Breakfast in the Philippines: food and diet quality as analyzed from the 2018 Expanded National Nutrition Survey.

BACKGROUND: The quality of foods taken during breakfast could contribute in shaping diet quality. This study determined the regularity of breakfast consumption and breakfast quality based on the food, energy and nutrient intakes of Filipinos. MATERIALS AND METHODS: Data from the 2018 Expanded National Nutrition Survey (ENNS) was extracted for analysis. There were 63,655 individuals comprising about 14,013 school-aged children (6-12 years old), 9,082 adolescents (13-18 years old), 32,255 adults (19-59 years old), and 8,305 elderly (60 years old and above). Two-day non-consecutive 24-h food recalls were used to measure food and nutrient intakes. Diet quality was measured using Nutrient-Rich Food Index (NRF) 9.3. The sample was stratified by age group and NRF9.3 tertiles. RESULTS AND FINDINGS: Results showed that 96 - 98% Filipinos across age groups were consuming breakfast. Children age 6-12 years have the highest NRF9.3 average score (417), followed by the elderly (347), adolescents (340), and adults (330). These scores were very low in comparison with the maximum possible NRF score which is 900. The essential nutrient intakes of respondents were significantly higher among those with the healthiest breakfast diet (Tertile 3) compared to those with the poorest breakfast diet (Tertile 1). However, participants in the healthiest breakfast diet did not meet 20% of the recommendations for calcium, fiber, vitamin C, and potassium. CONCLUSION AND RECOMMENDATIONS: This study revealed that majority of the population are regular breakfast consumers. However, the breakfast consumed regularly by Filipinos were found to be nutritionally inadequate. And even those classified under Tertile 3 which were assumed as having a better quality of breakfast were still found to have nutrient inadequacies. Thus, the study suggests that Filipinos must consume a healthy breakfast by including nutrient-dense foods such as fruits, vegetables, whole grains, fresh meat, and milk to provide at least 20-25% of the daily energy and nutrient intakes.

Analysis of food sources and nutrient intakes of selected breastfeeding mothers in Metro Manila, Philippines.

BACKGROUND: This study evaluated the food and nutrient intakes of selected breastfeeding mothers and identified the top food sources of nutrient intakes. METHODS: This is a cross-sectional, non-interventional study conducted in one of the private medical centers in Metro Manila, Philippines. PARTICIPANTS: The sample size included 70 mothers of healthy, term, exclusively breastfed infants aged 21-26 days at enrollment. Mothers were scheduled to visit the clinic at days 1, 22, 57, and day 90.Similarly, food diaries were obtained during these periods with a 3-day food record per clinic visit totaling to 12 records per mother at the end of 90 days. At every clinic visit, the records were validated face - to - face by the registered nutritionist - dietitians. An extension of the mother's participation until day 155 was implemented for the collection of clinical outcomes used by Pediatricians. Mean food intakes were calculated. A PC-Software for Intake Distribution Estimation (PC-SIDE) program was used in the estimation of inadequate intakes. Socio-economic status was collected using standard questionnaires. Weight and height were measured using standard techniques to compute for BMI. RESULTS: Anthropometric results for the breastfeeding mothers reported a mean weight of 56.9 kg (SE = 1.3) and a mean height of 152.4 cm (SE = 0.6). In terms of body mass index (BMI), 8.6% were chronic energy deficient, and 34.3% were overweight while 12.9% were obese. Mean energy intake of breastfeeding mothers was 2516.7 kcal/day, which was 28.6% higher than the EER of 1957 kcal/day. Mean protein intake was 78.4 g/day, which was 37% inadequate while fat intake as percentage of total energy was excessive by 4%. Nutrient inadequacy is high for almost all nutrients: iron (99%), folate (96%), riboflavin (39%), vitamin B6 (63%), vitamin B12 (46%) and thiamine (22%). The top 5-food sources with highest percent contribution to energy are rice (43.1%), bread (8.1%), pork (7.7%), powdered milk (5.9%), and sweet bakery products (5%). CONCLUSIONS: There is a high prevalence of protein and micronutrient inadequacies in the diet of breastfeeding mothers. The prevalence of overweight and obesity is high among breastfeeding mothers. These findings might be explained by the low variety and nutrient-poor foods consumed by the breastfeeding mothers. Understanding the major food sources of nutrient intake of breastfeeding mothers could be used to intensify if not craft interventions to address the nutrient gaps. Improving the maternal nutrition may contribute to having quality breastmilk to infants.

