Malaria prevention in Kenyan women of childbearing age

The objective of this program is to reduce malaria incidence in Kenya. Malaria poses a large public health challenge in Kenya, and although public health efforts have traditionally been focused on treatment of infected patients, due to increased drug resistance and lack of drug-adherence, prevention strategies are needed. This program targets Kenyan women, the likely caretakers in the home, and promotes malaria prevention behaviors through health education. ^ A planning group will be assembled and a needs assessment will be performed, verifying risk factors and conditions associated with malaria, as well as personal and external determinants. Behavioral and environmental outcomes will be determined, and performance objectives for each outcome will be established. Matrices of change objectives will be created, and detailed methods and strategies will be linked to each change objective. Program elements include media, education, and incentives. All materials used in this program will be subjected to pre-test to ensure cultural relevance and fidelity. Matrices of change objectives will be created for program adopters and implementers, as well as correlating methods and strategies associated with each change objective. Performance objectives will also be compiled for program maintainers. A program evaluation plan will follow "Pre-Post Comparison Group" design. Outcome evaluation and process evaluation will be conducted. The sample population will be screened based on age and gender so as to maintain comparability to the target population. Measurements will be taken before the program to establish baseline, directly following the program to determine short-term effects, and three months after the program is completed to determine long-term effects. ^ One limitation of this program is selection bias, due to the nature of quasi-experimental studies. Thorough screening prior to sample selection will minimize selection bias and ensure group homogeneity. Another limitation is attrition, and this will be minimized where possible through the use of incentives. In cases where loss to follow-up is not avoidable, such as death or natural disasters, the attrition effect will be estimated using structural equation modeling after reviewing the sample size, differential attrition and total attrition. ^ This intervention is based heavily on health promotion theories, but it is important to remember that in the field, the program plan will likely include only the necessary practical strategies. The target population, Kenyan women of childbearing age, will be significant in decreasing the malaria disease burden in Kenya.^

THE BACON CHOW STUDY: THE RELATIONSHIP BETWEEN INFECTIOUS ILLNESS AND GROWTH OF INFANTS

Multiple dietary deficiencies and high rates of infectious illness are major health problems leading to malnutrition and limitation of growth of children in developing countries. Longitudinal studies which provide information on illness incidence and growth velocity are needed in order to untangle the complex interrelationship between nutrition, illness and growth. From 1967 to 1973, researchers led by Dr. Bacon Chow of the Johns Hopkins University School of Hygiene undertook a quasi-experimental prospective study in Suilin Township, Taiwan to determine the effects of a nutritional supplement to the diets of pregnant and lactating women on the growth, development and resistance to disease of their offspring. This dissertation presents results from the analysis of infant morbidity and postnatal growth.^ Maternal nutritional supplementation has no apparent effect on the postnatal growth or morbidity of infants. Significant sex differences exist in growth response to illness and in illness susceptibility. Male infants have more diarrhea and upper respiratory illness. Respiratory illness is positively associated with growth rate in weight in the first semester of life. Diarrhea is significantly negatively associated with growth in length in the second semester. Small-for-date infants are more susceptible to illness in general and have a different pattern of growth response than large-for-date infants.^ Principal components analysis of illness data is shown to be an effective technique for making more precise use of ambiguous morbidity data. Multiple regression with component scores is an accurate method for estimating variance in growth rate predicted by indepenent illness variables. A model is advanced in which initial postnatal growth rate determines subsequent susceptibility to nutritional stress and infection. Initial growth rate is a function of prenatal nutrition, but is not significantly affected by maternal supplementation during gestation or lactation. Critical evaluation is made of nutritional supplementation programs which do not afford disease control.^

Influenza vaccination as a primary or secondary prevention for cardiovascular diseases: A systematic review of the literature

