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1.
Int J Biol Macromol ; 158: 318-326, 2020 Apr 28.
Artigo em Inglês | MEDLINE | ID: mdl-32353500

RESUMO

The present study is first of its kind that focuses upon the extraction of bromelain from pineapple core waste and stabilising it as insoluble cross-linked aggregates. The influence of process variables such as the choice of precipitant, type of cross-linker, concentration of cross-linker and the reaction time for cross-linking step was investigated upon the activity recovery of bromelain cross-linked aggregates. The optimization of this biocatalyst preparation specifically recovered 87% of the enzymatic activity available in pineapple core waste by ammonium sulphate (60%, w/v) precipitation followed by cross-linking for 4 h with 80 mM glutaraldehyde. Cross-linked bromelain aggregates were thermally more stable and exhibited higher pH stability in comparison to free bromelain. The cross-linked bromelain aggregates exhibited higher operational stability in different organic solvents at 4 °C. The highest operational stability (% stability given in parenthesis) was observed in acetone (100%) followed by hexane (53.6%), ethyl acetate (39.6%), ethanol (32.5%) and chloroform (14.9%). The kinetic studies revealed higher Km value (5.45 mM) after the formation of cross-linked bromelain aggregates as compared to free bromelain (5.04 mM) with almost similar Vmax values. Cross-linked bromelain aggregates also showed significant reusability characteristics with an activity retention of >85% after 5-time cycles. Such recyclability of bromelain cross-linked aggregates could lead to potential industrial applications in both food and non-food sector. In addition, the present extraction method avoids costs related to purification and expensive immobilization carriers.

2.
PLoS One ; 15(4): e0230978, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32236145

RESUMO

BACKGROUND: Acute respiratory infection (ARI) and diarrhoea are the leading causes of childhood morbidity and mortality in Ethiopia. Understanding the associations between infant and young child feeding (IYCF) and ARI and diarrhoea can inform IYCF policy interventions and advocacy in Ethiopia. This study aimed to investigate the relationship between IYCF practices and ARI and diarrhoea in Ethiopian children. METHODS: This study used the Ethiopia Demographic and Health Survey (EDHS) data for the years 2000 (n = 3680), 2005 (n = 3528), 2011 (n = 4037), and 2016 (n = 3861). The association between IYCF practices and (i) ARI and (ii) diarrhoea were investigated using propensity score matching and multivariable logistic regression models. The IYCF practices include early initiation of breastfeeding, exclusive breastfeeding (EBF), predominant breastfeeding, introduction of complementary foods, continued breastfeeding at two years and bottle feeding. RESULTS: Infants and young children who were breastfed within 1-hour of birth and those who were exclusively breastfed had a lower prevalence of ARI. Infants who were exclusively and predominantly breastfed had a lower prevalence of diarrhoea. Early initiation of breastfeeding (Odds ratio [OR]: 0.81; 95% confidence interval [CI]: 0.72, 0.92) and EBF (OR: 0.65; 95% CI: 0.51, 0.83) were associated with lower risk of ARI. Bottle-fed children had higher odds of ARI (OR: 1.36; 95% CI: 1.10, 1.68). Early initiation of breastfeeding and EBF were associated with lower odds of diarrhoea (OR: 0.88; 95% CI: 0.79, 0.94 for Early initiation of breastfeeding and OR: 0.51; 95% CI: 0.39, 0.65 for EBF). Infants who were predominantly breastfed were less likely to experience diarrhoea (OR: 0.69; 95% CI: 0.53, 0.89). CONCLUSION: The recommended best practices for preventing ARI and diarrhoeal diseases in infants and young children namely: the early initiation of breastfeeding, EBF and avoidance of bottle feeding should be institutionalized and scale-up in Ethiopia as part of implementation science approach to cover the know-do-gaps.

