Clinical utility of the KAMRA corneal inlay

The treatment of presbyopia has been the focus of much scientific and clinical research over recent years, not least due to an increasingly aging population but also the desire for spectacle independence. Many lens and nonlens-based approaches have been investigated, and with advances in biomaterials and improved surgical methods, removable corneal inlays have been developed. One such development is the KAMRA™ inlay where a small entrance pupil is exploited to create a pinhole-type effect that increases the depth of focus and enables improvement in near visual acuity. Short- and long-term clinical studies have all reported significant improvement in near and intermediate vision compared to preoperative measures following monocular implantation (nondominant eye), with a large proportion of patients achieving Jaeger (J) 2 to J1 (~0.00 logMAR to ~0.10 logMAR) at the final follow-up. Although distance acuity is reduced slightly in the treated eye, binocular visual acuity and function remain very good (mean 0.10 logMAR or better). The safety of the inlay is well established and easily removable, and although some patients have developed corneal changes, these are clinically insignificant and the incidence appears to reduce markedly with advancements in KAMRA design, implantation technique, and femtosecond laser technology. This review aims to summarize the currently published peer-reviewed studies on the safety and efficacy of the KAMRA inlay and discusses the surgical and clinical outcomes with respect to the patient’s visual function.

Essential features of serious games design in higher education:linking learning attributes to game mechanics

This paper consolidates evidence and material from a range of specialist and disciplinary fields to provide an evidence-based review and synthesis on the design and use of serious games in higher education. Search terms identified 165 papers reporting conceptual and empirical evidence on how learning attributes and game mechanics may be planned, designed and implemented by university teachers interested in using games, which are integrated into lesson plans and orchestrated as part of a learning sequence at any scale. The findings outline the potential of classifying the links between learning attributes and game mechanics as a means to scaffold teachers’ understanding of how to perpetuate learning in optimal ways while enhancing the in-game learning experience. The findings of this paper provide a foundation for describing methods, frames and discourse around experiences of design and use of serious games, linked to methodological limitations and recommendations for further research in this area.

Surrogate-based analysis and optimization for the design of heat sinks with jet impingement

Heat sinks are widely used for cooling electronic devices and systems. Their thermal performance is usually determined by the material, shape, and size of the heat sink. With the assistance of computational fluid dynamics (CFD) and surrogate-based optimization, heat sinks can be designed and optimized to achieve a high level of performance. In this paper, the design and optimization of a plate-fin-type heat sink cooled by impingement jet is presented. The flow and thermal fields are simulated using the CFD simulation; the thermal resistance of the heat sink is then estimated. A Kriging surrogate model is developed to approximate the objective function (thermal resistance) as a function of design variables. Surrogate-based optimization is implemented by adaptively adding infill points based on an integrated strategy of the minimum value, the maximum mean square error approach, and the expected improvement approaches. The results show the influence of design variables on the thermal resistance and give the optimal heat sink with lowest thermal resistance for given jet impingement conditions.

A Public-Private Partnership vélt és valós hangsúlyai Magyarországon = Assumed and actual emphases of Public-Private Partnership in Hungary

Írásunk a Public-Private Partnership (PPP) magyarországi megvalósulásának hangsúlyairól szól. Azt vizsgáljuk, hogy a szakmai közvélemény milyen képet alakíthatott ki e projektekről a szaksajtó olvasásán keresztül. Három tágabb elvi szempont sajtóbeli megjelenésének súlyát elemezzük: a PPP céljai, a feladatok hatékonyabb elvégzésének módja, illetve a társadalmi kontroll megvalósulása áll érdeklődésünk középpontjában. A tartalomelemzés matematikai-statisztikai módszereit alkalmazzuk. Következtetésünk, hogy a PPP-projektek általában még nem elvi lényegük szerint valósultak meg Magyarországon, bár az évek során érzékelhető pozitív irányú elmozdulás: tanulási folyamat történik. Ennek alapján nem szabad a PPP-t mint módszert elvetni a közfeladatok ellátásában, hanem alkalmazási módjának tökéletesítésére kell törekedni. = This working paper focuses on the perceptions of the Hungarian implementation of Public-Private Partnership (PPP) projects. It was examined how PPP was perceived in the wider public through the communication of the most read daily and weekly business journals. We analyzed the proportion of three broad aspects in the articles: the main goals of PPP, efficiency improvement as a substantial opportunity for value creation, and the role of democratic control. We applied the mathematical-statistical methods of content analysis. Our conclusion is that PPP-projects in Hungary are far from the normative model of implementation as discerned from literature, but from year to year a positive shift, a learning process can be observed. Therefore, instead of discarding PPP as a progressive government solution, Hungary should focus on improving the design and implementation of PPP projects.

