Stress and Resilience in Combat-Related PTSD: Integration of Psychological Theory and Biological Mechanisms

Post-traumatic stress disorder (PTSD) is a debilitating psychiatric disorder that has a major impact on the ability to function effectively in daily life. PTSD may develop as a response to exposure to an event or events perceived as potentially harmful or life-threatening. It has high prevalence rates in the community, especially among vulnerable groups such as military personnel or those in emergency services. Despite extensive research in this field, the underlying mechanisms of the disorder remain largely unknown. The identification of risk factors for PTSD has posed a particular challenge as there can be delays in onset of the disorder, and most people who are exposed to traumatic events will not meet diagnostic criteria for PTSD. With the advent of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM V), the classification for PTSD has changed from an anxiety disorder into the category of stress- and trauma-related disorders. This has the potential to refocus PTSD research on the nature of stress and the stress response relationship. This review focuses on some of the important findings from psychological and biological research based on early models of stress and resilience. Improving our understanding of PTSD by investigating both genetic and psychological risk and coping factors that influence stress response, as well as their interaction, may provide a basis for more effective and earlier intervention.

Petusta pitsaan : Ruokahuollon järjestelyt kriisiaikojen Suomessa

From bark bread to pizza - Food and exceptional circumstances: reactions of Finnish society to crises of food supply This study on the food supply under exceptional circumstances lies within the nutritional, historical and social sciences. The perspective and questions come under nutrition science, but are part of social decision-making. The study focuses on the first and second world wars as well as on contemporary society at the beginning of the 21st century. The main purpose of this study is to explore how Finnish society has responded to crises and what measures it has taken to sustain institutional food services and the food supply of households. The particular study interests include the school catering and food services in hospitals during the world wars. The situation in households is reflected in the counseling work carried out by state-run or civic organisations. Interest also focuses on the action of the scientific community. The decisions made in Finland are projected onto the solutions developed in some other European countries. The study is based primarily on the archive documents and annual reports prepared by food and health care authorities. Major source materials include scientific and professional publications. The evaluation of the situation in contemporary Finnish society is based on corresponding emergency plans and guidelines. The written material is supplemented by discussions with experts. Food rationing during the WWI and WWII differed in extent, details and unity. The food intake of some population groups was occasionally inadequate both in quantity, quality and safety. The counseling of the public focused on promoting self-sufficiency, improving cooking skills and widening food habits. One of the most vulnerable groups in regard to nutrition was long-term patients in institutions. As for future development, the world wars were never-theless important periods for public food services and counseling practices. WWII was also an important period for product development in the food industry. Significant work on food substitutes was carried out by Professor Carl Tigerstedt during WWI. The research of Professors A. I. Virtanen and Paavo Simola during WWII focused on vitamins. Crises threatening societies now differ from those faced a hundred years ago. Finland is bet-ter prepared, but in many ways more vulnerable to and dependent on other actors. Food rationing is a severe means of handling the scarcity of food, which is why contemporary society relies primarily on preparedness planning. Civic organisations played a key role during the world wars, and establishing an emergency food supply remains on their agenda. Although the objective of protecting the population remains the same for nutrition, food production, and food consumption, threat scenarios and the knowledge and skill levels of citizens are constantly changing. Continuous monitoring and evaluation is therefore needed.

Improving food supply

Improving the availability, accessibility and affordability of healthy food equitably is fundamental to improving nutrition and health. While theoretical models abound, in real world complex systems rarely are there opportunities to address leverage points systematically to improve food supply. This presentation describes efforts over the last 30 years to do just that by remote Australian Aboriginal communities, where a single community store is usually the major dietary source. Areas addressed include store governance and infrastructure, wholesale supply, transport and pricing policies including cross-subsidization. However, while there have been dramatic improvements in the availability, quality and price of fruit, vegetables and most other healthy foods over this time, the proportion of communities' energy intake from energy-dense nutrient-poor foods and drinks has increased. One cause may be the disproportionate increase in supply of unhealthy choices in terms of variety and shelf-space, consistent with changes in the food supply in broader Australia. The impact of changing social and environmental factors, food preferences and price elasticity will also be explored briefly. Clearly much more needs to be done to reduce the high prevalence of diet-related chronic disease in some vulnerable groups. In particular, efforts to continually improve the availability and affordability of healthy food also need to address the predominance of unhealthy choices in the food supply.

