951 research outputs found

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    Thesis (M.A.)--Boston University, 1949. This item was digitized by the Internet Archive

    An Etiological and Epidemiological Study of Dental Caries in Children Residing in East Tennessee

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    The present study examines caries variability in children, between the ages of 2 and 17, residing in the eastern portion of Tennessee. The purpose was to identify factors which are associated with dental health status in children. Biographic data on 99 children and their parents were obtained through the use of a questionnaire which was distributed in the offices of two pedodontists with practices in Knoxville. Dental health status was measured by the number of decayed, missing, and filled (DMF) teeth supplied by each child’s dental records. The Statistical Package for the Social Sciences (Nie et al. 1975) was used to analyze the data. The data demonstrated a great variability in the number of DMF teeth among children. Few of the variables derived from the questionnaire were significantly associated with dental health, but children with a history of stress related health disorders, such as allergies and asthma, had a higher rate of dental decay than their non-stressed counterparts. In addition, the data revealed that popular opinions on the cause and prevention of dental decay differed from the professional viewpoint. These findings led the researcher to pursue stress as a possible etiological factor in dental caries and to further examine folk orientations toward dental health. A questionnaire was sent through mail to the homes of 60 parents who agreed to be contacted by the researcher for further information. This questionnaire elicited information regarding the presence or absence of stress indicators in children. In addition, informants were asked to respond to statements reflecting curative, preventive, internal, and/or external orientations toward dental health. A T-Test demonstrated that children with a high number of DMF teeth had a higher number of stress indicators than children with a low DMF score. No significant differences were found between parents of high and low DMF children with regard to any of the four orientations (curative, preventive, internal, and/or external) toward dental health. Collectively, the sample favored curative and internal orientations toward dental health. The relationship between stress and caries was further explored in a sample of children from an Arikara Indian skeletal population. Caries rates were compared between a stressed population from the post-contact Leavenworth site and a non-stressed population from the pre-contact Mobridge 1 site. No significant differences were found between sites with regard to the frequency of caries. The major finding of this research is that the etiology of dental caries is complex and can not be explained with reference to any single variable. Stress may be an etiological factor involved in human dental caries. More research on stress as well as other psycho-social variables and their relation to dental health is needed

    Alien Registration- Mcgrath, Marie Joseph Eusehe (Orrington, Penobscot County)

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    https://digitalmaine.com/alien_docs/11056/thumbnail.jp

    Colobinae evolution: Using GIS to map the distribution of leaf monkeys across Southeast Asia over time

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    The Colobinae, or leaf monkeys, are distributed geographically across Africa and Asia. Colobinae are specialized arborealists and leaf eaters with sacculated stomachs, sheering teeth, reduced thumbs, and very mobile shoulders. Colobinae diverged ~10.9 million year ago (Ma) from the Cercopithecidae in Africa, and Asian colobines appear in the fossil record in the late Miocene ~8.5 Ma. However, an incomplete fossil record means little is known about the evolutionary pressures that led to Asian colobine migration and diversification. Here, we use recent fossil discoveries and geospatial information to develop hypotheses about how geographic barriers played direct roles in Asian colobine evolution. Using ArcGIS, we plotted Miocene-epoch to Pleistocene-epoch fossil Colobinae collection sites with overlapping geospatial information including geographic barriers that may have influenced species distribution like the Himalayas and the Hengduan Mountains. We also included extant species’ presence, distributions, and species diversity to assess patterns of distribution over time. Data from each epoch were compared to track species distribution over time. Results suggest that combining fossil data, extant species’ distributions, and biogeographically relevant geospatial elements provides some parameters for where and when Colobine adaptions were selected for. For example, cold climate adaptions in certain Asian Colobines, especially Rhinopithecus, are not recent and have shaped how that genus is distributed today. These parameters can support powerful hypothesis building about the evolutionary histories of extant species adapting behaviorally and anatomically to densely forested South East Asia.https://scholarscompass.vcu.edu/gradposters/1134/thumbnail.jp

    An approach to measuring dispersed families with a particular focus on children 'left behind' by migrant parents: findings from rural South Africa

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    There is growing policy and academic interest in the conditions, experiences, and well-being of migrant families stretched across origin and destination households. In South Africa, the dispersal of children and migrant parents across multiple households is a commonplace childhood experience. However, in common with the broader international context, quantitative analyses of the social and residential connections between children and migrant parents in South Africa have been limited by the lack of available data that document family arrangements from the perspective of more than one household. This paper describes a new data collection effort in the origin and destination households of migrants from rural KwaZulu-Natal and explains the methodology for using this data to examine multiple household contexts for children and parents. In order to illustrate the contribution that this form of data collection effort could make to family migration studies, the paper also presents results on the living arrangements of children ‘left behind’ by migrant parents; a potentially vulnerable group whose arrangements are challenging to examine with existing data sources. The empirical results show the majority (75%) of left behind children have previously migrated and a significant proportion of migrants' children (25%) were not living in their parent's origin or destination household. The findings highlight the need for careful measurement of the circumstances of left behind children and demonstrate the contribution of linked data for providing insights into the residential arrangements of migrants' children