A forgalomban lévő fásszárú dísznövénytaxonok szárazságtűrésének értékelése a klímaváltozás tükrében (Evaluation of the impact climate change on current drought-tolerant woody plants)

Regionális klímaváltozási forgatókönyvek szerint hazánk éghajlata az elkövetkező 90 évben a mainál jóval melegebb, a nyári évszakban csapadékszegényebb, összességében pedig szárazabb lesz. Kutatásunk célja volt felmérni szárazságtűrésük szerint a legjelentősebb faiskolák katalógusában fellelhető fa- és cserjefajokat (a gyűjtésben nem szerepelnek a faj alatti taxonok). A vizsgálatainkban szereplő öt faiskola növénykínálatát a tudományos nevek ellenőrzése után összesítettük, majd ezt követően az egyes fajokat vízigény szerinti kategóriákba soroltuk. A tényleges statisztikai értékelésbe – a 451 összegyűjtött faj tudományos neveinek ellenőrzése után – 420 fajt vontunk be, melyek 20%-a vízigényes, 53%-a közepesen vízigényes és 27%-a szárazságtűrő. Várakozásainkkal ellentétben a vízigényes fajok részaránya kevésnek mondható, ugyanakkor a szárazságtűrő fajok magasabb aránya kívánatos lenne. Ezért, a gyakorlati alkalmazást elősegítve, kiemeltünk olyan nemzetségeket, melyek kereskedelmi forgalmazását meg kellene kezdeni vagy fokozni, mint pl a Cupressus, Eucommia, Halimodendron, Paliurus, Pyrus, Rhus, Yucca Zanthoxylum, Zelkova, illetve olyanokat, melyek telepítését a jövőben nem, vagy csak kellő körültekintéssel javasoljuk, mint például a Clematis, Hydrangea, Liquidambar, Magnolia, Rhododendron nemzetségek. _____ According to regional climate change scenarios, the climate in Hungary will be warmer. Less precipitation is predicted in the summer seasons so, on the whole, it will be drier over the next 90 years. Our research attempted to survey the ornamental plant species in the most important nurseries in Hungary, in terms of their drought tolerance. The intraspecifi c taxa are not included. The plant assortment of the fi ve nurseries was merged after researching their scientifi c names. We then categorized species to 3 groups of drought tolerance. Out of 451 species, 420 of them were used in the statistical research. 20% of them were water demanding, 53% were medium drought tolerant and 27% were drought tolerant. In contrast to our initial expectation, the proportion of water demanding species was not too high. Nevertheless, the proportion of drought tolerant species should have been greater. We classifi ed the genera to assist in practical application. The trade of some of these species, such as Cupressus, Eucommia, Halimodendron, Paliurus, Pyrus, Rhus, Yucca, Zanthoxylum, Zelkova should be initiated or increased in the future. Other species, especially Clematis, Hydrangea, Liquidambar, Magnolia, Rhododendron are not recommended due to either their drought intolerance or their high maintenance requirement.