3.
Nutr J ; 19(1): 16, 2020 02 18.
Artigo em Inglês | MEDLINE | ID: mdl-32070350

RESUMO

OBJECTIVE: The purpose of this study was to examine the timing of introduction of complementary (solid) foods among infants in South Western Sydney, Australia, and describe the maternal and infant characteristics associated with very early introduction of solids. METHODS: Mother-infant dyads (n = 1035) were recruited into the "Healthy Smiles Healthy Kids" study by Child and Family Health Nurses at the first post-natal home visit. Data collected via telephone interviews at 8, 17, 34 and 52 weeks postpartum included timing of introduction of solids and a variety of maternal and infant characteristics (n = 934). Multiple logistic regression was used to identify factors independently associated with the risk of introducing solids very early, which for the purpose of this study was defined as being before 17 weeks. RESULTS: The median age of introduction of solids was 22 weeks. In total, 13.6% (n = 127) of infants had received solids before 17 weeks and 76.9% (n = 719) before 26 weeks of age. The practice of introducing solids early decreased with older age of the mother. Compared to women < 25 years of age, those who were 35 years or older were 72% less likely to introduce solids very early (OR = 0.28, CI95 0.14-0.58). Single mothers had more than twice the odds of introducing solids before the age of 17 weeks compared to married women (OR = 2.35, CI95 1.33-4.16). Women who had returned to work between 6 to 12 months postpartum were 46% less likely to introduce solids very early compared with those who were not working at the child's first birthday (OR = 0.54, CI95 0.30-0.97). Women born in Vietnam and Indian sub-continent had lower odds of introducing solids very early compared to Australian born women (OR = 0.42, CI95 0.21-0.84 and OR = 0.30, CI95 0.12-0.79, respectively). Infants who were exclusively formula-fed at 4 weeks postpartum had more than twice the odds of receiving solids very early (OR = 2.34, CI95 1.49-3.66). CONCLUSIONS: Women who are younger, single mothers, those not working by the time of child's first birthday, those born in Australia, and those who exclusively formula-feed their babies at 4 weeks postpartum should be targeted for health promotion programs that aim to delay the introduction of solids in infants to the recommended time.

4.
BMC Fam Pract ; 21(1): 34, 2020 02 13.
Artigo em Inglês | MEDLINE | ID: mdl-32054440

RESUMO

BACKGROUND: Poorly controlled diabetes leads to multiple complications including oral health problems. General practitioners (GPs) are at the forefront of management of chronic diseases in primary health care. Diabetes guidelines encourage a proactive role for GPs in oral health complications management in people with diabetes, yet little is known about this area of care. This study aimed to explore current practices, perceptions and barriers of GPs towards oral health care for people with diabetes. METHODS: We employed a qualitative research method utilising telephone interviews. Purposive and snowball sampling were used to recruit 12 GPs from Greater Sydney region. A thematic analysis involving an inductive approach was used to identify and analyse contextual patterns and themes. RESULTS: A majority of participants were males (n = 10), working in group practices (n = 11) with a mean ± SD age of 55 ± 11.4 years and 25 ± 13.6 years work experience. Three major themes emerged: oral health care practices in general practice settings; barriers and enablers to oral health care; and role of diabetes care providers in promoting oral health. Most GPs acknowledged the importance of oral health care for people with diabetes, identifying their compromised immune capacity and greater risks of infections as risk factors. GPs reported 20-30% of their patients having oral health problems, however their current oral health care practices relating to education, risk assessment and referrals were reported as very limited. GPs identified several barriers including time constraints, absence of referral pathways, and limited knowledge and training in promoting oral health care. They also reported patient barriers including oral health care costs and lower oral health awareness. GPs perceived that resources such as education/training, a standardised assessment tool and patient education materials could support them in promoting oral health care. GPs also perceived that other diabetes care providers such as diabetes educators could play an important role in promoting oral health. CONCLUSIONS: Despite current recommendations, GPs' current oral health care practices among people with diabetes are limited. Further strategies including capacity building GPs by developing appropriate oral health training programs and simple risk assessment tools along with accessible referral pathways are needed to address the current barriers.

5.
Inj Prev ; 2020 Jan 08.
Artigo em Inglês | MEDLINE | ID: mdl-31915273

RESUMO

BACKGROUND: The epidemiological transition of non-communicable diseases replacing infectious diseases as the main contributors to disease burden has been well documented in global health literature. Less focus, however, has been given to the relationship between sociodemographic changes and injury. The aim of this study was to examine the association between disability-adjusted life years (DALYs) from injury for 195 countries and territories at different levels along the development spectrum between 1990 and 2017 based on the Global Burden of Disease (GBD) 2017 estimates. METHODS: Injury mortality was estimated using the GBD mortality database, corrections for garbage coding and CODEm-the cause of death ensemble modelling tool. Morbidity estimation was based on surveys and inpatient and outpatient data sets for 30 cause-of-injury with 47 nature-of-injury categories each. The Socio-demographic Index (SDI) is a composite indicator that includes lagged income per capita, average educational attainment over age 15 years and total fertility rate. RESULTS: For many causes of injury, age-standardised DALY rates declined with increasing SDI, although road injury, interpersonal violence and self-harm did not follow this pattern. Particularly for self-harm opposing patterns were observed in regions with similar SDI levels. For road injuries, this effect was less pronounced. CONCLUSIONS: The overall global pattern is that of declining injury burden with increasing SDI. However, not all injuries follow this pattern, which suggests multiple underlying mechanisms influencing injury DALYs. There is a need for a detailed understanding of these patterns to help to inform national and global efforts to address injury-related health outcomes across the development spectrum.

