Association between maternal education and diet of children at 9 months is partially explained by mothers' diet

Infants of mothers of low educational background display consistently poorer outcomes, including suboptimal weaning diets. Less is known about the different causal pathways that relate maternal education to infants' diet. The present study aimed to test the hypothesis that the relationship between maternal education and infants' diet is mediated by mothers' diet. The analyses included 421 mother–infant pairs from the Melbourne Infant Feeding Activity and Nutrition Trial (InFANT) Program. Dietary intakes were collected from mothers when infants were aged 3 months, using a validated food frequency questionnaire relating to the past year, and in infants aged 9 months using 3 × 24-h recalls. Principal component analysis was used to derive dietary pattern scores, based on frequencies of 55 food groups in mothers, and intakes of 23 food groups in infants. Associations were assessed with multivariable linear regression. We tested the product ‘ab’ to address the mediation hypothesis, where ‘a’ refers to the relationship between the predictor variable (education) and the mediator variable (mothers' diet), and ‘b’ refers to the association between the mediator variable and the outcome variable (infants' diet), controlling for the predictor variable. Maternal scores on the ‘Fruit and vegetables’ dietary pattern partially mediated the relationships between maternal education and two infant dietary patterns, namely ‘Balanced weaning diet’ [ab = 0.11; 95% confidence interval (CI): 0.04; 0.18] and ‘Formula’ (ab = −0.08; 95%CI: −0.15; −0.02). These findings suggest that targeting pregnant mothers of low education level with the aim of improving their own diet may also promote better weaning diets in their infants.

Barriers and enablers to healthcare access and use among Arabic-speaking and Caucasian English-speaking patients with type 2 diabetes mellitus: a qualitative comparative study

OBJECTIVE: The objective of this study was to explore the decision-making processes and associated barriers and enablers that determine access and use of healthcare services in Arabic-speaking and English-speaking Caucasian patients with diabetes in Australia. STUDY SETTING AND DESIGN: Face-to-face semistructured individual interviews and group interviews were conducted at various healthcare settings-diabetes outpatient clinics in 2 tertiary referral hospitals, 6 primary care practices and 10 community centres in Melbourne, Australia. PARTICIPANTS: A total of 100 participants with type 2 diabetes mellitus were recruited into 2 groups: 60 Arabic-speaking and 40 English-speaking Caucasian. DATA COLLECTION: Interviews were audio-taped, translated into English when necessary, transcribed and coded thematically. Sociodemographic and clinical information was gathered using a self-completed questionnaire and medical records. PRINCIPAL FINDINGS: Only Arabic-speaking migrants intentionally delayed access to healthcare services when obvious signs of diabetes were experienced, missing opportunities to detect diabetes at an early stage. Four major barriers and enablers to healthcare access and use were identified: influence of significant other(s), unique sociocultural and religious beliefs, experiences with healthcare providers and lack of knowledge about healthcare services. Compared with Arabic-speaking migrants, English-speaking participants had no reluctance to access and use medical services when signs of ill-health appeared; their treatment-seeking behaviours were straightforward. CONCLUSIONS: Arabic-speaking migrants appear to intentionally delay access to medical services even when symptomatic. Four barriers to health services access have been identified. Tailored interventions must be developed for Arabic-speaking migrants to improve access to available health services, facilitate timely diagnosis of diabetes and ultimately to improve glycaemic control.

Risk factors and presence of antibodies to Brucella canis and smooth Brucella in dogs from the municipality of Araguaina, Tocantins, Brazil

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Evaluating the prevalence, content and readability of complementary and alternative medicine (CAM) web pages on the internet.

Complementary and alternative medicine (CAM) use is growing rapidly. As CAM is relatively unregulated, it is important to evaluate the type and availability of CAM information. The goal of this study is to deter-mine the prevalence, content and readability of online CAM information based on searches for arthritis, diabetes and fibromyalgia using four common search engines. Fifty-eight of 599 web pages retrieved by a "condition search" (9.6%) were CAM-oriented. Of 216 CAM pages found by the "condition" and "condition + herbs" searches, 78% were authored by commercial organizations, whose pur-pose involved commerce 69% of the time and 52.3% had no references. Although 98% of the CAM information was intended for consumers, the mean read-ability was at grade level 11. We conclude that consumers searching the web for health information are likely to encounter consumer-oriented CAM advertising, which is difficult to read and is not supported by the conventional literature.