A quantitative application of symbolic interactionism to advance directive completion by older adults

This study examined contextual and situational influences on older adults' decision to complete advance directives by means of a conceptual framework derived from symbolic interactionist theory and a cross-sectional, correlational research design. It was hypothesized that completion of advance directives among older adults would be associated with visiting or participating in the care of a terminally ill or permanently incompetent individual sustained by technology. Using a 53-item questionnaire, computer assisted telephone interviews (CATI) were conducted with 398 community dwelling adults between September and October 2003. Respondents were contacted using random-select dialing from a listed sample of 99% of household telephone numbers in one South Florida census tract. Over 90% of households in this tract include an individual age 65 or older. ^ The results revealed that contrary to most reports in the literature a substantial proportion of older adults (82%) had completed advance directives and that the link between older adults and document completion was mainly through attorneys and not mandated agents, health care professionals. Further, more than one third of older adults reported that religion/spirituality was not an important part of their life, suggesting that the recommended practice of offering religious/spiritual counseling to all those approaching death be reexamined. The hypothesis was not supported (p > .05) and is explained by the situational emphasis on the variables rather than on structural influences. In logistic regression analysis, only increasing age (p = .001) and higher education (p = < .001) were significant but explained only 10% of the variance in document completion. ^ Based on the findings, increased interdisciplinary collaboration is suggested with regard to the advance directive agenda. Since attorneys play a key role in document completion, other professions should seek their expertise and collaboration. In addition, the inclusion of a religious/spiritual preference section in all living wills should be considered as an essential part of a holistic and individually appropriate document. Implications for social work education, practice, and advocacy are discussed as well as suggestions for further research. ^

Predictors of safer sex behaviors of midlife and older women

Heterosexual transmission of the human immunodeficiency virus (HIV) in midlife and older women is increasing, yet little is known about the safer sex practices of these women. Identification of HIV risk and protective factors necessitates understanding of the influences of individual, interpersonal, and socio-environmental factors on the sexual behaviors of this understudied, at-risk population. The purpose of this study was to determine the influence of self esteem, sensation seeking, self silencing, sexual assertiveness, and HIV-stigma on the safer sex behaviors of women aged 50 and older. ^ This study was guided by the ecological perspective which emphasizes the multilevel factors affecting health behaviors within individual, interpersonal, and socio-environmental contexts. A community-based, ethnically diverse sample of 572 women aged 50 to 93 (M = 63.6 years, SD = 10.5) completed a 128-item anonymous questionnaire. This study used a cross-sectional, correlational research design. The data were analyzed using Pearson correlation coefficients and multiple regression analysis. ^ Results from the regression analysis with the predictors (i.e., ethnicity, education, self esteem, sensation seeking, self silencing, sexual assertiveness, and HIV stigma) indicated the model significantly predicted safer sex behaviors (p < .001). Self silencing (β = -.115, p < .05) was a significant predictor. The lower the self silencing scores, the higher the safer sex behavior scores. Further exploration of the data revealed that the greater the age of the woman, the more likely she is to engage in safer sex behaviors (β = .173, p < .001). While the data showed this model was statistically significant, its practical significance may be limited due to the low proportion of variance explained by age and self silencing. HIV/AIDS prevention interventions that are socially anchored, age-appropriate, and gender-specific are discussed and recommendations for socially meaningful strategies to reduce the number of new cases of HIV/AIDS in midlife and older women are presented. ^

The impact of the Florida state -mandated Basic Skills Exit Tests at Miami -Dade Community College

The purpose of this study was to explore the impact of the Florida State-mandated Basic Skills Exit Tests (BSET) on the effectiveness of remedial instruction programs to adequately serve the academically underprepared student population. The primary research question concerned whether the introduction of the BSET has resulted in remedial completers who are better prepared for college-level coursework. ^ This study consisted of an ex post facto research design to examine the impact of the BSET on student readiness for subsequent college-level coursework at Miami-Dade Community College. Two way analysis of variance was used to compare the performance of remedial and college-ready students before and after the introduction of the BSET requirement. Chi-square analysis was used to explore changes in the proportion of students completing and passing remedial courses. Finally, correlation analysis was used to explore the utility of the BSET in predicting subsequent college-level course performance. Differences based on subject area and race/ethnicity were explored. ^ The introduction of the BSET did not improve the performance of remedial completers in subsequent college-level courses in any of the subject areas. The BSET did have a negative impact on the success rate of students in remedial reading and mathematics courses. There was a significant decrease in minority students' likelihood of passing remedial reading and mathematics courses after the BSET was introduced. The reliability of the BSET is unacceptably low for all subject areas, based on estimates derived from administrations at M-DCC. Nevertheless, there was a significant positive relationship between BSET score and grade point average in subsequent college-level courses. This relationship varied by subject area and ethnicity, with the BSET reading score having no relationship with subsequent course performance for Black non-Hispanic students. ^ The BSET had no discernable positive effect on remedial student performance in subsequent college-level courses. In other words, the BSET has not enhanced the effectiveness of the remedial programs to prepare students for later coursework at M-DCC. The BSET had a negative impact on the progress and success of students in remedial reading and mathematics. ^

