Global Variation of Nutritional Status in Children Undergoing Chronic Peritoneal Dialysis : A Longitudinal Study of the International Pediatric Peritoneal Dialysis Network

While children approaching end-stage kidney disease (ESKD) are considered at risk of uremic anorexia and underweight they are also exposed to the global obesity epidemic. We sought to investigate the variation of nutritional status in children undergoing chronic peritoneal dialysis (CPD) around the globe. The distribution and course of body mass index (BMI) standard deviation score over time was examined prospectively in 1001 children and adolescents from 35 countries starting CPD who were followed in the International Pediatric PD Network (IPPN) Registry. The overall prevalence of underweight, and overweight/obesity at start of CPD was 8.9% and 19.7%, respectively. Underweight was most prevalent in South and Southeast Asia (20%), Central Europe (16.7%) and Turkey (15.2%), whereas overweight and obesity were most common in the Middle East (40%) and the US (33%). BMI SDS at PD initiation was associated positively with current eGFR and gastrostomy feeding prior to PD start. Over the course of PD BMI SDS tended to increase on CPD in underweight and normal weight children, whereas it decreased in initially overweight patients. In infancy, mortality risk was amplified by obesity, whereas in older children mortality was markedly increased in association with underweight. Both underweight and overweight are prevalent in pediatric ESKD, with the prevalence varying across the globe. Late dialysis start is associated with underweight, while enteral feeding can lead to obesity. Nutritional abnormalities tend to attenuate with time on dialysis. Mortality risk appears increased with obesity in infants and with underweight in older children.Peer reviewe

Self-determined citizens? New forms of civic activism and citizenship in Armenia

This article examines the recent emergence and growth of grassroots social movements in Armenia which are locally known as ‘civic initiatives’. It considers what their emergence tells us about the development of civil society and the changing understandings and practices of citizenship in Armenia in the post-Soviet period. It analyses why civic initiatives explicitly reject and distance themselves from formal, professionalised NGOs and what new models of civic activism and citizenship they have introduced. It argues that civic initiatives embrace a more political understanding of civil society than that which was introduced by Western donors in the 1990s

Photoluminescence of high optical quality CdSe thin films deposited by close-spaced vacuum sublimation

a b s t r a c t Polycrystalline CdSe thin films (d¼ 0.1-3.0 μm) have been deposited on a glass substrate by means of the close-spaced vacuum sublimation technique. X-ray diffraction measurements have shown that the films obtained at Т s 4473 K have only wurtzite phase. The influence of deposition conditions, in particular, the substrate temperature on the photoluminescence (PL) of CdSe films spectra was investigated. This let us study the effect of glass substrate on their optical quality as well as determine the nature and energy structure of the intrinsic defects and residual impurities in the films. The presence in PL spectrum of the most intense sharp donor bound exciton D 0 X-line for CdSe films obtained at T s ¼873 K indicates the n-type conductivity and their high optical quality. Intensive PL bands in the spectral range 1.65-1.74 eV were also observed, which are associated with the recombination of donor-acceptor pairs with the participation of the shallow donor and acceptor centers caused by Na(Li) residual impurities. As a result of the study of the PL spectra of CdSe films the optimal temperature conditions of their growth were determined, namely, the substrate temperature T s ¼ 873 K and the evaporator temperature T e ¼973 K