    The association between self-reported stigma and loss-to-follow up in treatment eligible HIV positive adults in rural KwaZulu-Natal, South Africa

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    The relationship between loss-to-follow-up (LTFU) in HIV treatment and care programmes and psychosocial factors, including self-reported stigma, is important to understand. This prospective cohort study explored stigma and LTFU in treatment eligible adults who had yet not started antiretroviral therapy (ART).Psychosocial, clinical and demographic data were collected at a baseline interview. Self-reported stigma was measured with a multi-item scale. LTFU was defined as not attending clinic in the 90 days since last appointment or before death. Data was collected between January 2009 and January 2013 and analysed using Cox Regression.380 individuals were recruited (median time in study 3.35 years, total time at risk 1065.81 person-years). 203 were retained (53.4%), 109 were LTFU (28.7%), 48 had died and were not LTFU at death (12.6%) and 20 had transferred out (5.3%). The LTFU rate was 10.65 per 100 person-years (95% CI: 8.48-12.34). 362 individuals (95.3%) started ART. Stigma total score (categorised in quartiles) was not significantly associated with LTFU in either univariable or multivariable analysis (adjusting for other variables in the final model): second quartile aHR 0.77 (95%CI: 0.41-1.46), third quartile aHR 1.20(95%CI: 0.721-2.04), fourth quartile aHR 0.62 (95%CI: 0.35-1.11). In the final multivariable model, higher LTFU rates were associated with male gender, increased openness with friends/family and believing that community problems would be solved at higher levels. Lower LTFU rates were independently associated with increased year of age, greater reliance on family/friends, and having children.Demographic and other psychosocial factors were more closely related to LTFU than self-reported stigma. This may be consistent with high levels of social exposure to HIV and ART and with stigma affecting LTFU less than other stages of care. Research and clinical implications are discussed

    Understanding family migration in rural South Africa: exploring children's inclusion in the destination households of migrant parents

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    Despite the removal of restrictions on movement and increasing female participation in migration, only a minority of migrant parents in South Africa include their children in their destination household. Quantitative analyses of the circumstances in which children accompany a migrant parent have been limited by the lack of available data that document family arrangements from the perspective of more than one household. This paper uses data about members of rural households in a demographic surveillance population in KwaZulu-Natal and a linked sample survey of adult migrants to examine factors associated with children's inclusion in the destination household of migrant parents, analyse the timing and sequence of children's moves to parental destination households, and describe the composition of parental origin and destination households. The findings confirm that in contemporary South Africa, only a small percentage (14%) of migrants' children who are members of the parental origin household are also members of the parental destination household. Membership of the parental destination household is associated with parental characteristics and the child's age, but not measures of socio-economic status, and children most commonly migrate several years after their migrant parent. Children included in the destination household of migrant fathers frequently live in small households, which also include their mother, whereas children included in the destination household of migrant mothers live in larger households. This study contributes to understanding the contexts of children's inclusion in parental destination households in South Africa and demonstrates the potential of data collected in migrants' origin and destination households

    Feeding Interventions for Infants with Growth Failure in the First Six Months of Life: A Systematic Review.

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    (1) Introduction: Current evidence on managing infants under six months with growth failure or other nutrition-related risk is sparse and low quality. This review aims to inform research priorities to fill this evidence gap, focusing on breastfeeding practices. (2) Methods: We searched PubMed, CINAHL Plus, and Cochrane Library for studies on feeding interventions that aim to restore or improve the volume or quality of breastmilk and breastfeeding when breastfeeding practices are sub-optimal or prematurely stopped. We included studies from both low- and middle-income countries and high-income countries. (3) Results: Forty-seven studies met the inclusion criteria. Most were from high-income countries (n = 35, 74.5%) and included infants who were at risk of growth failure at birth (preterm infants/small for gestational age) and newborns with early growth faltering. Interventions included formula fortification or supplementation (n = 31, 66%), enteral feeds (n = 8, 17%), cup feeding (n = 2, 4.2%), and other (n = 6, 12.8%). Outcomes included anthropometric change (n = 40, 85.1%), reported feeding practices (n = 16, 34%), morbidity (n = 11, 23.4%), and mortality (n = 5, 10.6%). Of 31 studies that assessed formula fortification or supplementation, 30 reported anthropometric changes (n = 17 no effect, n = 9 positive, n = 4 mixed), seven morbidity (n = 3 no effect, n = 2 positive, n = 2 negative), five feeding (n = 2 positive, n = 2 no effect, n = 1 negative), and four mortality (n = 3 no effect, n = 1 negative). Of eight studies that assessed enteral feed interventions, seven reported anthropometric changes (n = 4 positive, n = 3 no effect), five feeding practices (n = 2 positive, n = 2 no effect, n = 1 negative), four morbidity (n = 4 no effect), and one reported mortality (n = 1 no effect). Overall, interventions with positive effects on feeding practices were cup feeding compared to bottle-feeding among preterm; nasogastric tube feed compared to bottle-feeding among low birth weight preterm; and early progressive feeding compared to delayed feeding among extremely low birth weight preterm. Bovine/cow milk feeding and high volume feeding interventions had an unfavourable effect, while electric breast pump and Galactagogue had a mixed effect. Regarding anthropometric outcomes, overall, macronutrient fortified formula, cream supplementation, and fortified human milk formula had a positive effect (weight gain) on preterm infants. Interventions comparing human breastmilk/donor milk with formula had mixed effects. Overall, only human milk compared to formula intervention had a positive effect on morbidity among preterm infants, while none of the interventions had any positive effect on mortality. Bovine/cow milk supplementation had unfavourable effects on both morbidity and mortality. (4) Conclusion: Future research should prioritise low- and middle-income countries, include infants presenting with growth failure in the post-neonatal period and record effects on morbidity and mortality outcomes