Design and construction of a portable force-reflecting manual controller for teleoperation systems

A man-machine system called teleoperator system has been developed to work in hazardous environments such as nuclear reactor plants. Force reflection is a type of force feedback in which forces experienced by the remote manipulator are fed back to the manual controller. In a force-reflecting teleoperation system, the operator uses the manual controller to direct the remote manipulator and receives visual information from a video image and/or graphical animation on the computer screen. This thesis presents the design of a portable Force-Reflecting Manual Controller (FRMC) for the teleoperation of tasks such as hazardous material handling, waste cleanup, and space-related operations. The work consists of the design and construction of a prototype 1-Degree-of-Freedom (DOF) FRMC, the development of the Graphical User Interface (GUI), and system integration. Two control strategies - PID and fuzzy logic controllers are developed and experimentally tested. The system response of each is analyzed and evaluated. In addition, the concept of a telesensation system is introduced, and a variety of design alternatives of a 3-DOF FRMC are proposed for future development.

The impact of the Florida state-mandated basic skills exit test at Miami-Dade Community College

The purpose of this study was to explore the impact of the Florida State-mandated Basic Skills Exit Tests (BSET) on the effectiveness of remedial instruction programs to adequately serve the academically underprepared student population. The primary research question concerned whether the introduction of the BSET has resulted in remedial completers who are better prepared for college-level coursework. This study consisted of an ex post facto research design to examine the impact of the BSET on student readiness for subsequent college-level coursework at Miami- Dade Community College. Two way analysis of variance was used to compare the performance of remedial and college-ready students before and after the introduction of the BSET requirement. Chi-square analysis was used to explore changes in the proportion of students completing and passing remedial courses. Finally, correlation analysis was used to explore the utility of the BSET in predicting subsequent college-level course performance. Differences based on subject area and race/ethnicity were explored.

The effect of personality on the design team:lessons from industry for design education

This study examines the effect of individual character types in design teams through case studies at ARUP associates and five United Kingdom university design degree programmes. By observing an individual's approach and contribution within a team, patterns of design behaviour are highlighted and compared within the industrial and academic examples. Initial findings have identified discreet differences in design approach and ways of working. By identifying these initial character clusters, design behaviour can be predicted to help teams and individuals to strengthen their design process. This research brings together: 1. The design process and how engineering and design teams work to solve problems. 2. The natural characteristics of individuals and how they approach problems. This difference of approach can be viewed in relation to the design process where engineers and designers will recognise their preference for certain stages of the design process. This study suggests that these individual preferences are suited to different stages of the design process, and that industry uses teams to ensure a broad range of views, an approach design education would do well to apply by establishing collaborative input in the design process.

Referring heroin users from compulsory detoxification centers to community methadone maintenance treatment: a comparison of three models.

BACKGROUND: Both compulsory detoxification treatment and community-based methadone maintenance treatment (MMT) exist for heroin addicts in China. We aim to examine the effectiveness of three intervention models for referring heroin addicts released from compulsory detoxification centers to community methadone maintenance treatment (MMT) clinics in Dehong prefecture, Yunnan province, China. METHODS: Using a quasi-experimental study design, three different referral models were assigned to four detoxification centers. Heroin addicts were enrolled based on their fulfillment to eligibility criteria and provision of informed consent. Two months prior to their release, information on demographic characteristics, history of heroin use, and prior participation in intervention programs was collected via a survey, and blood samples were obtained for HIV testing. All subjects were followed for six months after release from detoxification centers. Multi-level logistic regression analysis was used to examine factors predicting successful referrals to MMT clinics. RESULTS: Of the 226 participants who were released and followed, 9.7% were successfully referred to MMT(16.2% of HIV-positive participants and 7.0% of HIV-negative participants). A higher proportion of successful referrals was observed among participants who received both referral cards and MMT treatment while still in detoxification centers (25.8%) as compared to those who received both referral cards and police-assisted MMT enrollment (5.4%) and those who received referral cards only (0%). Furthermore, those who received referral cards and MMT treatment while still in detoxification had increased odds of successful referral to an MMT clinic (adjusted OR = 1.2, CI = 1.1-1.3). Having participated in an MMT program prior to detention (OR = 1.5, CI = 1.3-1.6) was the only baseline covariate associated with increased odds of successful referral. CONCLUSION: Findings suggest that providing MMT within detoxification centers promotes successful referral of heroin addicts to community-based MMT upon their release.