Improving availability of mobile networks using a cluster routing protocol with redundant cluster head

We show a cluster based routing protocol in order to improve the convergence of the clusters and of the network it is proposed to use a backup cluster head. The use of a event discrete simulator is used for the implementation and the simulation of a hierarchical routing protocol called the Backup Cluster Head Protocol (BCHP). Finally it is shown that the BCHP protocol improves the convergence and availability of the network through a comparative analysis with the Ad Hoc On Demand Distance Vector (AODV)[1] routing protocol and Cluster Based Routing Protocol (CBRP)[2]

A metasynthesis of qualitative studies regarding opinions and perceptions about barriers and determinants of health services’ accessibility in economic migrants

Background: Access to health services is an important health determinant. New research in health equity is required, especially amongst economic migrants from developing countries. Studies conducted on the use of health services by migrant populations highlight existing gaps in understanding which factors affect access to these services from a qualitative perspective. We aim to describe the views of the migrants regarding barriers and determinants of access to health services in the international literature (1997–2011). Methods: A systematic review was conducted for Qualitative research papers (English/Spanish) published in 13 electronic databases. A selection of articles that accomplished the inclusion criteria and a quality evaluation of the studies were carried out. The findings of the selected studies were synthesised by means of metasynthesis using different analysis categories according to Andersen’s conceptual framework of access and use of health services and by incorporating other emergent categories. Results: We located 3,025 titles, 36 studies achieved the inclusion criteria. After quality evaluation, 28 articles were definitively synthesised. 12 studies (46.2%) were carried out in the U.S and 11 studies (42.3%) dealt with primary care services. The participating population varied depending mainly on type of host country. Barriers were described, such as the lack of communication between health services providers and migrants, due to idiomatic difficulties and cultural differences. Other barriers were linked to the economic system, the health service characteristics and the legislation in each country. This situation has consequences for the lack of health control by migrants and their social vulnerability. Conclusions: Economic migrants faced individual and structural barriers to the health services in host countries, especially those with undocumented situation and those experimented idiomatic difficulties. Strategies to improve the structures of health systems and social policies are needed.

Selection and application of risk management tools and techniques for build-operate-transfer projects

Construction projects are risky. However, the characteristics of the risk highly depend on the type of procurement being adopted for managing the project. A build-operate-transfer (BOT) project is recognized as one of the most risky project schemes. There are instances of project failure where a BOT scheme was employed. Ineffective rts are increasingly being managed using various risk management tools and techniques. However, application of those tools depends on the nature of the project, organization's policy, project management strategy, risk attitude of the project team members, and availability of the resources. Understanding of the contents and contexts of BOT projects, together with a thorough understanding of risk management tools and techniques, helps select processes of risk management for effective project implementation in a BOT scheme. This paper studies application of risk management tools and techniques in BOT projects through reviews of relevant literatures and develops a model for selecting risk management process for BOT projects. The application to BOT projects is considered from the viewpoints of the major project participants. Discussion is also made with regard to political risks. This study would contribute to the establishment of a framework for systematic risk management in BOT projects.

Analysis of the corporate political activity of major food industry actors in Fiji

BACKGROUND: Non-communicable diseases (NCDs) are the leading cause of mortality in Fiji, a middle-income country in the Pacific. Some food products processed sold and marketed by the food industry are major contributors to the NCD epidemic, and the food industry is widely identified as having strong economic and political power. However, little research has been undertaken on the attempts by the food industry to influence public health-related policies and programs in its favour. The "corporate political activity" (CPA) of the food industry includes six strategies (information and messaging; financial incentives; constituency building; legal strategies; policy substitution; opposition fragmentation and destabilisation). For this study, we aimed to gain a detailed understanding of the CPA strategies and practices of major food industry actors in Fiji, interpreted through a public health lens.

METHODS AND RESULTS: We implemented a systematic approach to monitor the CPA of the food industry in Fiji for three months. It consisted of document analysis of relevant publicly available information. In parallel, we conducted semi-structured interviews with 10 stakeholders involved in diet- and/or public health-related issues in Fiji. Both components of the study were thematically analysed. We found evidence that the food industry adopted a diverse range of strategies in an attempt to influence public policy in Fiji, with all six CPA strategies identified. Participants identified that there is a substantial risk that the widespread CPA of the food industry could undermine efforts to address NCDs in Fiji.

CONCLUSIONS: Despite limited public disclosure of information, such as data related to food industry donations to political parties and lobbying, we were able to identify many CPA practices used by the food industry in Fiji. Greater transparency from the food industry and the government would help strengthen efforts to increase their accountability and support NCD prevention. In other low- and middle-income countries, it is likely that a systematic document analysis approach would also need to be supplemented with key informant interviews to gain insight into this important influence on NCD prevention.