Molecular and biochemical characterisation of transgenic banana lines containing iron uptake and storage enhancing genes

This thesis investigated the basis for availability of iron (Fe) and zinc (Zn) content in different banana fruits grown in Uganda and Australia. Rather than micronutrient content levels in different banana cultivar, genotype and environment interactions explained much of the differences. Such information should provide important insights for future developments in the biofortification of banana. Bananas consumed in Uganda did not contain sufficient levels of Fe and Zn that meet the nutrient requirements for vulnerable groups.

Ruokauskomukset Mosambikin maaseudun raskaana olevilla ja imettävillä naisilla

Ihmisille ympäri maailmaa on tyypillistä valita tiettyjä ruokia suuremmasta valikoimasta syömäkelpoista ruokaa ja luoda mieltymyksiä sekä kieltoja joitakin ruokia kohtaan. Näitä ilmiöitä kutsutaan ruokauskomuksiksi ja ne ovat tärkeä osa kulttuuria. Niiden taustalla on usein terveydelliset perustelut tai sosiaalinen arvostus yhteisössä. Afrikassa on todettu olevan paljon erilaisia ruokauskomuksia, jotka kohdistuvat usein raskaana oleviin ja imettäviin naisiin sekä lapsiin, ryhmään, joka on fysiologisesti erityisen herkässä elämänvaiheessa. Ravitsemustilan tai ruokaturvan ollessa heikko, mahdollisilla ruokauskomuksilla voi olla merkittävät seuraukset erityisesti tämän väestönosan terveydentilaan. Aliravitsemus ja virheravitsemus ovat edelleen suuria ongelmia Afrikassa ja muissa kehittyvissä maissa. Tämän työn tavoitteena oli tutkia laadullisin menetelmin, onko erityisesti raskaana olevilla ja imettävillä naisilla Keski-Mosambikin maaseudulla, Zambézian maakunnassa, ruokauskomuksia, mitä ne mahdollisesti ovat, sekä arvioida voiko ruokauskomuksilla olla ravitsemuksellista merkitystä. Menetelminä oli 5 ryhmähaastattelua kolmessa kylässä ja 10 yksilöhaastattelua kahdessa kylässä. Tutkittavat olivat 12–78-vuotiaita naisia ja heitä oli yhteensä 27. Tulkkaus, tutkimusaiheen sensitiivisyys ja haastattelijan kokemattomuus aiheuttivat haasteita haastatteluiden toteutukseen. Tämän vuoksi menetelmää muokattiin ja se vaihdettiin ryhmähaastattelusta yksilöhaastatteluun tutkimuksen aikana. Ruokauskomukset vaihtelivat sekä kylien välillä että kylien sisällä, joskin niistä löytyi samantyyppisiä pääpiirteitä. Työssä todettiin, että raskaana oleviin ja imettäviin naisiin kohdistui tutkimusalueella ruokauskomuksia. Raskauden aikana tuli välttää pääasiassa proteiinipitoisia ruokia, kuten lihaa ja kalaa ja puolestaan suosia kasvisten, hedelmien ja viljatuotteiden käyttöä. Linnun munien syöntiä sekä suositeltiin että kehotettiin välttämään raskauden aikana. Raskauden aikana ilmeni lisäksi tietoinen tapa vähentää kassavapuuron tai ruuan syömistä kokonaisuudessaan. Imetyksen aikana ei vältetty juuri mitään ruokia, vaan suositeltiin kookosta ja kasviksia. Suurin osa perusteluista liittyi äidin ja lapsen terveyteen. Perustelut voitiin jakaa seuraaviin ryhmiin: lisää äidinmaidon tuotantoa; aiheuttaa vatsakipua äidillä; pitää yllä kuntoa ja estää vatsan kasvua; äidistä tulee vahva, terve ja hän saa vitamiineja; lapsen ulkonäkö muuttuu; lapsesta tulee terve ja vahva; lapsen käyttäytyminen muuttuu; aiheuttaa keskenmenon; aiheuttaa vaikean tai helpon synnytyksen. Ruokauskomukset ja terveysviranomaisilta tullut valistus oli osittain sekoittunut keskenään. Lähes kaikki naiset kertoivat noudattavansa näitä ruokauskomuksia. Muutamat naiset kertoivat suositeltavien ruokien kohdalla, että ruokien saatavuus tekee noudattamisen joskus vaikeaksi. Proteiinipitoisten ruokien välttäminen voi lisätä proteiinialiravitsemuksen riskiä ja syömisen vähentäminen saattaa lisätä riskiä saada riittämättömästi energiaa raskauden aikana. Suositeltavat ruuat todennäköisesti edistävät terveyttä. Tutkielman perusteella voitiin todeta, että vieraassa kulttuurissa tutkiminen vaatii tutkimusmenetelmältä paljon. Tärkeää on menetelmän joustavuus, jotta sitä voi muuttaa tutkimuskentällä toimivampaan ja luotettavampaan muotoon. Johtopäätöksenä todettiin, että suositeltavin menetelmä tutkittaessa ruokauskomuksia tällä tutkimusalueella olisi ollut yksilöhaastattelut, jossa olisi ollut mahdollisimman vähän osallistujia ja osallistujat olisivat olleet samaa sukupuolta ja saman ikäisiä. Terveyden ja ravitsemuksen kannalta on tärkeää, että ruokauskomuksista ollaan tietoisia ja väestön ruokauskomuksia tutkitaan alueittain, koska ne voivat vaihdella merkittävästi jopa kylien tai ihmisryhmien sisällä.