Os desafios para o ensino de emergências de psiquiatria em desastres e conflitos armados / The challenges of Teaching Psychiatric Emergencies in situations of natural disasters and armed conflicts

Resumo: Introdução: A população moçambicana tem sido recorrentemente afectada por situações traumáticas devido a catástrofes naturais (ciclones, secas, inundações) ou provocadas pelo homem (conflitos armados), que podem levar ao desenvolvimento de perturbações mentais que, se não forem identificadas e tratadas, deixarão sequelas graves e causarão cronicidade. Objetivo: Este estudo teve como objetivo promover uma reflexão sobre a inclusão de temas psiquiátricos de emergência em desastres naturais e conflitos armados nas disciplinas ou módulos de psiquiatria, nos cursos de formação de graduação nas escolas médicas de Moçambique. Método: Trata-se de revisão narrativa da bibliografia, realizada entre abril e junho de 2021, com foco na pesquisa de artigos e documentos publicados nas plataformas virtuais Research4Life, PubMed, Hifa-pt e Google Scholar que abordam o tema desastres naturais e conflitos armados e seu ensino para estudantes de Medicina na disciplina de psiquiatria. Resultado: A inclusão das emergências psiquiátricas em desastres e conflitos armados no curso de Medicina pode proporcionar aos clínicos gerais que atuam na atenção primária à saúde conhecimentos e habilidades para que possam reconhecer emergências psiquiátricas causadas por desastres naturais e conflitos armados e trabalhar nelas, levando em consideração que o país atualmente tem poucos médicos especializados em psiquiatria. Conclusão: A adequada organização e assistência em emergências psiquiátricas à população exposta a desastres naturais e conflitos armados contribui para a resiliência e salvaguarda da saúde mental das comunidades. Neste ensaio, refletimos sobre o desafio de incorporar os temas das emergências psiquiátricas causadas pela exposição a desastres naturais e conflitos bélicos como contribuição para melhorar as habilidades dos médicos generalistas na resposta às demandas prementes de saúde mental dessa população vulnerável.

Abstract: Introduction: The Mozambican population has been recurrently affected by traumatic situations due to natural (cyclones, droughts, floods) or man-made (armed conflicts) catastrophes, which can lead to the development of mental disorders that, if not identified and treated, result in severe sequelae and cause chronicity. Objectives: To promote a reflection on the inclusion of emergency psychiatric topics in natural disasters and armed conflicts in the disciplines or modules of psychiatry in undergraduate medical school courses in Mozambique. Methods: Narrative literature review carried out between April and June 2021, focusing on the research of articles and documents published on the virtual platforms Research4life, PubMed, Hifa-PT, Google Scholar and that address the topics of natural disasters and armed conflicts and the teaching of these topics to medical students in the discipline of psychiatry. Results: The inclusion of psychiatric emergencies in situations of natural disasters and armed conflicts in the medical course can provide general practitioners who work in primary health care with knowledge and skills to recognize and act in psychiatric emergencies caused by natural disasters and armed conflicts, taking into account the fact that the country currently has few doctors specialized in psychiatry. Final considerations: The adequacy of the organization and assistance in psychiatric emergencies to the population exposed to natural disasters and armed conflicts contributes to the resilience and protection of the mental health of the communities. In this article, we reflect on the challenge of incorporating the topics of psychiatric emergencies caused by exposure to natural disasters and armed conflicts as a contribution to improving the skills of general practitioners in responding to the pressing mental health demands of this vulnerable population.

Food Sources and Nutrient Intakes of Filipino Working Adults.

Nutrition is an integral part of economic development, since it influences workers' healthand productivity. This study evaluated the usual nutrient intakes and food sources of workingadults. We conducted a cross-sectional survey that involved 1264 selected working adults aged 19to 59 years old from randomly selected job sectors. Quantitative dietary data was collected by a 2-day, non-consecutive 24 h recall, while a dietary diversity questionnaire was used to assess the typesand frequency of foods consumed. Physical activity was measured using the World HealthOrganization global physical assessment questionnaire. The prevalence of inadequate intakes,defined as the percentage of adults with intakes less than the estimated average requirements (EAR)or acceptable macronutrient distribution ranges (AMDR) were estimated using the PC-Softwarefor Intake Distribution Estimation (PC-SIDE) program. The mean daily energy intake of workingadults was 1768 kcal/day or 74% of the Estimated Energy Requirements (EER) for this age group.The percentage contribution to the total energy of fats (58%) and proteins (34%) were excessivelyhigh. Consumption of fruits and vegetables was only 30% and 40% of the recommended nutrientintake, respectively. Salt intake was 52% above the adequate intake. Nutrient inadequacy was highin almost all nutrients, including iron (99%), folate (97.9%), riboflavin (95.8%), calcium (94.7%),vitamin C (87.3%), and thiamin (76.6%). The top five food sources of energy included rice (35.6%),pork (15.1%), fats and oils (4.7%), chicken (4.4%), and bread (3.8%). Energy and nutrient intakes ofworking adults is extremely sub-optimal due to the consumption of few nutrient-dense foods. Thismay pose a triple burden of malnutrition if left unsolved.