6.
Artigo em Inglês | MEDLINE | ID: mdl-31916850

RESUMO

RATIONALE: Limited information is available on racial/ethnic differences in pulmonary arterial hypertension (PAH). OBJECTIVES: Determine effects of race/ethnicity and ancestry on mortality and disease outcomes in diverse patients with PAH. METHODS: Group 1 PAH patients were included from two national registries with genome-wide data and two local cohorts and further incorporated in a global meta-analysis. Hazard ratios (HRs) were calculated for transplant-free all-cause mortality in Hispanics with Non-Hispanic whites (NHWs) as the reference group. Odds ratios (ORs) for inpatient-specific mortality in PAH patients were also calculated for race/ethnic groups from an additional National Inpatient Sample (NIS) dataset, not included in the meta-analysis. MEASUREMENTS AND MAIN RESULTS: After covariate adjustment, self-reported Hispanics (n=290) exhibited significantly reduced mortality versus NHWs (n=1970) after global meta-analysis (HR 0.60[0.41-0.87], p=0.008). Although not significant, increasing Native American genetic ancestry appeared to account for part of the observed mortality benefit (HR 0.48[0.23-1.01], p=0.053) in the two national registries. Finally, in the NIS, an inpatient mortality benefit was also observed for Hispanics (n=1524) versus NHWs (n=8829; OR 0.65[0.50-0.84], p=0.001). An inpatient mortality benefit was observed for Native Americans (n=185; OR 0.38[0.15-0.93], p=0.034). CONCLUSIONS: This study demonstrates a reproducible survival benefit for Hispanic Group 1 PAH patients in multiple clinical settings. Our results implicate contributions of genetic ancestry to differential survival in PAH.

7.
Nutrients ; 12(1)2020 Jan 19.
Artigo em Inglês | MEDLINE | ID: mdl-31963864

RESUMO

Early introduction of complementary foods can have a detrimental impact on children's long-term health. This study examined the timing and determinants of early introduction of core and discretionary foods among infants in Sydney, Australia. Mothers (n = 1035) from an ongoing population-based birth cohort study were interviewed at 8, 17, 34 and 52 weeks postpartum. The outcome was 'age at which particular core and discretionary food items were first introduced'. Multivariable logistic regression models were used to investigate family and infant-related determinants of early introduction of core (<17 weeks of age) and discretionary foods (<52 weeks of age). Of the 934 mother-infant dyads interviewed, 12% (n = 113) of infants were introduced core foods before 17 weeks of age (median: 22). Mothers working part-time (adjusted odds ratio (OR): 3.42, 95% confidence interval (CI): 1.54-7.62) and those exclusively formula-feeding their babies at four-weeks postpartum (adjusted OR 3.26, 95% CI: 1.99-5.33) were most likely to introduce core foods early. Ninety-five percent (n = 858) of infants were introduced discretionary foods before 52 weeks of age (median: 28). Low socio-economic status was significantly associated with early introduction of discretionary foods (adjusted OR: 3.72, 95% CI: 1.17-11.78). Compliance with infant feeding guidelines related to core foods was better; however, discretionary foods were introduced early in most infants.

