The Global Diet Quality Score Is Inversely Associated with Nutrient Inadequacy, Low Midupper Arm Circumference, and Anemia in Rural Adults in Ten Sub-Saharan African Countries

Background: Key nutrient deficits remain widespread throughout sub-Saharan Africa (SSA) whereas noncommunica­ ble diseases (NCDs) now cause one-third of deaths. Easy-to-use metrics are needed to track contributions of diet quality = 8 3 :J to this double burden. Objectives: We evaluated comparative performance of a novel food-based Global Diet Quality Score (GDOS) against Dani:' other diet metrics in capturing nutrient adequacy and undernutrition in rural SSA adults. � � Methods: We scored the GDOS, Minimum Dietary Diversity-Women (MDD-W). and Alternative Healthy Eating lndexen C: 2010 (AHEl-2010) using FFO data from rural men and nonpregnant, nonlactating women of reproductive age (15-49 y) "'Cl "'Cl ro in 10 SSA countries. We evaluated Spearman correlations between metrics and energy-adjusted nutrient intakes, and 3 age-adjusted associations with BMI, midupper arm circumference (MUAC), and hemoglobin in regression models. (:1J) I� Results: Correlations between the GDOS and an energy-adjusted aggregate measure of dietary protein, fiber, calcium, ...... iron, zinc, vitamin A, folate, and vitamin B-12 adequacy were 0.34 (95% Cl: 0.30, 0.38) in men and 0.37 (95% Cl: 0.32, (0 (/) 0.41) in women. The GDOS was associated (P . 0 with 01 OR in men: 0.44, 95% Cl: 0.22, 0.85; women: 0.57, 95% Cl: 0.31, 1.03] and anemia (05/01 OR in men: 0.56, (0 01 95% Cl: 0.32, 0.98; women: 0.60, 95% Cl: 0.35, 1.01 ). The MDD-W correlated better with some nutrient intakes, though w.j>. CT associated marginally with low MUAC in men (P= 0.07). The AHEl-2010 correlated better with fatty acid intakes, though '< tC C: associated marginally with low MUAC (P = 0.06) and anemia (P = 0.14) in women. Overweight/obesity prevalence was (1) !e. low, and neither the GDOS, MDD-W, nor AHEl-2010 were predictive. Conclusions: The GDOS performed comparably with the MDD-W in capturing nutrient adequacy-related outcomes i

Language of Lullabies: The Russification and De-Russification of the Baltic States

This article argues that the laws for promotion of the national languages are a legitimate means for the Baltic states to establish their cultural independence from Russia and the former Soviet Union

Temporal variation in confirmed diagnosis of fever-related malarial cases among children under-5 years by community health workers and in health facilities between years 2013 and 2015 in Siaya County, Kenya

Abstract Background Malaria case management continues to experience dynamic changes. Building community capacity is instrumental in both prevention and treatment of malaria. The World Health Organization (WHO) recommends utilization of well-trained and supervised community health workers (CHWs) to reduce the burden of malaria deaths among children under-5 years of age in Africa. Longitudinally-tracked information on utilization of CHWs by communities in terms of trends in diagnosis of malaria in children under-5 years of age is essential in influencing national and local malaria control policies and strategies. Methods A desktop review was carried out of a database consisting of confirmed uncomplicated malaria cases in 10 villages using CHWs and out-patient departments of 10 health facilities in children under-five for the period of 3 years between January 2013 and December 2015. Analyses of association between the diagnosed cases and satellite-based rainfall, village and time (months and years) were carried out using a Poisson regression model. Results Analysis of malaria diagnoses made by CHWs showed the following trends: (i) the incidence of reported documented malaria-positive fever cases increased with time (2013–2015) and the difference over the years was statistically significant (P  0.1). Looking at the number of diagnoses made at the health facilities, (i) The number of reported malaria-positive fever cases decreased with time (2013–2015) and the difference among the years was not statistically significant (P = 0.399), (ii) The long-term monthly sequence starting from highest to lowest number of reported malaria-positive fever cases was July, June, May, April, January, August, March, February, September, November, October and December, and the difference between the months was statistically significant (P < 0.001). Conclusions CHWs have the potential to play a major role in diagnosing and treating malaria, thereby decreasing under-five children mortality. Temporally, the risk of diagnosing malaria seems predictable and this may present opportunities for policy-targeted malaria preparedness and control. The findings are expected to support policy actions that may scale-up community health services in remote rural settings

