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Magnitudes of Various Forms of Undernutrition Among Children from the Composite Index of Anthropometric Failure in Sub-Saharan Africa:A Systematic Review and Meta-Analysis
Get PDF Background: Nearly half of under-five deaths are linked to undernutrition. Most evidence on undernutrition relies on conventional anthropometric measures. Conventional anthropometric measures fail to capture its overlapping forms and are limited in providing the true burden and distinct disaggregated patterns of undernutrition. Using the Composite Index of Anthropometric Failure (CIAF), this study aims to provide updated regional and country-level pooled prevalence estimates of the overall burden and various single and coexisting patterns of undernutrition among children in Sub-Saharan Africa (SSA). Methods: We systematically searched Medline, CINAHL, Web of Science, Scopus, and Google Scholar for studies published between January 2006 and October 2023. Studies reporting the prevalence of aggregated CIAF or any of the disaggregated forms of CIAF (stunting only, wasting only, underweight only, stunting-underweight, wasting-underweight, and stunting-wasting-underweight) based on the 2006 World Health Organisation (WHO) growth standard were included. Data extraction was performed by two reviewers, and discrepancies were resolved by consensus. Pooled prevalences of various categories of undernutrition were estimated using a random effect model meta-analysis. Subgroup analysis and meta-regression were performed to identify possible sources of heterogeneity among the included studies. Publication bias was checked using the Asymmetry funnel plot and Egger's test. The protocol was registered on PROSPERO (CRD42023458796). Result: This systematic review and meta-analysis identified 3898 published studies from the database search, of which 26 were included. In SSA, the overall pooled prevalence of undernutrition among children was 37.45% (95% Confidence Interval (CI): 31.97, 42.92). Of these, 10% (95% CI: 8.02, 11.98) of children experienced at least one coexisting form, and 25.5% (95% CI: 16.78, 33.72) experienced at least one single form of undernutrition. Stunting only [22.32% (95% CI: 18.26, 26.39)] was the most prevalent disaggregated pattern of undernutrition, followed by the coexistence of stunting with underweight [10.15% (95% CI: 8.17, 12.13)]. Conclusions: Over one in three children in SSA experienced at least one form of undernutrition. Nearly one-third of these undernourished children were affected by multiple forms of undernutrition. The high prevalence of coexisting undernutrition indicates the need to develop multi-indicator nutrition strategies that could simultaneously address the various dimensions of undernutrition in children. </p
Sport can do better:female athletes' perspectives on managing menstrual and hormonal contraceptive cycle-related symptoms
No full textIntroduction: Menstrual cycle-related symptoms (MCS) affect female athletes' wellbeing, quality of life, sports participation, and performance. Hormonal contraceptives (HCs) moderate hormone activity, but do not necessarily alleviate MCS. Recent research indicates no significant effect of the MC or HC cycle on measurable performance, yet perceived effects on performance and wellbeing remain noticeable. Thus, this study aimed to understand how female athletes are impacted by and manage MCS, and how they want these symptoms addressed in sporting contexts. Methods: Using a constructivist paradigm approach, experiences and perspectives of 30 female athletes [aged 19–32, 18 naturally cycling (NC) and 12 using HCs] from 17 sports were gathered through semi-structured interviews and analysed using reflexive thematic analysis. Results: Four main themes were identified: (1) significant impacts of MCS on athletes, (2) perceived functional difference when MCS are present, (3) uncertainty about the effectiveness of management strategies despite trying multiple options, and (4) a desire for a supportive sport environment with meaningful discussions about MCS, though there is reticence. Discussion: These findings highlight the need to view MCS as more than a minor inconvenience, consider athletes' perceptions, and pursue more research on evidence-based management options and MC culture change in sports. Regardless of the sport, it is crucial to advocate for athlete-centred training loads and schedules that can improve the overall experience of athletes enduring MCS, helping them continue to participate in sport and perform at their best.</p
Exploring the Multilevel Determinants of Suboptimal Maternal and Child Continuum of Care in Indonesia
