Does geographic targeting of nutrition interventions make sense in cities?

Although most developing country cities are characterized by pockets of substandard housing and inadequate service provision, it is not known to what degree low incomes and malnutrition are confined to specific neighborhoods. This analysis uses representative household surveys of Abidjan and Accra to quantify small-area clustering in service provision, demographic characteristics, consumption, and nutrition. Both cities showed significant clustering in housing conditions but not in nutrition, while income was clustered in Abidjan, but less so in Accra. This suggests that neighborhood targeting of poverty-alleviation or nutrition interventions in these and similar cities could lead to undercoverage of the truly needy.Food consumption. ,Human Nutrition. ,Urban poor Africa. ,Malnutrition Africa. ,Africa. ,

The constraints to good child care practices in Accra

Life in urban areas presents special challenges for maternal child care practices. Data from a representative survey of households with children less than 3 years of age in Accra were used to test a number of hypothesized constraints to child care, including various maternal (education, employment, marital status, age, health, ethnic group, migration status) and household-level factors (income, calorie availability, quality of housing and asset ownership, availability of services, household size, and crowding). An age-specific child care index was created using recall data on maternal child feeding practices and use of preventive health services. A hygiene index was created from spot check observations of proxies of hygiene behaviors. Multivariate analyses showed that maternal schooling was the most consistent constraint to both the care and the hygiene index. None of the household-level characteristics were associated with the care index, but better housing quality and access to garbage collection services were associated with better hygiene. Female head of household and larger family size were associated with poorer hygiene. The programmatic implications of these findings for nutrition education and behavior change interventions in Accra are discussed. The focus is on using the information to target the right practices to be modified as well as the main constraints to their adoption.FCND ,Child care. ,Ghana. ,Maternal and infant welfare Developing countries. ,Urban health. ,

Good care practices can mitigate the negative effects of poverty and low maternal schooling on children's nutritional status

This study uses data from a representative survey of households with preschoolers in Accra, Ghana to (1) examine the importance of care practices for children's height-for-age z-scores (HAZ); and (2) identify subgroups of children for whom good maternal care practices may be particularly important. Good caregiving practices related to child feeding and use of preventive health services were a strong determinant of children's HAZ, specially among children from the two lower income terciles and children whose mothers had less than secondary schooling. In this population, good care practices could compensate for the negative effects of poverty and low maternal schooling on children's HAZ. Thus, effective targeting of specific education messages to improve child feeding practices and use of preventive health care could have a major impact on reducing childhood malnutrition in Accra.Health services. ,Child care. ,Child Feeding. ,Poverty. ,

Problems With Complex Actions

We consider Euclidean functional integrals involving actions which are not exclusively real. This situation arises, for example, when there are $t$-odd terms in the the Minkowski action. Writing the action in terms of only real fields (which is always possible), such terms appear as explicitly imaginary terms in the Euclidean action. The usual quanization procedure which involves finding the critical points of the action and then quantizing the spectrum of fluctuations about these critical points fails. In the case of complex actions, there do not exist, in general, any critical points of the action on the space of real fields, the critical points are in general complex. The proper definition of the function integral then requires the analytic continuation of the functional integration into the space of complex fields so as to pass through the complex critical points according to the method of steepest descent. We show a simple example where this procedure can be carried out explicitly. The procedure of finding the critical points of the real part of the action and quantizing the corresponding fluctuations, treating the (exponential of the) complex part of the action as a bounded integrable function is shown to fail in our explicit example, at least perturbatively.Comment: 6+epsilon pages, no figures, presented at Theory CANADA

Acute stress affects peripersonal space representation in cortisol stress responders.

Peripersonal space is the representation of the space near the body. It is implemented by a dedicated multisensory-motor network, whose purpose is to predict and plan interactions with the environment, and which can vary depending on environmental circumstances. Here, we investigated the effect on the PPS representation of an experimentally induced stress response and compared it to a control, non-stressful, manipulation. We assessed PPS representation in healthy humans, before and after a stressful manipulation, by quantifying visuotactile interactions as a function of the distance from the body, while monitoring salivary cortisol concentration. While PPS representation was not significantly different between the control and experimental group, a relation between cortisol response and changes in PPS emerged within the experimental group. Participants who showed a cortisol stress response presented enhanced visuotactile integration for stimuli close to the body and reduced for far stimuli. Conversely, individuals with a less pronounced cortisol response showed a reduced difference in visuotactile integration between the near and the far space. In our interpretation, physiological stress resulted in a freezing-like response, where multisensory-motor resources are allocated only to the area immediately surrounding the body