The Effects of Organic Matter Amendments and Migratory Waterfowl on Greenhouse Gas and Nutrient Dynamics in Managed Coastal Plain Wetlands

Wetland ecosystems provide many valuable ecosystem services, including carbon (C) storage and improvement of water quality. Yet, restored and managed wetlands are not frequently evaluated for their capacity to function in order to deliver on these values. Specific restoration or management practices designed to meet one set of criteria may yield unrecognized biogeochemical costs or co-benefits. The goal of this dissertation is to improve scientific understanding of how wetland restoration practices and waterfowl habitat management affect critical wetland biogeochemical processes related to greenhouse gas emissions and nutrient cycling. I met this goal through field and laboratory research experiments in which I tested for relationships between management factors and the biogeochemical responses of wetland soil, water, plants and trace gas emissions. Specifically, I quantified: (1) the effect of organic matter amendments on the carbon balance of a restored wetland; (2) the effectiveness of two static chamber designs in measuring methane (CH4) emissions from wetlands; (3) the impact of waterfowl herbivory on the oxygen-sensitive processes of methane emission and coupled nitrification-denitrification; and (4) nitrogen (N) exports caused by prescribed draw down of a waterfowl impoundment.

The potency of CH4 emissions from wetlands raises the concern that widespread restoration and/or creation of freshwater wetlands may present a radiative forcing hazard. Yet data on greenhouse gas emissions from restored wetlands are sparse and there has been little investigation into the greenhouse gas effects of amending wetland soils with organic matter, a recent practice used to improve function of mitigation wetlands in the Eastern United States. I measured trace gas emissions across an organic matter gradient at a restored wetland in the coastal plain of Virginia to test the hypothesis that added C substrate would increase the emission of CH4. I found soils heavily loaded with organic matter emitted significantly more carbon dioxide than those that have received little or no organic matter. CH4 emissions from the wetland were low compared to reference wetlands and contrary to my hypothesis, showed no relationship with the loading rate of added organic matter or total soil C. The addition of moderate amounts of organic matter (< 11.2 kg m-2) to the wetland did not greatly increase greenhouse gas emissions, while the addition of high amounts produced additional carbon dioxide, but not CH4.

I found that the static chambers I used for sampling CH4 in wetlands were highly sensitive to soil disturbance. Temporary compression around chambers during sampling inflated the initial chamber CH4 headspace concentration and/or lead to generation of nonlinear, unreliable flux estimates that had to be discarded. I tested an often-used rubber-gasket sealed static chamber against a water-filled-gutter seal chamber I designed that could be set up and sampled from a distance of 2 m with a remote rod sampling system to reduce soil disturbance. Compared to the conventional design, the remotely-sampled static chambers reduced the chance of detecting inflated initial CH4 concentrations from 66 to 6%, and nearly doubled the proportion of robust linear regressions from 45 to 86%. The new system I developed allows for more accurate and reliable CH4 sampling without costly boardwalk construction.