Reliance on Facebook for news and its influence on political engagement.

This paper examines the link between reliance on Facebook for news, political knowledge, and political engagement in the Philippines. We tested five hypotheses using data gathered from an online survey of 978 Filipinos conducted from February 1 to March 31, 2016. Findings support the hypothesis that those who rely less on social media as a news source exhibit higher levels of perceived knowledge about politics than those who rely more on it for news. Controlling for traditional news use, following political officials or institutions on social media is associated with higher levels of political interest and engagement, those with more politically active friends on Facebook have higher levels of exposure to political content online, and there is a positive correlation between Facebook being a source of information about politics and discussing politics more often with others. However, the hypothesis that those with more friends on their network who are politically active, will have greater political knowledge and more political engagement than those who have few politically active friends on their Facebook network is not supported.

Density of convex intersections and applications.

In this paper, we address density properties of intersections of convex sets in several function spaces. Using the concept of Γ-convergence, it is shown in a general framework, how these density issues naturally arise from the regularization, discretization or dualization of constrained optimization problems and from perturbed variational inequalities. A variety of density results (and counterexamples) for pointwise constraints in Sobolev spaces are presented and the corresponding regularity requirements on the upper bound are identified. The results are further discussed in the context of finite-element discretizations of sets associated with convex constraints. Finally, two applications are provided, which include elasto-plasticity and image restoration problems.

Randomised phase II trial of gemcitabine plus vinorelbine vs gemcitabine plus cisplatin vs gemcitabine plus capecitabine in patients with pretreated metastatic breast cancer.

BACKGROUND: An increasing proportion of patients are exposed to anthracyclines and/or taxanes in the adjuvant or neoadjuvant setting. Re-exposure in the metastatic stage is limited by drug resistance, thus evaluation of non-cross-resistant regimens is mandatory. METHODS: Anthracycline-pretreated patients were randomly assigned to three gemcitabine-based regimens. Chemotherapy consisted of gemcitabine 1.000 mg m(-2) plus vinorelbin 25 mg m(-2) on days 1+8 (GemVin), or plus cisplatin 30 mg m(-2) on days 1+8 (GemCis), or plus capecitabine 650 mg m(-2) b.i.d. orally days 1-14 (GemCap), q3w. The primary end point was response rate. RESULTS: A total of 141 patients were recruited on the trial. The overall response rates were 39.0% (GemVin), 47.7% (GemCis) and 34.7% (GemCap). Median progression-free survival was estimated with 5.7, 6.9 and 8.3 months, respectively. Corresponding median survival times were 17.5 (GemVin), 13.0 (GemCis) and 19.4 months (GemCap). Neutropenia ≥grade 3 occurred in 16.7% (Gem/Vin), 4.4% (GemCis) and 0% (Gem/Cap), whereas non-haematological toxicities were rarely severe except grade 3 hand-foot syndrome in 2.0% of the GemCap patients (per patient analysis). CONCLUSIONS: This randomised phase II trial has revealed comparable results for three gemcitabine-based regimens regarding treatment efficacy and toxicity. Gemcitabine-based chemotherapy appears to be a worthwhile treatment option for pretreated patients with metastatic breast cancer.

Peanut agglutinin (PNA) binding sites: a useful marker for hormonal dependence in experimental breast cancer.

Histochemical studies were performed with the labeled lectin from Arachis hypogaea (peanut agglutinin, PNA) to detect the occurrence, distribution, and amount of this lectin receptor in N-nitrosomethylurea-induced rat mammary carcinomas. Since in normal rat mammary tissue, the formation and secretion of PNA binding sites are controlled by the combined action of estrogen and prolactin, the amount of secretion-associated PNA binding sites was correlated with tumor response to either ovariectomy or antiestrogenic treatment with tamoxifen. Free as well as sialic acid-substituted PNA binding sites which were represented by the disaccharide beta-D-Gal(1-3)NAcGal occurred in the apical cytoplasm of tumor cells and within the secretions of acinar and tubular structures. In contrast the whole tumor cell membrane contained predominantly sialic acid-substituted PNA binding sites. All of the tumors investigated contained some secretion-associated PNA binding sites. The values showed a continuum from very low to very high amounts. The number of PNA binding sites associated with secretory activity was lower in hormone-independent than in hormone-dependent tumors. Furthermore, there was an inverse relationship between mitotic and secretory activities with positive PNA staining. In conclusion, these studies revealed that the secretory PNA index, mitotic index, and especially the ratio of secretory PNA index to mitotic index represent useful parameters to select tumors for endocrine therapy in this experimental model.