Sustainable Aquaculture for Poverty Alleviation (SAPA): Strategy and implementation

There is general agreement amongst Government and many donors that aquaculture and improved aquatic resources management can make a significant and direct impact on poverty reduction and hunger eradication in Vietnam. The key policy issue is to better support poor and vulnerable groups who depend on or could make use of aquatic resources through the use of the livelihoods perspective. To address this issue the Ministry of Fisheries of Vietnam (MOFI) has prepared this Sustainable Aquaculture for Poverty Alleviation strategy - the SAPA strategy. (Pdf contains 54 pages).

Aquatic resources management for sustainable livelihoods of poor people: proceedings of the DFID-ARM e-mail conference, June 2000

This e-mail conference has been organised by the DFID Aquatic Resources Management (ARM) Programme, S E Asia. It forms part of a wider process of consultation including links with other donors, with government and non-government partners and participatory livelihood assessments with vulnerable groups who benefit from aquatic resources. The objective is to provide a forum for professionals who have been involved in aquatic resources management in the context of poor peoples’ livelihoods, to share experiences, reflect on approaches and contribute to their development. Participants can submit poster presentations (2-pagers) and contribute to the discussions (via the conference website) organised around 5 key issues, set out in this discussion paper. After 4 weeks online the contributed posters and discussions will be edited into a document assessing approaches to aquatic resources management, which benefit livelihoods of poor people. This will be downloadable from the website. (PDF contains 134 pages)

The food multimix concept: potential of an innovative food based approach on nutritional status in pregnant women in resource-poor communities

RATIONALE & OBJECTIVES: The food multimix (FFM)concept states that limited food resources can be combined using scientific knowledge to meet nutrient needs of vulnerable groups at low cost utilizing the ‘nutrient strengths’ of individual or candidate foods in composite recipes within a cultural context. METHODS: The method employed the food-to-food approach for recipe development using traditional food ingredients. Recipes were subjected to proximate and micronutrient analysis and optimized to meet at tleast 40% of recommended daily intakes. End products including breads, porridge and soup were developed. RESULTS: FMM products were employed in a feeding trial among 120 healthy pregnant women in Gauteng, South Africa resulting in improvements in serum iron levels from baseline values of 14.59 (=/-7.67) umol/L and 14.02 (=/-8.13) umol/L for control and intervention groups (p=0.71), to 16.03 (=/-5.67) umol/L and 18.66 (=/-9.41) umol/L (p=0.19). The increases from baseline to post-intervention were however statistically significant within groups. Similarly Mean Cell Volume values improved from baseline as well as serum ferritin and transferritin levels. CONCLUSION: The FMM concept has potential value in feeding programs for vulnerable groups including pregnant and lactating mothers.

Assessment of the nutritional value of wild leafy vegetables consumed in the Buhera District of Zimbabwe: a preliminary study