I explored the relationship between CH4 emissions and aquatic herbivores, which are recognized for imposing top-down control on the structure of wetland ecosystems. The biogeochemical consequences of herbivore-driven disruption of plant growth, and in turn, mediated oxygen transport into wetland sediments, were not previously known. Two growing seasons of herbivore exclusion experiments in a major waterfowl overwintering wetland in the Southeastern U.S. demonstrate that waterfowl herbivory had a strong impact on the oxygen-sensitive processes of CH4 emission and nitrification. Denudation by herbivorous birds increased cumulative CH4 flux by 233% (a mean of 63 g CH4 m-2 y-1) and inhibited coupled nitrification-denitrification, as indicated by nitrate availability and emissions of nitrous oxide. The recognition that large populations of aquatic herbivores may influence the capacity for wetlands to emit greenhouse gases and cycle nitrogen is particularly salient in the context of climate change and nutrient pollution mitigation goals. For example, our results suggest that annual emissions of 23 Gg of CH4 y-1 from ~55,000 ha of publicly owned waterfowl impoundments in the Southeastern U.S. could be tripled by overgrazing.

Hydrologically controlled moist-soil impoundment wetlands provide critical habitat for high densities of migratory bird populations, thus their potential to export nitrogen (N) to downstream waters may contribute to the eutrophication of aquatic ecosystems. To investigate the relative importance of N export from these built and managed habitats, I conducted a field study at an impoundment wetland that drains into hypereutrophic Lake Mattamuskeet. I found that prescribed hydrologic drawdowns of the impoundment exported roughly the same amount of N (14 to 22 kg ha-1) as adjacent fertilized agricultural fields (16 to 31 kg ha-1), and contributed approximately one-fifth of total N load (~45 Mg N y-1) to Lake Mattamuskeet. Ironically, the prescribed drawdown regime, designed to maximize waterfowl production in impoundments, may be exacerbating the degradation of habitat quality in the downstream lake. Few studies of wetland N dynamics have targeted impoundments managed to provide wildlife habitat, but a similar phenomenon may occur in some of the 36,000 ha of similarly-managed moist-soil impoundments on National Wildlife Refuges in the southeastern U.S. I suggest early drawdown as a potential method to mitigate impoundment N pollution and estimate it could reduce N export from our study impoundment by more than 70%.

In this dissertation research I found direct relationships between wetland restoration and impoundment management practices, and biogeochemical responses of greenhouse gas emission and nutrient cycling. Elevated soil C at a restored wetland increased CO2 losses even ten years after the organic matter was originally added and intensive herbivory impact on emergent aquatic vegetation resulted in a ~230% increase in CH4 emissions and impaired N cycling and removal. These findings have important implications for the basic understanding of the biogeochemical functioning of wetlands and practical importance for wetland restoration and impoundment management in the face of pressure to mitigate the environmental challenges of global warming and aquatic eutrophication.

Nutritional status of lactating mothers and their children 6-23 months of age in pre- and post-harvest seasons in two agro-ecological zones of rural Ethiopia