Background: Cardiovascular diseases (CVD) are the leading cause of morbidity and mortality worldwide. CVD mainly comprise of coronary heart disease and stroke and were ranked first and fourth respectively amongst leading causes of death in the United States. Influenza (flu) causes annual outbreaks and pandemics and is increasingly recognized as an important trigger for acute coronary syndromes and stroke. Influenza vaccination is an inexpensive and effective strategy for prevention of influenza related complications in high risk individuals. Though it is recommended for all CVD patients, Influenza vaccine is still used at suboptimal levels in these patients owing to prevailing controversy related to its effectiveness in preventing CVD. This review was undertaken to critically assess the effectiveness of influenza vaccination as a primary or secondary prevention method for CVD. ^ Methods: A systematic review was conducted using electronic databases OVID MEDLINE, PUBMED (National Library of Medicine), EMBASE, GOOGLE SCHOLAR and TRIP (Turning Research into Practice). The study search was limited to peer-reviewed articles published in English language from January 1970 through May 2012. The case control studies, cohort studies and randomized controlled trials related to influenza vaccination and CVD, with data on at least one of the outcomes were identified. In the review, only population-based epidemiologic studies in all ethnic groups and of either sex and with age limitation of 30 yrs or above, with clinical CVD outcomes of interest were included. ^ Results: Of the 16 studies (8 case control studies, 6 cohort studies and 2 randomized controlled trials) that met the inclusion criteria, 14 studies reported that there was a significant benefit in u influenza vaccination as primary or secondary prevention method for preventing new cardiovascular events. In contrary to the above findings, two studies mentioned that there was no significant benefit of vaccination in CVD prevention. ^ Conclusion: The available body of evidence in the review elucidates that vaccination against influenza is associated with reduction in the risk of new CVD events, hospitalization for coronary heart disease and stroke and as well as the risk of death. The study findings disclose that the influenza vaccination is very effective in CVD prevention and should be encouraged for the high risk population. However, larger and more future studies like randomized control trials are needed to further evaluate and confirm these findings. ^

Work instability. Presentation of an empirical model about its psychological impact

Research on the impact that work instability has on workers has the limitation of assess the relations among different variables separately, without examining the possible mediation relationships that can exists between them. The aim of this article is to test a conceptual model of the mediating relations between the uneasiness due to work instability and the psychological impact, in the framework of interactive stress theory, conducting a Path Analysis. 191 workers participated on the study, with a mean age of 31 years-old (SD = 11). Results showed that the proposed model didn't fit to the data. Alternative models were explored, consistent with the original conceptual model and the empiric evidence. A new causal model is proposed, where Uneasiness due to Work Instability as an independent variable, Personal Strain and Personal Resources as intervenient variables, and Anger, Hopelessness, and Satisfaction as dependent ones. The theoretical and empirical importance of the resulting model is discussed.

Biogenic silica in the coastal plume of the Mississippi River

The surface distributions of dissolved silicic acid, chlorophyll and diatom abundance were measured in the plume of the Mississippi River and adjacent waters during spring (late April and early May 1993) and summer (July 1992). In spring, the time of maximum river flow, there was an intense diatom bloom with a mean diatom abundance of 1.5 x 10**7 cells/l, more than an order of magnitude higher than in summer. Mixing curves of silicic acid concentration ([Si(OH)4]) versus salinity indicate that biological uptake within the river plume removed >99% of the Si(OH)4 supplied by the river in spring and 80 to 95% in summer. In spring [Si(OH)4] was occasionally depleted to <0.2 µM-among the lowest values ever reported from the ocean-with extensive depletion to >=0.5 µM over the shelf. In summer [Si(OH)4] was less severely depleted; the lowest measured was 0.93 µM and all others were >=2.4 µM. 30Si kinetic experiments were performed during both spring and summer to measure the degree to which the rate of Si uptake by the natural diatom assemblages was limited in situ by substrate availability. In spring the dependence of the specific uptake rate (V) on extracellular [Si(OH)4] conformed much more closely to the Michaelis-Menten saturation function than has been observed in past studies. Strong dependence of V on [Si(OH)4] was observed throughout the most Si(OH)4-depleted (<0.5 µM) region, where V was limited to 12 to 45% of the diatom assemblages' maximum uptake rate (Vmax). Half-saturation concentrations for Si uptake (Ks) averaged 0.85 uM (range = 0.48 to 1.71; n = 7) in spring, with the lowest values equal to the lowest previously reported for natural diatom assemblages. There was only 1 station in summer where V was limited by [Si(OH)4], and at that station Ks was 5.3 µM-quite high in comparison with previous studies. At stations where V was limited by [Si(OH)4], in both spring and summer, Chaetoceros spp. were numerically dominant; where there was no Si limitation other diatoms, usually Skeletonema costatum, dominated. The data thus indicate strong Si limitation in spring, with diatom assemblages well adapted to low [Si(OH)4], but little or no Si limitation in summer. Historical data suggest that coastal Si(OH)4 depletion and Si limitation may be recent phenomena in the northern Gulf of Mexico, resulting from increasing [NO3-] and decreasing [Si(OH)4] in the Mississippi River during the past 30 to 50 yr.

