQ QoL, adjusted for body mass index (BMI), prior myocardial infarction, and site (P = 0.0032). Low coronary flow reserve (CFR <2.5) subjects improved MPRI (P < 0.0137), SAQ angina frequency (P = 0.027), and SAQ-7 (P = 0.041).ConclusionsIn this mechanistic trial among symptomatic subjects, no obstructive CAD, short-term late sodium current inhibition was not generally effective for SAQ angina. Angina and myocardial perfusion reserve changes were related, supporting the notion that strategies to improve ischaemia should be tested in these subjects.Trial registrationclinicaltrials.gov Identifier: NCT01342029
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