The objective of this study was to assess seasonal variation in nutritional status and feeding practices among lactating mothers and their children 6-23 months of age in two different agro-ecological zones of rural Ethiopia (lowland zone and midland zone). Food availability and access are strongly affected by seasonality in Ethiopia. However, there are few published data on the effects of seasonal food fluctuations on nutritional status and dietary diversity patterns of mothers and children in rural Ethiopia. A longitudinal study was conducted among 216 mothers in two agro-ecological zones of rural Ethiopia during pre and post-harvest seasons. Data were collected on many parameters including anthropometry, blood levels of haemoglobin and ferritin and zinc, urinary iodine levels, questionnaire data regarding demographic and household parameters and health issues, and infant and young child feeding practices, 24 h food recall to determine dietary diversity scores, and household use of iodized salt. Chi-square and multivariable regression models were used to identify independent predictors of nutritional status. A wide variety of results were generated including the following highlights. It was found that 95.4% of children were breastfed, of whom 59.7% were initially breastfed within one hour of birth, 22.2% received pre-lacteal feeds, and 50.9% of children received complementary feedings by 6 months of age. Iron deficiency was found in 44.4% of children and 19.8% of mothers. Low Zinc status was found in 72.2% of children and 67.3% of mothers. Of the study subjects, 52.5% of the children and 19.1% of the mothers were anaemic, and 29.6% of children and 10.5% of mothers had iron deficiency anaemia. Among the mothers with low serum iron status, 81.2% and 56.2% of their children had low serum zinc and iron, respectively. Similarly, among the low serum zinc status mothers, 75.2% and 45.3% of their children had low serum in zinc and iron, respectively. There was a strong correlation between the micronutrient status of the mothers and the children for ferritin, zinc and haemoglobin (P <0.001). There was also statistically significant difference between agro-ecological zones for micronutrient deficiencies among the mothers (p<0.001) but not for their children. The majority (97.6%) of mothers in the lowland zone were deficient in at least one micronutrient biomarker (zinc or ferritin or haemoglobin). Deficiencies in one, two, or all three biomarkers of micronutrient status were observed in 48.1%, 16.7% and 9.9% of mothers and 35.8%, 29.0%, and 23.5%, of children, respectively. Additionally, about 42.6% of mothers had low levels of urinary iodine and 35.2% of lactating mothers had goitre. Total goitre prevalence rates and urinary iodine levels of lactating mothers were not significantly different across agro-ecological zones. Adequately iodised salt was available in 36.6% of households. The prevalence of anaemia increased from post-harvest (21.8%) to pre-harvest seasons (40.9%) among lactating mothers. Increases were from 8.6% to 34.4% in midland and from 34.2% to 46.3% in lowland agro-ecological zones. Fifteen percent of mothers were anaemic during both seasons. Predictors of anaemia were high parity of mother and low dietary diversity. The proportion of stunted and underweight children increased from 39.8% and 27% in post-harvest season to 46.0% and 31.8% in pre-harvest season, respectively. However, wasting in children decreased from 11.6% to 8.5%. Major variations in stunting and underweight were noted in midland compared to lowland agroecological zones. Anthropometric measurements in mothers indicated high levels of undernutrition. The prevalence of undernutrition in mothers (BMI <18.5kg/m2) increased from 41.7 to 54.7% between post- and pre-harvest seasons. The seasonal effect was generally higher in the midland community for all forms of malnutrition. Parity, number of children under five years and regional variation were predictors of low BMI among lactating mothers. There were differences in minimum meal frequency, minimum acceptable diet and dietary diversity in children in pre-harvest and post-harvest seasons and these parameters were poor in both seasons. Dietary diversity among mothers was higher in lowland zone but was poor in both zones across the seasons. In conclusion, malnutrition and micronutrient deficiencies are very prevalent among lactating mothers and their children 6-23 months old in the study areas. There are significant seasonal variations in malnutrition and dietary diversity, in addition to significant differences between lowland and midland agro-ecological zones. These findings suggest a need to design effective preventive public health nutrition programs to address both the mothers’ and children’s needs particularly in the preharvest season.

Commodification of retirement and the emergence of rural gated communities: The associated challenges for rural planning

Abstract:
This paper combines demographic ageing and retirement lifestyles with rural in-migration processes and suggests the emergence of a specific rural form of gated community; namely, park homes. All year round or permanent (as opposed to seasonal) residential mobile homes (resembling detached bungalows in design and appearance) are commonly referred to as 'park homes'. With a growing proportion of the UK population aged 65 and over, combined with increasing longevity, meeting the residential preferences and lifestyle aspirations of an ageing population is potentially 'big business' for the private sector. Park home living, with their resident age restrictions (normally 50 years and over), is increasingly marketed as a retirement option in rural and coastal locations of the UK. However, many areas are often remote with declining populations and limited community services. Operators have sought to tap into retiree aspirations for a 'place in the country' and 'sell' the concept of park home living as a specific form of housing, community and lifestyle. Park homes are frequently marketed as a means to release equity from the sale of a large family home to fund a retirement lifestyle and as friendly communities of like-minded people, always willing to lend support or provide assistance if required. The physical and social composition of such sites represent a form of rural gated community. This paper seeks to identify the rural planning issues which emerge from such developments and asks: who are moving to park home sites and why? do park homes provide those who otherwise could not afford a 'place in the country' the option of rural living? does park home living live-up to residents' expectations of the rural idyll or retirement lifestyle? do they give rise to issues of gentrification and geriatrification of the countryside? what are the prospects for residents to 'age in place'? might ageing residents become financially trapped in such developments giving rise to park ghettoization? what are the associated challenges for rural policy-makers and public service providers?