Hypercube matrix computation task

A major objective of the Hypercube Matrix Computation effort at the Jet Propulsion Laboratory (JPL) is to investigate the applicability of a parallel computing architecture to the solution of large-scale electromagnetic scattering problems. Three scattering analysis codes are being implemented and assessed on a JPL/California Institute of Technology (Caltech) Mark 3 Hypercube. The codes, which utilize different underlying algorithms, give a means of evaluating the general applicability of this parallel architecture. The three analysis codes being implemented are a frequency domain method of moments code, a time domain finite difference code, and a frequency domain finite elements code. These analysis capabilities are being integrated into an electromagnetics interactive analysis workstation which can serve as a design tool for the construction of antennas and other radiating or scattering structures. The first two years of work on the Hypercube Matrix Computation effort is summarized. It includes both new developments and results as well as work previously reported in the Hypercube Matrix Computation Task: Final Report for 1986 to 1987 (JPL Publication 87-18)

Urban challenges to food and nutrition security

This review of recent literature explores the urban face of food and nutrition security in a more comprehensive, integrated way than most previous efforts. The review is organized around a conceptual framework that identifies food insecurity, inadequate caring behaviors, and poor health as the primary causes of malnutrition. It discusses current knowledge in eight areas that require the special attention of policymakers, development practitioners, and program administrators who wish to improve urban food and nutrition security: the sources and cost of food; incomes and employment; urban agriculture; urban diets; child caregiving practices; childhood mortality, morbidity, and malnutrition; health and environment; and social assistance programs, or safety nets. The review also reports on the magnitude of rural-urban and intra-urban health differences in mortality, morbidity, and malnutrition. In conclusion, the review indicates which policy issues and knowledge gaps remain for future research to address.Urban health. ,Urban poor Services for. ,Food security. ,Malnutrition. ,Child care. ,

Prosthesis–patient mismatch is less frequent and more clinically indolent in patients operated for aortic insufficiency

ObjectiveTo date, no study has focused on the incidence and effects of prosthesis–patient mismatch in patients requiring aortic valve replacement for aortic insufficiency. We hypothesized that the incidence and implications of prosthesis–patient mismatch in patients with aortic insufficiency might be different than for aortic stenosis or mixed disease because the annulus is generally larger in aortic insufficiency and left ventricular remodeling might differ.MethodsNinety-eight patients with lone aortic insufficiency (≥3+ with a preoperative mean gradient <30 mm Hg) were followed over 7.7 ± 4.3 years (maximum, 17.5 years) with clinical and echocardiographic assessments. They were compared with 707 patients who had aortic valve replacement for aortic stenosis or mixed disease. Prosthesis–patient mismatch was defined as an in vivo indexed effective orifice area of 0.85 cm2/m2 or less.ResultsCompared with patients with aortic stenosis/mixed disease, patients with aortic insufficiency had approximately half the incidence of prosthesis–patient mismatch (P = .003). Patients with prosthesis–patient mismatch had significantly higher transprosthesis gradients postoperatively. An independent detrimental effect of prosthesis–patient mismatch on survival was observed in patients with aortic stenosis/mixed disease who had preoperative left ventricular dysfunction (hazard ratio, 2.3; P = .03) but not in patients with aortic insufficiency, irrespective of left ventricular function (hazard ratio, 0.7; P = .7). In patients with aortic stenosis/mixed disease with left ventricular dysfunction, prosthesis–patient mismatch predicted heart failure symptoms by 3 years after aortic valve replacement (odds ratio, 6.0; P = .002), but there was no such effect in patients with aortic insufficiency (P = .8). Indexed left ventricular mass regression occurred to a greater extent in patients with aortic insufficiency than in patients with aortic stenosis/mixed disease (by an additional 29 ± 5 g/m2, P < .001), and there was a trend for prosthesis–patient mismatch to impair regression in patients with aortic insufficiency (by 30 ± 17 g/m2, P = .1).ConclusionsThe incidence and significance of prosthesis–patient mismatch differs in patients with aortic insufficiency compared with those with aortic stenosis or mixed disease. In patients with aortic insufficiency, prosthesis–patient mismatch is seen less frequently and has no significant effect on survival and freedom from heart failure but might have a negative effect on left ventricular mass regression