Safety Issues in Cell-Based Intervention Trials

We report on the deliberations of an interdisciplinary group of experts in science, law, and philosophy who convened to discuss novel ethical and policy challenges in stem cell research. In this report we discuss the ethical and policy implications of safety concerns in the transition from basic laboratory research to clinical applications of cell-based therapies derived from stem cells. Although many features of this transition from lab to clinic are common to other therapies, three aspects of stem cell biology pose unique challenges. First, tension regarding the use of human embryos may complicate the scientific development of safe and effective cell lines. Second, because human stem cells were not developed in the laboratory until 1998, few safety questions relating to human applications have been addressed in animal research. Third, preclinical and clinical testing of biologic agents, particularly those as inherently complex as mammalian cells, present formidable challenges, such as the need to develop suitable standardized assays and the difficulty of selecting appropriate patient populations for early phase trials. We recommend that scientists, policy makers, and the public discuss these issues responsibly, and further, that a national advisory committee to oversee human trials of cell therapies be established

Safety issues in cell-based intervention trials

We report on the deliberations of an interdisciplinary group of experts in science, law, and philosophy who convened to discuss novel ethical and policy challenges in stem cell research. In this report we discuss the ethical and policy implications of safety concerns in the transition from basic laboratory research to clinical applications of cell-based therapies derived from stem cells. Although many features of this transition from lab to clinic are common to other therapies, three aspects of stem cell biology pose unique challenges. First, tension regarding the use of human embryos may complicate the scientific development of safe and effective cell lines. Second, because human stem cells were not developed in the laboratory until 1998, few safety questions relating to human applications have been addressed in animal research. Third, preclinical and clinical testing of biologic agents, particularly those as inherently complex as mammalian cells, present formidable challenges, such as the need to develop suitable standardized assays and the difficulty of selecting appropriate patient populations for early phase trials. We recommend that scientists, policy makers, and the public discuss these issues responsibly, and further, that a national advisory committee to oversee human trials of cell therapies be established.status: publishe

Public Stem Cell Banks: Considerations of Justice in Stem Cell Research and Therapy

Faden et al discuss the forthcoming transition of stem cell research from basic science to the development of therapies, which raises important questions of justice. They argue that they have great therapies and only a limited assortment of patients to give them to: the therapies would work only for patients whose immune systems are compatible with the stem cell lines from which the therapies are derived. If they develop therapies from cell lines that are compatible with the largest possible segments of the population, they will tend to benefit primarily whites

Development and Validation of a Novel Food-Based Global Diet Quality Score (GDQS)

Background Poor diet quality is a major driver of both classical malnutrition and noncommunicable disease (NCD) and was responsible for 22% of adult deaths in 2017. Most countries face dual burdens of undernutrition and NCDs, yet no simple global standard metric exists for monitoring diet quality in populations and population subgroups.ObjectivesWe aimed to develop an easy-to-use metric for nutrient adequacy and diet related NCD risk in diverse settings. Methods Using cross-sectional and cohort data from nonpregnant, nonlactating women of reproductive age in 10 African countries as well as China, India, Mexico, and the United States, we undertook secondary analyses to develop novel metrics of diet quality and to evaluate associations between metrics and nutrient intakes and adequacy, anthropometry, biomarkers, type 2 diabetes, and iteratively modified metric design to improve performance and to compare novel metric performance to that of existing metrics. Results We developed the Global Diet Quality Score (GDQS), a food-based metric incorporating a more comprehensive list of food groups than most existing diet metrics, and a simple means of scoring consumed amounts. In secondary analyses, the GDQS performed comparably with the Minimum Dietary Diversity - Women indicator in predicting an energy-adjusted aggregate measure of dietary protein, fiber, calcium, iron, zinc, vitamin A, folate, and vitamin B12 adequacy and with anthropometric and biochemical indicators of undernutrition (including underweight, anemia, and serum folate deficiency), and the GDQS also performed comparably or better than the Alternative Healthy Eating Index - 2010 in capturing NCD-related outcomes (including metabolic syndrome, change in weight and waist circumference, and incident type 2 diabetes). Conclusions The simplicity of the GDQS and its ability to capture both nutrient adequacy and diet-related NCD risk render it a promising candidate for global monitoring platforms. Research is warranted to validate methods to operationalize GDQS assessment in population surveys, including a novel application-based 24-h recall system developed as part of this project