8.
Inj Prev ; 2020 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-31941758

RESUMO

BACKGROUND: Falls can lead to severe health loss including death. Past research has shown that falls are an important cause of death and disability worldwide. The Global Burden of Disease Study 2017 (GBD 2017) provides a comprehensive assessment of morbidity and mortality from falls. METHODS: Estimates for mortality, years of life lost (YLLs), incidence, prevalence, years lived with disability (YLDs) and disability-adjusted life years (DALYs) were produced for 195 countries and territories from 1990 to 2017 for all ages using the GBD 2017 framework. Distributions of the bodily injury (eg, hip fracture) were estimated using hospital records. RESULTS: Globally, the age-standardised incidence of falls was 2238 (1990-2532) per 100 000 in 2017, representing a decline of 3.7% (7.4 to 0.3) from 1990 to 2017. Age-standardised prevalence was 5186 (4622-5849) per 100 000 in 2017, representing a decline of 6.5% (7.6 to 5.4) from 1990 to 2017. Age-standardised mortality rate was 9.2 (8.5-9.8) per 100 000 which equated to 695 771 (644 927-741 720) deaths in 2017. Globally, falls resulted in 16 688 088 (15 101 897-17 636 830) YLLs, 19 252 699 (13 725 429-26 140 433) YLDs and 35 940 787 (30 185 695-42 903 289) DALYs across all ages. The most common injury sustained by fall victims is fracture of patella, tibia or fibula, or ankle. Globally, age-specific YLD rates increased with age. CONCLUSIONS: This study shows that the burden of falls is substantial. Investing in further research, fall prevention strategies and access to care is critical.

9.
BMC Oral Health ; 20(1): 11, 2020 Jan 14.
Artigo em Inglês | MEDLINE | ID: mdl-31937284

RESUMO

BACKGROUND: Despite great improvement in child oral health, some children subgroups still suffer from higher levels of dental caries. Geographic and socioeconomic barriers and the lack of access to dental care services are among common reasons for poor oral health in children. Historically in Australia, oral health therapists or dental therapists have been responsible for providing dental care for school children through the School Dental Services (SDS). The current SDS has been unable to provide sustainable dental care to all school children due to a reduction in workforce participation and limited resources. We propose a paradigm shift in the current service through the introduction of user-friendly technology to provide a foundation for sustainable dental care for school children. METHODS/DESIGN: We describe an ongoing parallel, two-armed, non-inferiority randomised controlled trial that compares routine and teledental pathway of dental care in children aged 4-15 years (n = 250). Participating schools in Western Australia will be randomly assigned to the control or teledental group, approximately three schools in each group with a maximum of 45 children in each school. All participants will first receive a standard dental examination to identify those who require urgent referrals and then their teeth will be photographed using a smartphone camera. At the baseline, children in the control group will receive screening results and advice on the pathway of dental care based on the visual dental screening while children in the teledental group will receive screening results based on the assessment of dental images. At 9 months follow-up, all participants will undergo a final visual dental screening. The primary outcomes include decay experience and proportion of children become caries active. The secondary outcomes include the diagnostic performance of photographic dental assessment and costs comparison of two pathways of dental care. DISCUSSION: The current project seeks to take advantage of mobile technology to acquire dental images from a child's mouth at school settings and forwarding images electronically to an offsite dental practitioner to assess and prepare dental recommendations remotely. Such an approach will help to prioritise high-risk children and provide them with a quick treatment pathway and avoid unnecessary referrals or travel. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry, ACTRN12619001233112. Registered 06 September 2019.

10.
JBI Database System Rev Implement Rep ; 18(1): 135-145, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31385935

RESUMO

OBJECTIVE: The objectives of this review are to examine whether overweight/obese children experience more dental caries compared with non-overweight/non-obese children, and to identify common risk factors associated with both conditions. INTRODUCTION: Systematic reviews have shown that any evidence on a link between overweight and/or obesity and dental caries remains inconclusive. This relationship has not been assessed for children under six years of age with primary dentition. Therefore, an updated systematic review of this topic is necessary as its findings will be important for young children, clinicians, researchers and policy makers. INCLUSION CRITERIA: Studies examining children under six years of age and with complete primary dentition at the time of dental caries assessment will be included. The exposure of interest is the overweight and/or obesity status of children under six years of age. The outcome is dental caries in children with complete primary dentition. There will be no restriction on setting, date or language. METHODS: MEDLINE, Web of Science, Cochrane Central Register of Controlled Trials, Embase, PsycINFO, ProQuest Central, Scopus, CINAHL, and Google Scholar will be searched for eligible studies. The electronic database search will be supplemented by OpenGrey and Grey Literature Report databases, ProQuest Dissertations and Theses Global, and the International Association for Dental Research conference websites. Two reviewers will independently screen and select studies, assess methodological quality and extract data. Meta-analysis will be performed, if possible, and the Grading of Recommendations Assessment Development and Evaluation (GRADE) Summary of Findings presented. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42018085292.

