Factors associated with the health and nutritional status of children under 5 years of age in Afghanistan: family behaviour related to women and past experience of war-related hardships

<p>Abstract</p> <p>Background</p> <p>The present study was performed to assess, beyond socio-economic factors, independent associations between the health and nutritional status of children under 5 years old and (1) family behavioural factors related to women with regard to child care and (2) war-related experience by the household of hardships in Afghanistan.</p> <p>Methods</p> <p>The subjects were all children born during the previous 5 years from 1400 households in Kabul Province, Afghanistan and were selected by multistage sampling in March 2006. Height and weight measurements of the children and culturally sensitive interviews with their mothers were conducted by household visits. Child mortality, morbidity and nutritional status were evaluated. Four areas were assessed as variables for family behavioural factors related to women: education of mothers, child marriage of the mothers, maternal autonomy in obtaining healthcare for children and preference for a female physician. Hardships experienced by the family were examined by determining their satisfaction of basic material needs and by any experience of being forced to leave a preferred residence.</p> <p>Results</p> <p>A total of 2474 children from 1327 households completed the examinations and interviews; among them, 101 children were deceased by the time of the interview visits. Diarrhoea (32.5%) and acute respiratory infection (41.0%) were common child health problems and both emaciation (12.4%) and linear growth retardation (39.9%) were prevalent. Regardless of the influence of economic, demographic, family behavioural or hardships experience factors, a lack of maternal autonomy (79.1%) was associated with the occurrence of acute respiratory infection (odds-ratio = 1.72; 95% confidence interval = 1.23, 2.40), and linear growth retardation of children (odds-ratio = 1.38; 95% confidence interval = 1.01, 1.90); a lack of education of the mother (71.7%) and child marriage of the mothers (18.3%) were associated with diarrhoea (odds-ratio = 1.84; 95% confidence interval = 1.40, 2.41; odds-ratio = 1.46; 95% confidence interval = 1.08, 1.96, respectively); a shortage of basic material needs (59.1%) was associated with diarrhoea (odds-ratio = 1.35; 95% confidence interval = 1.08, 1.68); and migration inside the country (52.9%) was associated with underweight children (odds-ratio = 2.48; 95% confidence interval = 1.13, 5.44).</p> <p>Conclusion</p> <p>A lack of education of the mothers, child marriage, lack of maternal autonomy, shortage of basic material needs and internal displacement showed independent and significant negative associations with child health and nutritional variables in this country that has experienced a long period of conflict.</p

Bioengineered titanium surfaces affect the gene-expression and phenotypic response of osteoprogenitor cells derived from mouse calvarial bones

This study investigated the in vitro effects of bioactive titanium surfaces on osteoblast differentiation. Three titanium substrates were tested: a commercially pure titanium (Cp Ti), an alkali- and heat-treated titanium (AH Ti), and an apatite-formed titanium (Ap Ti) generated by soaking AH Ti in a simulated body fluid. Chemical evaluation of the surface reactivity was analysed at nanometre scale by X-ray photoelectron spectroscopy (XPS), and at micrometre scale by energy dispersive X-ray microanalysis (EDX). It showed that the estimated proportion of the surface covered by adsorbed serum proteins differed between the three substrates and confirmed the bioactivity of AH Ti, illustrated by surface calcium and phosphate deposition when immersed in biological fluids. Mouse calvaria osteoblasts were cultured on the substrates for 15 days with no sign of cytotoxicity. Enzyme immunoassay and Real-Time RT-PCR were used to follow osteoblast differentiation through the production of osteocalcin (OC) and expression of several bone markers. At day 15, a significant up-regulation of Runx2, Osx, Dlx5, ALP, BSP, OC and DMP1 mRNA levels associated with an increase of OC production were observed on AH Ti and Ap Ti when compared to Cp Ti. These results suggest that bioengineered titanium has a great potential for dental applications in enhancing osseointegration