Wild leafy vegetables play a vital role in the livelihoods of many communities in Africa. The focus of this study was to investigate the nutritional value of wild vegetables commonly consumed by the people of Buhera District in the Manicaland province of Zimbabwe. A variety of vegetables including Amaranthus hybridus, Cleome gynandra, Bidens pilosa, Corchorus tridens, and Adansonia digitata were collected during a survey in Buhera District. Samples were processed employing traditional methods of cooking and drying, then subjected to proximate and micronutrient analyses. The results indicate that these vegetables were particularly high in calcium, iron, and vitamin C. Compared with Brassica napus (rape), Amaranthus hybridus contained twice the amount of calcium, with other nutrients almost in the same range. Compared with Spinacia oleracea (spinach), Amaranthus hybridus contained three times more vitamin C (44 mg/100 g). Calcium levels were 530 mg/100 g. Amaranthus hybridus was also found to contain 7, 13, and 20 times more vitamin C, calcium, and iron respectively compared with Lactuca sativa (lettuce). Cleome gynandra contained 14 mg/100 g, 115 mg/100 g, 9 mg/100 g of vitamin C, calcium, and iron respectively. Bidens pilosa was found to be a valuable source of vitamin C (63 mg/100 g), iron (15 mg/100 g), and zinc (19 mg/100 g), compared with Brassica oleracea (cabbage). The leaves of Corchorus tridens were an excellent source of vitamin C (78 mg/100 g), calcium (380 mg/100 g), and iron (8 mg/100 g). The Adansonia digitata leaves were also rich in vitamin C (55 mg/100 g), iron (23 mg/ 100 g), and calcium (400 mg/100 g). Based on these nutrient contents, the above vegetables will have potential benefits as part of feeding programmes, as well as their promotion as part of composite diet for vulnerable groups.

The food multimix concept: new innovative approach to meeting nutritional challenges in Sub-Saharan Africa

Food insecurity, chronic hunger, starvation and malnutrition continue to affect millions of individuals throughout the developing world, especially Sub-Saharan Africa. Various initiatives by African governments and International Agencies such as the UN, the industrial nations, the International Monetary Fund, the World Bank and the World Trade Organisation to boost economic development, have failed to provide the much-needed solution to these challenges. The impact of these economic shifts and the failures of structural adjustment programmes on the nutritional well-being and health of the most vulnerable members of poor communities cannot be over-emphasised. The use of ad hoc measures as an adjunct to community-based rural integrated projects have provided little success and will be unsustainable unless they are linked to harnessing available local resources. The present paper therefore focuses on exploring alternative ways of harnessing the scant agricultural resources by employing a scientific approach to food-related problem-solving. The food multimix (FMM) concept offers a scientific contribution alongside other attempts currently in use by the World Food Programme, WHO and FAO to meet the food insecurity challenges that confront most of the developing world in the twenty-first century. It is an innovative approach that makes better use of traditional food sources as a tool for meeting community nutritional needs. The FMM concept employs a food-based approach using traditional methods of food preparation and locally-available, cheap and affordable staples (fruits, pulses, vegetables and legumes) in the formulation of nutrient-enriched multimixes. Developed recipes can provide >= 40% of the daily nutritional requirements of vulnerable groups, including patients with HIV/AIDS and children undergoing nutrition rehabilitation. The FMM approach can also be used as a medium- to long-term adjunct to community-based rural integration projects aimed at health improvement and economic empowerment in Sub-Saharan Africa.

The Olympic Games and urban displacement: the case of Beijing

Urban spectacles such as the Olympic Games have been long perceived as being able to impose desired effects in the city that act as host. This kind of urban boost may include the creation of new jobs and revenue for local community, growth in tourism and convention business, improvements to city infrastructure and environment, and the stimulation of broad reform in the social, political and institutional realm. Nevertheless at the other end of the debate, the potentially detrimental impacts of Olympic urban development, particularly on disadvantaged and vulnerable groups, have also been increasingly noticed in recent years and subsequently cited by a number of high profile anti-Olympic groups to campaign against Olympic bids and awards. The common areas of concern over Olympic-related projects include the cost and debts risk, environmental threat, the occurrence of social imbalance, and disruption and disturbance of existing community life. Among these issues, displacement of low income households and squatter communities resulting from Olympic-inspired urban renewal are comparatively under-explored and have emerged as an imperative area for research inquiry. This is particularly the case where many other problems have become less prominent. Changing a city’s demographic landscape, particularly displacing lower income people from the area proposed for a profitable development is a highly contentious matter in its own right. Some see it as a natural and inevitable outgrowth of the process of urban evolution, without which cities cannot move towards a more attractive location for consumption-based business. Others believe it reflects urban crises and conflicts, highlighting the market failures, polarization and injustice. Regardless of perception,these phenomena are visible everywhere in post-industrial cities and particularly cannot be ignored when planning for the Olympic Games and other mega-events. The aim of this paper is to start the process of placing the displacement issue in the context of Olympic preparation and to seek a better understanding of their interrelations. In order to develop a better understanding of this issue in terms of cause, process, influential factors and its implication on planning policy, this paper studies the topic from both theoretic and empirical angles. It portrays various situations where the Olympics may trigger or facilitate displacement in host cities during the preparation of the Games, identifies several major variables that may affect the process and the overall outcome, and explores what could be learnt in generic terms for planning Olympic oriented infrastructure so that ill-effects to the local community can be effectively controlled. The paper concludes that the selection of development sites, the integration of Olympic facilities with the city’s fabric, the diversity of housing type produced for local residents and the dynamics of the new socioeconomic structure.