11.
Obes Rev ; 21(3): e12960, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31721413

RESUMO

Obesity and dental caries in children are significant health problems. The aims of this review are to identify whether children aged 6 years and younger with overweight and/or obesity have higher dental caries experience compared with children with normal weight and, secondly, to identify the common risk factors associated with both conditions. Medline, Embase, and seven other databases were systematically searched followed by lateral searches from reference lists, grey literature, theses, conference proceedings, and contacting field experts. Longitudinal observational studies addressing overweight and/or obesity and dental caries in children aged 6 years and younger were included. A random effects model meta-analyses were applied. Nine studies were included in this review. Children with overweight and obesity had a significantly higher dental caries experience compared with children with normal weight (n = 6). The pooled estimates showed that difference in caries experience between the two groups was statistically significant. Low levels of parental income and education were identified to be associated with both conditions in the sample population. Children with overweight and obesity are more vulnerable to dental caries. Low levels of parental income and education influence the relationship between the two conditions. However, the quality of evidence varied considerably; therefore, findings should be interpreted cautiously.

12.
Matern Child Nutr ; : e12926, 2019 Dec 12.
Artigo em Inglês | MEDLINE | ID: mdl-31833239

RESUMO

Introducing appropriate complementary feeding at 6 months of age is crucial for the optimal growth and development of an infant. In Ethiopia, however, no previous national-level studies have examined the trends and associated factors of complementary feeding practices. The aim of this study is to investigate the trends and determinants of complementary feeding practices in Ethiopia from 2005 to 2016. The study was conducted using the Ethiopia Demographic and Health Survey (EDHS) data for 2005 (N = 2,520), 2011 (N = 2,850), and 2016 (N = 2,864). Percentage point changes in complementary feeding indicators were estimated to examine the trends over the EDHS years. Multivariate logistic regression was used to examine the association between socioeconomic, demographic, health service, and community-level factors and (a) the introduction of complementary foods, (b) minimum dietary diversity (MDD), (c) minimum meal frequency (MMF), and (d) minimum acceptable diet (MAD). The proportion of mothers who met MDD increased from 6.3% to 13.5% (p < .001), and MAD increased from 4.1% to 7.1% (p = .003) from 2005 to 2016. Improvements in the introduction of complementary foods (from 50.3% to 59.5%, p = .051) and MMF (from 41.3% to 43.6%, p = .288) were not statistically significant. Maternal education and occupation were associated with the introduction of complementary foods, MDD, MMF, and MAD. Higher partner education and frequent antenatal visits were associated with MDD and MAD. Children whose mothers listened to the radio had higher odds of MDD, MMF, and MAD. Our analysis of the EDHS suggests that the proportion of MDD and MAD were unacceptably low. Interventions aiming to improve complementary feeding practices in Ethiopia should also target mothers with low education, antenatal service usage, and media exposure.

13.
BMC Pediatr ; 19(1): 428, 2019 Nov 11.
Artigo em Inglês | MEDLINE | ID: mdl-31711461

RESUMO

BACKGROUND: The World Health Organization recommends that mothers should exclusively breastfeed their infants until 6 months of age due to the benefits for the mother and the child. There is documented evidence on exclusive breastfeeding from Ethiopia, but not specifically from Samara-Logia city administration. This study aimed to assess the factors associated with early termination of exclusive breastfeeding among mother-infant dyads in Samara-Logia, Ethiopia. METHODS: A cross-sectional study was conducted in March 2018. Data were collected on 484 randomly selected mother-infant dyads. The Kaplan Meier curve with the log-rank test was used to compare the survival difference. Cox regression models were used to identify the predictors of early termination of exclusive breastfeeding. RESULTS: The cumulative proportion of survival probability of exclusive breastfeeding to 6 months was 64.5%, with the median duration of 6 months. Mothers having partners with formal education [Adjusted hazard ratio (AHR): 0.58; 95% confidence interval (CI): 0.39, 0.85], receiving counseling on exclusive breastfeeding at antenatal check-up [AHR: 0.62; 95% CI: 0.43, 0.91], giving birth in a health institution [AHR: 0.50; 95% CI: 0.28, 0.88], initiating breastfeeding within the first hour [AHR: 0.41; 95% CI: 0.24, 0.68], and perceiving breast milk adequate for the first 6 months [AHR: 0.17; 95% CI: 0.12, 0.25] were associated with lower hazard of discontinuing exclusive breastfeeding before 6 months. CONCLUSION: This study showed that the cumulative proportion of survival probability on exclusive breastfeeding was low in Samara-Logia city administration. Educating husbands to support their partners, strengthening infant feeding counseling, promoting institutional delivery, educating women about the benefit of early initiation of breastfeeding, and expanding urban health extension program are important to improve the duration of exclusive breastfeeding in Ethiopia.