Análise da atenção prestada aos pacientes portadores de hipertensão arterial no município de Piraí com bases nos registros dos prontuários ambulatoriais e hospitalares

O controle da Hipertensão Arterial é central para que seja alcançada maior eficiência na redução de eventos adversos secundários ao descontrole crônico da pressão arterial. Os resultados de uma atenção integral aos portadores não se esgotam no acesso e disponibilização de fármacos eficazes no controle da pressão arterial. Ela envolve a rede integrada de serviços, orientada pela atenção primária, com serviços especializados e hospitalares na atenção das intercorrências. O cuidado aos portadores destes agravos crônicos exige dos serviços e profissionais da atenção primária a implantação de estratégias de acolhimento, efetivação de vínculos e projetos terapêuticos e uma intervenção que abrange a promoção, prevenção, assistência e reabilitação. Com esta questão em mente é que este projeto buscou analisar a atenção prestada aos portadores de Hipertensão Arterial no município de Piraí com base nos registros dos prontuários ambulatoriais e hospitalares. Foram computados e analisados os prontuários de pacientes internados por agravos que, direta ou indiretamente, estão relacionados ao descontrole da pressão arterial. Identificaram-se um total de 61 pacientes internados com diagnóstico de internação de Crise Hipertensiva e Acidente Vascular Encefálico no ano de 2010, no Hospital Flávio Leal. A partir dos registros hospitalares foram selecionados 35 pacientes. Estes eram moradores do município de Piraí, adscritos a equipes básicas no município e tiveram seus diagnósticos de internação confirmados na alta hospitalar. A segunda etapa do estudo analisou, na Unidade de Saúde da Família, os prontuários familiares dos casos de internação. Foi observado que não havia uniformidade na forma de registro e de arquivamento dos prontuários entre as unidades básicas. Nos prontuários clínicos não havia campos destinados aos registros de aspectos psicossociais, mudança de comportamento ou adesão. As anotações eram centradas na doença e nos tratamentos farmacológicos. A participação de profissionais não médicos nos registros clínicos era escassa. A Ficha B do SIAB (Ficha de Acompanhamento do Paciente Hipertenso) que contém os dados sobre comportamento e risco cardiovascular foi encontrada apenas em 3 das 8 unidades visitadas. Segundo os dados dos prontuários analisados a distribuição de consultas e visitas domiciliares foi muito irregular. Com um total de 10 prontuários sem registros de consultas no ano em que o pacientes foi internado. A gravidade dos pacientes internados pode ser identificada pelo elevado número de óbitos entre os casos analisados. Muitos dos casos apresentavam sequelas neurológicas e comorbidades que provavelmente dificultava suas idas às unidades de saúde da família. Aspectos psicossociais, familiares e da comunidade estavam, em sua maioria, ausente dos prontuários familiares analisados dos pacientes internados. Também não foram encontrados anotações sobre projetos terapêuticos multidisciplinares que individualizassem e hierarquizassem os agravos e os riscos físicos e psicossociais dos pacientes. A análise evidencia que os registros nos prontuários não traduzem a abrangência de uma atenção integral aos portadores de Hipertensão Arterial no âmbito da Atenção Primária.

Inteligência competitiva como estratégia para serviços de informação: monitoramento web de bibliotecas especializadas na área de química

O presente trabalho tem como objetivo mostrar como as técnicas da Inteligência Competitiva podem ser adaptadas para o ambiente de serviços de informação, apresentando um projeto de monitoramento web de bibliotecas universitárias especializadas na ár ea de Química como estratégia para a melhoria contínua desses ser viços, através da comparação de serviços de informação análogos, selecionados entre as quatro primeiras instituições classificadas no Webometrics - Ranking Web of World Universities , fornecendo dados para o incremento e atualização dos conteúdos informaciona is disponíveis na página virtual de bibliotecas dessa área, melhorando seu acesso e dis ponibilização de informação, bem como contribuindo para a maximização da visibilidade e a valiação da instituição universitária. Palavras-Chave: Inteligência Competitiva, Monitoramento Web, Bibli otecas Universitárias e especializadas, Página Virtual, Serviços de Informa ção