Work instability. Presentation of an empirical model about its psychological impact

Research on the impact that work instability has on workers has the limitation of assess the relations among different variables separately, without examining the possible mediation relationships that can exists between them. The aim of this article is to test a conceptual model of the mediating relations between the uneasiness due to work instability and the psychological impact, in the framework of interactive stress theory, conducting a Path Analysis. 191 workers participated on the study, with a mean age of 31 years-old (SD = 11). Results showed that the proposed model didn't fit to the data. Alternative models were explored, consistent with the original conceptual model and the empiric evidence. A new causal model is proposed, where Uneasiness due to Work Instability as an independent variable, Personal Strain and Personal Resources as intervenient variables, and Anger, Hopelessness, and Satisfaction as dependent ones. The theoretical and empirical importance of the resulting model is discussed.

Work instability. Presentation of an empirical model about its psychological impact

Research on the impact that work instability has on workers has the limitation of assess the relations among different variables separately, without examining the possible mediation relationships that can exists between them. The aim of this article is to test a conceptual model of the mediating relations between the uneasiness due to work instability and the psychological impact, in the framework of interactive stress theory, conducting a Path Analysis. 191 workers participated on the study, with a mean age of 31 years-old (SD = 11). Results showed that the proposed model didn't fit to the data. Alternative models were explored, consistent with the original conceptual model and the empiric evidence. A new causal model is proposed, where Uneasiness due to Work Instability as an independent variable, Personal Strain and Personal Resources as intervenient variables, and Anger, Hopelessness, and Satisfaction as dependent ones. The theoretical and empirical importance of the resulting model is discussed.

(Table 1) Activity of alkali phosphatase in suspended matter at 20°C and environmental temperatures, and recycling time of organic phosphorus in the Barents and Norwegian seas

Alkali phosphatase activity and hydrochemical structure of waters in the Barents and Norwegian seas were investigated. In a sea with the seasonal bioproduction cycle alkali phosphatase activity is also seasonal, rising with trophic level of waters. At the end of hydrological and biological winter activity is practically zero. Alkali phosphatase activity is especially important in summer, when plankton has consumed winter supply of phosphate in the euphotic layer and nutrient limitation of primary production begins. In summer production and destruction cycle, apparent time for recycling of phosphorus by phosphatase in suspended matter in the euphotic layer of the Barents Sea and Norwegian Sea averages from 7 to 30 hours.

Production of biogenic silica during the EBENE cruise, Equatorial Pacific

During the EBENE cruise (November 1996), distributions of biogenic silica concentration and production rates were investigated in the surface waters of the equatorial Pacific (180°W, from 8°S to 8°N), with particular emphasis on the limitation of the biogenic silica production by ambient silicic acid concentrations. Integrated over the depth of the euphotic layer, concentrations of biogenic silica and production rates were maximum at the Equator (8.0 and 2.6 mmol/m**2/d) and decreased more or less symmetrically polewards. Contribution of diatoms to the new production was estimated indirectly, comparing biogenic silica production rates and available data of new and export production in the same area. This comparison shows that new production in the equatorial area could mostly be sustained by diatoms, accounting for the major part of the exported flux of organic carbon. Kinetics experiments of silicic acid enrichment were performed. Half saturation constants were 1.57 µM at 3°S and 2.42 µM at the Equator close to the ambient concentrations. The corresponding Vmax values for Si uptake were 0.028/h at 3°S and 0.052/h at the equator. Experiments also show that in situ rates were restricted to 13-78% of Vmax, depending on ambient silicic acid concentrations. This work provides the first direct evidence that the rate of Si uptake by diatom populations of the equatorial Pacific is limited by the ambient concentration of silicic acid. However, such Si limitation might not be sufficient in itself to explain the low diatom growth rates observed, and additional limitation is suggested. One hypothesis that is consistent with the results of Fe limitation studies is that Fe and Si limitations may interact, rather than just being a mutually exclusive explanation for the HNLC character of the system.