Cinderella comes to the Ball: Article 14 and the right to non-discrimination in the ECHR

Article 14 ECHR has often been derided as a Cinderella provision, but during the last few years, this has started to change. This article examines how Article 14 has developed, and may live up to its potential as a powerful non-discrimination principle. The case law developments in relation to the “ambit” requirement in Article 14, the development of indirect discrimination case law, and the approval of positive action, all point to a more substantive conception of equality, which offers protection to disadvantaged and vulnerable groups.

Vetting Sexual Offenders: State Over-extension, the Punishment Deficit and the Failure to Manage Risk

This article examines the state regulation of sexual offenders in the particular context of pre-employment vetting. A successive range of statutory frameworks have been put in place, culminating in the Safeguarding Vulnerable Groups Act 2006, to prevent unsuitable individuals from working with the vulnerable, and children in particular. Contemporary legislative and policy developments are set against a backdrop of broader concerns in the area of crime and justice, namely risk regulation, preventative governance and ‘precautionary logic.’ Proponents of these approaches have largely ignored concerns over their feasibility. This article specifically addresses this fissure within the specific field of vetting. It is argued that ‘hyper innovation’ and state over-extension in this area are particularly problematic and have resulted in exceptionally uncertain and unsafe policies. These difficulties relate principally to unrealistic public expectations about the state’s ability to control crime; unintended and ambiguous policy effects; and ultimately the failure of the state to deliver on its self-imposed regulatory mandate to effectively manage risk.

Vegetarian diets, low-meat diets and health:a review

OBJECTIVE: To review the epidemiological evidence for vegetarian diets, low-meat dietary patterns and their association with health status in adults. DESIGN: Published literature review focusing primarily on prospective studies and meta-analyses examining the association between vegetarian diets and health outcomes. RESULTS: Both vegetarian diets and prudent diets allowing small amounts of red meat are associated with reduced risk of diseases, particularly CHD and type 2 diabetes. There is limited evidence of an association between vegetarian diets and cancer prevention. Evidence linking red meat intake, particularly processed meat, and increased risk of CHD, cancer and type 2 diabetes is convincing and provides indirect support for consumption of a plant-based diet. CONCLUSIONS: The health benefits of vegetarian diets are not unique. Prudent plant-based dietary patterns which also allow small intakes of red meat, fish and dairy products have demonstrated significant improvements in health status as well. At this time an optimal dietary intake for health status is unknown. Plant-based diets contain a host of food and nutrients known to have independent health benefits. While vegetarian diets have not shown any adverse effects on health, restrictive and monotonous vegetarian diets may result in nutrient deficiencies with deleterious effects on health. For this reason, appropriate advice is important to ensure a vegetarian diet is nutritionally adequate especially for vulnerable groups.

Welfare regime and social class variation in poverty and economic vulnerability in Europe: an analysis of EU-SILC

In this paper we address a set of interrelated issues. These comprise increasing concerns about reliance on nationally based income poverty measures in the context of EU enlargement, the relative merits of one-dimensional versus multidimensional approaches to poverty and social exclusion and the continuing relevance of class-based explanations of life chances. When identifying economically vulnerable groups we find that, contrary to the situation with national income poverty measures, levels of vulnerability vary systematically across welfare regimes. The multidimensional profile of the economically vulnerable sharply differentiates them from the remainder of the population. While they are also characterised by distinctively higher levels of multiple deprivation, a substantial majority of the economically vulnerable are not exposed to such deprivation. Unlike the national relative income approach, the focus on economic vulnerability reveals a pattern of class differentiation that is not dominated by the contrast between the self-employed and all others. In contrast to a European-wide relative income approach, it also simultaneously captures the fact that absolute levels of vulnerability are distinctively higher among the lower social classes in the less comprehensive and generous welfare regimes while class relativities are significantly sharper at the other end of the spectrum.