No full textObjective: Understanding the multilevel factors associated with completeness of care across the continuum of maternal and child health is needed in order to reduce maternal and child mortality and morbidity in Indonesia. This study aims to assess the multilevel determinants of continuum of care (CoC) and its contextual factors in Indonesia. Methods: Data from the 2017 Indonesian Demographic and Health Survey were analyzed. A total of 14,398 women aged 15–49 years who had live births 5 years preceding the survey were analyzed for maternal CoC, while data from 9,206 women and their children (aged < 36 months) were analyzed for maternal CoC and vaccination. Maternal CoC include antenatal care visits, safe facility delivery, and postnatal care. Vaccination includes the 10 recommended dosages of vaccination adjusted for age. Multilevel logistic regression was used to analyse variations in maternal CoC at the individual, household and community levels. Results: Our findings showed that only half of the women in our study had the complete maternal CoC, and only one-third had both the complete CoC and vaccination for their children. The odds of completing CoC and vaccination are lower among women aged < 20 years, have ≥ 4 children, have low socioeconomic status, and live in rural areas or outside Java-Bali. Pregnancy-related factors were also associated with CoC completeness. Conclusions for Practice: Targeted interventions to improve awareness and increase access that go beyond the individual factors should be developed. In addition to awareness campaigns, interventions aimed at reducing disparities across the different regions in Indonesia should be implemented to improve completeness of maternal CoC and vaccination.</p
Variability of Terminology Used to Describe Unwanted Workplace Behaviors in Nursing:A Scoping Review
No full textBackground: Unwanted workplace behaviors impact all organizations, but in the discipline of nursing, these behaviors impact both the welfare of nurses and the quality and safety of patient care. The terminology adopted to describe these behaviors varies widely, leading to confusion and inconsistency in research and practice. Objectives: This scoping review aims to explore the variability in the terminology used to describe unwanted workplace behaviors in nursing, identify the most commonly used terms, and analyze the implications of this variability for research, policy, and practice. Methods: The Population, Concept, and Context mnemonic was used to frame the review, as recommended by the Joanna Briggs Institute. A comprehensive literature search was conducted using relevant databases. Keywords used in the search included “moral harassment, nursing, definition, meaning, description,” “Shaming,” “Mobbing,” “Bullying,” “Vertical violence,” “Horizontal violence,” “Incivility,” “Microaggression,” “Lateral violence.” Boolean operators (AND, OR) were used to combine search terms appropriately. Results: The initial search yielded 299 references. Following full-text screening, 51 studies met the inclusion criteria and were included in the final review. The review revealed 13 different terms used to describe unwanted workplace behaviors. Conclusion: The review highlights a lack of consensus across the discipline. There is a call for a singular term to be applied across the field which would support policy implementation and practice.</p
Effects on Maternal Mental Health and Parental Functioning of an Interdisciplinary Intervention to Support Women in Vulnerable Positions Through Pregnancy and Early Motherhood:A Randomized Controlled Trial
No full text Background/Objectives: The transition to motherhood can be particularly challenging for women with limited socioeconomic resources or mental health concerns. The FAmily Clinic And Municipality (FACAM) intervention was designed to provide additional support through health visitors or family therapists, starting in pregnancy and continuing until the child reached school age. This paper evaluates the effects of the FACAM intervention on the secondary outcomes, maternal mental health and parental functioning during the child's first year of life. Methods: A total of 331 pregnant women were randomized to either the FACAM intervention (n = 163) or usual care (n = 168). Participants completed questionnaires at baseline and at 3 (N = 284) and 12 (N = 248) months postpartum. Outcomes included maternal mental well-being, satisfaction with motherhood, depressive symptoms, parental stress, parental reflective functioning, worries, and breastfeeding duration. Results: At 12 months postpartum, FACAM mothers reported greater concern about housing issues (b = 0.56, 95% CI [0.06, 1.06], p = 0.03). No other significant differences in the reported outcomes were observed between the groups. Conclusion: The FACAM intervention did not demonstrate superiority over usual care in improving maternal mental health and parental functioning during the first year postpartum. The high-quality and needs-based approach of standard care in Denmark may have limited the potential for additional interventions to yield measurable improvements in maternal outcomes. </p