La gestión de la sequía: contribuciones para su evaluación

La sequía afecta a todos los sectores de la sociedad y se espera que su frecuencia e intensidad aumente debido al cambio climático. Su gestión plantea importantes retos en el futuro. El enfoque de riesgo, que promueve una respuesta proactiva, se identifica como un marco de gestión apropiado que se está empezando a consolidar a nivel internacional. Sin embargo, es necesario contar con estudios sobre las características de la gestión de la sequía bajo este enfoque y sus implicaciones en la práctica. En esta tesis se evalúan diversos elementos que son relevantes para la gestión de la sequía, desde diferentes perspectivas, con especial énfasis en el componente social de la sequía. Para esta investigación se han desarrollado cinco estudios: (1) un análisis de las leyes de emergencia aprobadas durante la sequía 2005-2008 en España; (2) un estudio sobre la percepción de la sequía de los agricultores a nivel local; (3) una evaluación de las características y enfoque de gestión en seis casos de estudio a nivel europeo; (4) un análisis sistemático de los estudios de cuantificación de la vulnerabilidad a la sequía a nivel global; y (5) un análisis de los impactos de la sequía a partir en una base de datos europea. Los estudios muestran la importancia de la capacidad institucional como un factor que promueve y facilita la adopción del enfoque de riesgo. Al mismo tiempo, la falta de estudios de vulnerabilidad, el escaso conocimiento de los impactos y una escasa cultura de la evaluación post-sequía destacan como importantes limitantes para aprovechar el conocimiento que se genera en la gestión de un evento. A través del estudio de las leyes de sequía se evidencia la existencia de incoherencias entre cómo se define el problema de la sequía y las soluciones que se plantean, así como el uso de un discurso de securitización para perseguir objetivos más allá de la gestión de la sequía. El estudio de percepción permite identificar la existencia de diferentes problemas y percepciones de la sequía y muestra cómo los regantes utilizan principalmente los impactos para identificar y caracterizar la severidad de un evento, lo cual difiere de las definiciones predominantes a otros niveles de gestión. Esto evidencia la importancia de considerar la diversidad de definiciones y percepciones en la gestión, para realizar una gestión más ajustada a las necesidades de los diferentes sectores y colectivos. El análisis de la gestión de la sequía en seis casos de estudio a nivel europeo ha permitido identificar diferentes niveles de adopción del enfoque de riesgo en la práctica. El marco de análisis establecido, que se basa en seis dimensiones de análisis y 21 criterios, ha resultado ser una herramienta útil para diagnosticar los elementos que funcionan y los que es necesario mejorar en relación a la gestión del riesgo a la sequía. El análisis sistemático de los estudios de vulnerabilidad ha evidenciado la heterogeneidad en los marcos conceptuales utilizados así como debilidades en los factores de vulnerabilidad que se suelen incluir, en muchos casos derivada de la falta de datos. El trabajo sistemático de recolección de información sobre impactos de la sequía ha evidenciado la escasez de información sobre el tema a nivel europeo y la importancia de la gestión de la información. La base de datos de impactos desarrollada tiene un gran potencial como herramienta exploratoria y orientativa del tipo de impactos que produce la sequía en cada región, pero todavía presenta algunos retos respecto a su contenido, proceso de gestión y utilidad práctica. Existen importantes limitaciones vinculadas con el acceso y la disponibilidad de información y datos relevantes vinculados con la gestión de la sequía y todos sus componentes. La participación, los niveles de gestión, la perspectiva sectorial y las relaciones entre los componentes de gestión del riesgo considerados constituyen aspectos críticos que es necesario mejorar en el futuro. Así, los cinco artículos en su conjunto presentan ejemplos concretos que ayudan a conocer mejor la gestión de la sequía y que pueden resultar de utilidad para políticos, gestores y usuarios. ABSTRACT Drought affects all sectors and their frequency and intensity is expected to increase due to climate change. Drought management poses significant challenges in the future. Undertaking a drought risk management approach promotes a proactive response, and it is starting to consolidate internationally. However, it is still necessary to conduct studies on the characteristics of drought risk management and its practical implications. This thesis provides an evaluation of various relevant aspects of drought management from different perspectives and with special emphasis on the social component of droughts. For the purpose of this research a number of five studies have been carried out: (1) analysis of the emergency laws adopted during the 2005-2008 drought in Spain; (2) study of farmers perception of drought at a local level; (3) assessment of the characteristics and drought management issues in six case studies across Europe; (4) systematic analysis of drought vulnerability assessments; and (5) analysis of drought impacts from an European impacts text-based database. The results show the importance of institutional capacity as a factor that promotes and facilitates the adoption of a risk approach. In contrast, the following issues are identified as the main obstacles to take advantage of the lessons learnt: (1) lack of vulnerability studies, (2) limited knowledge about the impact and (3) limited availability of post-drought assessments Drought emergency laws evidence the existence of inconsistencies between drought problem definition and the measures proposed as solutions. Moreover, the securitization of the discourse pursue goals beyond management drought. The perception of drought by farmers helps to identify the existence of several definitions of drought. It also highlights the importance of impacts in defining and characterizing the severity of an event. However, this definition differs from the one used at other institutional and management level. As a conclusion, this remarks the importance of considering the diversity of definitions and perceptions to better tailor drought management to the needs of different sectors and stakeholders. The analysis of drought management in six case studies across Europe show different levels of risk adoption approach in practice. The analytical framework proposed is based on six dimensions and 21 criteria. This method has proven to be a useful tool in diagnosing the elements that work and those that need to be improved in relation to drought risk management. The systematic analysis of vulnerability assessment studies demonstrates the heterogeneity of the conceptual frameworks used. Driven by the lack of relevant data, the studies point out significant weaknesses of the vulnerabilities factors that are typically included The heterogeneity of the impact data collected at European level to build the European Drought Impact Reports Database (EDII) highlights the importance of information management. The database has great potential as exploratory tool and provides indicative useful information of the type of impacts that occurred in a particular region. However, it still presents some challenges regarding their content, the process of data collection and management and its usefulness. There are significant limitations associated with the access and availability of relevant information and data related to drought management and its components. The following improvement areas on critical aspects have been identified for the near future: participation, levels of drought management, sectorial perspective and in-depth assessment of the relationships between the components of drought risk management The five articles presented in this dissertation provides concrete examples of drought management evaluation that help to better understand drought management from a risk-based perspective which can be useful for policy makers, managers and users.

