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The interrelations between nutrition, social and economic trajectories during adolescence among girls in Ghana
No full textA dearth of data on the trends, efficacy, and timing (regarding menarche) of intervention impedes progress in the design of targeted policies and interventions that can holistically improve adolescents’ nutrition. This thesis primarily aims to examine the interrelations between nutrition, social, and economic trajectories during adolescence among girls in Ghana using a systematic narrative literature review on the socio-cultural and economic (SCE) determinants and consequences of adolescent undernutrition, analyses of secondary cross-sectional data in Ghana, and a randomised placebo-controlled trial among adolescent girls in north-eastern Ghana. Chapter 1 provides the background and rationale that informed the thesis and describes the specific research objectives for each chapter.In chapter 2, we undertook a systematic review of published literature to provide a narrative overview of the SCE determinants and consequences associated with undernutrition among adolescents in low and lower-middle-income countries. We identified 98 articles from PubMed, SCOPUS and CAB-Abstracts on determinants and consequences of undernutrition as defined by stunting, thinness, overweight and micronutrient deficiencies. At the individual level, significant determinants included age, sex, birth order, religion, ethnicity, educational and literacy level, working and marital status. At the household level, parental education and occupation, household size and composition, income, socio-economic status, and resources were associated with undernutrition. Few determinants were found at the broader community level, which included the residence, sanitation, school type, and seasonality. The sex-specific differences in undernutrition for adolescents were inconclusive. The consequences of adolescent undernutrition were mainly related to education and cognition. Most studies were cross-sectional in design, limiting inferences of causality to the description of associations, and very few studies were found for sub-Saharan Africa, indicating clear research gaps that informed the next parts of this study.In chapter 3, we describe a secondary data analysis of baseline data of an impact evaluation of the Ghana School Feeding Programme indicating that anaemia is a severe public health problem among rural school-aged children (6-9 years; n=323) and adolescents (10-17 years; n=319) in Ghana, irrespective of sex. The mean haemoglobin was 113.8 ± 13.1g/L and the overall prevalence of anaemia was 52.3%, being higher among school-aged children (55.1%) compared to adolescents (49.5%). Agro-ecological zone and age were independent predictors of anaemia, but the effect of age was only significant for girls and not boys.Chapter 4 examines the trends-over-time and the factors associated with malnutrition among adolescent girls in Ghana using cross-sectional data from 3 nationwide Ghana Demographic and Health Surveys (GDHS) conducted in 2003 (n=983), 2008 (n=955) and 2014 (n=857). Stunting was about 8% among the adolescent girls in 2003, declining by only 1.5% points in 2014. Although only 2% of the girls were thin in 2003, the prevalence decreased by <1.0% point in 2014. However, overweight/obesity among the girls increased by 4.3% points in 2014 from 10.0% in 2003, after adjusting for significant predictors of overweight/obesity including household size, wealth index, and the marital status of the girl. Anaemia remained severe (2003: 44.3%; 2008: 62.1% and 2014: 47.3%) without a clear trend.We also undertook a comparative analysis of data of non-pregnant adolescent girls (n=857) and adolescent boys (n=870) aged 15–19 years from the 2014 GDHS to assess and contrast the association between malnutrition, pre-hypertension/hypertension (PHH) and sex among adolescents (Chapter 5). Compared to adolescent girls, boys were more than twice likely to be stunted [Prevalence ratio (PR) 2.58, 95% C.I (1.77, 3.76)], thinness [PR 2.67, 95% C. I (1.41, 5.09)] and about twice likely to have PHH [PR 1.96, 95% C. I (1.47, 2.59)] but less likely to be overweight/obese [PR 0.85, 95% C.I (0.08, 0.29)]. Girls were more at risk of the detrimental effects of poor education on stunting and PHH. A higher empowerment index while inversely associated with stunting for girls [PR 0.82, 95% C.I (0.67, 0.99)] also increased their risk of overweight/ obesity [PR 1.31, 95% C.I (1.02, 1.68)]. A higher household wealth index increased the likelihood of overweight/obesity for adolescent girls but was inversely associated with stunting and PHH for adolescent boys.Chapter 6 describes the implementation of our primary study, Ten2Twenty-Ghana, a 26-week randomised placebo-controlled trial with multiple-micronutrient fortified biscuits (MMB) compared to unfortified biscuits (UB) among adolescent girls in north-eastern Ghana. The study evaluated the effect of consuming MMB 5 days/week for 26 weeks compared to UB on micronutrient status, height, and cognitive performance of female adolescents. We also explored to what extent the intervention effect varied in girls that had or did not yet experience menarche. We found no effect of the intervention on plasma ferritin, transferrin receptor concentration and retinol-binding protein. MMB consumption did not affect anaemia, micronutrient deficiencies and anthropometric indices at the population level. After adjusting