14.
Rom J Ophthalmol ; 63(3): 264-267, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31687629

RESUMO

Objective. To report a rare presentation of solitary retinal capillary hemangioma manifesting with combined retinal detachment as initial presentation and its successful management. Methods. A 35-year-old healthy Indian male presented with combined retinal detachment associated with solitary retinal capillary hemangioma as initial presentation; a clinical entity still not reported in literature. Patient was managed with pars plana vitrectomy combined with retinectomy, endolaser, & silicon oil tamponade with good visual & anatomical recovery. Results. Patient had good clinical outcome with final best-corrected visual acuity (BCVA) of 6/ 24 and well attached retina at last follow-up. Conclusion. Solitary retinal capillary hemangiomas can rarely present with advanced vitreo-retinal complications like combined retinal detachment as initial manifestation that can be effectively managed with skilled & appropriate surgical intervention.


Assuntos
Angiofluoresceinografia/métodos , Hemangioma Capilar/diagnóstico , Descolamento Retiniano/etiologia , Neoplasias da Retina/diagnóstico , Recurvamento da Esclera/métodos , Acuidade Visual , Vitrectomia/métodos , Adulto , Seguimentos , Fundo de Olho , Hemangioma Capilar/complicações , Hemangioma Capilar/cirurgia , Humanos , Masculino , Retina/patologia , Retina/cirurgia , Descolamento Retiniano/diagnóstico , Descolamento Retiniano/cirurgia , Neoplasias da Retina/complicações , Neoplasias da Retina/cirurgia
15.
PLoS One ; 14(10): e0222572, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31603930

RESUMO

BACKGROUND: Cigarettes and their by-products (i.e., smoke; ash) are a complex, dynamic, and reactive mixture of around 5,000 chemicals. Cigarette smoking potentially harms nearly every organ of the human body, causes innumerable diseases, and impacts the health of smokers and those interacting with the smokers. Smoking brings greater health problems in the long-term like increased risk of stroke and brain damage. For students, peer pressure is one of the key factors contributing to cigarette smoking. Therefore, this systematic review and meta-analysis assessed the impact of peer pressure on cigarette smoking among high school and university students in Ethiopia. METHODS: An extensive search of key databases including Cochrane Library, PubMed, Google Scholar, Hinari, Embase and Science Direct was conducted to identify and access articles published on the prevalence of cigarette smoking by high school and university students in Ethiopia. The search period for articles was conducted from 21st September, 2018 to 25th December 25, 2018. All necessary data were extracted using a standardized data extraction checklist. Quality and risk of bias of studies were assessed using standardized tools. Heterogeneity between the included studies was assessed using Cochrane Q-test statistic and I2 test. To estimate the pooled prevalence of cigarette smoking, a random effects model was fitted. The impact of peer pressure on cigarette smoking was determined and was reported in Odds Ratio (OR) with 95% Confidence Interval (CI). Meta-analysis was conducted using Stata software. RESULTS: From 175 searched articles, 19 studies fulfilled the eligibility criteria and were included in this study. The pooled prevalence of cigarette smoking among Ethiopian high school and university students was 15.9% (95% CI: 12.21, 19.63). Slightly higher prevalence of cigarette smoking was noted among university students [17.35% (95% CI: 13.21, 21.49)] as compared to high school students [12.77% (95% CI: 6.72%, 18.82%)]. The current aggregated meta-analysis revealed that peer pressure had a significant influence on cigarette smoking (OR: 2.68 (95% CI: 2.37, 3.03). CONCLUSION: More than one sixth of the high school and university students in Ethiopia smoke cigarette. Students who had peer pressure from their friends were more likely to smoke cigarette. Therefore, school-based intervention programs are needed to reduce the high prevalence of cigarette smoking among students in Ethiopia.