    Management of acute malnutrition in infants aged under 6 months (MAMI): current issues and future directions in policy and research.

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    BACKGROUND: Globally, some 4.7 million infants aged under 6 months are moderately wasted and 3.8 million are severely wasted. Traditionally, they have been over-looked by clinicians, nutritionists, and policy makers. OBJECTIVE: To present evidence and arguments for why treating acute malnutrition in infants under 6 months of age is important and outline some of the key debates and research questions needed to advance their care. METHODS: Narrative review. RESULTS AND CONCLUSIONS: Treating malnourished infants under 6 months of age is important to avoid malnutrition-associated mortality in the short-term and adverse health and development outcomes in the long-term. Physiological and pathological differences demand a different approach from that in older children; key among these is a focus on exclusive breastfeeding wherever possible. New World Health Organization guidelines for the management of severe acute malnutrition (SAM) include this age group for the first time and are also applicable to management of moderate acute malnutrition (MAM). Community-based breastfeeding support is the core, but not the sole, treatment. The mother-infant dyad is at the heart of approaches, but wider family and community relationships are also important. An urgent priority is to develop better case definitions; criteria based on mid-upper-arm circumference (MUAC) are promising but need further research. To effectively move forward, clinical trials of assessment and treatment are needed to bolster the currently sparse evidence base. In the meantime, nutrition surveys and screening at health facilities should routinely include infants under 6 months of age in order to better define the burden and outcomes of acute malnutrition in this age group

    Antimicrobial and micronutrient interventions for the management of infants under 6 months of age identified with severe malnutrition: a literature review.

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    BACKGROUND: Infants under 6 months (U6M) contribute a significant proportion of the burden and mortality of severe malnutrition globally. Evidence of underlying aetiology in this population is sparse, but it is known that the group includes ex-preterm and low birthweight (LBW) infants. They represent a unique population given their dependence on breastmilk or a safe, secure alternative. Nutrition agencies and health providers struggle to make programming decisions on which interventions should be provided to this group based upon the 2013 WHO Guidelines for the 'Management of Severe Acute Malnutrition in Infants and Young Children' since there are no published interventional trial data focussed on this population. Interim guidance for this group might be informed by evidence of safety and efficacy in adjacent population groups. METHODOLOGY: A narrative literature review was performed of systematic reviews, meta-analyses and randomised controlled trials of antimicrobial and micronutrient interventions (antibiotics, deworming, vitamin A, vitamin D, iron, zinc, folic acid and oral rehydration solution (ORS) for malnutrition) across the population groups of low birthweight/preterm infants, infants under 6 months, infants and children over 6 months with acute malnutrition or through supplementation to breastfeeding mothers. Outcomes of interest were safety and efficacy, in terms of mortality and morbidity. RESULTS: Ninety-four articles were identified for inclusion within this review. None of these studied interventions exclusively in severely malnourished infants U6M. 64% reported on the safety of studied interventions. Significant heterogeneity was identified in definitions of study populations, interventions provided, and outcomes studied. The evidence for efficacy and safety across population groups is reviewed and presented for the interventions listed. CONCLUSIONS: The direct evidence base for medical interventions for severely malnourished infants U6M is sparse. Our review identifies a specific need for accurate micronutrient profiling and interventional studies of micronutrients and oral fluid management of diarrhoea amongst infants U6M meeting anthropometric criteria for severe malnutrition. Indirect evidence presented in this review may help shape interim policy and programming decisions as well as the future research agenda for the management of infants U6M identified as malnourished
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