CONTROL DOCUMENTAL SOBRE GRUPOS ÉTNICOS INDÍGENAS COSTARRICENSES: 1980-2003

En Costa Rica se ha hecho poco por realizar el control documental nacional sobre grupos étnicos indígenas, esto puede ser tipificado como una debilidad, dos obras son el universo de fuentes de referencia.La necesidad de contar con el control documental sobre/de grupos étnicos indígenas costarricenses entre 1980-2003, es el propósito que persiguió esta investigación, además brindar un aporte de valor histórico, cultural y científico a aquellas personas interesadas en la temática indígena costarricense.Este control documental pretende agrupar la temática en estudio de dicho período. Es importante mencionar que en Costa Rica existen controles documentales sobre otras temáticas, no así de la temática indígena.Este control facilitará el rescate de la cultura indígena costarricense, es un aporte al control documental nacional y universal, contiene documentos de los años comprendidos entre 1980-2003, el mismo es fundamental para el acceso y disponibilidad de la información que forma parte de la actividad propia del profesional en bibliotecología, el cual se realiza dé acuerdo con las normas y criterios establecidos a nivel nacional e internacional. Además servirá y contribuirá como antecedente para futuros controles documentales sobre esta temática.

Editorial

The continuous emergence of new scenarios that provide access and availability of information, promote synergies compared to the transfer of data, breaking the traditional schemes for the promotion of universal freedom and development of world democracy.

RISKS TO FOOD AVAILABILITY AND ACCESS FROM CLIMATE POLICIES: AN INTEGRATED ASSESSMENT OF REGIONAL FOOD AVAILABILITY AND ACCESS WITH ALTERNATIVE CLIMATE MITIGATION STRATEGIES TO 2050

Although mitigating GHG emissions is necessary to reduce the overall negative climate change impacts on crop yields and agricultural production, certain mitigation measures may generate unintended consequences to food availability and access due to land use competition and economic burden of mitigation. Prior studies have examined the co-impacts on food availability and global producer prices caused by alternative climate policies. More recent studies have looked at the reduction in total caloric intake driven by both changing income and changing food prices under one specific climate policy. However, due to inelastic calorie demand, consumers’ well-being are likely further reduced by increased food expenditures. Built upon existing literature, my dissertation explores how alternative climate policy designs might adversely affect both caloric intake and staple food budget share to 2050, by using the Global Change Assessment Model (GCAM) and a post-estimated metric of food availability and access (FAA). My dissertation first develop a set of new metrics and methods to explore new perspectives of food availability and access under new conditions. The FAA metric consists of two components, the fraction of GDP per capita spent on five categories of staple food and total caloric intake relative to a reference level. By testing the metric against alternate expectations of the future, it shows consistent results with previous studies that economic growth dominates the improvement of FAA. As we increase our ambition to achieve stringent climate targets, two policy conditions tend to have large impacts on FAA driven by competing land use and increasing food prices. Strict conservation policies leave the competition between bioenergy and agriculture production on existing commercial land, while pricing terrestrial carbon encourages large-scale afforestation. To avoid unintended outcomes to food availability and access for the poor, pricing land emissions in frontier forests has the advantage of selecting more productive land for agricultural activities compared to the full conservation approach, but the land carbon price should not be linked to the price of energy system emissions. These results are highly relevant to effective policy-making to reduce land use change emissions, such as the Reduced Emissions from Deforestation and Forest Degradation (REDD).