16.
Int Breastfeed J ; 14: 40, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31528197

RESUMO

Background: At the national level in Ethiopia, there is limited knowledge of trends and factors associated with early initiation of breastfeeding and exclusive breastfeeding (EBF), particularly during the Millenium Development Goal (MDG) era (2000-2015). The study aimed to examine the trends and determinants of early initiation of breastfeeding and EBF in Ethiopia between 2000 and 2016. Methods: Using the Ethiopia Demographic and Health Survey (EDHS) data for the years: 2000 (n = 3680), 2005 (n = 3528), 2011 (n = 4037) and 2016 (n = 3861), trends in early initiation of breastfeeding and EBF were estimated. Multivariate logistic regression models that adjusted for confounders, sampling weight, clustering and stratification were used to examine the association between socioeconomic, demographic, health service and community level factors with early initiation of breastfeeding and EBF from 2000 to 2016. Results: The prevalence of early initiation of breastfeeding increased from 48.8% in 2000 to 75.7% in 2016 in Ethiopia. Improvement in EBF prevalence was not statistically significant (from 54.5% in 2000 to 59.9% in 2016). Over the study period, informal maternal employment (Adjusted Odds Ratio [aOR] 0.75; 95% Confidence Interval [CI] 0.68, 0.83), frequent antenatal care visits (aOR 0.74; 95% CI 0.65, 0.85), and cesarean birthing (aOR 0.22; 95% CI 0.17, 0.30) were associated with delayed initiation of breastfeeding. Birthing in the health facility (aOR 1.35; 95% CI 1.05, 1.75) and residing in the metropolis region (aOR 1.95; 95% CI 1.65, 2.32) were associated with timely initiation of breastfeeding. In a similar period, informally employed mothers (aOR 1.37; 95% CI 1.15, 1.63) and those with six or more family size (aOR 1.46; 95% CI 1.10, 1.93) were more likely to exclusively breastfeed their babies. Conclusion: Early initiation of breastfeeding improved in Ethiopia during the MDG era but it is still below the national target; progress in EBF remained slow. To improve breastfeeding outcomes and meet the global breastfeeding targets in Ethiopia, infant feeding efforts should focus on improving key modifiable factors, including place and mode of birthing and socioeconomic status of mothers.

17.
J Curr Ophthalmol ; 31(3): 345-348, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31528774

RESUMO

Purpose: To report a complication little reported until now: to and fro migration of the dexamethasone implant between the anterior and posterior segment (wandering Ozurdex) of sclera fixated intraocular lens (IOL) eyes and its effective management. Methods: Two cases of to and fro migration of Ozurdex (wandering Ozurdex) in two pseudophakic patients with scleral fixated posterior chamber IOL: first, a case of Vogt Koyanagi Harada (VKH) disease and second, a case of pseudophakic cystoids macular edema (CME) were successfully managed. Results: Both patients were initially managed with repositioning of implants by supine posturing and use of drugs, but implants again migrated into anterior chamber and underwent surgical removal with preservation of corneal transparency. Conclusions: Patients with scleral fixated posterior chamber IOL present a high risk of anterior chamber migration of the Ozurdex implant. Prompt removal of Ozurdex implant in these patients can reduce risk of endothelial decompensation. In such cases, returning the implant with positioning is not a good option.

18.
Enzyme Microb Technol ; 130: 109368, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31421728

RESUMO

In this work, the effect of particle size on alkali pretreatment of the almond shell was evaluated for recovery of hemicellulose. Further, endoxylanase from Thermomyces lanuginosus was immobilized on Fe-based magnetic nanoparticles to enable reuse of enzyme. Reduction in particle size significantly influences the recovery of hemicellulose as particle size below 120 µm enable recovery of 97% available hemicellulose in 1 h at 121 °C with 2 M alkali. The enzyme could retain 93.3% of enzymatic activity upon immobilization onto magnetic support using glutaraldehyde (25 mM) and was at par with the free enzyme in terms of pH and temperature profile. The measurement of reaction kinetics (Km and Vmax) indicates similar values for free and immobilized enzyme. The structural and morphological analysis indicates presence near spherical magnetic core and successful cross-linking of the enzyme without alteration of the magnetic core. The immobilized enzyme was able to hydrolyze hemicellulose to produce XOS, the yield equivalent to 67.4% of that obtained using free enzyme at 50 °C. The comparison of XOS production ability at 50 and 60 °C, suggests that the immobilized enzyme retains activity as similar yield was obtained at both temperatures, whereas, the yield for free enzyme decreases significantly. The XOS yield on recycling of immobilized enzyme for three successive cycles was found to reduce to 41% of the initial cycle. However, in all cycles of enzymatic hydrolysis, the percentage of xylobiose was found to be above 90%.