Physiological and Biomechanical Characteristics of Inline Speed Skating:A Systematic Scoping Review
Get PDFThe physiological and biomechanical characteristics of inline speed skating have not been systematically mapped nor research evidence synthesized. The aim was to identify and synthesize novel elements across studies, including participant characteristics, outcomes measures, experimental protocol, main outcomes and other relevant information, to inform evidence-based guidelines and recommendations. Following the PRISMA 2020 guidelines, a systematic search of databases was conducted to identify relevant studies. The extracted data were charted and synthesized to summarize the physiological and biomechanical aspects of inline speed skating. From 272 records, 22 studies met the defined criteria. Studies related to inline speed skating focused primarily on physiological variables (n = 14) and lower limb muscles function, with limited evidence on biomechanics of inline speed skating (n = 5) and the combination of biomechanics and physiology (n = 3). An overall unclear risk of bias was observed (59% of studies). Although studies have examined physiological and biomechanical variables, continuous physiological and biomechanical assessments of skaters performing different skills on both straight and curved tracks have not been conducted. Therefore, well-planned physiological and biomechanics studies are required to uncover underexplored areas in research and support the development of sport-specific studies.</p
Where next for global climate deliberation:From proof of concept to a role in transformation
Get PDFBuilding on the proof of concept that was the 2021 Global Assembly on the Climate and Ecological Crisis, we explore an expanded and even institutionalized role for effective and consequential citizen deliberation in global climate governance. Such an expanded role could not just strengthen citizen voices in negotiations, but also counter vested interests, promote civic learning, enhance the legitimacy of governance, foster global solidarity, and generate reflective input to galvanize policies.</p
MIP-GAF:A MLLM-Annotated Benchmark for Most Important Person Localization and Group Context Understanding
No full textEstimating the Most Important Person (MIP) in any social event setup is a challenging problem mainly due to contextual complexity and scarcity of labeled data. Moreover, the causality aspects of MIP estimation are quite subjective and diverse. To this end, we aim to address the problem by annotating a large-scale 'in-the-wild' dataset for iden-tifying human perceptions about the 'Most Important Person (MIP)' in an image. The paper provides a thorough description of our proposed Multimodal Large Language Model (MLLM) based data annotation strategy, and a thor-ough data quality analysis. Further, we perform a comprehensive benchmarking of the proposed dataset utilizing state-of-the-art MIP localization methods, indicating a significant drop in performance compared to existing datasets. The performance drop shows that the existing MIP localization algorithms must be more robust with respect to 'in-the-wild' situations. We believe the proposed dataset will play a vital role in building the next-generation social situation understanding methods. The dataset and associated code will be made available for research purposes.</p
Cry1 resistance in a CRISPR/Cas9-mediated HaCad1 gene knockout strain of the Australian cotton bollworm Helicoverpa armigera conferta (Lepidoptera: Noctuidae)
No full textBACKGROUND: Helicoverpa armigera is a highly polyphagous species that causes huge losses to agricultural and horticultural crops worldwide. In the cotton industry, H. armigera, including the Australian subspecies H. armigera conferta, is largely managed by using genetically modified crops that express insecticidal toxins, such as Cry1Ac. Resistance to Cry1proteins occurs and, in some cases, is mediated by changes to HaCad1, a gene that encodes the midgut protein cadherin. Around the world, numerous resistance-associated polymorphisms have been identified in the HaCad1 gene of H. armigera, but Cry1Ac resistance is rare in the Australian subspecies. We used CRISPR/Cas9 to disrupt the cadherin gene in H. armigera conferta and characterised the resulting phenotype with bioassays and transcriptomics.RESULTS: Compared to the parental strain, the newly generated HaCad1 knockout strain is 44-fold and 17-fold more resistant to Cry1Ac and Cry1A.105, respectively, while wild-type and knockout insects were equally resistant to Cry1F. CONCLUSION: The disruption of the HaCad1 gene causes Cry1Ac resistance in Australian H. armigera conferta. However, Cry1Ac resistance remains rare in Australian field populations suggesting that Australia’s approach to pest management in cotton has prevented widespread Cry1Ac resistance.<br/