for the girl’s baseline age, height-for-age z-score and baseline micronutrient status, vitamin A deficiency increased by 6.15% (95% C.I 0.72, 11.59) for pre-menarche girls in the MMB compared to the UB group, but deficient/low vitamin A status decreased substantially by 9.63% (95% C.I -18.94, -0.32) for MMB girls who were post-menarche compared to their UB peers. In anaemic subjects, we found evidence that MMB consumption improves mathematics scores and working memory of pre-menarche girls.Overall, our findings pointed to a triple-burden of malnutrition for Ghanaian adolescent girls which included a steady burden of protein-energy undernutrition, an increasing burden of overnutrition, which was associated with cardiovascular risk and a persistent burden of severe anaemia, affirming the need for double duty actions to holistically tackle malnutrition. Intervention programmes must tackle a broad range of context-specific socio-cultural and economic factors at several levels (individual, household, and community) that influence adolescent nutritional status. We concluded in our primary study that MMB consumption did not improve micronutrient status, cognition, and height, but reduced the prevalence of deficient/low vitamin A status for post-menarche girls. This thesis also suggests menarche may influence the vitamin A status of girls, but this warrants further investigation. Our findings also suggest boys are likewise affected by malnutrition and poor cardiovascular health; hence they should be included alongside girls in nutrition and health intervention programmes
The association between dietary diversity and anthropometric indices of children aged 24-59 months: A cross-sectional study in northern Ghana
Full text linkThe quality of diet has been shown to influence the nutritional status of children and women in some developing contexts. However, studies on the association between diet quality and the nutritional status of children aged 24-59 months are scanty in sub-Saharan Africa. More so, the conclusions from the few studies that are available are inconsistent. The objective of this study was to determine the association between the dietary diversity score (DDS) and the nutritional status of children aged 24-59 months in the Tolon District of Ghana. The study population included 200 child-mother pairs, randomly selected from 2 large rural communities in the Tolon district of Ghana. A single qualitative 24-hour recall (24HR) and semi-structured questionnaires were used to collect children’s data through face-to-face interviews with their mothers/caregivers. Anthropometry measures were used to define wasting (WHZ < -2SD), underweight (WAZ < -2SD) and stunting (HAZ < -2SD). A summated DDS was based on the Food and Agriculture Organization’s 13 food groupings. Multiple linear regression models, adjusting for potential confounding variables (including the child’s age, sex, birth order, sickness, mother’s age, literacy and occupation, paternal age, occupation and household size, wealth and food security) were fitted to analyse the association between DDS and nutritional status (WHZ, WAZ and HAZ). The prevalence rates of stunting, underweight and wasting among the sampled children were 58.3%, 20.3% and 4.2%, respectively. The mean DDS was 6.3 ± 1.2 out of a possible maximum score of 13, with the dietary pattern mostly plant foods with little consumption of animal source foods. There was a significant positive association between DDS and WHZ (β=0.16, P=0.03) and adjusting for potential confounding variables did not change the observed association. The association between DDS and WAZ was significantly positive only after adjusting for confounding variables (β=0.17, P=0.01). Although positive, the association between DDS and HAZ was not statistically significant in both crude (β=0.03, P=0.73) and adjusted (β=0.10, P=0.29) models. The high prevalence of stunting and underweight among the children requires urgent attention from the ministry of health and its development stakeholders. The findings of the present study suggest improvement in dietary diversity may be an effective approach to improving wasting and underweight during the life phase when young children are completely reliant on family meals. Sensitization programmes on dietary diversification need to be strengthened in child-welfare clinics. Intervention programmes such as backyard gardening, small ruminant rearing and income-generation activities may improve access to a diverse diet
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Full text linkWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
koamabayili/VECTRON-author-checklist: VECTRON author checklist
No full textWe have done our best to complete the author checklist relating to the use of animals in the hut study. Note that the objective for the hut study was to evaluate the IRS treatment applications for residual efficacy against Anopheles mosquitoes, including the local An. coluzzii mosquito population. Cows were only used to attract mosquitoes into the huts and no tests were carried out directly on the cows. The author checklist is intended for use with studies where experiments are carried out on animals, which is why we have had such difficulty in completing this for the hut study, as many of the questions do not relate to how the cows were used
Author-wise bibliometric analysis based on entropy.
No full textAuthor-wise bibliometric analysis based on entropy.</p
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