Assuntos
Endo-1,4-beta-Xilanases/metabolismo , Enzimas Imobilizadas , Glucuronatos/biossíntese , Oligossacarídeos/biossíntese , Prunus dulcis/química , Álcalis/química , Estabilidade Enzimática , Concentração de Íons de Hidrogênio , Hidrólise , Cinética , Polimerização , Polissacarídeos/metabolismo , Temperatura
19.
Nutr J ; 18(1): 47, 2019 08 27.
Artigo em Inglês | MEDLINE | ID: mdl-31455363

RESUMO

BACKGROUND: Despite progress, suboptimal feeding practices and undernutrition particularly in the form of stunting still remains a major issue among children aged less than 5 years in Bangladesh. Since mothers are the primary caregivers of young children, maternal nutrition counselling can be effective in improving knowledge and practices on child feeding. The Building Resources Across Communities (BRAC) initiated a nutrition counselling intervention using its essential health care (EHC) skeleton in 114 sub-districts of Bangladesh in 2012. This study assessed the role of this intervention on the prevalence of stunting and feeding practices among children aged less than 5 years. METHODS: The data was collected as part of a nationwide cross-sectional survey, which followed a two-stage cluster random sampling procedure and was conducted between October 2015 and January 2016. The present study analyzed the information of 3009 mother-children dyads from two selected survey areas: i) areas where the EHC package was delivered (comparison; n = 1452), ii) areas with EHC plus nutrition counselling package (intervention; n = 1557) was delivered. The Chi-square test was done to compare the child feeding practices and stunting prevalence between intervention and comparison. The degree of strength of the association of stunting and the intervention was estimated using a mixed-effect logistic regression model. RESULTS: The study revealed that the prevalence of stunting was significantly lower in areas where the intervention was delivered compared to the comparison areas (29% vs. 37%, P < 0.001). Furthermore, after adjusting for administrative zone, household wealth quintile, child's age, gender, maternal age, education, occupation, cluster disparity, and variation between study groups, it was seen that the risk of stunting was 25% lower in the intervention areas compared to the comparison areas (aOR: 0.75, 95% CI: 0.60-0.94; P = 0.012). Optimal child feeding practices were also more common among mothers from intervention areas than those of the comparison areas (exclusive breastfeeding: 72.7 vs. 59.4%, P = 0.008; feeding 4+ food groups: 42.9 vs. 34.1%, P < 0.001; having minimum acceptable diet: 31.2 vs. 25.3%, P = 0.017; feeding multiple micro-nutrient powder: 16.2 vs. 7.4%, P < 0.001). CONCLUSIONS: The study highlighted that nutrition counselling of mothers may be effective in reducing childhood stunting with concomitant improvement in optimal feeding practices in children under 5 years of age. The frontline community health workers can be trained to counsel mothers on optimal child feeding practices and this could help reduce the prevalence of stunting.

20.
Int Breastfeed J ; 14: 37, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31428184

RESUMO

Background: Breastfeeding practices such as early initiation of breast milk and exclusive breastfeeding are key to the reduction of childhood morbidity and mortality. Despite the importance of these practices, rates of timely initiation of breastfeeding and exclusive breastfeeding remain suboptimal in many sub-Saharan countries. This study aimed to examine the determinants of early initiation of breastfeeding and exclusive breastfeeding in the first 5 months in Malawi. Methods: This study used the 2015-16 Malawi Demographic and Health Survey data. A total of 6351 children born during the last 24 months and 1619 children aged 0-5 months at the time of the survey were analyzed for early initiation of breastfeeding and exclusive breastfeeding outcomes, respectively. Socio-demographic and socio-economic factors including individual, household and community-level factors were tested for association with early initiation of breastfeeding and exclusive breastfeeding using logistic regression models. Results: The proportion of timely initiation of breast milk and exclusive breastfeeding were 76.9 and 61.2%, respectively. Delivering at a health facility (adjusted odds ratio [aOR] 1.77, 95% confidence interval [CI] 1.10, 2.87), vaginal delivery (aOR 3.15, 95% CI 2.40, 4.13), and singleton births (aOR 1.96, 95% CI 1.20, 3.21) were independent factors associated with the increased likelihood of timely initiation of breastfeeding. Age of children was associated with increased odds of exclusive breastfeeding, with children aged 3-5 months being less likely to be exclusively breastfed (aOR 0.24, 95% CI 0.18, 0.31). Conclusions: Healthcare providers and programs aimed at increasing rates of early initiation of breastfeeding should take into consideration women at risk such as those giving birth through caesarean section, giving birth at home, and having multiple births. Further, women with children aged 3-5 months should be targeted with health promotion interventions for exclusive breastfeeding.

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